Endocrinology Of Age

Question 1

Sarcopaenia?

Answer 1

Loss of skeletal muscle

Question 2

Lean body mass decline

Answer 2

6-8% from mid 30s

Question 3

Metabolic syndrome includes?

Answer 3

Visceral obesity
Dyslipidaemia
Hyperglycaemia
Hypertension

Question 4

Post menopausal oestrogen levels?

Answer 4

E2 is low, high LH and FSH

Question 5

HRT Risks?

Answer 5

Other risk factors Venous thromboembolism, breast cancer (especially over 5 years use), endometrial cancer (unopposed oestrogen)

Age.. more than 60
More than 10 years post mp
Type of HRT and route

Question 6

Most erectile dysfunction is due to?

Answer 6

Atherosclerotic

Question 7

Potential risks of testosterone treatment?

Answer 7

Prostrate hypertrophy/cancer, erthyropoesis so increase risk of thrombosis and increased MI and strokes

Question 8

Bone treatment?

Answer 8

Biphosphonates

Question 9

Growth hormone treatment risk?

Answer 9

Increasing Cancer risk in increasing IGF1 levels, T2Dm

Side effects: oedema, arthralgias and carpal tunnel syndrome

Question 10

Increased cortisol possibly causes?

Answer 10

Cognitive decline

Question 11

Low DHEA: cortisol conditions?

Answer 11

Inflammatory disease, cancer, T2D

Question 12

Thyroid function in age?

Answer 12

Low T3, same t4 and slightly high TSH

Question 13

Leptin is produced by?

Answer 13

White adipose tissue

Question 14

Low leptin levels?

Answer 14

Increased food intake and decreased energy expenditure, low fertility

Question 15

What symptoms do menopausal women experience?

Answer 15

Hot flushes and night sweats

Question 16

Testosterone levels at 75years is…?

Answer 16

2/3 of that at 25 years of age

Question 17

Clinical hypogonadism signs in men?

Answer 17

Decreased sexual function
Increased osteoporosis
And decreased muscle strength

Question 18

Effects of T4 treatment?

Answer 18

Increasing risk of osteoporosis, atrial fibrillation and risk in elderly with atherosclerotic corona roes

Question 19

Low leptin levels mean?

Answer 19

Increase food intake, decrease energy expenditure and decrease in fertility

Question 20

In starvation what happens to hormone levels?

Answer 20

Low LH, FSH, Low oestrogen and testosterone. Low fertility and amenorrhoea

Question 21

Obese and hyperphagic mouse mean?

Answer 21

Low gonadotrophin, incomplete development of reproductive organs, doesn’t reach sexual maturity and infertile

Question 22

How does kisspeptin work?

Answer 22

Mediated by leptin and highly responsive to oestrogen

Question 23

What happens in starvation and anorexia in terms of growth hormone?

Answer 23

Growth hormones increase and IGF1 decrease, may be due to down regulation of hepatic GH receptors or post receptor defect

Can be reversible with refeeding

Question 24

In fasting cortisol levels?

Answer 24

Peak

Question 25

In starvation what happens to thyroid functions?

Answer 25

TSH and T4 levels are lower. Less conversion of T4 to T3 and more conversion of T4 into T3 inactive form

Question 26

In starvation changes in thyroid hormones cause?

Answer 26

Lower basal metabolic rate and conserving energy

Question 27

When does weight plateau?

Answer 27

50-70

Question 28

Age of menopause?

Answer 28

50 +- 2

Question 29

Median duration of menopause symptoms?

Answer 29

7 years

Question 30

At 75. Years testosterone is what than at 25 years?

Answer 30

2/3

Question 31

Insulin like growth factor 1 with age?

Answer 31

Decreases

Question 32

T4 treatment can cause harm by?

Answer 32

Risk of oestoporosis, atrial fibrillation, and increased risk of atherosclerotic coronaries in elderly

Question 33

In AN hormones are?

Answer 33

Low LH and FSh, low oestorgen and testosterone, hypothalamic amenorrhoea

Question 34

Age at menopause?

Answer 34

50 plus or minus 2 years

Question 35

Growth hormone treatment can?

Answer 35

Increase lean body mass by 2kg And decrease fat mass by 2 kg No change in bone mineral density and lipids

Question 36

Potential harm with T4 treatment?

Answer 36

Increased risk of osteoporosis, atrial fibrillation and atherosclerotic coronaries

Question 37

In starvation?

Answer 37

Decreased glucose, insulin and increased leptin sensitivity

Question 38

Starvation and androgens?

Answer 38

Low LH and FSH and oestrogen and testosterone, low fertility amenorrhoea Osteoporosis

Question 39

Oh ob mouse?

Answer 39

``` Hyper-Hamid and obese Low gonadotrophin Incomplete development of reproductive organs Doesn’t reach sexual maturity Infertile ```

Question 40

Giving leptin treatment?

Answer 40

``` Reduce obesity Restore gn secretion Mature gonad Induced puberty Restore fertility ```

Question 41

Kisspeptin is?

Answer 41

A GnRH secratgogue, highly responsive to oestrogen Mediated by leptin

Question 42

In starvation what happen to growth hormone?

Answer 42

Increases, and insulin like growth factor 1 decreases

Question 43

In starvation thyrolic rate oid function?

Answer 43

TSH and T4 lower limit of normal Less T4 conversion to T3 More t4 conversion to rT3 Consequences: conserve energy Lower basal metabolic

Question 44

What increases with age?

Answer 44

``` Cortisol FSH LH TSH Glucose Insulin ```

Question 45

What increases with starvation?

Answer 45

GH | cortisol