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Nick's MD1 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What will you cause if you prescribe your patient too much hydrocortisone?

A

Cushing’s syndrome

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2
Q

Which layer of the adrenal cortex synthesises aldosterone?

A

Glomerulosa

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3
Q

Which half of the pituitary has a vascular link to the hypothalamus?

A

Anterior

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4
Q

What class of drug is propylthiouracil?

A

Thioamine

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5
Q

Which hormone mediates the effects of growth hormone?

A

IGFs

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6
Q

What is another name for somatotropin?

A

Growth hormone

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6
Q

Which half of the pituitary is the neurohypophysis?

A

Posterior

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6
Q

Where is oxytocin synthesised?

A

Hypothalamus

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6
Q

Where is ADH synthesised?

A

Hypothalamus

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6
Q

Which hypothalamic nuclei send axons to the posterior pituitary?

A

Supraoptic and paraventricular nuclei

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6
Q

Which hormone inhibits prolactin release?

A

Dopamine

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6
Q

What causes acromegaly?

A

Overproduction of growth hormone during adulthood

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6
Q

What effect does T3 have on basal metabolic rate?

A

Increases

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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

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6
Q

Give a 4 word definition of Hashimoto’s thyroiditis

A

Autoimmune destruction of thyroid

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6
Q

What happens to TSH levels in Hashimoto’s thyroiditis?

A

Increased

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6
Q

What is the gross pathology of the thyroid gland in Grave’s disease

A

Diffuse symmetrical enlargement

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6
Q

What type of hypersensitivity is Grave’s disease?

A

Type 2 = antibody mediated

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6
Q

What effects does cortisol have on carbohydrate metabolism?

A

Increases gluconeogenesis and increases serum glucose levels

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6
Q

Which cells secrete testosterone?

A

Leydig cells of testis

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6
Q

What does leuprorelin inhibit?

A

FSH and LH release

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6
Q

Give a 1-word definition of Cushing’s syndrome

A

Hypercortisolism

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6
Q

What is pheochromocytoma?

A

Tumour of adrenal medulla causing hypersecretion of catecholamines

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6
Q

Which cells does cortisol act on?

A

Nearly every cell in the body

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7
Q

What causes cretinism?

A

Insufficient maternal iodine during pregnancy

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8
Q

What effect does long term treatment with cortisol have on ACTH?

A

Decreases it

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9
Q

What is another name for somatomedins?

A

IGFs

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10
Q

What is the autoimmune condition in which stimulatory autoantibodies cause increased secretion of thyroxine?

A

Grave’s disease

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10
Q

Which hormones are released from the posterior pituitary?

A

ADH and oxytocin

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10
Q

Which gland releases insulin like growth factor?

A

Liver

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10
Q

What effect does T3 have on the sympathetic nervous system?

A

Sympathomimetic

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10
Q

If someone is hot all the time, what is their likely thyroid state?

A

Hyperthyroid

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11
Q

Where is the only place in the body that adrenaline is synthesised?

A

Adrenal medulla

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12
Q

What happens to TRH levels in Grave’s disease?

A

Decreased

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12
Q

What happens to TSH levels in secondary hypothyroidism?

A

Decreases because of pituitary or hypothalamic damage

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12
Q

What happens to TSH levels in primary hyperthyroidism?

A

Decreased

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13
Q

How are thyroid hormones transported in the blood?

A

Bound to thyroid binding globulins (TBG)

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14
Q

Which organs primarily make oestrogen and progesterone?

A

Ovaries and placenta

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16
Q

What is the active ingredient in betadine?

A

Iodine

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18
Q

Which classes of hormones are lipophilic?

A

Steroids and thyroid hormones

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19
Q

Aldosterone increases excretion of which ion?

A

Potassium

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21
Q

Which amino acid are amine hormones derived from?

A

Tyrosine

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22
Q

Which inflammatory enzymes do glucocorticosteroids suppress the synthesis of?

A

PLA-2, iNOS and COX-2

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24
Q

What effect does cortisol have on the immune system?

A

Supresses it

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25
Q

Which hormone inhibits release of growth hormone?

A

Somatostatin

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26
Q

Name 3 visual signs on the body (not face) of someone with Cushing’s syndrome

A

Striae (stretch marks). Fat pads behind neck. Abdominal adiposity.

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27
Q

What are three complications of treatment with thioamines?

A

Goitre, hepatotoxicity and agranulocytosis

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28
Q

What is the RDI for iodine?

A

150 ug

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28
Q

When do cortisol levels peak?

A

Morning

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29
Q

Which hormones does the adrenal medulla release?

A

Adrenaline and noradrenaline

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30
Q

What causes gigantism?

A

Overproduction of growth hormone before puberty

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31
Q

Which class of drugs can be used to treat hyperthyroidism?

A

Thioamines

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32
Q

What are the 2 gonadotropins?

A

LH and FSH

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33
Q

Which foods are particularly naturally rich in iodine?

A

Sea fish, crustaceans and kelp

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34
Q

How is Hashimoto’s thyroiditis managed?

A

Thyroxine

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36
Q

Give a 4-word definition of Cushing’s disease

A

Pituitary adenoma causing hypercortisolism

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37
Q

Which thyroid hormone is released in greater amounts?

A

T4

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38
Q

What happens to TSH levels in primary hypothyroidism?

A

Increases

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40
Q

Which hormone stimulates release of ACTH?

A

Corticotropin releasing hormone

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42
Q

Which hormones are decreased in Addison’s disease?

A

Aldosterone and cortisol

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43
Q

Which hormone does growth hormone stimulate?

A

Insulin like growth factor 1 (IGF-1)

44
Q

Which challenge test can be used for assessing adrenal gland function?

A

Dexamethasone suppression test

45
Q

What effect does aldosterone have on sodium?

A

Increases sodium reabsorption

46
Q

What effect will aldosterone deficiency have on potassium?

A

Increase in plasma [K+]

47
Q

What will happen if you have too much iodine?

A

Goitre

48
Q

List 4 main functions of glucocorticoids

A

Stimulate gluconeogenesis in liver. Mobilise amino acids from muscle. Stimulate lipolysis from adipose tissue. Immunosupression

49
Q

Which organ does prolactin act on?

A

Breast

50
Q

What is the pathway for thyroxine release?

A

TRH => TSH => T4

51
Q

What may be the result of severe lack of maternal iodine during pregnancy?

A

Cretinism

52
Q

What is cortisone?

A

A metabolite of cortisol that is almost biologically inactive

54
Q

What is hydrocortisone?

A

Cortisol

55
Q

Which hormones can increase the release of growth hormone?

A

Ghrelin and growth hormone release hormone

56
Q

What happens to TSH levels in Grave’s disease?

A

Decreased

57
Q

What connects the pituitary to the hypothalamus?

A

Infundibulum

59
Q

Which layer of the adrenal cortex produces sex steroids?

A

Reticularis

60
Q

What happens to T4 levels in Grave’s disease?

A

Elevated

61
Q

Which hormone is used in the home pregnancy test?

A

human chorionic gonadotropin (hCG

62
Q

Why don’t we often do thyroid biopsies?

A

It is very vascular => risk of bleed

63
Q

Which hormone stimulates prolactin release?

A

PRF = prolactin releasing factor

65
Q

What is suggested by the presence of anti-thyroid peroxidase antibodies?

A

Hashimoto’s thyroiditis

66
Q

If someone is cold intolerant, what is their likely thyroid state?

A

Hypothyroid

67
Q

Which antibodies are generated in Hashimoto’s thyroiditis?

A

Anti-thyroglobulin and anti-thyroid peroxidase

68
Q

In which condition is there autoimmune destruction of the adrenal cortex?

A

Addison’s disease

70
Q

Which cells of the adrenal medulla secrete catecholamines?

A

Chromaffin cells

71
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

72
Q

Which enzyme iodinates thyroglobulin?

A

Thyroid peroxidase

73
Q

Which half of the pituitary is the adenohypophysis?

A

Anterior

74
Q

What is the autoimmune condition in which the thyroid gland is attacked?

A

Hashimoto’s thyroiditis

75
Q

What is endogenous hydrocortisone called?

A

Cortisol

77
Q

What do we call cortisol when it is given as a drug?

A

Hydrocortisone

79
Q

Which hormone causes epiphyseal plates to close?

A

Oestrogen

80
Q

Which layer of the adrenal cortex synthesises cortisol?

A

Fasciculata

82
Q

What is the most active endogenous glucocorticoid?

A

Cortisol

83
Q

Give a 3 word definition of goitre

A

Enlarged thyroid gland

84
Q

Where in the body is hydrocortisone synthesised?

A

Nowhere - hydrocortisone is a drug so it’s probably made in Germany

86
Q

What are the 6 hormones released from the anterior pituitary?

A

TSH, LH, FSH, prolactin, growth hormone, ACTH

87
Q

How is iodine taken up into thyroid cells from the bloodstream?

A

Sodium iodine symport

88
Q

What are the 3 layers of the adrenal cortex from superficial to deep?

A

GFR Glomerulosa Fasciculata. Reticularis

90
Q

What is the pathway for cortisol release?

A

CRH => ACTH => cortisol

91
Q

Where is thyroid stimulating hormone synthesised?

A

Anterior pituitary

93
Q

Which protein is iodinated to synthesise T3 and T4?

A

Thyroglobulin

94
Q

What’s the most common cause of goitre?

A

Iodine deficiency

95
Q

Where is thyroid releasing hormone synthesised?

A

Hypothalamus

96
Q

What is the half life of cortisol?

A

60-90 mins

98
Q

Which reaction does HMG-coA reductase catalyse?

A

HMG-CoA => Melavonic acid + CoA

99
Q

What effect does prolonged hypercortisolism have on blood pressure?

A

Raises it

100
Q

Where are anterior pituitary hormones synthesised?

A

In the anterior pituitary

101
Q

What does prolactin stimulate?

A

Milk production

103
Q

Give a 4 word definition of Grave’s thyroiditis

A

Autoimmune stimulation of thyroid

104
Q

What is the half life of thyroxine?

A

7 days

105
Q

Which cells of which organ secrete calcitonin?

A

Parafollicular (or C cells) of thyroid gland

106
Q

What type of cells are in the anterior pituitary?

A

Glandular epithelium

107
Q

What are thioamines used to treat?

A

Hyperthyroidism

108
Q

How many carbons are there in cholesterol?

A

27

109
Q

Which half of the pituitary has a neural link to the hypothalamus?

A

Posterior

110
Q

What is the most abundant steroid in the body?

A

Cholesterol

112
Q

Which receptor is the target of the autoimmune antibodies in Grave’s disease?

A

Thyroid stimulating hormone receptor

113
Q

Which hormone controls basal metabolic rate?

A

Thyroid hormones

114
Q

Which hormones does gonadotropin releasing hormone stimulate?

A

LH and FSH

116
Q

What are the two main functions of oxytocin?

A

Milk ejection from breast and uterine contractions during labour

117
Q

In which bone does the pituitary sit?

A

Sphenoid bone

118
Q

What type of cells are in the posterior pituitary?

A

Neural

119
Q

What happens to follicular cells in Grave’s disease?

A

Hypertrophy and hyperplasia

120
Q

Name 3 visual signs in the face of someone with Cushing’s syndrome

A

Red cheeks, acne and moon face

121
Q

What are the 3 histological features of Hashimoto’s thyroiditis?

A

1 Mononuclear inflammatory infiltrate 2 Abundant eosinophilic, granular cytoplasm in follicular cells 3 Intersititial fibrosis

122
Q

Define myxoedema

A

Hypothyroidism causes mucopolysaccharide depositions, resulting in puffiness around eyes, chin, pretibial and exophthalmos

123
Q

POMC is cleaved to yield what?

A

ACTH and beta endorphin

124
Q

What does thyroid stimulating immunoglobulin target?

A

TSH receptor

125
Q

What happens to TSH levels in iodine insufficiency?

A

Increases

126
Q

What effect does aldosterone have on potassium?

A

Increases potassium excretion

127
Q

What is the most potent synthetic glucocorticoid?

A

Dexamethasone

128
Q

What do we call it when someone has too much cortisol?

A

Cushing’s syndrome

129
Q

What happens to plasma [glucose] in Cushing’s syndrome?

A

Elevated

130
Q

Which hormones does the adrenal cortex release?

A

Aldosterone, cortisol and androgens

132
Q

What is the gold standard for diagnosing diabetes?

A

Glucose tolerance test

133
Q

Which organ makes testosterone?

A

Testes

135
Q

Aldosterone increases reabsorption of which ion?

A

Sodium

136
Q

Which drug is used to treat hypothyroidism?

A

Thyroxine

137
Q

Which half of the pituitary is linked to the hypothalamus via a capillary bed?

A

Anterior

138
Q

Which thyroid hormone is more active?

A

T3

139
Q

Give a 2-word definition of Conn’s syndrome

A

Primary hyperaldosteronism

140
Q

Where is prolactin released from?

A

Anterior pituitary

141
Q

What class of drug is carbimazole?

A

Thioamine

142
Q

Where is cortisol converted into cortisone?

A

kidney

143
Q

Where is cortisone converted into cortisol?

A

Liver

144
Q

Which drug would be used to replace missing aldosterone?

A

Fludrocortisone

145
Q

Where would you find a phaeochromocytoma?

A

Adrenal medulla

146
Q

What type of epithelium normally lines the thyroid follicles?

A

simple cuboidal

147
Q

What is the colour of the cut surface of the normal thyroid gland?

A

Pale brownish red due to its iodine content and high vascularity

148
Q

Follicles or Hürthle are typically seen in which condition?

A

Hashimoto’s thyroiditis

Nick's MD1 (28 decks)

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