Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What is goitre?

A

Any swelling of the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name 4 possible causes of diffuse smooth goitre.

A

Physiological (increased demands for thyroid hormone, e.g. pregnancy)
Grave’s disease
Thyroiditis
Dietary iodine deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What general findings would you find in hyperthyroidism?

A 
Warm, moist skin
Fine hair/alopecia
Peripheral oedema
Onchylosis
Thyroid acropachy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What two drugs can cause hyperthyroidism?

A

Iodine

Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In what thyroid condition would you see gynaecomastia?

A

Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is hyperthyroidism?

A

Condition caused by increased levels of circulating thyroxine (T4) and/or tri-iodothyronine (T3)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

In which gender is thyroid disease more common?

A

Female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you investigate hyperthyroidism?

A 
TSH
Free T3 and T4
FBC
Liver enzymes
ESR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drugs would be used to treat hyperthyroidism?

A

Beta-blockers for symptom control

Carbimazole or propylthiouracil +/- additional T4 (block and replace method)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What surgery would you consider to treat hyperthyroidism?

A

Thyroidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why are hyperthyroid patients encouraged to stop smoking?

A

Smoking is main risk factor for thyroid eye disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Grave’s disease?

A

An autoimmune disorder of the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs can cause hypothyroidism?

A

Lithium

Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the difference between T4 and T3?

A

T4 is the pro hormone and is converted to T3 in peripheral tissues, where T3 then has an action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is TRH and where is it secreted?

A

Thyrotropin-releasing hormone

Secreted by hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is TSH and what produces it?

A

Thyroid-stimulating hormone

Produced by thyrotrophs of pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does TSH do?

A

Increases serum levels of T3 and T4

Promotes conversion of T4 to T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the effects of thyroid hormones of CVS?

A

Increased heart rate

Increased cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the effects of thyroid hormones on skeletal system?

A

Increased bone turnover and resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In general, what do thyroid hormones do to the body?

A

Increase basal metabolic rate

Increase rate of oxygen consumption under basal conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What produces calcitonin?

A

Parafollicular (or C) cells in thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the effect of calcitonin?

A

Decrease the level of calcium in the blood by inhibiting action of osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is hypothyroidism?

A

Underactivity of the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where is the common cause of hypothyroidism?

A

Primary (from the thyroid gland)

not higher up the axis, i.e. secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name symptoms of hypothyroidism.

A 
Tiredness/malaise
Weight gain
Cold intolerance
Goitre
Bradycardia
Slow-relaxing reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How would you investigate hypothyroidism?

A

Serum TSH
Free T3 and T4
FBC
Lipids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What would you expect to see on a blood test of someone with primary hypothyroidism?

A

High TSH

Low T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How would you treat hypothyroidism and for how long?

A

Levothyroxine (synthetic thyroxine)

For life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the four categories of hormones?

A

Peptide and proteins
Amino acid derivatives
Steroids
Fatty acid derivatives (eicosanoids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

By which process are protein preprohormones modified in the ER?

A

Glycosylation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are steroid hormones derived from?

A

Cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where are steroid hormones synthesised?

A

Adrenals
Gonads
Placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Name the hormones produced and secreted by the anterior pituitary.

A 
LH and FSH
Growth hormone
Prolactin
TSH
ACTH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does the posterior pituitary gland do?

A

Stores (but does not produce) vasopressin (ADH) and oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the most common cause of pituitary disease?

A

Pituitary tumour

37
Q

What is Cushing’s syndrome?

A

Describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of cortisol

38
Q

What is Cushing’s disease?

A

Increase secretion of ACTH from the anterior pituitary

39
Q

What is the most common cause of Cushing’s disease?

A

Pituitary adenoma

40
Q

How would you investigate a suspected pituitary tumour?

A

MRI of the pituitary

Visual fields

41
Q

What are the three major conditions usually caused by secretions from pituitary adenomas?

A

Hyperprolactinaemia (prolactine excess)
Acromegaly/gigantism (GH excess)
Cushing’s disease (excess ACTH secretion)

42
Q

Name some causes of hypopituitarism.

A

Congenital (eg Kallmann’s syndrome)
Infection (eg basal meningitis)
Vascular (eg carotid artery aneurysm)
Neoplastic (eg pituitary tumour)

43
Q

What stimulates release of ACTH?

A

Corticotropin-releasing hormone from the hypothalamus

44
Q

What does ACTH do?

A

Stimulates cortisol production and secretion from zone fasciculata of the adrenal cortex

45
Q

What is the predominant mineralocorticoid produced in humans and where is it produced?

A

Aldosterone from the zone glomerulosa in the adrenal cortex

46
Q

What does carbimazole do?

A

Inhibit formation of thyroid hormones

Is also an immunosuppressive agent

47
Q

What is thyroid crisis or ‘thyroid storm’?

A 
Rapid deterioration of hyperthyroidism with: 
Hyperpyrexia 
Severe tachycardia
Extreme restlessness
Cardiac failure
Liver dysfunction
48
Q

In the foetus what do the testis produce to promote sexual differentiation and what does it do?

A

Anti-Mullerian hormone

Causes atrophy of the Mullerian ducts

49
Q

What do pulses of GnRH released from the hypothalamus cause secretion of?

A

LH and FSH from the pituitary

50
Q

What does LH do in male?

A

Stimulate production of testosterone from Leydig cells of testis

51
Q

What does FSH do in the male?

A

Stimulate Sertoli cells in seminiferous tubules to produce mature sperm and inhibins A and B

52
Q

What does LH do in the female?

A

Stimulate ovarian androgen production by ovarian theca cells

53
Q

What does FSH do in the female?

A

Stimulate follicular development and aromatase activity

Stimulate release of inhibin from ovarian stromal cells

54
Q

In early puberty which gonadotropin begins to rise first?

A

FSH

55
Q

What is precocious puberty?

A

Development of secondary sexual characteristics, or menarche in girls, at or before age of 9

56
Q

How would you investigate precocious puberty?

A 
LHRH/LH
FSH test
MRI pituitary
oestradiol
ovarian ultrasound
Free T4
Bone age scan
57
Q

What is Kallmann’s syndrome?

A

Isolated GnRH deficiency

usually X-linked

58
Q

What is Addison’s disease?

A

Primary hypoadrenalism, caused by destruction of entire adrenal cortex

59
Q

How are cortisol levels affected in Addison’s?

And how does this affect levels of CRH and ACTH?

A

Reduced cortisol, leads to increased CRH and ACTH

60
Q

What causes hyper pigmentation in Addison’s?

A

Increased levels of CRH and ACTH

61
Q

How do you treat Addison’s disease?

A

Long-term glucocorticoid and minerlaocorticoid replacement

62
Q

What are the clinical features of Addison’s?

A 
Hyperpigmentation
Postural hypotension
Weight loss
Depression
Malaise
63
Q

What can cause secondary hypoadrenalism?

A

Hypothalamic-pituitary disease (inadequate ACTH production)

Long-term steroid therapy

64
Q

What are the clinical features of Cushing’s syndrome?

A 
Plethora
Bruising
Hypertension
Weight gain
Pathological fractures
Striae (purple or red)
Proximal myopathy
65
Q

How would you confirm diagnosis of Cushing’s syndrome?

A 
48-hour low dose dexamethasone test
24-hour urinary free cortisol measurements
Circadian rhythm (cortisol blood tests)
66
Q

What tests would you use to determine the cause Cushing’s syndrome?

A 
Adrenal CT/MRI
Pituitary MRI
Plasma potassium levels
High-dose dexamethasone test
Plasma ACTH levels
CRH test
Chest X-ray
67
Q

What causes congenital adrenal hyperplasia?

A

Autosomal recessive deficiency of enzyme in cortisol synthetic pathway
Most commonly 21-hydroxylase deficiency

68
Q

How can severe CAH present at birth?

A

With sexual ambiguity or adrenal failure

69
Q

How is cortisol affected in CAH and what does this cause?

A

Cortisol is reduced

Feedback leads to increased ACTH secretion

70
Q

What is hyperaldosteronism?

A

Disorder of the adrenal cortex characterised by excess aldosterone production

71
Q

What are the clinical features of hyperaldosteronism?

A

Sodium retention and potassium loss, causing hypokalaemia and hypertension

72
Q

What are the main causes of primary hyperaldosteronism?

A

Bilateral adrenal hyperplasia (normally idiopathic)

Adrenal adenoma

73
Q

What occurs in secondary hyperaldosteronism?

A

Excess renin stimulation of zone glomerulosa

74
Q

How is bilateral adrenal hyperplasia treated?

A

Spironolactone (aldosterone antagonist)

75
Q

What are phaechromocytomas and paragangliomas?

A

Rare tumours of the sympathetic NS that secrete catecholamines

76
Q

How is the secretion of PTH controlled?

A

Plasma calcium levels

77
Q

What is the effect of PTH?

A

Increase in serum calcium:
Increase osteoclast activity
Stimulate uptake of calcium in GIT
Enhance urinary excretion of phosphate

78
Q

What causes high levels of calcitonin to be released?

A

Rise in serum calcium

79
Q

What are the most common causes of hypercalcaemia?

A

Primary hyperparathyroidism

Malignancies

80
Q

What are the causes of primary hyperparathyroidism?

A

Single parathyroid adenoma

Diffuse hyperplasia of all parathyroid glands

81
Q

What is the cause of secondary hyperparathyroidism?

A

Physiological compensatory hypertrophy of parathyroid glands, due to hypocalcaemia caused by chronic kidney disease or vitamin D deficiency

82
Q

Name some symptoms of severe hypercalcaemia.

A 
Tiredness/malaise
Dehydration
Depression
Renal colic (from stones)
Hypertension
Haematuria
Bone pain
Abdo pain
83
Q

How would you investigate hyperparathyroidism?

A 
Fasting serum calcium and phosphate
Serum PTH
Renal function
24-hour urinary calcium
Abdominal X-rays
Imaging for tumour (eg MRI)
84
Q

How is primary hyperparathyroidism medically managed?

A

High fluid intake
Low calcium and vitamin D intake
Exercise encouraged

85
Q

When is surgery indicated for primary hyperparathyroidism?

A 
Renal stones/impaired renal function
Bone involvement
Marked hypercalcaemia
Young patient (i.e. <50)
Previous episode of severe acute hypercalcaemia
86
Q

What are the main causes of hypocalcaemia?

A

Chronic kidney disease
Severe vitamin D deficiency
Post-thyroid or parathyroid surgery
Idiopathic hypoparathyroidism

87
Q

How does hypoparathyroidism normally present?

A

Neuromuscular irritability

Neuropsychiatric manifestations

88
Q

How is hypoparathyroidism normally diagnosed?

A

History
Clinical picture
Low serum calcium
Absent/low PTH levels

89
Q

What is Conn’s syndrome?

A

Primary hyperaldosteronism

Medicine (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions