Endocrine Flashcards
2 types of cells of anterior pituitary and hormones secreted:
Basophils: “B-FLAT”
- FSH, LH, ACTH, TSH
Acidophils:
- prolactin, growth hormone
Hormone secreted by intermediate lobe of pituitary
Melanotropin
Anabolic effects of insulin
- Increased glucose transport in skeletal and adipose tissue
- Increased glycogen synthesis and storage
- Increased triglyceride synthesis
- Increased protein synthesis
- Increased cellular uptake of K and aa’s
- Inhibits glucagon release
- Na retention (kidneys)
Insulin-independent glucose uptake in which organs:
BRICK L
- Brain
- RBCs
- Intestine
- Cornea
- Kidneys
- Liver
Functions of glucagon
Glycogenolysis
Gluconeogenesis
Lipolysis
Ketone production
Name of GH analog and used to treat which condition:
Tesamorelin
- Rx HIV-associated lipodystrophy
Features of pituitary prolactinoma
High prolactin inhibit GnRH and cx galactorrhea:
- Amenorrhea
- Osteoporosis
- Hypogonadism
- Galactorrhea
Causes of galactorrhea (via hyperprolactinemia)
Anti-psychotics
Prolactinoma
Increased TRH
Functions of cortisol
“cortisol is A BIG FIB”
- +Appetite
- +BP
- +Insulin resistance
- +Gluconeogenesis, lipolysis, proteolysis
- -Fibroblast activity –> poor wound healing
- -Inflammation and immune response
- -Bone formation (decreased osteoblast activity)
Outline the Wolff-Chaikoff effect
Excessive iodine temporarily inhibits thyroid peroxidase –> decreased iodine organification –> decreased T3/T4 production
Neural crest derivatives
“SOME SALT”
- Schwann cells
- Odontoblasts
- Melanocytes
- Enterochromaffin cells
- Spinal membranes (pia and arachnoid)
- Adrenal medulla/ganglia
- Laryngeal cartilage
- Tracheal cartilage
Opsoclonus-myoclonus syndrome associated with:
Neuroblastoma
“dancing eyes dancing feet”
6 P’s of congenital hypothyroidisms
6P’s: Pot-bellied, Pale, Puffy-faced child with Protruding umbilicus, Protuberant tongue and Poor brain development
Treatment of thyroid storm
4 P’s:
- propranolol (B-blocker)
- propylthiouracil
- prednisolone (corticosteroid)
- Potassium iodide (Lugol iodine)
What is the Jod-Basedow phenomenon?
Opposite of Wolff-Chaikoff effect:
Thyrotoxicosis if pt with iodine deficiency and partially autonomous thyroid tissue is made iodine replete
Describe pseudohypoparathyroidism type 1A
Albright Hereditary Osteodystrophy Unresponsiveness of kidney to PTH --> hypocalcemia despite high PTH Shortened 4th/5th digit, short stature AD Defective Gs protein apha-subunit Inherited from mother due to imprinting
Describe pseudopseudohypoparathyroidism
- Physical features of Albright Hereditary Osteodystrophy
- Without end-organ PTH resistance (PTH normal)
- Inherited from father
Describe Nelson syndrome
Enlargement of existing ACTH-secreting pituitary adenoma after bilateral adrenalectomy for refractory Cushing disease
- PC: hyperpigmentation, headaches, bitemp hemianopia
- Rx: pituitary irradiation or resection
Causes of SIADH
- Ectopic ADH (eg small cell lung CA)
- CNS disorders/head trauma
- Lung ds
- Drugs (eg cyclophosphamide)
Treatment of SIADH
- fluid retention, diuretics, salt tablets, IV hypertonic saline, conivaptan, tolvaptan, demeclocycline
Characteristics of SIADH
- Euvolemic hyponatremia
- Excessive free water retention
- Urine osmolality > serum osmolality
Features of glucagonoma
D’s:
- dermatitis (necrolytic migratory erythema)
- diabetes (hyperglycemia)
- declining weight
- depression
Rx of glucagonoma
Octreotide
Surgery
Define Whipple’s Triad
- Low blood glucose
- Symptoms of hypoglycemia
- Resolution of symptoms after normalization of glucose levels
Somatostatin inhibit the secretion of:
- Secretin
- CCK
- Glucagon
- Insulin
- Gastrin
- Gastric inhibitory peptide
Features of Carcinoid syndrome
Neuroendocrine tumour - secrete 5HT
Sx: Recurrent flushing, diarrhoea, asthmatic wheezing, right-sided valvular lesions
Dx: increased 5-hydroxyindoleacetic acid (5-HIAA) in urine, niacin deficiency
Rx: surgical resection, octreotide
Rule of 1/3 in Carcinoid syndrome
1/3 metastasize
1/3 present with 2nd malignancy
1/3 are multiple
Hyponatremia, hyperkalemia, hyperchloremia, non-anion gap metabolic acidosis =
Primary adrenal insufficiency
