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IMS > endocrinology > Flashcards

endocrinology Flashcards

1
Q

what is the role of the posterior pituitary gland?

A

storing hormones

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2
Q

what is the role of the anterior pituitary gland?

A

producing hormones

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3
Q

what glands are controlled by the pituitary gland?

A 
parathyroid
thyroid 
adrenal cortex
pancreas
ovaries/testes
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4
Q

what glands are not controlled by the pituitary gland?

A

parathyroid (calcium storage)
adrenal medulla - adrenaline and noradrenaline
pancreas (sugar)
gut hormones

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5
Q

what is CRH and what does it do?

A

corticotrophin released hormone, it stimulates ACTH secretion which in turn stimulates the adrenal gland

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6
Q

what is GHRH and what does it do?

A

growth hormone releasing hormone and it stimulates CH

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7
Q

what is TRH and what does it do?

A

thyrotrophin releasing hormones which stimulates TSH secretion

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8
Q

what 5 hormones does the anterior pituitary gland produce?

A 
GH
ACTH
LH and FSH 
TSH 
PRL
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9
Q

what is GH? and what does it do?

A

growth hormone

stimulates skeletal growth

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10
Q

what is ACTH?

A

adrenocorticotrophic hormone

stimulates the adrenal gland to produce steroids

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11
Q

What are LH and FSH?

A

gonadotrophin hormones

stimulates the testes and ovaries to produce sex hormones

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12
Q

what is TSH?

A

thyroid stimulating hormone

stimulates the thyroid to produce thyroid hormones

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13
Q

what is PRL?

A

prolactin

stimulates breast milk production

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14
Q

what do adrenal steroids inhibit?

A

ACTH and CRH

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15
Q

what does thryroid hormones inhibit?

A

TRH and TSH

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16
Q

what do sex hormones inhibit?

A

GnRH, LH and FSH

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17
Q

what does Gh inhibit?

A

GHRH

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18
Q

what do C-cells do and where are they?

A

in thyroid gland, they produce calcitonin for calcium metabolism

not under control of pituitary but by the 4 parathyroid glands sitting behind the thyroid

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19
Q

what is calcium metabolism controlled by?

A

parathyroid glands

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20
Q

what 4 things take part in calcium metabolism?

A

kidneys

gut

bones

thyroid

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21
Q

how do the kidneys help with calcium metabolism?

A

they excrete calcium and produce active vitamin D which increases the absorption of calcium

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22
Q

how does the gut help with calcium metabolism?

A

involved in the absorpiton of calcium

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23
Q

how does the thyroid help with calcium metabolism?

A

c-cells in the thyroid produce calcitonin for calcium metabolism.
not under the control of the pituitary

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24
Q

how do bones help with calcium metabolism?

A

storage of caclium

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25
Q

what does the adrenal cortex produce?

A

corticosteroids - cortisol
androgens - male sex hormones
mineralcorticord - aldosterone

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26
Q

what does the adrenal medulla produce?

A

catecholamines - adrenaline, noradrenaline and dopamine

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27
Q

what part of the adrenal gland is not controlled by the pituitary?

A

the adrenal medulla

or production of mineralcorticord by the cortex. this is renin-angiotensin system which controls blood pressure

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28
Q

in primary hyperthyroidism what levels of thyroid hormone and TSH would you expect to see?

A

high levels of thyroid hormone but low levels of TSH as it is a problem in the thyroid not the pituitary

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29
Q

what can you use static tests for?

A

diagnose problems in thyroid and sex glands

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30
Q

what can you use stimulation tests for?

A

hormonal undersecretion where static tests are not enough as results are ambiguous

31
Q

what can you use surpression tests for?

A

hormonal oversecretion

32
Q

what is the synacthin test?

A

giving patient CTH to test for adrenal insufficiency

failure to respond to CTH suggests failure of the gland

33
Q

give 2 examples of surpression tests?

A

giving steroids to test for endogenous steroid production

giving glucose to test for GH secretion - as glucose should switch off GH secretion

34
Q

what is a prolactinoma?

A

a pituitary tumour secreting prolactin

35
Q

what are the symptoms of prolactin over-secretion?

A

galactorrhoea
amenorrheoa in women
sexual dysfunction in men
headaches and visual feild problems

36
Q

which kind of over-secreting pituitary tumour can be treated non-surgically?

A

prolactinoma

37
Q

what are the symptoms of excess growth hormone in adults?

A

acrmegalic face
wide and large hands/feet
increased sweating

38
Q

what is the diagnosis of growth hormone excess?

A

surpression tests are neccessary

glucose is given, this should decrease palsma levels of GH but not in those with GH excess

imaging is neccessary to confirm presence of pituitary gland tumour

39
Q

what is the treatment of oversecreting GH tumour?

A

surgical removal of the tumour

radiotherapy and medical therapy sometimes needed as surgery does not always remove whole tumour

40
Q

what are 3 cuases of cortisol oversecretion?

A

pituitary secreting ACTH tumour - cushing disease

adrenal tumour screting cortisol

cancer producing ACTH - lung cancer?

41
Q

symptoms of cortisol over secretion

A 
growth arrest in children
typical face: round face, acne, hirsuitism
fat redistribution = truncal obesity
skin abnormalities = thin skin, brusing, stretch marks
hypertension
diabetes
increased risk of infection
worsening wound healing
42
Q

how do you test for over secretion of cortisol?

A

surpression tests - dexamethanosome surpession test

this tests for failure to surpress endogenous cortisol production

43
Q

how do you treat cortisol over secretion?

A

for pituitary or adrenal:
surgery and radiotherpay/medical treatment

cancer related:
treat original cancer first

44
Q

what is the most common cause of hyperthyroidism?

A

graves disease

an autoimmune condition that results in the body attacking the thyroid gland, causing it to over secrete

45
Q

what are 5 causes of hyperthyroidism?

A 
graves disease
toxic nodule/toxic MNG
thyroiditis
drug induced - e.g. aminodorane
rarities
46
Q

name 5 clinical presentations of hyperthyroidism

A 
hyperactivity/irritability/insomnia
palpitations
weightloss
menstrual probs
thyroid eye disease
47
Q

what can be seen in examination of someone with hyoerthyroidism?

A

hand tremor
increased sweating
fast pulse
enlarged thyroid

48
Q

what does a smooth enlarged thyroid suggest?

A

graves disease

49
Q

what does a nodular enlarged thyroid suggest?

A

toxic nodules

50
Q

what does a tender enlarged thyroid suggest?

A

thyroiditis

51
Q

how can you test for hyperthyroidism?

A

blood test

52
Q

what are 3 ways to treat hyperthyroidism?

A

antithyroid drugs
radioactive iodine
surgery

53
Q

symptoms of GH undersecretion in children and adults

A

children = failure to grow

adults = not always any symptoms, but can show as tiredness and depression

54
Q

test for GH under secretion?

A

stimulation test:
glucagon stimulation test
insulin stress test

55
Q

treatment for GH under secretion?

A

growth hormone replacement

56
Q

what can cause steroid undersecretion?

A

adrenal or pituitary failure

57
Q

what are 4 clinical presentation sof steroid under secretion

A

failure of growth in children
severe tiredness
dizziness - low BP
abdominal pain - V+D

58
Q

How do you treat steroid undersecretion?

A

replace missing hormones with tablets

59
Q

how do you test for steroid undersecretion?

A

stimulation testing

synacthen test (ACTH) if primary adrenal failure is suspected

GST or IST if secondary adrenal failure is suspected

60
Q

what are the cuases of hypothyroidism - primary and secodnary?

A

primary = autoimmune or drug induced

secondary = complete pituitary failure

61
Q

what are some symptoms of hypothyroidism?

A 
weakness and dry skin
cold and less sweating
imparied memory
constipation
weight gain
hair loss
62
Q

how do you test for hypothyroidism?

A

static thyroid function test

63
Q

how do you treat hypothyroidism?

A

thyroid hormone replacement

64
Q

what are the causes of primary sex hormone undersecretion and secondary?

A 
primary = ovarian failure or testicular failure
secondary = pituitary failure
65
Q

what is the presentation of sex hormone under secretion in men and women?

A 
men = erectile dysfunction and decreased libido
women = menstrual abnormalities
66
Q

how do you test for sex hormone under secretioN?

A

Static test
testosterone in men
oestradiol in women
FSH/LH in both

67
Q

how do you treat sex hormone under secretioN?

A

hormone replacement therpay

pituitary hormone replacement

68
Q

what are 2 causes of pituitary failure?

A

large tumour

infarction

69
Q

how do you test for pituitary failure?

A

combination of static and stimulatroy tests as it involves multiple hormones

70
Q

what is the cuase of endocrine problems that are not to do with the pituitary?

A

parathyroid issues
primary hyperparathyroidism
cancer
certain drugs

71
Q

clinical presentation of hypercacaemia?

A

thirst and increased urine output
constipation
abdominal pain

72
Q

what is the structure of steroid hormones?

A

3 six sided carbon rings and 1 five sided carbon ring

73
Q

how do steroid hormones work?

A

move through cell membrane and bind to receptors in the nucleus or cytosol
the hormone receptor complex acts as a transcription factor causing mRNA to be transcribed

74
Q

what is conns syndrome?

A

when adrenal gland makes too much aldosterone

leads to high blood pressure

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