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MRCS > Endocrine path/ physiology > Flashcards

Endocrine path/ physiology Flashcards

1
Q

What is the function of Calcitonin in the Kidneys

A

Increases excretion of calcium AND phosphate

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2
Q

What stimulates renin secretion

A

-reduction in extracellular fluid volume
-low BP
-sympathetic stimuli

eg: cardiac failure, hypotension, renal artery constriction, sodium depletion, hemorrhage, dehydration

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3
Q

What converts angiotensinogen to angiotensin I

A

Renin

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4
Q

What converts angiotensin I to angiotensin II

A

ACE (angiotensin converting enzyme)

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5
Q

What factors stimulate growth hormone secretion

A

Sleep
exercise
protein rich diet
circulating oestradiol
HYPOglycaemia

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6
Q

What factors inhibit growth hormone secretion

A

HYPERglycaemia
carb rich diet
free fatty acids
somatostatin
cortisol

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7
Q

How would you differentiate between a primary and secondary adrenal insufficiency

A

Presence of hyperpigmentation:

present= ACTH produced by pituitary= ACTH also acts as melanocyte stimulating hormone= primary insufficiency

absent= no ACTH produced by pituitary= secondary insufficiency

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8
Q

During embryological development, when does the thyroid gland first appear and where

A

Week 4

At the foramen caecum of the base of the tongue

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9
Q

Where is the final position of the thyroid gland and when does it reach this position

A

Thyroid travels along the thyroglossal duct to reach its final position at week 24

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10
Q

What is the communication between the initial and final positions of the thyroid gland called

A

Thyroglossal duct

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11
Q

What is the complication of I&D or untreated thyroglossal cyst

A

Fistula

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12
Q

What is a thyroglossal cyst

A

A cystic remnant of the thyroglossal duct

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13
Q

What are the actions of insulin

A

1- movement of glucose + potassium from blood into cells

2- glycogenesis (converts glucose to glycogen and stores in liver/ muscles)

3- lipogenesis (converts glucose to triglycerides and stores in liver/ adipose tissue)

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14
Q

Function of following hormones on glucose/ glycogen:

Glucagon
Cortisol
adrenaline
thyroxine

A

Glucagon- glycogenolysis, gluconeogenesis

Cortisol-glycogenesis, gluconeogenesis

adrenaline-glycogenolysis, gluconeogenesis

thyroxine-increased blood glucose

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15
Q

What are the structures present anterior to the thyroid gland

A

Pre-tracheal fascia
Infrahyoid muscles:
-sternothyroid
-sternohyoid
-omohyoid

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16
Q

At what level of the neck does the thyroid sit?

A

C5-T1

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17
Q

What fascia surrounds the thyroid

A

Pre-tracheal fascia

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18
Q

What nerves are found and where are they situated in relation to the thyroid

A

external and recurrent laryngeal nerves (medial to thyroid)

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19
Q

Arterial supply of thyroid

A

superior + inferior thyroid arteries

3-10% also have thyroid ima/ internal mammary arteries

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20
Q

Venous drainage of thyroid

A

superior
middle
inferior thyroid veins

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21
Q

Which veins supplying the thyroid drain into the internal jugular

A

superior + middle thyroid veins

22
Q

Which veins supplying the thyroid drain into the subclavian vein

A

inferior thyroid vein

23
Q

Where do the arteries supplying the thyroid originate from

A

superior thyroid = external carotid
inferior thyroid= thyrocervical trunk

24
Q

Which nerve is in close proximity to the superior thyroid artery

A

external laryngeal nerve

25
Q

Which nerve is in close proximity to the inferior thyroid artery

A

recurrent laryngeal nerve

26
Q

In thyroidectomy for a well-differentiated thyroid carcinoma- what is the level of neck dissection carried out

A

Level 6 neck dissection

27
Q

Which lymph nodes drain the thyroid

A

deep cervical

28
Q

Where can the recurrent laryngeal nerve be found (_____ triangle) and describe its boundaries

A

Beahr’s triangle

superior= inferior thyroid artery
medial= trachea
lateral= common carotid artery

29
Q

Describe the path of the recurrent laryngeal nerve

A

right:
hooks under the brachiocephalic trunk
travels in tracheo-oesophageal groove
goes under the thyroid gland inferiorly

left:
hooks under arch of aorta
travels in tracheo-oesophageal groove
goes under the thyroid gland inferiorly

30
Q

What artery is related to the external laryngeal nerve

A

superior thyroid

31
Q

Action of the recurrent and external laryngeal nerves

A

recurrent:
innervates ALL the instrinsic muscles of the larynx (EXCEPT cricothyroid)

-thyroarytenoids
-posterior cricoarytenoids
-lateral cricoarytenoids
-transverse arytenoid
-oblique arytenoid

external laryngeal:
-cricothyroid

32
Q

What are the intrinsic muscles of the larynx

A

-thyroarytenoids
-posterior cricoarytenoids
-lateral cricoarytenoids
-transverse arytenoid
-oblique arytenoid
-cricothyroid

33
Q

What are the extrinsic muscles of the larynx

A

supra + infrahyoid muscles

34
Q

Name the suprahyoid muscles

A

geniohyoid
mylohyoid
digastric (sup/ inferior bellies)
stylohyoid

35
Q

Name the infrahyoid muscles

A

thyrohyoid
sternohyoid
sternothyroid
omohyoid (2x bellies)

36
Q

What are the 8 steps of thyroid hormone production

A
  1. active transport of iodine from blood into follicular cells
  2. Oxidation of iodine to iodide (I-) in follicular cells
  3. Iodide moves into to colloid and binds with the tyrosine+thyroglobulin molecule with the help of thyroid peroxidase
  4. depending on how many iodine bind to tyrosine+thyroglobulin molecule, MIT and DIT are made
  5. TSH from pituitary stimulates the movement of MIT/ DIT back into follicular cells via vacuoles BY PINOCYTOSIS
  6. lyzosomes/ proteases are released into these vacuoles and breakdown MIT/ DIT, alanine is produced as a byproduct
  7. thyroglobin is released back into colloid
  8. remaining T3/ T4 is released in the plasma
37
Q

What are the hormones produced by the thyroid gland

A

Thyroxine T4
Triiodothyronine T3
calcitonin

38
Q

What plasma proteins transport T3/4

A

Thyroid binding globulin (TBG)
Thyroid binding prealbumin (TBPA)
Albumin

39
Q

At which point in the production of T3/4 does carbimazole/ PTU act

A

blocks oxidization of iodine to iodide

40
Q

What is the structure of thyroid follicles

A

follicular cells are arranged around colloid and surrounding these clusters of follicular cells are capillaries

41
Q

What hormone stimulates the secretion of testosterone

A

Luteinizing hormone from leydig cells (interstitial cells)

42
Q

What cells produce the hormone that stimulates testosterone secretion

A

Basophilic gonadotrophs in the anterior pituitary

43
Q

Function of FSH in men

A

Works with testosterone to make androgen binding protein (ABP)

ABP keeps testosterone levels high in the tubular fluid

44
Q

What inhibits secretion of prolactin

A

Somatostatin
Dopamine

45
Q

What factors increase prolactin secretion

A

Pregnancy
Stress response

46
Q

What hormones increase following the stress response

A

Glucagon
cortisol
growth hormone
ADH/ vasopressin
prolactin (preg)

47
Q

What happens to thyroid hormones and insulin in the stress response

A

Decreased levels of Insulin, T3, T4

48
Q

In response to hyponatremia-what happens to renin levels

A

INCREASES

49
Q

Effect of Growth hormone on glucose concentrations

A

increases glucose

50
Q
A

MRCS (22 decks)

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