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SBO5 > Endocrine Pathologies > Flashcards

Endocrine Pathologies Flashcards

1
Q

What are the effects of insulin?

A

Carbs: Liver: + storage of glucose as glycogen

Fats: Adipose tissue: +conversion of glucose to fat

Proteins:
- glucogenesys
+ Cellular uptake of AA

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2
Q

What are the effects of lack of insulin?

A

Fats: used as fuel source
Protein: AA used as fuel

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3
Q

What are the effects of glucagon?

A

Affect liver

  • breakdown glycogen (glycogenolosis)
  • Synthesis of glucose (gluconeogenesis)

Lower blood levels of AA

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4
Q

What messenger does glucagon use to act?

A

second messenger

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5
Q

What is diabetes?

A

clinical syndrome characterised by hyperglycaemia

due to absolute or relative insulin deficiency

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6
Q

How is diabetes diagnosed?

A

blood sugar > 11.1
fasting sugar> 7
HbA1c>6.5

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7
Q

What are the classifications of diabetes?

A 
Primary
- diabetes type 1: Absolute deficiency (insulin dependant) 10% adults
- diabetes type 2: relative 
deficiency 
88% adults

Secondary
arises from known pathology

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8
Q

what is pre-diabetes?

A

Impaired glucose tolerance

*levels higher than normal but not high enough to be diabetes

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9
Q

What causes diabetes type 1

A

Genetics: Environmental factors
Autoimune T1DM
Virus: rubella, epstein barr, cytomegalovirus

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10
Q

What causes diabetes type 2

A

Old, fat, lazy, smokers

Genetics T2DM

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11
Q

What is oxidative stress and what pathology is associated to?

A

stress fat tissues: releases cytokines which in T2DM impair insulin receptors = target cells less responsive
also damage beta cells in pancreas

Obesity associated with decrease insulin receptor density

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12
Q

What type of insulin deficiency is T1DM related to?

A

absolute deficiency (type 1 diabetes)

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13
Q

What type of insulin deficiency is T2DM related to?

A

Diabetes type 2 - relative deficiency = insuline resistance

process: 
target cells become resistant 
initial stage: hyperinsulinaemia
later stage: beta cell exhaustion 
leads to insulnpaenia
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14
Q

what are the clinical features for type 1 diabetes mellitus (T1DM)

A

polyphagia (gluttony with no wight gain)
polyuria (fast pee)
polydipsia (thirst)
Glycosuria (sugar in pee)

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15
Q

what are the clinical features for type 2 diabetes mellitus (T2DM)

A

hyperglycaemia
glycosuria
+ risk infection

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16
Q

What are the complications for diabetes?

A

Acute

  • hypoglycaemia (low sugar)
  • Ketoacidosis (body can’t produce insulin)

Chronic

  • vascular disease
  • diabetic neuropathy
  • diabetic foot (no feeling on foot)
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17
Q

What are the clinical features for hypoglycaemia?

A

CNS: fatigue HA drowsiness, speech problem

ANS: sweating, trembling, pounding heart, hunger

Severe hypo: coma, convulsion, brain damage

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18
Q

What are the complications of Diabetic ketoacidosis (DKA)

A 
death
Ketone acidosis (decrease PH)
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19
Q

What are the clinical features of ketoacidosis?

A 
***MEDICAL EMERGENCY***
hyperglycemia
acetone breath
respiratory compensation
mental disturbance
pheripheral vasodilation
20
Q

What is diabetic vascular disease and what are its complications?

A

group of blood vessel pathologies

atherosclerosis = diabetic Macroangiopathy (large vessel)

Arteriosclerosis = diabetic microanginiopathy (capillaries)

21
Q

What are the chronic complications of diabetic foot?

A

low limb amputation

gangrena - necrosis

22
Q

What is the first line pharmachological management of T2DM?

A

biguanides
+ glucose uptake
- glycogenesis
- intestinal absorption

23
Q

Thyroglobulin is the percursor for which thyroid hormones?

A

T4 - T3

24
Q

What do parafollicular cells secrete

A

calcitonin

25
Q

How are thyroid hormones classified?

A

Aminoacids

contain iodine

26
Q

What receptor does TSH bind to?

A

follicular cell receptors

27
Q

What are the effects of thyroid hormones?

A

gene transcription
catecholamine effect
regulate normal function

28
Q

What is nontoxic goitre?

A

enlargement of thyroid gland - normal function maintained

29
Q

What is the cause of goitre?

A

iodine deficiency

30
Q

What is hypothyroidism?

A

Deficiency of T3 and T4

in fetes leads to intelectual disability “cretinism”

31
Q

How is hypothyroidism classified?

A

Primary: failure of thyroid
- Hashimoto (autoimune)

Secondary: TSH deficiency

Tertiary: TRH deficiency

32
Q

What is hashimoto thyroids

A

primary type thyroidism

• Autoimmune disorder characterised by lymphocyte-mediated inflammation and fibrosis

33
Q

What is chronic lymphocytic thyroiditis?

A

Secretion of IgG anticoagulant affecting

  • thyroglobulin
  • thyroid peroxide

Early disease: leads to goitre

34
Q

What are the clinical features for chronic lymphocytic thyroiditis?

A

goitre
- metabolic rate
GAG - skin accumulation may lead to myxoedema and increase risk of angina

35
Q

Whta hormone replacement therapy is used for Lymphocytic thyroids?

A

levothyroxine

36
Q

What is thyrotoxicosis?

A

thyroid hormone excess “graves disease”

37
Q

What is the pathophysiology of graves disease?

A

Antibodies affect TSH receptors (TSHrAbs)

+ levels T4 & T3
produce goitre

antibodies fluctuate with severity of disease

38
Q

What are the clinical features of Thyroxicosis?

A 
\+ metabolic rate
\+ apetite & thirst
\+ palpitations
nervousness/ psychosis
menstrual irregularities
loss of libido
39
Q

Clinical features for graves disease

A

ocular changes
- eyes pop out

skin changes= GAG in legs

40
Q

Management of graves disease

A

any thyroid drugs PTU - reduce thyroid peroxidase

41
Q

What is the most common type of thyroid cancer?

A

papillary carcinoma

42
Q

what are the risk factors for thyroid cancer?

A

radiation
Family Hx
benign thyroid disease

43
Q

What are the clinical features for thyroid cancer?

A

enlarge nodule, firm not tender

neck discomfort due to pressure

44
Q

Management for thyroid cancer?

A

thyroidectomy - surgery

45
Q

What is the function of parathyroid glands

A

secrete parathyroid hormone PTH which increases plasma levels of Calcium Ca2.

If Ca2 is high PTH is inhibited

PTH + renal excretion

calcitonin pose PTH actions on bone

46
Q

What are the clinical features of hyperparathyroidism?

A 
hypercalcaemia
-bones
- stones
- abdo groans 
\+ BP
47
Q

What are the clinical features of hypoparathyroidism?

A

hypocalacemia
+ excitability of sensory and motor nerves
- BP

SBO5 (16 decks)

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