Endocrinology

Question 1

What is the treatment of pan-hypopituitarism?

Answer 1

Remove the tumour and multiple replacement therapy (gonadal steroids, adrenal steroids and thyroid hormones).

Question 2

In disorders involving the pituitary gland, what are the first hormones to be affected?

Answer 2

Gonadotropins (FSH, LH)

Question 3

What are the effects of a ADH (normally) in terms of physiological homeostasis?

Answer 3

Decreased osmotic pressure of blood and increased water retention.

Question 4

What type of endocrine dysfunction is diabetes insipidus?

Answer 4

Hyposecretion

Question 5

Lack of what hormone causes diabetes insipidus?

Answer 5

ADH/vasopressin

Question 6

Name the two main symptoms of diabetes insipidus

Answer 6

Polyuria and polydipsia

Question 7

What are the two main causes of diabetes insipidus

Answer 7

Neurogenic (brain/Pituitary trauma) and nephrogenic (end organ – kidney insensitivity).

Question 8

What is the treatment of diabetes insipidus?

Answer 8

Replacement therapy with synthetic ADH analogue and nasal spray as peptides and not orally active.

Question 9

Name the hypersecretion disorder of ADH

Answer 9

SIADH

syndrome of inappropriate ADH

Question 10

Name the two main symptoms of SIADH

Answer 10

Decrease in frequency of urination and excessive fluid retention.

Question 11

Name the causes of SIADH

Answer 11

Physiological (prolonged cold, stress, trauma, anxiety and pain) and pathological (ADH secreting tumour and brain disorder/damage).

Question 12

Name the treatment for SIADH

Answer 12

Limit fluid intake and remove tumour

Question 13

What is the pathophysiology of pan-hypopituitarism?

Answer 13

Loss of vision and peripheral field as tumour squashes optic nerves.

Question 14

TSH levels be higher or lower in children with hypothyroidism

Answer 14

Higher, there is reduced negative feedback of T3/T4 on hypothalamus and pituitary

Question 15

Name the primary and secondary causes of hypothyroidism

Answer 15

Primary – failure of thyroid hormone

Secondary – hypothalamic or anterior pituitary failure, autoimmune damage to gland and the lack of dietary iodine

Question 16

How can hypothyroidism be treated in adults and children?

Answer 16

In adults lifelong replacement therapy with T4 and children thyroid replacement therapy.

Question 17

Name two things the thyroid hormones do in the body

Answer 17

Calorigenic (raise the basal metabolic rate and increase more CO2 and heat in tissues)
Cardiovascular system (raise cardiac output)
Growth and maturation (embryo development, CNS, promotes effects of GH)

Question 18

Compares the symptoms of hypothyroidism and hyperthyroidism

Answer 18

Hypothyroidism weight gain, cold intolerance, lethargic, reduced cardiac output.
Hyperthyroidism weight loss, heat intolerance, high cardiac output.

Question 19

Then the primary and secondary causes of hyperthyroidism

Answer 19

Primary – hypersecretory thyroid hormone

Secondary – excess TRH or TSH secretion and Graves’ disease (thyroid stimulating antibodies mimic TSH)

Question 20

Is adrenaline secreted from the adrenal medulla or cortex?

Answer 20

Adrenaline is secreted by the adrenal medulla

Question 21

What hormones are secreted by the adrenal cortex?

Answer 21

Cortisol and aldosterone

Question 22

What causes neonatal hyperthyroidism?

Answer 22

The mother has graves disease and maternal antibodies mimicking TSH transfer across the placenta. Once the baby is born, antibodies will die and condition will go.

Question 23

How do you treat hyperthyroidism in adults?

Answer 23

Antithyroid drugs, interfere with T3 and T4

Surgical removal or radioactive iodine (but then T4 for replacement therapy needed).

Question 24

What are the symptoms of excess growth hormone?

Answer 24

In children giantism.

In adults acromegaly (thickening of bones and soft tissues and coarsening of features).

Question 25

What is a symptom of hypopituitarism (too little growth hormone) in childhood?

Answer 25

Dwarfism

Question 26

How do you treat giantism in children?

Answer 26

Surgical removal of picture a tree and then replacement therapy needed. No big need to treat though.

Question 27

What hormones would you specifically look out for when diagnosing Laron syndrome?

Answer 27

Serum growth hormone would be higher than normal and serum infant great hormone (IGF–1) undetectable.

Question 28

Describe the adrenal gland in Cushing’s disease

Answer 28

Adrenocortical hyperplasia (enlarged). Pituitary adenoma secreting ACTH or ectopic ACTH production.

Question 29

What disorder is associated with hyposecretion of cortisol?

Answer 29

Addison’s disease. Autoimmune disease that causes the destruction of the adrenal cortex or infectious diseases such as tuberculosis.

Question 30

Name the disorder associated with hypersecretion of cortisol

Answer 30

Cushing’s syndrome, raise pituitary ACTH secretion.