Endocrinology Flashcards
1
Q
What will you cause if you prescribe your patient too much hydrocortisone?
A
Cushing’s syndrome
2
Q
Which layer of the adrenal cortex synthesises aldosterone?
A
Glomerulosa
3
Q
Which half of the pituitary has a vascular link to the hypothalamus?
A
Anterior
4
Q
What class of drug is propylthiouracil?
A
Thioamine
5
Q
Which hormone mediates the effects of growth hormone?
A
IGFs
6
Q
What is another name for somatotropin?
A
Growth hormone
6
Q
Which half of the pituitary is the neurohypophysis?
A
Posterior
6
Q
Where is oxytocin synthesised?
A
Hypothalamus
6
Q
Where is ADH synthesised?
A
Hypothalamus
6
Q
Which hypothalamic nuclei send axons to the posterior pituitary?
A
Supraoptic and paraventricular nuclei
6
Q
Which hormone inhibits prolactin release?
A
Dopamine
6
Q
What causes acromegaly?
A
Overproduction of growth hormone during adulthood
6
Q
What effect does T3 have on basal metabolic rate?
A
Increases
6
Q
What do the results of a dexamethasone suppression test typically show in someone with Cushing syndrome?
A
Dexamethasone fails to suppress cortisol levels
6
Q
Give a 4 word definition of Hashimoto’s thyroiditis
A
Autoimmune destruction of thyroid
6
Q
What happens to TSH levels in Hashimoto’s thyroiditis?
A
Increased
6
Q
What is the gross pathology of the thyroid gland in Grave’s disease
A
Diffuse symmetrical enlargement
6
Q
What type of hypersensitivity is Grave’s disease?
A
Type 2 = antibody mediated
6
Q
What effects does cortisol have on carbohydrate metabolism?
A
Increases gluconeogenesis and increases serum glucose levels
6
Q
Which cells secrete testosterone?
A
Leydig cells of testis
6
Q
What does leuprorelin inhibit?
A
FSH and LH release
6
Q
Give a 1-word definition of Cushing’s syndrome
A
Hypercortisolism
6
Q
What is pheochromocytoma?
A
Tumour of adrenal medulla causing hypersecretion of catecholamines
6
Q
Which cells does cortisol act on?
A
Nearly every cell in the body
7
What causes cretinism?
Insufficient maternal iodine during pregnancy
8
What effect does long term treatment with cortisol have on ACTH?
Decreases it
9
What is another name for somatomedins?
IGFs
10
What is the autoimmune condition in which stimulatory autoantibodies cause increased secretion of thyroxine?
Grave's disease
10
Which hormones are released from the posterior pituitary?
ADH and oxytocin
10
Which gland releases insulin like growth factor?
Liver
10
What effect does T3 have on the sympathetic nervous system?
Sympathomimetic
10
If someone is hot all the time, what is their likely thyroid state?
Hyperthyroid
11
Where is the only place in the body that adrenaline is synthesised?
Adrenal medulla
12
What happens to TRH levels in Grave's disease?
Decreased
12
What happens to TSH levels in secondary hypothyroidism?
Decreases because of pituitary or hypothalamic damage
12
What happens to TSH levels in primary hyperthyroidism?
Decreased
13
How are thyroid hormones transported in the blood?
Bound to thyroid binding globulins (TBG)
14
Which organs primarily make oestrogen and progesterone?
Ovaries and placenta
16
What is the active ingredient in betadine?
Iodine
18
Which classes of hormones are lipophilic?
Steroids and thyroid hormones
19
Aldosterone increases excretion of which ion?
Potassium
21
Which amino acid are amine hormones derived from?
Tyrosine
22
Which inflammatory enzymes do glucocorticosteroids suppress the synthesis of?
PLA-2, iNOS and COX-2
24
What effect does cortisol have on the immune system?
Supresses it
25
Which hormone inhibits release of growth hormone?
Somatostatin
26
Name 3 visual signs on the body (not face) of someone with Cushing's syndrome
Striae (stretch marks). Fat pads behind neck. Abdominal adiposity.
27
What are three complications of treatment with thioamines?
Goitre, hepatotoxicity and agranulocytosis
28
What is the RDI for iodine?
150 ug
28
When do cortisol levels peak?
Morning
29
Which hormones does the adrenal medulla release?
Adrenaline and noradrenaline
30
What causes gigantism?
Overproduction of growth hormone before puberty
31
Which class of drugs can be used to treat hyperthyroidism?
Thioamines
32
What are the 2 gonadotropins?
LH and FSH
33
Which foods are particularly naturally rich in iodine?
Sea fish, crustaceans and kelp
34
How is Hashimoto's thyroiditis managed?
Thyroxine
36
Give a 4-word definition of Cushing's disease
Pituitary adenoma causing hypercortisolism
37
Which thyroid hormone is released in greater amounts?
T4
38
What happens to TSH levels in primary hypothyroidism?
Increases
40
Which hormone stimulates release of ACTH?
Corticotropin releasing hormone
42
Which hormones are decreased in Addison's disease?
Aldosterone and cortisol
43
Which hormone does growth hormone stimulate?
Insulin like growth factor 1 (IGF-1)
44
Which challenge test can be used for assessing adrenal gland function?
Dexamethasone suppression test
45
What effect does aldosterone have on sodium?
Increases sodium reabsorption
46
What effect will aldosterone deficiency have on potassium?
Increase in plasma [K+]
47
What will happen if you have too much iodine?
Goitre
48
List 4 main functions of glucocorticoids
Stimulate gluconeogenesis in liver. Mobilise amino acids from muscle. Stimulate lipolysis from adipose tissue. Immunosupression
49
Which organ does prolactin act on?
Breast
50
What is the pathway for thyroxine release?
TRH =\> TSH =\> T4
51
What may be the result of severe lack of maternal iodine during pregnancy?
Cretinism
52
What is cortisone?
A metabolite of cortisol that is almost biologically inactive
54
What is hydrocortisone?
Cortisol
55
Which hormones can increase the release of growth hormone?
Ghrelin and growth hormone release hormone
56
What happens to TSH levels in Grave's disease?
Decreased
57
What connects the pituitary to the hypothalamus?
Infundibulum
59
Which layer of the adrenal cortex produces sex steroids?
Reticularis
60
What happens to T4 levels in Grave's disease?
Elevated
61
Which hormone is used in the home pregnancy test?
human chorionic gonadotropin (hCG
62
Why don't we often do thyroid biopsies?
It is very vascular =\> risk of bleed
63
Which hormone stimulates prolactin release?
PRF = prolactin releasing factor
65
What is suggested by the presence of anti-thyroid peroxidase antibodies?
Hashimoto's thyroiditis
66
If someone is cold intolerant, what is their likely thyroid state?
Hypothyroid
67
Which antibodies are generated in Hashimoto's thyroiditis?
Anti-thyroglobulin and anti-thyroid peroxidase
68
In which condition is there autoimmune destruction of the adrenal cortex?
Addison's disease
70
Which cells of the adrenal medulla secrete catecholamines?
Chromaffin cells
71
What is the most common cause of hyperthyroidism?
Grave's disease
72
Which enzyme iodinates thyroglobulin?
Thyroid peroxidase
73
Which half of the pituitary is the adenohypophysis?
Anterior
74
What is the autoimmune condition in which the thyroid gland is attacked?
Hashimoto's thyroiditis
75
What is endogenous hydrocortisone called?
Cortisol
77
What do we call cortisol when it is given as a drug?
Hydrocortisone
79
Which hormone causes epiphyseal plates to close?
Oestrogen
80
Which layer of the adrenal cortex synthesises cortisol?
Fasciculata
82
What is the most active endogenous glucocorticoid?
Cortisol
83
Give a 3 word definition of goitre
Enlarged thyroid gland
84
Where in the body is hydrocortisone synthesised?
Nowhere - hydrocortisone is a drug so it's probably made in Germany
86
What are the 6 hormones released from the anterior pituitary?
TSH, LH, FSH, prolactin, growth hormone, ACTH
87
How is iodine taken up into thyroid cells from the bloodstream?
Sodium iodine symport
88
What are the 3 layers of the adrenal cortex from superficial to deep?
GFR Glomerulosa Fasciculata. Reticularis
90
What is the pathway for cortisol release?
CRH =\> ACTH =\> cortisol
91
Where is thyroid stimulating hormone synthesised?
Anterior pituitary
93
Which protein is iodinated to synthesise T3 and T4?
Thyroglobulin
94
What's the most common cause of goitre?
Iodine deficiency
95
Where is thyroid releasing hormone synthesised?
Hypothalamus
96
What is the half life of cortisol?
60-90 mins
98
Which reaction does HMG-coA reductase catalyse?
HMG-CoA =\> Melavonic acid + CoA
99
What effect does prolonged hypercortisolism have on blood pressure?
Raises it
100
Where are anterior pituitary hormones synthesised?
In the anterior pituitary
101
What does prolactin stimulate?
Milk production
103
Give a 4 word definition of Grave's thyroiditis
Autoimmune stimulation of thyroid
104
What is the half life of thyroxine?
7 days
105
Which cells of which organ secrete calcitonin?
Parafollicular (or C cells) of thyroid gland
106
What type of cells are in the anterior pituitary?
Glandular epithelium
107
What are thioamines used to treat?
Hyperthyroidism
108
How many carbons are there in cholesterol?
27
109
Which half of the pituitary has a neural link to the hypothalamus?
Posterior
110
What is the most abundant steroid in the body?
Cholesterol
112
Which receptor is the target of the autoimmune antibodies in Grave's disease?
Thyroid stimulating hormone receptor
113
Which hormone controls basal metabolic rate?
Thyroid hormones
114
Which hormones does gonadotropin releasing hormone stimulate?
LH and FSH
116
What are the two main functions of oxytocin?
Milk ejection from breast and uterine contractions during labour
117
In which bone does the pituitary sit?
Sphenoid bone
118
What type of cells are in the posterior pituitary?
Neural
119
What happens to follicular cells in Grave's disease?
Hypertrophy and hyperplasia
120
Name 3 visual signs in the face of someone with Cushing's syndrome
Red cheeks, acne and moon face
121
What are the 3 histological features of Hashimoto's thyroiditis?
1 Mononuclear inflammatory infiltrate 2 Abundant eosinophilic, granular cytoplasm in follicular cells 3 Intersititial fibrosis
122
Define myxoedema
Hypothyroidism causes mucopolysaccharide depositions, resulting in puffiness around eyes, chin, pretibial and exophthalmos
123
POMC is cleaved to yield what?
ACTH and beta endorphin
124
What does thyroid stimulating immunoglobulin target?
TSH receptor
125
What happens to TSH levels in iodine insufficiency?
Increases
126
What effect does aldosterone have on potassium?
Increases potassium excretion
127
What is the most potent synthetic glucocorticoid?
Dexamethasone
128
What do we call it when someone has too much cortisol?
Cushing's syndrome
129
What happens to plasma [glucose] in Cushing's syndrome?
Elevated
130
Which hormones does the adrenal cortex release?
Aldosterone, cortisol and androgens
132
What is the gold standard for diagnosing diabetes?
Glucose tolerance test
133
Which organ makes testosterone?
Testes
135
Aldosterone increases reabsorption of which ion?
Sodium
136
Which drug is used to treat hypothyroidism?
Thyroxine
137
Which half of the pituitary is linked to the hypothalamus via a capillary bed?
Anterior
138
Which thyroid hormone is more active?
T3
139
Give a 2-word definition of Conn's syndrome
Primary hyperaldosteronism
140
Where is prolactin released from?
Anterior pituitary
141
What class of drug is carbimazole?
Thioamine
142
Where is cortisol converted into cortisone?
kidney
143
Where is cortisone converted into cortisol?
Liver
144
Which drug would be used to replace missing aldosterone?
Fludrocortisone
145
Where would you find a phaeochromocytoma?
Adrenal medulla
146
## Footnote
What type of epithelium normally lines the thyroid follicles?
simple cuboidal
147
## Footnote
What is the colour of the cut surface of the normal thyroid gland?
## Footnote
Pale brownish red due to its iodine content and high vascularity
148
Follicles or Hürthle are typically seen in which condition?
Hashimoto's thyroiditis
