ENDOCRINOLOGY Flashcards by megan king

What enzymes produced by acidophil cells use JAK-STAT signalling

growth hormone
prolactin

other cells using JAK-STAT: EPO, TPO, leptin, IL-2, IL-6, IFN-Y

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cause of increased BMR in hyperthyroidism

increased synthesis **Na-K ATPase **

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cause of increased SNS activity in hyperthyroidism

increased expression B1 adrenergic receptors

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what happens to mensturation, cholesterol and blood glucose levels in hyperthyroidism

oligo = menorrhoea
hypo = cholesterolemia
hyper = glycemia

gluconeogenesis, glycogenolysis increased

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glycosaminoglycans are made up of

chondroitin sulfate
hyaluronic acid

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exopthalmos and pretibial myxoedema are caused by

fibroblasts express TSH
TSH activation results in glycosaminoglycan (GAGs) buildup –> inflammation, fibrosis, oesema

AB stimulation of fibroblasts

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autoantibody IgG stimulates TSH receptor

HSII

Graves disease

increased synthesis/release thyroid hormone

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non-tender goiter
raised TSH, T4, T3
ADHD

thyroid hormone resistance

decreased sensitivty peripheral tissues to thyroid h. - receptor defect

receptor defect

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graves disease is triggered by -?antibodies binding to -?

thyrotropin receptor antibodies
activating TSH receptor

TSH receptor on other cells - fibroblasts, adipocytes -> exothalmous

thyrotropin also called TSH(thyroid stimulating hormone)

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propanolol can be used to treat hyperthyroid B-adrenergic (SNS) symptoms. what is used to treat exopthalmos

glucocorticoids
(it is immune mediated (TSH driven), not treated by BB)

other SNS symptoms can be addressed with BB use

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brittle hair/nails, fatigue
low TSH
low T4
menstural cycle not returned
postpartum

secondary hypothyroidism
(Sheehan syndrome)

hypothalamic-pituitary dysfunction

ischaemic necrosis pituitaty gland –> from systemic hypotension during delivery

Hashimoto and postpartum thyroiditis (variant of hashimoto occuring with 1yr pregnancy) = high TSH (primary hypothyroid)

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mental retardation
short stature
coarse facial features
enlarged tongue
umbilical hernia
maternal hypothyroidism early pregnancy

cretinism
(neonate hypothyroidism)

affects brain, skeletal development

also occur due to dyshormonogenetic goiter - TPO defect (cant do oxidation, organification, coupling)

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most common congenital adrenal hyperpasia

21-hydroxylase deficiency

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AR
adrenal hyperplasia
skin hyperpigmentation

3 types

congenital adrenal hyperplasia

ACTH stim –> MSH production –> skin pigmentation

17a
21
11B

(starts with 1) = causes HTN
(ens with 1) = causes virulisation

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increased BP
decreased K
low cortisol
decreased sex hormones

17a-hydroxylase deficiency

XX lacks 2’ sexual dev
XY atypical genitalia, undescended testes

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decreased BP
increased K
decreased cortisol
increased sex hormones

21-hydroxylase deficiency

salt wasting
increased renin
increased 17-hydroxyprogesterone

XX virilisation
infancy (newborn)

increased BP
decreased K
decreased coristol
increased sex hormones

11B-hydroxylase deficiency

decreased aldosterone
increased 11B-deoxycortisterone
decrease renin

infancy - severe HTN
childhood - precocious puberty
XX virilisation

weakness
fatigue
decreased appetite
constipation
renal calculi
osteitis fibrosis cystica
increased calcum
decreased phosphorous

parathyroid adenoma

part of MEN1 (parathyroid adenoma)

main cause of primary pyperparathyroidism
‘stones, thrones, bones, grones, psychiatric overtones’

functino of chief cells of parathyroid gland

secrete PTH

woman
loss of peripheral vision
amennorhoea

prolactinoma
(pituitary adenoma) m/c

mass effect -> optic chiasm compression -> bitemoral hemianopsia
suppress GnRH -> inhibit FSH, LH -> amenorhhoea

acute viral illness
diffusely tender thyroid
absence of iodine uptake
multinucleated giant cells on FNA

subacute granulomatous thyroiditis
(de quervains)

attenuated vaccine properties

non viable organism
still posses antigens

Leptin inhibits hunger by counteracting the effect of

hypothalamic neuropeptide Y (NPY)
(potent stimulator of hunger)

skin tags hyperhydrosis prognathism, brow protrusion broadening hands, feet arthritis carpel tunnel organomegaly

acromegaly | hyperplasia articular cartilage & synovial hypertrophy ## Footnote excess GH increased IGF-1

what can stimulate lactotrophs

T**R**H (thyroid regulating hormone) | dopamine inhibits prolactin

hyperosmotic volume contraction is

loss of free water retention of electrolytes ## Footnote diabetic insipidus decreased fluid intake excessive sweating (sweat is hypotonic)

sweat is

hypotonic

example of isoosmotic volume contraction

gastrointestinal haemorrhage/diarrhoea | isotonic loss ECF no effect osmolality or ICF

in diabetes insipidus you will see osmolality ECF ICF

osmolality increased ECF decreased ICF decreased | hyperosmotic volume contraction

in pheochromocytoma, treatment of _\_\_ is given first before treatment og _\_\_ to prevent

alpha blocker beta blocker hypotensive crisis | if BB given first, unopposed vasoconstriction

hypertension headache sweating tachycardia polycythemia *are symptoms of what tumour*

pheochromocytoma | neuroendocrine (adrenal tumour) ## Footnote tx with a-blocker THEN b-blocker

function of epinephrine in hypoglycaemia

selective ativation of adrenal medullary epinephrine ** | key ligant in **glycogenolysis** & **gluconeogenesis** ## Footnote acts on **hepatocytes** a and b receptors -> release intreacellular Ca -> activates glycogen phosphorylase increases **gluconeogenesis** through **fructose bisphosphate 2** activation (b adrenergic)

factors (3) required to increase bone minral density | Wolffs law

stress - weightbearing/strenuous available calcium, Vit D oestrogen/testosterone (key regulators) | stress vitamins hormones ## Footnote hihger sex hormone levels puberty --> mineral density increases most tails of 3rd decade (not reoccur readily) osteoclast then > osteoblast

what hormones regulate physeal growth, ossification and closure

testosterone and oestrogen ## Footnote aromitisation of testosterone to oestrogen --> closure of physis in later puberty

effects (2) of cortisol on bone

increased osteoclast activity decreased bone mineral density | 'glucocorticoid'

osteoporosis is more common women than men because

women start out with lower peak bone mass compared to males | female bone mineral density decreases more rapidly after menopause