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Clin Sci 3 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

3 Action of hormones

A

Endocrine action- hormone is distributed in the blood and binds to distant target cells e.g insulin

Paracrine action- the hormone acts locally by diffusing from its source to target cells in the neighbourhood e.g prostaglandins

Autocrine action- the hormone acts on the same cell that produced it e.g growth hormone for cancer cells

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2
Q

difference between fat soluable and water soluable

A

fat soluable- slow acting, long half life e.g steroid

water soluable- fast acting, short half-life e.g insulin and adrenaline

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3
Q

Pineal Gland

A
  • synthesises and secretes melatonin, serotonin
  • communicates info about environmental lighting to various parts of the body
  • melatonin can entrain biological rhythms, has important effects on reproduction function
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4
Q

Pituitary Gland

A

Master gland of the body

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5
Q

Anterior pituitary hormones

A
  • Growth hormone
  • Thyroid-stimulating hormone
  • adrenocorticotropic hormone
  • prolactin
  • luteinizing hormone
  • follice- stimulating hormone
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6
Q

Posterior pituitary hormones

A

ADH

oxytocin

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7
Q

Growth hormone

A

Target organ: liver, adipose tissue

Promotes growth and control of metabolism of lipids, proteins and carbs

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8
Q

Prolactin

A

Target organ: mammary glands

Milk production

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9
Q

Luteinizing hormone and follicle-stimulating hormone

A

Target organs: ovary and teste

Control of reproductive system

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10
Q

ADH

A

Target organ: kidneys

Conservation of water

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11
Q

Oxytocin

A

Target organ: ovary and testis

Stimulates milk ejection and uterine production

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12
Q

Hypothalamus

A

Power behind the throne

It releases and inhibits hormones,reflecting their on anterior pituitary hormones

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13
Q

Thymus function

A

Secretes hormones that regulate development and later activation of T lymphocytes

Shrinkage after puberty

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14
Q

Thyroid gland

A

Largest endocrine gland, has highest blood flow
Anterior and lateral sides
Produces T3,T4 via converting iodine into thyroid hormones
Calcitonin

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15
Q

Calcitonin

A

Cells produce calcitonin that decrease blood ca2+, promotes ca2+ deposition and bone formation

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16
Q

Thyroxine (T3,T4)

A

Regulated by anterior pituitary
Increases body’s metabolic rate, o2 consumption
Increase heat production, HR, increase contraction strength, increase RR
Stimulates appetite and breakdown, CHO,lipids and proteins

Has a negative feedback control, increase in conc in the blood, decrease in TSH,TRH

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17
Q

Parathyroid glands

A

Maintain calcium and phosphate levels

Produces PTH and calcitonin

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18
Q

PTH (parathyroid hormone)

A

Increase calcium

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19
Q

Adrenal medulla

A

Makes catecholamines, adrenaline and noradrenaline

This then
Increases BP, HR,blood flow to skeletal muscles
Increases pulmonary airflow
Decreases digestion and urine formation
Stimulates glycogenesis,glyconeogenesis, glycogenolysis

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20
Q

Adrenal cortex

A

Releases
Mineralocorticoids- control electrolyte balance e.g aldosterone( na+ retention, k+ retention)

Glucocorticoids- e.g cortisol, stimulates fat/protein catabolism, gluconeogenesis, release of fatty acids/glucose into the blood, anti-inflammatory effect, immune suppression with long term use

Sex steroids- androgens and estrogen- important after menopause

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21
Q

Pancreas

A

Position: retropertoneal, inferior and dorsal to stomach
98% of organ produces digestive enzymes
Releases insulin

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22
Q

Insulin

A

Secreted after a meal so that carbs can increase glucose blood levels
Stimulates glucose and amino acid uptake
Nutrient storage effect
Antagonises glucagon

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23
Q

Ovary

A

Estradiol- granuolosa cells in ovarian follicle secrete it in first half of menstrual cycle and again after ovulation

Progesterone- secreted after ovulation for 12 days

Inhibin- suppress FSH secretion

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24
Q

Functions of estradiol and progesterone

A

Development of reproduction system and physique
Regulation of menstrual cycle, sustain pregnancy
Prepare mammary glands for lactating

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25
Q

Testes

A

Secrete testosterone and estrogen for development of reproductive system, sperm production and sex drive

Sertoli cells secrete inhibit to decrease FSH secretion and stabilise sperm

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26
Q

Ss of inappropriate ADH secretion

A 
Anorexia
Nausea
Cheyenne-strokes resp pattern
Muscle aches
Tremors
MS
infection
Haemorrhage
Pneumonia
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27
Q

Neurogenic diabetes inspididus

A

Deficiency in ADH secretion from posterior pituitary
OR production in hypothalamus

results in lack of circulating ADH

can be caused by head trauma, stroke, hypothalamic/pituitary tumor,surgery, infection

28
Q

Nephrogenic diabetes inspididus

A

improper response to ADH in the kidneys
caused by renal disease/failure

ss: thirst, polyuria, dehydration

29
Q

Hypopituitarism

A

Lack of secretion of some of the vital hormones that the pituitary produces

Can be caused by
tumors, infection, inflammation, Post-partum haemorrhage, traumatic head injury, radiation, congenital abnormality

such as 
ACTH
TH
LH & FSH
GH
Prolactin
30
Q

Panhypopituitarism

A

All hormones affected

31
Q

Hyperpituitarism

A

hypersecretion of pituitary hormones

4 common types

  • Prolactinoma
  • Corticotropinoma
  • Somatotropinoma
  • Thyrotropinoma
32
Q

Hyperpituitarism (Prolactinoma)

A

benign of the pituitary gland
most common
hypersecretion of prolactin

ss: amenorrhoea, increase milk production, vertigo, loss of pubic hair, nausea and vomiting, erectile dysfunction
treatment: dopamine antagonist drugs

33
Q

Hyperpituitarism (Corticotropinoma)

A

Also known as Cushings disease

Increase in ACTH secretion
usually a result of pituitary adenoma or excess corticotropin-releasing hormone being secreted by the hypothalamus

SS: weight gain, increase hair growth, moonshaped face, insomnia, irregular menstruation, fatigue, depression,

treatment: removing tumor, radiation therapy, adrenalectomy

34
Q

hyperpituitarism ( Somatotropinoma)

A
  • hypersecretion of GH
  • causes giantism in children by a pituitary adenoma which leads to excess growth of long bones,hands, feet resulting in extreme height
  • Causes Acromegaly in adults, usually results in severe disfigurement, enlargement of hands and feet, CNS impairment, diabetes, hypermetabolism, weakness, HT, atherosclerosis
    treatment: Somatostatin, dopamine agonists, GH receptor antagonist, surgery and radiation therapy
35
Q

hyperpituitarism (Thyrotropinoma)

A

characterised by hypersecretion of thyroid-stimulating hormone
mostly caused by a pituitary adenoma
results in hyperthyroidism

36
Q

Hyperthyroidism

A

increase production/hypersecretion of thyroid hormone

causes 
toxic adenoma
inflammation of thyroid
amiodarone admin
excessive iodine uptake
37
Q

Graves disease

A
  • increase production of T4 + enlargement of thyroid gland
  • occurs due to TSH immunoglobins, binding to the TSH receptors on the thyroid gland, stimulates the secretion of thyroid hormones
  • Pituitary gland reacts to this high level of circulating TH, supresses the addtional secretion of TSH

SS: tachy,AF,HT, goitre, tremors, palpitation, fatigue, Increase RR, weightloss, heat intolerance, irregular menstruation

treatment: antithyroid drugs, radio-iodine, thyroidectomy

38
Q

Thyrotoxic Crisis/ Thyroid Storm

A

rare but life threatening
complication of hyperthyroidism

Characterised by

  • high fever
  • tachycardia/tachyarrythmias
  • vomiting
  • agitation/ irritability
  • MI/heart failure

treatment: antithyroid drugs, beta blockers, corticosteriods, mechanical ventilation, inorganic iodine

39
Q

Hypothyroidism

A

Malfunction of hypothalamus, pituitary, thyroid gland in producing TH

40
Q

Primary causes of Hypothyroidism

A
  • thyroid gland disorder
  • thyroidectomy
  • amyloidosis
  • sarcoidosis
  • cretinism
  • hashimoto thyroiditis
41
Q

Secondary causes of Hypothyroidism

A
  • failure to stimulate normal thyroid function
  • inadequate production of TH
  • pituitary failure to produce TSH
  • hypothalamic failure to produce TRH
  • iodine deficiency
42
Q

Cretinism

A

cogenital deficiency of TH usually as a result of maternal hypothyroism

can lead to deficiency of embryonic/neonatal life and incorrect development of thyroid gland

SS: physical/ mental retardation
delayed bone maturation/puberty
neurological/cognitive impairment

treatment: exogenous thyroxine

43
Q

Hashimoto Thyroidosis

A

caused by an autoimmune response
thyroid cells are attacked, gradual destruction of follicles

ss fatigue, weight gain, feeling cold, joint/muscle pain, bradycardia, depression,fertility issues

risk factors
neonatal resp distress, low birth weight, preterm delivery, miscarriage

treatment TH replacement drugs

44
Q

Thyroid Carcinoma

A

thought to be caused by genetic/ environmental factors

ss
neck pain, changes in voice, signs of nodules

treatment
thyroidectomy, TSH supression therapy

45
Q

Myxoedema Coma

A

decompensated hypothyroidism
precipitated by a stressful event such as illness, MI, stroke

SS
ACS, hypoventilation, hypothermia, hypoxia, hypoglycaemia, hypercapnia, bradycardia

46
Q

Hyperparathyroidism

A

increase secretion of PTH from one or more of the 4 glands

results in hypercalcaemia, hypophospataemia

47
Q

Primary causes of Hyperparathyroidism

A

hyperfunction of parathyroid gland

ss
polyuria, chronic low back pain, osteopenia, osteoporosis, pancreatitis, kidney stones, muscle weakness

causes
tumor, hyperplasia, CCF, PE

treatment
removal,calcimetics,

48
Q

Secondary causes of hyperparathyroidism

A

secretion of PTH in a normal fashion in response to hypocalcaemia

SS
osteomalacia, defective mineralisation/calcification of bones, ss of calcium imbalances

caused by
Vit D deficiency, chronic renal failure. decrease in levels of calcium

49
Q

hypoparathyroidism

A

decrease function of parathyroid glands resulting in hyposecretion of PTH resulting in hypocalcaemia, hyperphosphatemia

ss
paraesthesia, seizures, bronchospasms, insomnia, bone pain, muscle cramps, abdo pain, arrythmias, headache

causes
trauma, autoimmune destruction, Digeorge syndrome

treatment
IV calcium, Vit D and calcium supplements, injection in PTH

50
Q

Cushings syndrome

A

chronic hypercortisolism
rare, more common
abnormally high circulating level of glucocorticosteriod hormones

causes
tumor, prolonged administration of corticosteriod drugs

ss
central obesity, thinning skin, osteoporosis, acne, menstrual irregularity, muscle atrophy, purple stretch marks, sleep disturbances

treatment
ceasing any corticosteriod treatment
removal of tumor, bilateral adrenectomy, admin of drugs + inhibits cortisol secretion

51
Q

hyperaldosteronism

A

increase secretion of aldosterone by adrenal glands
results in hypokalaemia and alkalosis

causes
crohns syndrome
hyperplasia
overactivity of renin-aldosterone-angiotensin system
stenosis
tumor

ss
HT, headache, muscle spasm, fatigue, polyuria, polydipsia, metabolic acidosis

treatment
removal of adenoma spironolactone

52
Q

Pneochromocytoma

A

tumor of adrenal medulla, hypersecretion of catecholamines, results in hyperactivity of SNS

ss
HT,tachy, anxiety, pallor, weight loss, palpitation, diaphoresis, headaches, hyperglycaemia

treatment
removal of tumor, adrenalectomy, admin of irreversible adrenoreceptor blocker,

53
Q

Adrenal insufficiency

A

decrease secretion of adrenal steroids

causes
addison disease
sepsis
tuberculosis
impairment of pit/hypothalamic gland

ss
fatigue, HT, weight loss, nausea and vom, diaphoresis, fever, headache, hyperpigmentation of skin

treatment
HRT, injectible cortisol, vasopressor therapy, IV Saline, Dextrose, glucosteriods

54
Q

Addison crisis/ adrenal crisis

A

collection of SS indicating severe adrenal insufficiency

ss
sudden pain
seizure
slurred speech
confusion
severe vomiting
hypoglycaemia
hypekalemia
fever
55
Q

Glucagon

A

Alpha cells
increas blood glucose levels
stimulates liver to release glucose stores from glycogen
stimulates gluconeogenesis by breaking down fats and fatty acids

56
Q

insulin

A

beta cells
decrease in blood glucose levels
increase in glucose transportation into cells, increase glucose metabolism by cells, increase liver glycogen stores

57
Q

Somatostatin

A

produced in delta cells
inhibits secretion of insulin
regulates cell of pancreatic islet
inhibits release of GH from the pituitary gland

58
Q

Type 1 Diabetes Mellitus

A

Deficiency in insulin secretion,resulting in hyperglycaemia

caused by
decrease of B cells in pancreas
autoimmune mediated

ss polyuria, lethargy, polyphagia, decrease in weight loss, dry mouth, diabetic ketoacidosis

59
Q

Diabetes Type II

A

deficiency in insulin secretion/ insulin resistance resulting in hyperglycaemia
inappropriate release of glucose into blood from liver

causes
lifestyle
obesity
genetics

ss blurred vision, poluria, polydipsia, weight loss, fatigue, recurrent infection,

treatment
lifestyle intervention, weight loss surgery, anti diabetic,hypoglycaemic agents

60
Q

Diabetic Ketoacidosis

A

Shortage of insulin, often precipiated by an underlying cause
Circulation of fatty acids, glucagon, adrenaline,ketone bodies=ACIDOSIS

bicarbonate buffering system attempts to compensate and maintain homeostasis but quickly overwhelmed

ss
nausea, vom, HT,tachy, dehydration, cerebral oedema, confusion, lethargy, fruity breath
POLYDIPSIA
POLYURIA
POLYPHAGIA

treatment
fluid replacement, airway mx, insulin, glucose,

61
Q

Hyperosmolar hyperglycaemia state

A

results in osmotic diruesis but in the absence of ketone bodies
usually occurs in T2 DM pt who still secrete enough insulin to mitigate to formation of ketone bodies

ss
hyperglycaemia, polyuria, dehydration, seizure, coma, death, sensory/motor impairment

treatment
IV fluid
electrolyte replacement

62
Q

Diabetic retinopathy

A

damage to retina with prolonged hyperglycaemia or poorly controlled BSL in diabetic pt

can cause blindness

63
Q

Diabetic neuropathy

A

nerve damage secondary to poorly controlled diabetes
results of poor vascular supply to nerve endings

ss
dizziness, dysphagia, nerve pain, sexual dysfunction, speech impairment

64
Q

Diabetic nephropathy

A

progressive renal impairment/damage caused by damage to the blood vessels in the glomeruli
scarring of the glomeruli

ss
tiredness, headache, nausea and vomiting, frequent urination, lower limb oedema

65
Q

Diabetic Cardiomyopathy

A

ventricular dilation, enlargement of heart cells, decrease systolic function, interstitual fibrosis

caused by vascular disease, neuropathy, metabolic alterations, alteration of ion homeostatis

66
Q

microvascular disease

A

results from prolonged hyperglycaemia

Clin Sci 3 (6 decks)

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