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PA3305- Mod 10 > Endocrinology (7) > Flashcards

Endocrinology (7) Flashcards

1
Q

causes of true endocrine disorders (3)

A
  1. Undersecretion or receptor problem (XY, testicular feminization)
  2. Hyperplasia (enlargement of endocrine gland)
  3. Over secretion (bushings)
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2
Q

lab tests for hormone diseases (3)

A
  1. measurement on horomone conce
    - -if high=supress then measure
    - -if low= stim then measure
  2. Imaging organ producing horomones
  3. Serum autoantibody measurement for cause
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3
Q

hormone measurement methods (3)

A

Bioassays measure bioactivity (gold)
Immunoassays for peptide hormones
Mass spectrometry

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4
Q

hormones measured from hypothalamus(1), Pituitary(5), Throid (3), Adrenal (4)

A

hypothalmus- ADH

Pituitary- ACTH,TSH,GH,LH,FSH,Prolactin

Thyroid- t4,T3, calcitonin

Adrenal- sex, cortisol, aldosterone, catechoamines

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5
Q

hypothalamic disease causes (4)

A

anatomic abnormality
tumor
severe head injury
post surgical

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6
Q

what does the ant pituitary release

A 
Thyroid stim hormone
adreno cortical h
luteinizing h
follicle stim
growth hormone
prolactin
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7
Q

what are the post pituitary horomones

A

ADH (urinary retention)

Oxytocin

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8
Q

ADH causes what in acute and chronic def

A

diabetes insipidus

acute- develop in pt with known pituitary disease as result of surgery/radiotherapy

chronic- more than 1 month (perminent disease)

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9
Q

Causes of diabetes insipidus (4)

A

pituitary and hypothalmic tumors
latrogenic (surgery)
idiopathic
kidney tubule resistance to ADH

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10
Q

hypopituitarism- s/s actute and chronic

A

acute- fatigue, weakness, dizziness, nausea etc

chronic- tiredness, pallor, anorexia, weight loss

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11
Q

causes of hypopituitarism

A

Tumor (mc)
infarction
tauma
cong

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12
Q

Hormones released into blood in hyperpituiritism tumor

A 
prolactin (50% of tumors)
GH
ACTH (cushings)
LH/FSH
non functional (20%)
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13
Q

what does hyperprolactinaemia cause

A
  • infertility

- visual probs

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14
Q

possible causes of smallness

A
  • primary hypothyroidism
  • glucocorticoid excess
  • hypopituitarism
  • growth hormone decreased
  • growth hormone resistance
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15
Q

lab assessmentt of GH

A

Stim tests using: Arganine, insuline, clonidine, l dopa etc

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16
Q

What is turners syndrome

A

low GH causing small stature

  • webbed neck
  • widley spaced nips
  • coartication of aorta
  • wide carrying angle
  • primary amenorrhea
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17
Q

Growth hormone excess diseases/ could be due to (4)

A
  • pituitary tumor
  • congenital adrenal hyperplascia
  • hyperthyroidism
  • klinefelter syndrome
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18
Q

Adverse effects of GH therapy

A 
Creutzfeldt jacob disease
lukemia/cancer incidence
acromegaly
personality changes
SCFE
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19
Q

Acromegaly hormone causes

A

GHRH increases GH
Somatostatin decreases GH
most effect of GH is seen after GH metabolism to IGF1

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20
Q

how to test for GH disease

A

inhibit GH and see if oral glucose response causes no response

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21
Q

if thyroid disease is in your genes what symptoms will u see

A

premature graying hair
hair loss
left handedness
dyslexia in males

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22
Q

thyroid function and control

  • what is released and what does it stim
  • feedback
A

thyrotropin releasing hormon stims TSH from ant pituitary

-free t3/t4 supresses TRH

23
Q

biologically active from of thyroid hormones

A

t3
t4

-t3 is 3-4x more biologically active

24
Q

thyroid functioning testing

A

Serum/plama TSH - usually the only test needed

Free T4- confirmatory test

25
Q

key aspect with thyroid disease and lab data

A

Can be thyroid disease w normal serum thyroid hormone levels as there is a lag phase (lots of thyroid hormone is stored in fate)

26
Q

clinical features of hypothyroid

A 
letharygy, fatigue, sleepiness
slow pulse
cold intolerance
weight gain 
dryness
hoarness
27
Q

etiology of hypothroid

A

autoimmune destruction of thyroid (hashimoto)
surgical tx
radiation of thyroid
hypopituitarism

28
Q

mayo clinic testing protocol TSH

A

undetected- hyperthyroid
sub normal- borderline
normal seum TSH- no more tests
Increased serum TSH-hypothyroid

29
Q

hashimotos thyroiditis- age, gender etc

A 
older W (W;M 10:1)
in 50% of Hashimotos the thyroid becomes under active
30
Q

in systemic illness serum TSH is what

A

TSH is decreased

31
Q

clinical features of hyperthyroidism

A 
Heat intolerence
weight loss
palpitations
fatigue
Exophthalmos (usually women 20-45 years of age complain or sore, gritty eyes, irritability etc
32
Q

causes of hyperthroid

A

diffuse toxic goiter (graves disease)
Solitary or multiple toxic adenoma
thyroiditis
iodine/iodine containing drugs

33
Q

What are thyrotropic-receptor antibodies

A

IgG against TSH receptors seen in Graves disease

34
Q

How to test for thyroid cancers

A

Tests for Serum TSH

Then i131 uptake

35
Q

Adrenocorticotrophin (ACTH) release from pituitary is caused by

A

corticotropin releasing horomone from hypothalamus in respnse to:

  • cortisol decrease in plasma
  • stress
  • glucose decrease
  • bac pyrogens
36
Q

outer/middle/inner layers of adrenal and what they make

A

outer- zona glomerulosa= aldosterone

middle- zona fasciculata= corticosteroids, androgens, oestrogens

Inner- zona reticularis= corticosteroids, androgens oestrogen

medulla makes catecholamines

37
Q

Hypoadrenalism (addisons disease) s/s

A
  • low blood pressure
  • low plasma sod
  • high plasma pot
  • low plasma cortisol
  • letharagy
  • anorexia
  • pigmintation of hand creases
38
Q

hypoadrenalism etiology (3)

A

Autoantibodies (mc)

Infections

Long term steroid use

39
Q

Hypoadrenalism (addisons) lab abnormalities

A 
Serum Na decreased
Serum K increased
No serum cortisol response to ACTH
low serum glucose
serum urea increased
40
Q

Hyperadrenalism hormones to note

A

cortisol
adosterone
adrenal androgens

41
Q

Cortisol effects (5)

A
  1. gluconeogenesis
  2. Increased pro breakdown
  3. anti inflammatory
  4. Haematopoiesis
  5. lipolysis
42
Q

what is hypercosticsol called and population

A

Cushings syndrome

Male to femal 1:4

43
Q

Hypercostisolism symptoms

A
  • increased abdominal fat 94%
  • high blood pressure 82%
  • Secondardy diabetes mellitues 85%
  • Sexual malfunction 75%
  • Baldness and facial hair in women 75%
44
Q

Causes of hypercortisolism (5)

A 
Pituitary tumor (cushings)
Adrenal tumor (cushings)
Lung tumor (ectopic acth)
iatrogenic
stress
45
Q

lab dx in hypercostisol

A

serum cortisol increased
low dose dexamethasone used to supress serum cortisol, Then high dose dexamethasone to supress serum cortisol (to distinguish cushings disease from syndrome)

46
Q

How to tell cushings disease from ccushings syndrome

A

ACTH iis increased in CD but not in syndrome

47
Q

cushings syndrome symptoms

A 
face changes
buffalo hump
cardiac probs
obesity
purple stretch marks
48
Q

hyper adrenal symtoms

A

ovarian or adrenal carcinomas give excess androgens (hair on face and virillization in women)

  • polydipsia/polyuria
  • weakness/mm cramps
  • mild to mod high bp
49
Q

Adosterone excess primary (lab, cause)

A

rare

-serum aldosterone increased and serum renin decreased

50
Q

Aldosterone excess secondary lab

A

serum aldosterone and serum renin increased

51
Q

adrenal hyperplasia screening tests + confirmatory tests

A

serum k decreased, urin k increased

confirm

  • normal saline IV supresses plama aldosterone
  • captopril supresses
52
Q

hyper adrenaline cause

A

90% in adrenal medulla (pheochromocytoa)

53
Q

Pheochromocytoma symptoms

A

headache
excess sweat
palpatins
hypertension

54
Q

dx tests for pheochromocytoma

A

urine metanephrine
urine vanillyl mandelic acid (VMA)

–both increased substatially

PA3305- Mod 10 (9 decks)

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