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Diabetes > Fundamentals of Endocrinology > Flashcards

Fundamentals of Endocrinology Flashcards

1
Q

What are the consequences of diabetes?

A
  • Atherosclerosis
  • Diabetic retinopathy
  • Renal failure
  • Ulcers- gangrene
  • Erectile dysfunction
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2
Q

What are the symptoms and signs of Cushing’s Syndrome?

A
  • High blood pressure
  • Diabetes
  • High blood cholesterol
  • Central (visceral) obesity
  • Stretch marks
  • Bruising
  • Osteoporosis
  • Muscle weakness
  • Infertility
  • Depression
  • Memory loss

Pituitary tumour= to much ACTH so cortisol from adrenal glands
*Curable= remove tumour

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3
Q

What is a hormone?

A

Circulating factors which act on remote target organs

=endocrine, paracrine (local), autocrine (own self), neurotransmission (dopamine)

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4
Q

What are the classical endocrine glands?

A
  • Thyroid
  • Adrenal
  • Ovary
  • Testis
  • Pancreas
  • Parathyroids
  • Pituitary
  • Most other organs make or metabolise hormones (liver, kidney, brain, bone, adipose, skin, gut, heart)
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5
Q

What hormones does the pituitary gland secrete?

A
  • ACTH
  • LH
  • FSH
  • GH
  • PRL
  • TSH
  • AVP
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6
Q

What hormones does the thyroid secrete?

A
  • Thyroxine

- Calcitonin

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7
Q

What hormones does the parathyroid secrete?

A

-PTH

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8
Q

What hormones does the pancreas secrete?

A
  • Insulin

- Glucagon

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9
Q

What hormones does the adrenal cortex secrete?

A
  • Cortisol
  • Aldosterone
  • DHEA
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10
Q

What hormones does the adrenal medulla secrete?

A
  • Adrenaline

- Noradrenaline

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11
Q

What hormones does the ovary secrete?

A
  • Oestrogen

- Inhibin

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12
Q

What hormones does the testis secrete?

A

-Testosterone

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13
Q

What hormones does the adipose tissue secrete?

A
  • Leptin (hunger cessation- resistance in obesity)
  • Adiponectin
  • Resistin
  • TNFa
  • IL6
  • Cortisol
  • Angiotensinogen
  • PAI-1
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14
Q

What are the different types of hormone structure?

A 
-Peptides (gene products)
=Growth hormone
=Insulin
=Thyroxine
-Amines (modified AAs)
=Adrenaline
=Noradrenaline
-Steroids (from cholesterol)
=Oestrogen
=Androgen
=Glucocorticoids (metabolism and stress)
=Vitamin D
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15
Q

Describe the receptors for hormones

A

-Peptides and amines
=Surface receptors
=Second messengers
=Multiple cellular effects

-Steroids and thyroid hormones
=Nuclear receptors
=Via transcription/ translation
=Many target genes

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16
Q

What is unicoid?

A

-Small testis= less to no testosterone
=Long limbs as plates did not fuse (require sex steroids to stop growing)
=No puberty

17
Q

Describe the anatomy of the pituitary fossa

A

-Gland lies beneath pituitary stalk (blood and nerves) from hypothalamus
-Optic chiasm above pituitary gland
-Low intensity microadenoma= pituitary tumour
=Bigger tumours= acromegaly (stretches and damages optic chiasm- loss of outer field of vision)

18
Q

How is growth hormone regulated?

A

-Regulated by GHRH (growth hormone releasing hormone) from hypothalamus
-Stimulates pituitary gland directly to produce GH
=complex cascade
-insulin growth factor type 1 created in liver

19
Q

What lead to an excess of growth hormone?

A
  • Acromegaly/ gigantism
  • Genetics (Gs alpha mutations= inside GH producing cell so always active)
  • Immune- antibodies stimulate GH
  • Pituitary tumours, or those producing IFG1 or related IGF2
  • GHRH hypersecretion
  • Factitious use by body builders
20
Q

What are the causes of hypothyroidism?

A 
-Source gland damage
=Genetic/ developmental failure (thyroid synthetic enzyme defects)
=Autoimmune (Hashimoto's)
=Tumours/ infiltrations (rare)
=Iatrogenic (carbimazole, radio-iodine)
=Surgery (thyroidectomy)

-Target organ resistance
=Pre-receptor defects (monodeiodinase defects)
=Receptor mutations (thyroid resistance syndrome)
=Post-receptor

21
Q

Generally, how can we make a diagnosis in endocrinology?

A
  • If hormone deficient= show it can be stimulated normally
  • If excess hormone= show it can be suppressed normally
  • Sometimes just basal levels of the hormone or regulators are sufficient for diagnoses
22
Q

Describe endocrine therapy

A

-If hormone deficient, replace it
=Diurnal rhythms
=Stress or illness and requirements may alter

-If excess hormone, suppress/ remove
=Often better to remove all and replace back to physiology

-Monitor replacement if possible (TSH for thyroxine)

23
Q

Describe glucocorticoid remedial hyperaldosteronism

A

-Curable hypertension
-Genetic endocrine disease
-Aldosterone synthase (controlled by renin and Angiotensin 2) and cortisol synthase (11-hydroylase, controlled by ACTH)= highly homologous
=Promoter regions similar
=Unequal lining up of chromosomes= regulatory regions mixed up so more aldosterone made (chimeric gene) under ACTH control

24
Q

How can you treat glucocorticoid remedial hyperaldosteronism?

A
  • Suppress ACTH

- Give glucocorticoid- turns off ACTH production so ectopic aldosterone synthesis stopped

Diabetes (30 decks)

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