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Phase2A > Endocrine > Flashcards

Endocrine Flashcards

1
Q

what are the characteristics of water soluble hormones?

A

fast clearance

short half life

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2
Q

what are the characteristics of lipid soluble hormones?

A

diffuse into cell
slow clearance
long half life

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3
Q

what are examples of water and lipid soluble hormones?

A

water- peptides, monoamines

lipid- steroids, thyroid hormone

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4
Q

which hormone switches off appetite?

A

leptin

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5
Q

which hormone switches on appetite?

A

Ghrelin

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6
Q

what is obesity?

A

excessive accumulation of fat which may impact on health

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7
Q

where is TSH produced?

A

pituitary gland

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8
Q

what effect does removal of the thyroid gland have on TSH levels?

A

raised TSH

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9
Q

what effect does an overactive thyroid gland have on TSH levels?

A

reduced TSH

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10
Q

screening for which hormone can be used to check thyroid activity?

A

TSH

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11
Q

where is TRH produced?

A

hypothalamus

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12
Q

where are T3 and T4 hormones produced?

A

Thyroid

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13
Q

what effect do T3 and T4 have on TRH production?

A

negative feedback

more T3/4 = reduced TRH production

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14
Q

what effect do T3/4 have on TSH production?

A

negative feedback

more T3/4 = reduced TRH production

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15
Q

production of TSH is stimulated by which hormone?

A

TRH

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16
Q

production of T3/4 is stimulated by which hormone?

A

TSH

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17
Q

where is dopamine produced?

A

hypothalamus

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18
Q

where is prolactin released from?

A

anterior pituitary

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19
Q

dopamine inhibits the release of which hormone from the anterior pituitary gland?

A

prolactin

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20
Q

pressure of the pituitary on the optic chiasm causes which classical presentation?

A

bitemporal hemianopia

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21
Q

where is cortisol produced?

A

adrenal glands

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22
Q

what is goitre?

A

enlarged thyroid

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23
Q

what are the signs of graves disease?

A

goitre, weight loss, insomnia

pretibial myxoedema, thyroid eye disease, thyroid acropachy

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24
Q

what affect does graves disease have on the thyroid?

A

excessive growth- hyperthyroidism

25
Q

what effect does PTH have on bone?

A

causes increased bone resorption

26
Q

what effect does PTH have on absorption of calcium?

A

increased absorption in small intestine

27
Q

PTH regulated which ion?

A

Ca2+

28
Q

when calcium in serum is low which hormone is stimulated to be released?

A

PTH

29
Q

what is the cause of graves disease?

A

autoimmune IgG antibodies produced which mimic TSH by binding to receptors to stimulate T3/4 production. causing hyperplasia of follicular cells

30
Q

how is graves disease diagnosed?

A

TSH levels low due to high T3/T4, TSHr antibodies high, ultrasound, radioactive thyroid uptake test

31
Q

what are causes of hyperthyroidism?

A

graves disease (IgG antibodies), pituitary adenoma of thyrotrophs, toxic thyroid adenoma, amiodarone, iodine intake, thyroid medication

32
Q

what are actions of T3/4?

A

INC METABOLISM, initiate transcription, CNS development, growth, inc gluconeogenesis, inc HR&CO, inc RR

33
Q

what are the signs of hypothyroidism?

A

BRADYCARDIC
bradycardia, reflexes relax slowly, ataxia, dry skin, yawning, cold hands, ascites, round puffy face, defeated low mood, immobile, congestive HF

34
Q

what are the causes of hypothyroidism?

A

autoimmune (anti thyroid auto antibodies), hashimotos, iodine deficiency, DM1, surgery

35
Q

what is the treatment for hypothyroidism?

A

thyroid replacement- oral levothyroxine

36
Q

describe hypothalamus pituitary thyroid axis?

A

TRH from hypothalamus causes TSH release from pituitary gland (thyrotrophs) which causes T3/4 production in thyroid gland (both have neg feedback on TRH)

37
Q

what is the difference between cushings syndrome and disease?

A

syndrome is any reason for high cortisol, disease refers to a pituitary tumour of corticotrophs

38
Q

what are exogeneous causes of cushings syndrome?

A

iatrogenic (e.g. steroid use for RA)

39
Q

what are endogeneous causes of cushings syndrome?

A

cushings disease(pit tumour), ectopic acth tumour, adrenal adenoma/carcinoma

40
Q

what effects can a pituitary tumour have on hormones?

A

GH from somatotrophs- acromegaly
TSH from thyrotrophs- hyperthyroidism
ACTH from corticotrophs- cushings disease
prolactinoma- prolactin from lactotrophs causes hyperprolactaemia

41
Q

what effects does elevated cortisol have?

A

anxiety, depression, memory problems, cvd (hyperglycaemia), dampened immune system (infection), hypertension, central obesity, muscle wasting, osteoporosis, thin skin

42
Q

how is cushings diagnosed?

A

random plasma cortisol, give oral dexamethasone then test cortisol (in healthy individual it has negative feedback on ACTH), MRI pituitary, CT adrenals, plasma ACTH

43
Q

what does a low plasma ACTH in an individual who you suspect cushings in suggest?

A

adrenal tumour rather than pituitary tumour

44
Q

what causes type 1 diabetes?

A

autoimmune destruction of beta cells in the pancreas, therefore insulin deficiency

45
Q

what are the three common symptoms of type 1 diabetes?

A

polyuria/nocturia
polydipsia
weight los

46
Q

how does ketoacidosis occur in type 1 diabetic?

A

breakdown of fatty acids for energy due to lack of glucose in the cells (low insulin), which causes acetyl coA to be produced and therefore ketones increase

47
Q

what are the 4 P’s of type 2 diabetes?

A

polyuria, polydipsia, polyphagia, paraesthesia

48
Q

what tests define diabetes?

A

fasting glucose > 7mmol/L
plasma glucose > 11.1mmol/L
Haemoglobin A1c > 48mmol/mol

49
Q

what effects does insulin have?

A

DEC BLOOD GLUCOSE: increases uptake of glucose into fat/muscle cells, deceases hepatic glucose output, decreases gluconeogenesis/glycogenolysis/lipolysis

50
Q

what effects does glycogen have?

A

INC BLOOD GLUCOSE: decrease uptake into fat/muscle cells, increases hepatic output, increases glycogenolysis/gluconeogenesis/lypolysis

51
Q

what are the macrovascular effects of diabetes?

A

cerebrovascular events, limb ischaemia, coronary heart diease

52
Q

what are the microvascular effects of diabetes?

A

retinopathy, nephropathy, neuropathy

53
Q

what are symptoms/signs of acromegaly?

A

excessive sweating, large hands/feet, headache, visual problems/ sleep apnoea/ large brow, jaw, nose
insidious onset!

54
Q

what is the name given to acromegaly in children and how does it differ?

A

giantism

before epiphyseal bone plates fuse in long bones

55
Q

what are the treatments for acromegaly?

A

surgical removal, somatostatin analogues, GH antagonists

56
Q

how is acromegaly diagnosed?

A

GH plasma test (not reliable due to pulsatile nature), IGF1 raised (production stimulated by GH), glucose tolerance test (glucose in blood has negative feedback on GH, inc bg and test GH), MRI for tumour

57
Q

what is conns syndrome?

A

adrenal adenoma releasing aldosterone causing hyperaldosteronism

58
Q

hows is conns syndrome diagnosed?

A

aldosterone renin ratio (low renin and high aldosterone), saline infusion and test aldosterone (not supressed in conns), CT/MRI tumour

59
Q

treatment for conns syndrome?

A

laproscopic adrenalectomy

Phase2A (8 decks)

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