Endocrinology Flashcards
Hormone
A hormone is a material which is released from secretory cells in the body, that travels through the body via the blood, and has an effect on target cells located some distance away.
What does cholesterol act as a precursor of? And what is the precursor of cholesterol
It is the precursor to bile acids, steroid hormones and oxysterols. Cholesterol is synthesized from its precursor unit acetyl-CoA (Ac-CoA).
Difference between glycogenolysis and glycogenesis
The formation of glycogen from glucose is known as glycogenesis, and the breakdown of glycogen to form glucose is called glycogen metabolism or glycogenolysis. Increased cyclic adenosine monophosphate (cAMP) catalyzes the breakdown of glycogen (glycogenolysis)
Through what processes is glucose produced
Glycogenolysis and gluconeogenesis
In a fed state, is it glucose or insulin that dominates?
Insulin
In a fasting state, is it glucose or insulin that dominates?
Glucagon
What does the RAAS system do?
The renin-angiotensin-aldosterone system (RAAS) is a hormone system that plays a key role in regulating blood pressure and fluid balance in the body
Steven’s Johnson Syndrome
A rare, serious disorder of the skin and mucous membranes. Looks like bed red patches
Lyell’s syndrome
Toxic epidermal necrolysis, also known as Lyell’s syndrome, is a type of severe skin reaction. Together with Stevens–Johnson syndrome it forms a spectrum of disease, with TEN being more severe. Early symptoms include fever and flu-like symptoms.
Bacterial fasciitis - necrotising fasciitis
A serious bacterial infection that destroys tissue under the skin.
Flesh-eating disease occurs when bacteria enter the body through a break in the skin. People with a weakened immune system can be at greater risk of developing this condition.
The condition spreads quickly. Symptoms include blisters, fever, fatigue and pain worse than a person would expect based on the wound’s appearance.
Pemphigoid
Bullous pemphigoid is a rare skin condition that causes blisters on your skin. It’s an autoimmune disease. Certain medications may trigger bullous pemphigoid, but healthcare providers aren’t sure exactly what causes it. It can be well-managed with medication
Petechiae
Petechiae are tiny spots of bleeding under the skin or in the mucous membranes (mouth or eyelids). They are purple, red or brown dots, each about the size of a pinpoint. They’re not raised or bumpy.
How do opioids act in the brain
Opioids can depress breathing by changing neurochemical activity in the brain stem, where automatic body functions such as breathing and heart rate are controlled.
Opioids can reinforce drug taking behavior by altering activity in the limbic system, which controls emotions.
Opioids can block pain messages transmitted through the spinal cord from the body.
Differences between fore brain, midbrain, hindbrain
The forebrain, midbrain, and hindbrain are the three main brain divisions. The forebrain handles higher cognitive functions, the midbrain controls motor movement and sensory processing, and the hindbrain manages coordination, balance, and autonomic functions like breathing and heart rate.
Multiple sclerosis
Multiple sclerosis (MS) is a chronic disease of the central nervous system. MS is unpredictable. Some people may be only mildly affected. Others may lose the ability to see clearly, write, speak, or walk. Early symptoms can include vision problems, trouble walking, and tingling feelings.
HHS
Hyperosmolar hyperglycemic state (HHS) is a life-threatening complication of diabetes — mainly Type 2 diabetes. HHS happens when your blood glucose (sugar) levels are too high for a long period, leading to severe dehydration and confusion.
Measurement: meq/L
Milliequivalents per litre (mEq/L) Some medical tests report results in milliequivalents per litre (mEq/L). An equivalent is the amount of a substance that will react with a certain number of hydrogen ions. A milliequivalent is one-thousandth of an equivalent.
The role of glucagon
Glucagon is a glucoregulatory peptide hormone that counteracts the actions of insulin by stimulating hepatic glucose production and thereby increases blood glucose levels
- Causing the liver to decrease glucose consumption.
- Initiating the release of glucose from glycogen, a sugar storage molecule primarily in the liver and skeletal muscle.
- Promoting the production of glucose from amino acids.
- Initiating the release of glucose into the bloodstream.
Glycogenolysis
Breakdown of glycogen to form glucose
The formation of glycogen from glucose is known as glycogenesis, and the breakdown of glycogen to form glucose is called glycogen metabolism or glycogenolysis. Increased cyclic adenosine monophosphate (cAMP) catalyzes the breakdown of glycogen (glycogenolysis)
Gluconeogenesis
Gluconeogenesis is a metabolic pathway that results in the biosynthesis of glucose from certain non-carbohydrate carbon substrates.
particularly glycerol, lactate, pyruvate, propionate, and glucogenic amino acids.[1] Gluconeogenesis essentially reverses glycolysis
Glycolysis
Glycolysis is the process in which glucose is broken down to produce energy. It produces two molecules of pyruvate, ATP, NADH and water. The process takes place in the cytoplasm of a cell and does not require oxygen. It occurs in both aerobic and anaerobic organisms.
Related to DKA how are ketones produced?
Ketone synthesis in the liver produces acetoacetate and beta-hydroxybutyrate from two acetyl CoA molecules. This process begins in the mitochondria of the liver after transporting the fatty acyl CoA molecule into the inner mitochondrial membrane by the carnitine shuttle.
Glycosuria
Glycosuria is a term that defines the presence of reducing sugars in the urine, such as glucose, galactose, lactose, fructose, etc. Glucosuria connotes the presence of glucose in the urine and is the most frequent type of glycosuria and is the focus of this review
Osmotic diuresis
Osmotic diuresis is increased urination due to the presence of certain substances in the fluid filtered by the kidneys. This fluid eventually becomes urine. The process of osmosis created by these substances cause additional water to come into the urine, increasing its amount.21 Jul 2022
Lipolysis
Lipolysis is the metabolic process through which triacylglycerols (TAGs) break down via hydrolysis into their constituent molecules: glycerol and free fatty acids (FFAs).
Hyperketonemia
Hyperketonemia is a condition with elevated blood levels of acetoacetate, 3-β-hydroxybutyrate, and acetone. Several physiological and pathological triggers, such as fasting, ketogenic diet, and diabetes cause an accumulation and elevation of circulating ketones
Kuasmaul’s respiration
Kussmaul breathing is an abnormal breathing pattern characterized by rapid, deep breathing at a consistent pace. It’s a sign of a medical emergency — usually diabetes-related ketoacidosis (DKA), which can affect people with diabetes and people with undiagnosed Type 1 diabetes.
Polypharmacy
Polypharmacy is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions
Syndrome X
Microvascular angina, previously known as cardiac syndrome X, also known as coronary microvascular dysfunction or microvascular coronary disease is a type of angina with signs associated with decreased blood flow to heart tissue but with normal coronary arteries.
Central vs general obesity
General obesity is measured by body mass index (BMI). The BMI is calculated as the ratio of weight (kilograms) to height squared (meters) [17]. Central obesity or abdominal obesity (truncal obesity) is an excess build-up of abdominal fat [18]. The waist circumference (WC), waist-hip ratio (WHR) are its indicators.
Lipogenesis
lipogenesis is the conversion of fatty acids and glycerol into fats, or a metabolic process through which acetyl-CoA is converted to triglyceride for storage in fat.
Glycogenesis
Glycogenesis or glycogen synthesis is a multi-step process that begins with converting glucose to glucose-6-phosphate via hexokinase or the liver isoform of hexokinase known as glucokinase. This process is an essential step as the addition of a phosphate group traps glucose within the cell.
Metabolism - revision
Metabolism refers to all the chemical processes going on continuously inside your body that allow life and normal functioning (maintaining normal functioning in the body is called homeostasis). These processes include those that break down nutrients from our food, and those that build and repair our body.
Dysglycaemia/ pre- diabetic
Result of insulin resistance and decreased signaling / decreased insulin effects along the metabolic pathway
One of criterium for defining MeS is that of impaired fasting glucose (“pre-DM”).
Do not have to fulfill diagnostic criteria for overt Type 2 diabetes.
“Pre-diabetes” implies limited functional ability of -cell to compensate for insulin resistance
Significant risk of Type 2 diabetes mellitus in patients with MeS
Claudication
Claudication is pain in your thigh, calf, or buttocks that happens when you walk a certain distance. As the condition gets worse, the pain occurs when you walk shorter distances. Over time, it can become too painful to walk. It may be a symptom of peripheral artery disease (PAD).
Polycthaemia
Polycythemia, also called erythrocytosis, refers to increased red blood cell mass, noted on laboratory evaluation as increased hemoglobin and hematocrit levels
Dystocia
“Labor dystocia” (difficult or obstructed labor)2 encompasses a variety of concepts, ranging from “abnormally” slow dilation of the cervix or descent of the fetus during active labor3 to entrapment of the fetal shoulders after delivery of the head
Preeclampsia- revision
Preeclampsia, formerly called toxemia, happens when you’re pregnant and have high blood pressure, too much protein in your pee, and also swelling in your legs, feet, and hands. It can range from mild to severe. It usually happens late in pregnancy, though it can come earlier or just after delivery.
Encephalocele
Encephalocele (en-sef-a-lo-seal) is a sac-like protrusion of the brain and membranes that cover it through an opening in the skull. Surgery is required to place the brain and membranes back in the skull. Researchers estimate about 1 in every 10,400 babies is born with encephalocele in the United States.
Non- specific symptoms
Some symptoms are specific, that is, they are associated with a single, specific medical condition. Nonspecific symptoms, sometimes also called equivocal symptoms, are not specific to a particular condition. They include unexplained weight loss, headache, pain, fatigue, loss of appetite, night sweats, and malaise.
Postprandial hypoglycaemia
Hypoglycemia is the medical term for low blood sugar. Reactive hypoglycemia, sometimes called postprandial hypoglycemia, happens when blood sugar drops after a meal — usually within four hours after eating. Symptoms of hypoglycemia may include: Shakiness.
Pretibial myxedema
Pretibial myxedema is a skin condition that causes plaques of thick, scaly skin and swelling of your lower legs. This condition is a form of Graves’ disease and can affect people diagnosed with thyroid conditions
Hashimoto’s thyroiditis
Commonest cause for autoimmune hypothyroidism
Antibodies against TSH receptors
De Quervains tenosynovitis
A painful condition affecting the tendons on the thumb side of the wrist.
Repetitive hand or wrist movements can make the condition worse.
The main symptoms are pain and tenderness in the wrist, often below the base of the thumb.
2 conditions cause weight loss
Hyperthyroidism
Diabetes
Oncholysis
Onycholysis is a condition in which the nail separates from the skin beneath it. It may be caused by a nail injury, fungus, or psoriasis. The condition does not go away, and you must wait until a new nail grows in.
Most common thyrotoxicosis / hyperthyroidism
Graves disease
Myxedema coma
Myxedema coma is defined as severe hypothyroidism leading to decreased mental status, hypothermia, and other symptoms related to slowing of function in multiple organs. It is a medical emergency with a high mortality rate.0
Rales
Rales. Small clicking, bubbling, or rattling sounds in the lungs. They are heard when a person breathes in (inhales
Diaphoresis
Sweating esp to an unusual degree as a symptom of a disease or side eff3ct of a drug
Another nam3 is secondary hyperhidrosis meaning excessive sweating
Postpartum thyroiditis
Inflammation and swelling of thyroid gland
Affects 5% of women in the year after pregnancy - usually goes away on its own
Risk factors for thyroid nodules
Female gender
Increased age
Iron deficiency
Obesity
Alcohol and smoking
Metabolic syndrome
Lifestyle risks for hyperthyroidism
Injury or trauma to thyroid
Psychological distress
Smoking
History of meds like lithium and iodine in high dosages
Sing,e thyroid nodules - non neoplastuc
Hyperolastic nodule - arising spontaneously or partial thyroidectomy
Colloid n
Cyst
Thyroiditic n
How could thyroid hemiagenesis present + what is it
Abscence of half the thyroid gland - asymptomatic
Presents as a hyperplasia of the existing lobule mimicking a thyroid nodule
Neoplasm - revision
An abnormal mass of tissue that forms when cells grow and divide more than they should or do no5 due when they should. Can be benign or malignant
Non- neoplasticism thyroid diseases - name 2 - why would they have lumps
Hashimoto’s disease and subacute thyroiditis
Not true nodules - just expression of the underlying thyroid disease
Hodgkin’s lymphoma
Type of cancer of the lymphatic system
Limits body’s ability to fight infections as it progresses
Difference between Hodgkin and non- Hodgkin’s lymphoma
NHL may arise in lymph nodes anywhere in the body
Whereas HL arises in the upper body, neck; chest or armpits - also progresses more typically than NHL
Predictors of thyroid malignancy
Male
Older age
Hoarseness
Rapid growth of nodules
Dysphasia
Paplabke lymph nodes
Immobility with swallowing
Pager’s disease
Chronic long lasting disorder causes bones to grow larger and become weaker than normal
Normal calcium levels
(2.1 - 2.5 mmol/L
Main hormone systems imvolved in calcium regulation
PTH
VIT D
CALCITONIN - Kessler importance
PTH role regarding calcium
Increases calcium
Decrease Po4
D3 and D2 - which ones is produced in skin requiring UV light
D3. Which is cholecalciferol
D2 - ergocalciferol is just a dietary plant source and pharmacological supplement
Where does activation of ViT D occur
Liver and kidney
Where is calcitonin produced and in which area of the earth is it used + why is it release
Produced by c cells of the thyroid and it is important in sea water fish to regulate calcium balance in presence of high calcium in sea water BUT has little physiological role in humans and land animals
Released in response to hyperglycaemia
Reduced mobilisation of calcium from skeleton via reduction in bone resorption
Causes of hypercalcemia
Mineral abnormality
90-95 due to hyperparathyroidism or malignancy
In hypercalcemia, how do granulomatous diseases present
An example is sarcoidosis or TB - it presents with low PTH AND no malignancy which is why it’s odd
Also 1a hydroxalase may be present and increases ViT D leading to an excess thus excess in hypercalcemia, hyperphosphatemia and hypercalcituria (excess of calcium in the urine)
Parenteral
administered or occurring elsewhere in the body than the mouth and alimentary canal. So not through intestines or digestive tract
Enema
a procedure in which liquid or gas is injected into the rectum, to expel its contents or to introduce drugs or permit X-ray imaging.
Myeloma
Myeloma is a type of cancer that develops from plasma cells made in the bone marrow. Bone marrow is the spongy tissue found inside the inner part of some of our large bones.
Affects plasma cells
