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Biochemistry > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What does the posterior pituitary gland produce?

A

ADH and oxytocin

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2
Q

What are the carrier proteins for ADH and oxytocin called?

A

Neurophisins

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3
Q

Difference between anterior and posterior pituitary glands?

A

Anterior has no direct neural connection to hypothalamus

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4
Q

How does the hypothalamus communicate with the anterior gland

A

By small regulatory hormones synthesised by the hypothalamus via hypothalamic portal system

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5
Q

How do ADH and oxytocin reach the posterior gland?

A

Via nerve axons

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6
Q

What does oxytocin do?

A

Controls interuterine contractions and lactation

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7
Q

What does ADH do?

A

Enhances reabsorption of water from kidney collecting ducts

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8
Q

What is the hypothalamic portal system?

A

System allowing communication between hypothalamus and anterior

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9
Q

Name 6 hormones produced by anterior pituitary gland (FLATPG)

A 
Growth hormone
Prolactin
Thyroid stimulating hormone
Follicular stimulating hormone 
Leutinising hormone
Adrenocorticotrophic hormone
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10
Q

What organ does growth hormone act on?

A

Liver

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11
Q

What organ does FSH act on and what does it do?

A

Ovary and testes- oestrogen synthesis, oogenesis and spermatogenesis

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12
Q

What does LH act on?

A

Ovary and testes - ovulation, corpus leutheum development and testosterone synthesis

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13
Q

What does adrenocortictrophic hormone do (acth)

A

Adrenal cortex of skin- glucocorticoid synthesis- pigmentation

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14
Q

How are thyroid hormones formed?

A

In thyroid gland by iodination and coupling of tow molecules of the amino acid tyrosine

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15
Q

What is iodine in the diet used for?

A

1/3 used by thyroid gland and small amount in salivary glands- rest excreted

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16
Q

What initiates uptake of iodine from diet?

A

TSH

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17
Q

What halpens iodide within the thyroid gland?

A

It is converted to iodine

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18
Q

What happens thyroglobulin?

A

The thyrosine residues of thyroglobulin are iodine see to form mono and di-iodotyrosine (MIT and DIT)

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19
Q

What is thyroxine (T4) made of?

A

DIT and DIT coupled

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20
Q

What is triiodothyronine (T3) made of?

A

MIT and DIT

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21
Q

How are thyroid hormones released into blood? Clue= follicular cells

A

Thyroglobulin taken up into follicular cells that fuse with lysosomes to form phagocytic vacuoles. Subsequent proteolysis releases thyroid hormone

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22
Q

What is TSH?

A

28kda glycoprotein made up of an alpha and beta subunit

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23
Q

True or false: the beta subunit of TSH is found in other pituitary hormones?

A

False

24
Q

In the blood stream what does t3 and t4 bind to?

A

Thyroxine binding globulin– prevents renal loss

25
Q

True or false: only bound t3 and t4 are active

A

False- only free is active

26
Q

What is the major product of the thyroid gland?

A

T4 but is converted to the more potent T3

27
Q

What stimulates the anterior pituitary to produce TSH?

A

Thyrotrophonin releasing hormone (TRH)

28
Q

Hypothyroidism results in what?

A

Reduced t4 and increased TSH

29
Q

How common s hypothyroidism and what are the symptoms

A

1-2% lethargy slow relaxation of muscles cold intolerance

30
Q

What causes primary hypothyroid?

A

Defect within thyroid hormone secretion

31
Q

What is secondary hypothyroidism?

A

Defect within pituitary or hypothalamus

32
Q

What is hashimotos thyroiditis?

A

Primary autoimmune hypothyroidism

33
Q

What is the TSH ref range for primary hypothyroidism?

A

About 10mU/L (ref 0.3-5.5)!

34
Q

What is the ref range of fT4 in hypothyroidism?

A

Below (0-26pmol/L)

35
Q

What do patients with a TSH above the ref range and fT4 within the ref range have?

A

Sub clinical hypothyroidism

36
Q

What should u measure in patients with sub clinical hypothyroidism?

A

Thyroid peroxidase antibodies (TPO) and repeat tests every 3 mts

37
Q

What is a typical dose of thyroxine for a patient with hypothyroidism?

A

50-100 micrograms

38
Q

When would t3 be used to treat a patient?

A

In the case of myxoderma coma

39
Q

How common is congenital hypothyroidism?

A

1:4000 screened as part of new born screening programme

40
Q

What would results for secondary hypothyroidism be?

A

TSH to be normal or Low and ft4/ft3 low

41
Q

How common is hyperthyroidism? What are symptoms

A

0.5-2% of all women. Weight loss, goitre, muscle weakness

42
Q

What are the most common causes of hyperthyroidism?

A

90% Graves’ disease. Toxic multinodular goitre, toxic adenoma
Iodine containing dugs- amiodarone

43
Q

What results do you expect in hyperthyroidism?

A

Low TSH and high ft3 and ft4

44
Q

Can you get low TSH and normal t4 but high t3

A

T3- thyrotoxicosis

45
Q

What cause Graves’ disease?

A

TSH receptor antibodies

46
Q

How do u characterise subclinical hyperthyroidism

A

Low TSH but normal t3 and t4

47
Q

How do you treat hyperthyroidism?

A

Thionamide

48
Q

How could cushings disease (too much corticosteroid) alter TFTs

A

Cushings can result in reduced TBG which can alter levels of free t3 and t4

49
Q

True or false: TSH can fall during acute phase illness and rise during recovery

A

True

50
Q

What effect do corticosteroids have on TFTs

A

Suppress TSH

51
Q

What effect does Lithium cabimizole and thiouricils have

A

Inhibit t3 and t4

52
Q

What effect do oestrogen have?

A

Increase TBG concentration

53
Q

Hat effect does androgens have

A

Reduce TBG

54
Q

What effect do the antiinflammatories salicitates have?

A

Compete with t4 for TBG binding

55
Q

Effect of amiodarone (heart medication)?

A

Inhibits conversion of t4 to t3, inhibits t4 cellular uptake

Biochemistry (8 decks)

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