Endocrine

Question 1

What does TRH stand for?

Answer 1

Thyro-tropin releasing hormone

Question 2

What does TSH stand for?

Answer 2

Thyroid stimulating hormone

Question 3

What does T3 stand for?

Answer 3

Triidothyronine

Question 4

What does T4 stand for?

Answer 4

Thyroxine

Question 5

What is compensated euthyroidism?

Answer 5

When there are reduced levels of T3 and T4 (perhaps due to a thyroidectomy) and there is an increased secretion of TRH and TSH which stimulates the thyroid to produce more T3 and T4 until it becomes normal

Question 6

What is a primary endocrine disease?

Answer 6

It is a disease of the end-organ. It leads to a loss of negative feedback and subsequent elevation in the corresponding anterior pituitary hormone

Question 7

What is secondary endocrine disease?

Answer 7

There are low or inappropriately normal levels of the pituitary trophic hormone in the face of a low end-organ hormone level.

Question 8

What are the two patterns of hormone secretion?

Answer 8

Continuous or pulsatile

Question 9

What is the anterior pituitary gland formed from anteriorly?

Answer 9

An upgrowth of Rathke’s pouch

Question 10

Which hormones are secreted by the posterior pituitary gland?

Answer 10

ADH

Oxytocin

Question 11

Which hormones are secreted by the anterior pituitary gland?

Answer 11

TSH
GH
PRL (prolactin)
FSH
LH
ACTH

Question 12

How can benign pituitary adenomas cause problems?

Answer 12

1. Local effects
2. Excess hormone secretion
3. Inadequate production of hormone by the remaining normal pituitary

Question 13

What are the possible local effects of pituitary tumours?

Answer 13

1. Problems with visual pathways- field defects and visual loss
2. Press on the cavernous sinus and causes III, IV and VI cranial nerve lesions
3. Bony structures and the meninges surrounding the fossa, causes headache
4. Hypothalamic centres are affected: altered appetite, obesity, thirst, somnolence/ wakefulness, precocious puberty
5. Presses on ventricles which causes the interruption of CSF
6. Invades the sphenoid sinus which causes CSF rhinorrhoea

Question 14

How can you investigate a pituitary tumour?

Answer 14

MRI

Visual field test (often shows bitemporal hemianopia and upper temporal quadrantanopia)

Question 15

Which hormones excesses are usually associated with pituitary tumours?

Answer 15

1. prolactin excess
2. GH excess
3. Excess ACTH secretion

Question 16

How are pituitary tumours managed?

Answer 16

1. Removal by surgery
2. Radiotherapy
3. Somatostatin analogues or dopamine agonists can cause shrinkage of specific types of tumour
4. Replacement of hormone deficiencies

Question 17

What are the diffrential diagnoses of a pituitary adenoma?

Answer 17

1. Craniopharyngoma
2. Uncommon tumours such as pinealomas, germinomas, chondromas, gliomas, meningiomas
3. Hypophysitis
4. Carotid artery aneurysms

Question 18

In which order are hormones affected in hypopituitarism?

Answer 18

GH
FSH
LH
TSH
ACTH
PRL

Question 19

What is hypopituitarism?

Answer 19

Decreased secretion of anterior pituitary hormones

Question 20

What is panhypopituarism?

Answer 20

Decreased secretion of all anterior pituitary hormones