Endocrinology Flashcards
What is the treatment of pan-hypopituitarism?
Remove the tumour and multiple replacement therapy (gonadal steroids, adrenal steroids and thyroid hormones).
In disorders involving the pituitary gland, what are the first hormones to be affected?
Gonadotropins (FSH, LH)
What are the effects of a ADH (normally) in terms of physiological homeostasis?
Decreased osmotic pressure of blood and increased water retention.
What type of endocrine dysfunction is diabetes insipidus?
Hyposecretion
Lack of what hormone causes diabetes insipidus?
ADH/vasopressin
Name the two main symptoms of diabetes insipidus
Polyuria and polydipsia
What are the two main causes of diabetes insipidus
Neurogenic (brain/Pituitary trauma) and nephrogenic (end organ – kidney insensitivity).
What is the treatment of diabetes insipidus?
Replacement therapy with synthetic ADH analogue and nasal spray as peptides and not orally active.
Name the hypersecretion disorder of ADH
SIADH
syndrome of inappropriate ADH
Name the two main symptoms of SIADH
Decrease in frequency of urination and excessive fluid retention.
Name the causes of SIADH
Physiological (prolonged cold, stress, trauma, anxiety and pain) and pathological (ADH secreting tumour and brain disorder/damage).
Name the treatment for SIADH
Limit fluid intake and remove tumour
What is the pathophysiology of pan-hypopituitarism?
Loss of vision and peripheral field as tumour squashes optic nerves.
TSH levels be higher or lower in children with hypothyroidism
Higher, there is reduced negative feedback of T3/T4 on hypothalamus and pituitary
Name the primary and secondary causes of hypothyroidism
Primary – failure of thyroid hormone
Secondary – hypothalamic or anterior pituitary failure, autoimmune damage to gland and the lack of dietary iodine
How can hypothyroidism be treated in adults and children?
In adults lifelong replacement therapy with T4 and children thyroid replacement therapy.
Name two things the thyroid hormones do in the body
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)
Compares the symptoms of hypothyroidism and hyperthyroidism
Hypothyroidism weight gain, cold intolerance, lethargic, reduced cardiac output.
Hyperthyroidism weight loss, heat intolerance, high cardiac output.
Then the primary and secondary causes of hyperthyroidism
Primary – hypersecretory thyroid hormone
Secondary – excess TRH or TSH secretion and Graves’ disease (thyroid stimulating antibodies mimic TSH)
Is adrenaline secreted from the adrenal medulla or cortex?
Adrenaline is secreted by the adrenal medulla
What hormones are secreted by the adrenal cortex?
Cortisol and aldosterone
What causes neonatal hyperthyroidism?
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.
How do you treat hyperthyroidism in adults?
Antithyroid drugs, interfere with T3 and T4
Surgical removal or radioactive iodine (but then T4 for replacement therapy needed).
What are the symptoms of excess growth hormone?
In children giantism.
In adults acromegaly (thickening of bones and soft tissues and coarsening of features).
What is a symptom of hypopituitarism (too little growth hormone) in childhood?
Dwarfism
How do you treat giantism in children?
Surgical removal of picture a tree and then replacement therapy needed. No big need to treat though.
What hormones would you specifically look out for when diagnosing Laron syndrome?
Serum growth hormone would be higher than normal and serum infant great hormone (IGF–1) undetectable.
Describe the adrenal gland in Cushing’s disease
Adrenocortical hyperplasia (enlarged). Pituitary adenoma secreting ACTH or ectopic ACTH production.
What disorder is associated with hyposecretion of cortisol?
Addison’s disease. Autoimmune disease that causes the destruction of the adrenal cortex or infectious diseases such as tuberculosis.
Name the disorder associated with hypersecretion of cortisol
Cushing’s syndrome, raise pituitary ACTH secretion.
