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LCRS > Endocrinology tutorials > Flashcards

Endocrinology tutorials Flashcards

1
Q

What is a worrying change?

A

Crossing centiles

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2
Q

Define 25% centile in terms of short stature

A
  • Centile (percentile) is a measure used in statistics indicating the value below which a given percentage of observations in a group of observations falls
  • 25% of individuals have a shorter stature and 75% of individuals have a taller stature
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3
Q

Causes of short stature

A
  • endocrinal (growth hormone deficiency, hypothyroidism, vitamin D deficiency, Cushings from excess circulating cortisol in the body)
  • nutritional(malnutrition)
  • syndromes (Downs)
  • Constitutional growth and puberty delay
  • Systemic illness (affects the entire body)
  • emotional/psychological deprivation
  • dysplasia (skeletal dysplasia=dwarfism)
  • genetic conditions

-often emotional and nutritional causes are classified together

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4
Q

GH stimulation test

A
  • Growth hormone stimulation test
  • IV (intravenous) line inserted into a vein in your arm or hand
  • initial blood sample taken
  • GH stimulated added into the body through the IV line (insulin to reduce blood glucose levels)
  • Blood samples are then taken at regular intervals through the same IV line
  • Blood samples then analysed to see if the expected amount of GH (growth hormone) was produced in response to the stimulant
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5
Q

Difference between insulin and growth hormone

A
  • growth hormone counteracts insulin effects on blood glucose levels
  • insulin decreases the blood glucose levels
  • growth hormone increases the blood glucose levels
  • we stimulate growth hormone release when insulin concentrations are low=protection against hypoglycaemia
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6
Q

Cushing’s Syndrome

A
  • excess circulating cortisol

- high BMI accompanied with short stature as diagnostic factors

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7
Q

Define polydipsia

A

Extreme thirst

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8
Q

Define polyuria

A

Increased/excessive urine production (large volumes of urine)

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9
Q

Define symptom

A

Patient complaint

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10
Q

Define sign

A

What you find on examination

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11
Q

Expected pattern in the osmolality of urine during the water deprivation test (type of biochemical test)

A

/

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12
Q

DDAVP and its impact on the osmolality of urine

A

/

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13
Q

Underlying causes of cranial diabetes insipidus

A
  • tumour (malignancy)
  • head trauma
  • infection
  • inflammation
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14
Q

Investigations for diabetes insipidus

A

/

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15
Q

Causes of weight loss

A
  • Hyperthyroidism
  • Diabetes
  • Cancer
  • Eating disorders
  • Infection
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16
Q

Surrogate marker for insulin measured

A
  • Insulin has low half life and is not a stable molecule so cannot be measured
  • Measure C-peptide
  • C-peptide was part of the proinsulin molecule and was cleaved for co-secretion with insulin from the pancreas (secretion from the pancreas at the same time)=more stable with a longer half life
17
Q

Define angina pectoris

A

chest pain

18
Q

Steps to reduce the risk of cardiovascular disease

A
  • Exercise
  • Control hypertension (high blood pressure)
  • Statins to address LDL cholesterol
  • Diet
  • Reduce BMI (body mass index)
19
Q

Why do we get glycosuria?

A
  • Insulin deficiency leads increased glycogenolysis and gluconeogenesis (inability to inhibit these processes) so the patient becomes hyperglycaemic
  • blood glucose levels exceed the renal reabsorptive capacity
20
Q

Why do we get polyuria?

A

-Hyperglycaemia leads to osmotic diuresis

21
Q

Define glycosuria

A

Presence of glucose in the urine

22
Q

Define diabetes

A

Where the fasting blood glucose is more than 7 mmol/L or the random glucose is more than 11 mmol/L
-Values were decided from evidence of diabetic retinopathy (damage to the back of the eye from high blood sugar levels)

23
Q

Impaired fasting blood glucose levels for prediabetes

A

6mmol/L- 7mmol/L (more than 6 is abnormal and requires monitoring)

24
Q

Impaired random blood glucose levels for prediabetes

A

7.8mmol/L-11.0mmol/L

25
Q

ADH characteristics

A
  • made in the hypothalamus
  • released from the posterior pituitary gland
  • More ADH secreted leads to dark and concentrated urine, because of increased reabsorption of water molecules back into the bloodstream (water retention and preservation)
26
Q

Clinical features of hyperthyroidism (thyrotoxicosis)

A 
SPEEDING UP=features relative to what is normal in the patient
-often not conscious of symptoms to begin with
-affects all systems 
General features:
-weight loss
-increased appetite
-sweating
-heat intolerance
-swelling in the neck (goitre)
Neuropsychiatric:
-irritability
-insomnia
-tremor in hands
Cardiovascular:
-tachycardia
-low diastolic blood pressure
Respiratory:
breathlessness
Gastrointestinal:
-diarrhoea
Musculoskeletal:
-osteoporosis
Gynaecology:
-heavy/irregular periods
27
Q

Results of thyroid function test for hyperthyroidism

A

High thyroid hormone levels meaning low TSH levels due to negative feedback mechanism

28
Q

Clinical features of hypothyroidism

A 
SLOWING DOWN=features relative to what is normal in the patient
General:
-pale
-weight gain
-fatigue
-swelling of the neck (goitre)
-cold intolerance
Gastrointestinal:
-constipation
Cardiac:
-low heart rate
Gynaecology:
-heavier and longer periods
29
Q

Results of thyroid function test for hypothyroidism

A

Low thyroid hormone levels meaning high TSH levels due to negative feedback mechanism

30
Q

Causes of hyperthyroidism

A
  • Grave’s disease= overactive thyroid gland leading to high levels of thyroxine
  • High levels of thyroxine results in signal to brain to release low levels of TSH from the pituitary gland
  • autoimmune disease=TSH receptor stimulating antibody can stimulate the thyroid gland to secrete thyroid hormones
31
Q

Difference between hyperthyroidism and cancer patients?

A

-cancer patients lose weight whilst also losing their appetite whereas patients with hyperthyroidism lose weight but have an increased appetite

32
Q

What is a featured of hormonal imbalance?

A

Fatigue

LCRS (3 decks)

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