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Phase 2A Ikenna > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Examples of water-soluble hormones

A

Peptides
Monoamines

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2
Q

Examples of fat-soluble hormones

A

Thyroid hormone
Steroids

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3
Q

Are steroid hormones stored

A

No they are synthesised on demand

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4
Q

Are water soluble hormones stored

A

Yes, in vesicles

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5
Q

Another name for adrenaline

A

Epinephrine

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6
Q

What percentage of thyroid hormones are protein bound

A

99% as they are not water soluble

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7
Q

What percentage of T3 in the circulation is secreted directly by thyroid

A

20%

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8
Q

What are the 4 hormone classes

A

Peptides
Amines
Iodothyronines
Cholesterol derivatives and steroids

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9
Q

What does vitamin D stimulate

A

mRNA production

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10
Q

What does conjugation of iodothyrosines give rise to

A

T3 and T4 which are stored in colloid bound to thyroglobulin

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11
Q

What is synergism

A

Combined effects of two hormones amplified e.g. glucagon with epinephrine

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12
Q

What is antagonism

A

One hormone opposes the other hormone e.g. glucagon antagonises insulin

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13
Q

Function of leptin

A

Switches off appetite and is immunostimulatory

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14
Q

When do leptin blood levels increase

A

After a meal

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15
Q

When do leptin blood levels decrease

A

After fasting

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16
Q

Function of Peptide YY

A

Inhibits gastric motility
Reduces appetite

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17
Q

What secretes Peptide YY

A

Neuroendocrine cells in ileum, pancreas and colon

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18
Q

Functions of cholecystokinin

A

delays gastric emptying
gall bladder contraction
insulin release
Satiety(via vagus nerve)

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19
Q

Function of Ghrelin

A

Growth hormone release
Increases appetite(orexigenic)

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20
Q

What does orexigenic mean

A

Stimulates appetite

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21
Q

What are incretins

A

A group of metabolic hormones that stimulate a decrease in blood glucose levels

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22
Q

What do alpha cells secrete

A

Glucagon

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23
Q

What do beta cells secrete

A

Insulin

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24
Q

Insulin effect on glucagon

A

Inhibits it

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25
Q

Does insulin inhibit glucagon in diabetes

A

No this effect is lost

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26
Q

Main characteristic of diabetes mellitus

A

Hyperglycaemia

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27
Q

What random plasma glucose shows diabetes

A

> 11 mmol/l

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28
Q

What fasting plasma glucose shows diabetes

A

> 7 mmol/l

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29
Q

What HbA1c value shows diabetes

A

> 48mmol/mol

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30
Q

What is type 1 diabetes

A

An insulin deficiency characterised by loss of beta cells due to autoimmune destruction

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31
Q

What is a catabolic state

A

when you are breaking down or losing overall mass, both fat and muscle

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32
Q

What is an anabolic state

A

Where the body builds and repairs muscle tissue

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33
Q

What is polydipsia

A

The feeling of extreme thirstiness

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34
Q

What is polyuria

A

A condition where the body urinates more than usual and passes excessive or abnormally large amounts of urine each time you urinate

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35
Q

What causes ketoacidosis

A

Breakdown/metabolism of fats in the body into ketones

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36
Q

What is a hyperosmolar hyperglycaemic state

A

A metabolic complication of diabetes mellitus characterized by severe hyperglycemia, extreme dehydration

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37
Q

What is severe hypoglycaemia

A

When you are hypoglycaemic and are unable to treat yourself ie need third party help

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38
Q

Two ways to treat hypoglycaemia

A

Insulin
Sulphonylureas

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39
Q

Macrovasular comlications of type 2 diabetes

A

Atherosclerotic cardiovascular disease
Stroke
Myocardial infarction
Peripheral arterial disease

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40
Q

Microvascular complications of type 2 diabetes

A

Diabetic kidney disease
Chronic kidney disease
Retinopathy
Peripheral neuropathy
Autonomic neuropathy
Foot problems
Diabetic ketoacidosis

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41
Q

What type of feedback is calcium homeostasis

A

Negative feedback

42
Q

Parathyroid hormone actions

A

Decreased phosphate reabsorption
Decreased serum phosphate
Decreased FGF-23
Increased 1,25-D

43
Q

Parathyroid hormone response to decreased serum calcium

A

Increased Calcium ion reabsorption
Bone resorption

44
Q

Do small changes in serum calcium result in a big or small change in PTH

A

Big

45
Q

Consequences of hypocalcaemia

A

Paraesthesia
Muscle spasm
Seizures
Basal ganglia calcification
Cataracts
ECG abnormalities

46
Q

What is paraesthesia

A

An abnormal sensation typically tingling or prickling

47
Q

What is Pseudohypoparathyroidism

A

Resistance to parathyroid hormone

48
Q

Pituitary thyroid axis

A

Hypothalamus> releases TRH
TRH stimulates Pituitary to release TSH
TSH stimulates Thyroid to produce T4 and T3

49
Q

GH/IGF-I axis

A

Hypothalamus secretes GHRH (+) and SMS (-)
These stimulate the pituitary which releases GH
GH acts on the liver
Liver produces IGF-I which has a negative effect on the hypothalamus

50
Q

3 vital points of what tumours cause

A

Pressure on local structure e.g bitemporal hemianopia
Pressure on normal pituitary e.g hypopituitarism
Functioning tumour

51
Q

What is a functioning tumour

A

A tumour that is found in endocrine tissue and makes hormones

52
Q

Examples of functioning tumours

A

Prolactinoma
Acromegaly
Cushing’s disease

53
Q

What is a prolactinoma

A

A noncancerous (benign) pituitary tumour that produces a hormone called prolactin

54
Q

Who are prolactinomas more common in

A

Women

55
Q

Effects of prolactinomas

A

Loss of libido
Visual field defect

56
Q

Treatment of prolactinomas

A

Dopamine agonist eg
Cabergoline or bromocriptine

57
Q

What is Goitre

A

Englargement of thyroid gland

58
Q

What is toxic goitre

A

Extra thyroid gland is produced

59
Q

3 mechanisms for increased thyroid hormone

A

Overproduction of thyroid hormone
Leakage of preformed hormone from thyroid
Ingestion of excess thyroid hormone

60
Q

Most common cause of hyperthyroidism

A

Graves’ disease

61
Q

Antithyroid drug

A

Thionamides

62
Q

Function of thionamides

A

Decreases synthesis of new thyroid hormone

63
Q

What is hypothyroidism

A

Absence / dysfunction thyroid gland

64
Q

Most common cause of hypothyroidism

A

Hashimoto’s thyroiditis

65
Q

Causes of hypothyroidism in children

A

Resistance to thyroid hormone
Isolated TSH deficiency

66
Q

What is the normal osmolality in the body

A

282 - 295 mOsmol/kg

67
Q

What does a lack of vasopressin cause

A

Cranial diabetes insipidus

68
Q

What does vasopressin resistance cause

A

Nephrogenic diabetes insipidus

69
Q

What does too much vasopressin release when it should not be released cause (syndrome of anti-diuretic hormone secretion – SIAD)

A

Hyponatraemia

70
Q

What happens in diabetes insipidus

A

Your blood glucose levels are normal, but your kidneys can’t properly concentrate urine.

71
Q

3 main G protein coupled receptors in water maintenance

A

V1a - vasculature
V2 - renal collecting tubules - reabsorption of water
V1b - pituitary

72
Q

Definition of hyponatraemia

A

serum sodium < 135 mmol/l

73
Q

Severe hyponatraemia

A

serum sodium < 125 mmol/l

74
Q

Normal serum sodium

A

135-144mmol

75
Q

What does reduced insulin lead to

A

Fat breakdown and formation of glycerol and free fatty acids

76
Q

What do fatty acids do to glucose uptake

A

They impair it

77
Q

What are free fatty acids oxidised to

A

Ketone bodies

78
Q

What do ketones(weak organic acids) cause

A

Anorexia
Vomiting

79
Q

What defines diabetic ketoacidosis

A

Hyperglycaemia (plasma glucose usually <50 mmol/l)
Raised plasma ketones (urine ketones > 2+)
Metabolic acidosis – plasma bicarbonate < 15 mmol/l

80
Q

Causes of Diabetic ketoacidosis

A

Treatment errors e.g. insulin dose reduced or stopped
Previously undiagnosed diabetes

81
Q

Management of diabetic ketoacidosis

A

Rehydration
Insulin
Replacement of electrolytes(K+)
treat underlying cause
Treatment must be started without delay

82
Q

Treatment of type 1 diabetes

A

Insulin treatment
Judge carbohydrate intake
Awareness of blood glucose lowering effect of exercise

83
Q

Function of type 1 diabetes management

A

To restore the physiology of the beta cell

84
Q

Factors that make it difficult for people with diabetes to sustain effective self management

A

Risk of hypoglycaemia
Too arduous a treatment
Risk of weight gain
Interference with lifestyle
Lack of sufficient training from diabetes teams

85
Q

What is the commonest type of monogenic diabetes

A

Maturity-onset diabetes of the young (MODY)

86
Q

Is MODY autosomal dominant

A

Yes

87
Q

Is MODY Non-insulin dependent

A

Yes

88
Q

What is the glucose sensor of beta cells

A

GCK(Glucokinase gene)

89
Q

How does acromegaly cause diabetes

A

Excessive secretion of growth hormone causes insulin resistance to rise

90
Q

How does Pheochromocytoma cause diabetes

A

Increased Gluconeogenesis
Decreased glucose uptake

91
Q

What drugs increase insulin resistance

A

Glucocorticoids

91
Q

What drugs increase insulin resistance

A

Glucocorticoids

92
Q

Common signs of adrenal insufficiency

A

Hypotension and cardiovascular collapse
Fatigue
Fever
Hypoglycaemia
Hyponatraemia and hyperkalaemia

93
Q

Pharmaceutical name for cortisol

A

Hydrocortisone

94
Q

What are circadian rhythms

A

Physical, mental and behavioural changes that follow a daily cycle

95
Q

Example of primary adrenal insufficiency

A

Addison’s disease

96
Q

Example of secondary adrenal insufficiency

A

Hypopituitarism

97
Q

Example of tertiary adrenal insufficiency

A

Suppression of HPA

98
Q

Is it the adrenal medulla or cortex that is controlled by the pituitary gland

A

The adrenal cortex

99
Q

Where is growth hormones main site of action to stimulate IGF1 release

A

Liver

100
Q

Typical features of cortisol deficiency

A

Hypotension
Muscle aches
Weight loss
Lethargy

Phase 2A Ikenna (5 decks)

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