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The Patient (Y3-1) > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

How does the posterior pituitary differ from the anterior pituitary?

A

Hypothalamus secretes hormones which travel down axons to the posterior pituitary - direct neural link
Anterior pituitary - the hypothalamus secretes hormones which trigger the secretion of other hormones from the anterior pituitary

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2
Q

Name two conditions associated with hypersecretion of hormones

A 
Graves' disease
Addison's disease
Hyperinsulinism 
Cushing's disease
Congenital adrenal hyperplasia
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3
Q

Name two conditions associated with hyposecretion of hormones

A

Diabetes

Hypothyroidism

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4
Q

Describe the events, triggered by stress, that take place in the HPA axis

A

The hypothalamus secretes CRH in response to stress. This then triggers the release of ACTH from the anterior pituitary. This then leads to the release of cortisol from the adrenal cortex.
Negative feedback loop induced by cortisol to stop the hypothalamus producing CRH and the anterior pituitary releasing ACTH

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5
Q

Which three protein hormones are released by the placenta?

A

Placental lactogenic
CRH
chronic gonadotropin

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6
Q

What hormone is produced by the heart to reduce blood volume?

A

If someone is hypertensive, atrial natriuretic peptide - stimulates kidneys to excrete more salt, thereby decreasing blood volume and therefore blood pressure

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7
Q

Where are the parvicellular neurones located and what do they do?

A

Located in the hypothalamus and secrete regulatory hormones into the blood stream, which travel through the portal system to the anterior pituitary, triggering secretion of other hormones

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8
Q

Where are magnocellular neurones located and what do they do?

A

Located in the hypothalamus and have long axons which extend down into the posterior pituitary. When hypothalamus receives a signal, hormones are released from the pituitary

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9
Q

What is the difference between tropic and non-tropic hormones?

A

Tropic regulate the function of other primary endocrine glands to produce effector hormones. Non-tropic hormones act directly on other tissues

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10
Q

Name the tropic hormones

A

FSH
LH
ACTH
TSH

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11
Q

Name the non-tropic hormones

A

Prolactin

Growth hormones

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12
Q

Hypersecretion of which hormone leads to gigantism in children?

A

Growth hormone

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13
Q

Hypersecretion of growth hormones leads to which condition in adults?

A

Acromegaly

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14
Q

What is the difference between somatostatin and somatotropin?

A

Somatostatin (GHIH) regulates the secretion of growth hormone. Used to treat GH hypersecretion
Somatotropin is used as treatment for growth hormone deficiency

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15
Q

How is acromegaly treated?

A

Somatostatin

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16
Q

What are the causes of GH deficiency?

A 
Insufficient hormone production caused by:
- mutation of GH gene 
- head injury of infection
- radiotherapy 
- hypothalamic or pituitary tumour
GH resistance caused by:
- GH binding protein mutations 
- GH receptor mutations
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17
Q

What are the functions of oxytocin?

A

Stimulation of milk ejection

Stimulation of uterine contractions at birth

18
Q

Describe the positive feedback loop, linked to oxytocin, that takes place during labour

A

Pressure on the cervix applied by baby activates sensory neurones
Hypothalamus secretes oxytocin in waves
Oxytocin diffuses down to the uterus, receptors in the uterus respond and the uterus contracts
This pushes the baby’s head further down onto the cervix, applying more pressure so more oxytocin is released –> gradual build up of contractions

19
Q

What is diabetes insipidus and what are the types?

A

Excessive urine production - up to 16L/day. Causes:

  • 1) Hypothalamic diabetes insipidus
  • 2) Nephrogenic diabetes insipidus
20
Q

What is the difference between hypothalamic diabetes insipidus and nephrogenic diabetes insipidus?

A

Hypothalamic is due to decreased ADH secretion, caused by head trauma, infection etc.
Nephrogenic is due to improper response of the kidneys to ADH, meaning they cannot concentrate urine. Caused by renal disease.

21
Q

How is diabetes insipidus treated?

A

Hypothalamic - exogenous vasopressin

Nephrogenic - increase water consumption

22
Q

Where is melatonin produced and what is its function?

A

Melatonin is produced in the pineal gland by pinealocytes. It plays a role in regulating circadian rhythm.
Production is inhibited by light to the retina and is permitted by darkness

23
Q

What can melatonin be used to treat?

A

Seasonal affective disorder and insomnia

24
Q

What is the rate limiting step in steroidogenisis?

A

Conversion of cholesterol to pregnenolone

25
Q

What is the main carrier protein for exogenous steroids?

A

Transcortin

26
Q

What is the carrier protein for natural and synthetic steroids?

A

Albumin

27
Q

How is addison’s disease treated?

A

Hydrocortisone with or without fludricortisone

28
Q

How is congenital adrenal hyperplasia treated?

A

Synthetic steroid e.g. betamethasone

29
Q

What is the role of aminoglutethimide?

A

Blocks steroid synthesis, used in treatment of Cushing’s syndrome, prostate cancer

30
Q

What is the role of metyrapone?

A

Inhibits 11-B hydroxylase therefore reducing MC and GC synthesis. Used in treatment of Cushing’s syndrome and hyperaldosteronism

31
Q

Why is the synthesis of androgens important for women?

A

Because androgens adrostenedione and testosterone are converted by aromatase to oestrogen. Without andorgens, oestrogen wouldn’t be synthesised

32
Q

Gonadotrophins need proteins to carry them through the blood. True or false?

A

False - they are water soluble macromolecules that generally travel through the blood without the need for carrier proteins

33
Q

How is the production of gonadotrophins regulated?

A

GnRH neurones in the hypothalamus release gonadotrophins via rapid or slow frequency pulses -
Rapid –> LH
Slow –> FSH

34
Q

Name a drug that is used in assisted reproduction therapy to ‘shut down’ the ovary in advance of a controlled cycle of ovulatory stimulation

A

Buserelin - GnRH agonist
Stimulates the production of LH and FSH but long-term use leads to receptor down-regulation, insensitivity to GnRH and therefore lack of production of LH and FSH

35
Q

How is puberty initiated?

A

Fat deposition leads to release of leptin
Leptin stimulates the release of kisspeptin neurones in the hypothalamus
GnRH neurones are stimulated to release GnRH
Anterior pituitary releases gonadotrophins –> menarche

36
Q

What is endometriosis and how is it caused and treated?

A

Establishment and growth of endometrial tissue outside the uterus
Mostly arises by reflux menstruation - where endometrial tissue fragments shed at menses, pass through the fallopian tube, becoming established in ectopic sites
Treatment - surgery, NSAIDs, aromatase inhibitors, combined oral steroid contraceptive

37
Q

Describe the hormonal changes during pregnancy

A

hCG is produced by the placenta - it rescues the corpus luteum –> increase in progesterone and oestrogen levels
hCG peak is towards the end of the first trimester and then it drops dramatically due to degeneration of CL
oestrogen and progesterone levels remain high and continue to rise until birth as the placenta begins producing these hormones (at 7-9 weeks) instead of the CL = luteoplacental switch

38
Q

What is the use of mifepristone in pregnancy?

A

Progesterone receptor antagonist -
blocks preparation of endometrium for pregnancy
counteracts the suppressive effect of progesterone on myometrial contractility
Used as an abortifacient in first half of pregnancy

39
Q

What is pre-term labour defined as?

A

<37 weeks gestation

40
Q

What are the current treatments for pre-term labour?

A

Tocolytics - only prolong pregnancy for 48 hours

e.g. nifedipine, atosiban, ritodrine

41
Q

Which drug is used in ectopic pregnancy?

A

Methotrexate - folate antagonist, blocks DNA synthesis

The Patient (Y3-1) (8 decks)

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