Endocrinology Disease summary Flashcards
What are the 6 hormones produced by the pituitary gland?
Mnuemonic FLATPIG
FSH LH ACTH TSH Prolactin GH FLATPIG
Give a brief description of what the hormones in the menstrual cycle
FSH is released from the pituitary and stimulates the follicle development in the ovaries. The FSH then subsequently starts the production of oestrogen. When estrogen is in the body it acts as a positive feedback loop. Eventually this stops and leads to LH to be released by the pituitary and causes there to be release of the egg
What does GH do?
Acts on the whole body. Stimulates protein and growth synthesis. It also leads to gluconeogenesis
What is ACTH?
This is a hormone that is released by the pituitary gland and leads to cortisol release and also androgen release from the adrenal medulla.
What is TSH ?
Stimulates the release of thyroid hormones and thus speeds everything up!
What hormone can inhibit prolactin release ?
Dopamine
DM: name 4 complications
- Neuropathy
- Nephropathy
- CVS disease
- Retinopathy
- Impotence
Name 3 secondary causes of diabetes:
Haemochromatosis Obesity Pancreas removal Cushings Steroid usage
What is the name given to thickening and darkening of skin on a diabetic patient?
Acanthosis Nigricans
Diagnosis of DM:
Random blood glucose
Fasting blood glucose
HbA1c
11.1.
Fasting > 7
6.5%
What two drugs should all diabetics be put on as a preventative ?
Statin
ACE inhibitor (if black or over the age of 55 give CCB)
Reduces the risk of CVS disease and also kidney disease
Hypoglycaemia: suggest two non diabetic causes and give a series of symptoms
Diabetes, Liver Disease and Addisons
Autonomic: sweaty, anxious, hunger, tremor, palpitations and dizziness.
Can also lead to personality change and incoherence.
How do you treat someone with hypoglycemia?
IV glucose and
IM glucagon
Thyroid Disease: name the two hormones . Which one is produced in more abundance?
T3- Tri-iodo-thyronine
T4: Thyroxine.
Thyroxine is produced more. It is made in the follicular cells and is made from lots of iodine.
What is a goitre?
This is a palpable swelling of the thyroid gland that is found at the front of the neck. The lump will move up and down as people swallow.
Explain the thyroid hormone cycle:
TRH is released by the hypothalamus. This then stimulates the pituitary gland to release TSH. TSH then leads to the thyroid producing T4- thyroxine and T3.
TSH inhibits the production of TRH.
How does Graves disease cause hyperthyroid?
It works my leading to the production of TSH-r antibodies that bind to TSH receptors. This then stimulates the production of thyroid hormones. Too many hormones are made.
What happens in the eyes of graves THYROID patients?
What happens on their legs?
Conjuctival edema, exophthalmos, corneal ulceration
NEED IV methyl prednisolone!!
Pre-tibila myxoedema.
What two drugs can cause hyperthyroidism?
Amiodarone
Lithium
Iodine
Treatment of hyperthyroid includes:
BB- propanolol
Carbimazole
Radioactive iodine and surgery
What is the main cause of hypothyroid?
Hashimotos Thyroiditis
Iodine Deficency
Drug induced (amiodarone, carbimazole)
What symptoms will a patient with hypothyroid have?
BRADTCARDIC
Bradycardia Reflexes slow Ataxia Dry hair Yawning Cold hands Ascites Round puffy face Defeated demeanor Immobile Congestive cardiac failure
What will be seen in a patient blood work with Hypothyroid?
Will have a high TSH and low T3 and T4
antibodies for TPO
Treatment for hypothyroid?
Lifelong levothyroxine
What are the three layers of the adrenal gland?
Zona Glomerulosa: Aldosterone
Zona Fasciculata : Cortisol
Zona Reticularis: Androgens
Cushing’s Disease: What is it?
It is a condition that involves the excess production of glucocorticoids
What does cortisol do?
It is released by the zone glomerulosa and is used in increasing carbohydrate and protein catabolism. It allows for increased deposition of fat and glycogen
Give 5 points on the clinical presentation of a patient with Cushing’s:
- Patients are obese +moon faces
- Patients have mood changes
- Erectile dysfunction or irregular periods
- Muscle atrophy and think skin
- Acne
- Osteoporosis
How is Cushing’s diagnosed?
You do an over night dexamethasone suppression test and measure the serum cortisol at 8am
You could also measure the urine free cortisol
** in suppression. If a patient has cushings there will not have any sign of suppression**
What is acromegaly?
Excessive GH production
Normally caused by a pituitary tumor
How does acromegaly present?
Normally presents as headaches, excessive sweating, visual disturbance, increased weight, deep voice carpal tunnel and a protruding jaw
Name 4 co morbidities/complications of acromegaly
Diabetes Impaired glucose tolerance Sleep apnea Cardiomyopathy Bowel Cancer
Diagnosis of acromegaly. What do you do?
You need to look at the levels of glucose, Ca2+ and phosphate in the blood.
You then need to look at the plasma GH levels and do a Glucose tolerance test. This is done as normally glucose inhibits GH release.
Treatment for acromegaly?
Somatostatin analogue: Lanreotide
Treatment of high prolactin?
Give patient oral cabergoline
Name 3 changes on a patients ECG with hypokalemia:
Flat T waves
ST depression
Long QT
What is Addisons disease?
What are the symptoms?
How do we diagnose it?
How do we treat it?
It is a destruction of the adrenal cortex. Causing there to be a decrease in mineral corticoid, sex androgens and cortisol in the body.
Symptoms include: amenorrhea, impotence, diarrhea, vomiting, weight loss, bronze skin, vitiligo, weight loss and lethargy.
Diagnose with a short ACTH stimulation test
Check the adrenal antibodies
Treatment: IV hydrocortisone, Glucose and IV saline
Treatment of Diabetes insipidus?
IV Desmopressin
