Miscellaneous

Question 1

what causes increased urination?

Answer 1

type 1 diabetes
type 2 diabetes
diabetes insipidus
UTI
hypercalcaemia

Question 2

groans (constipation
moans (depression, fatigue)
bones (sore bones0
kidney stones

Answer 2

hypercalcaemia

Question 3

if you suspect diabetes insipidus what test should you do and what would be the result?

Answer 3

fluid deprivation test

if fluid output doesnt decrease then its a positive test

Question 4

at what level is HbA1c considered elevated?

Answer 4

> 48mmol/L

Question 5

what happens to glucose in kidneys?

Answer 5

passively secreted then actively reabsorbed

Question 6

what is the ideal glucose plasma conc?

Answer 6

3.6-5.8mmol/L

Question 7

what is Kaussmaul breathing and where do you see it?

Answer 7

deep laboured breathing occurs in presence of excessive ketone bodies in blood

in type 1 diabetes only!

Question 8

do babies of diabetic mothers have a larger birth weight?

Answer 8

yes but they are of normal length

Question 9

why are babies of diabetic mother heavier ?

Answer 9

cause glucose can cross the placenta but insulin cant. so baby has more glucose than normal so there is increased fat

Question 10

what should pregnant diabetic mother supplement theri diet with?

Answer 10

folic acid

Question 11

what are babies of diabetic mothers are risk of?

Answer 11

CNS deformities e.g spina bifida

Question 12

what is acromegaly?

Answer 12

excess growth hormone

can cause diabetes

Question 13

what is cushings syndrome?

Answer 13

excess cortisol

can stop uptake of glucose in muscles

Question 14

bag of bones appearance on X ray?

Answer 14

Charcot Foot

Question 15

are the adrenal glands retroperitoneal structures>

Answer 15

yes

Question 16

what are the 2 parts of the adrenal glands?

Answer 16

medulla

cortext

Question 17

what are the 5 zones of the adrenal glands?

Answer 17

connective tissue
zona glomerulosa
zona fasciculate
zona reticularis
medualla

Question 18

what hormones does the medulla secrete?

Answer 18

adrenalin and noradrenaline

Question 19

what hormones does the zona reticularis secrete?

Answer 19

aldosteronee

dehydroepiandrosterone

Question 20

what hormones does the zona fasciculate secrete?

Answer 20

cortisol
cortisone
corticosterone

Question 21

what are adrenaline and noradrenaline derived from?

Answer 21

tyrosine within the chromaffin cellss

Question 22

can medulla hormones be made early and stored?

Answer 22

yes

Question 23

what stimulates the synthesis and release of aldosterone?

Answer 23

angiotensin 2

Question 24

what does aldosterone do on the kidneys?

Answer 24

increases NaCl retention+reabsorption

due to osmosis, water is also reabsorbed and there is an increase in blood volume and therefore an increase in BP

Question 25

name 2 types of primary aldosteronism?

Answer 25

conn;s syndrome adrenal hyperplasia

Question 26

what is conn's syndrome?

Answer 26

excess amounts of aldosterone is secreted by a tumour in in the cells of the zona glomerulosa

Question 27

increase NaCl increase water decrease potassium signs of hypertension and hypokalaemia?

Answer 27

conn's syndrome

Question 28

how do you diagnose conn's and adrenal hyperplasia?

Answer 28

aldosterone to renin ratio if >750 then do saline suppression test

Question 29

what is the treatment for Conn's/ adrenal hyperplasia?

Answer 29

if unilateral-remove gland aldosterone receptor anatgonist-spironolactone

Question 30

what are the side effects of spironolactone?

Answer 30

nausea rashes gynaecomastia

Question 31

what is cushings syndrome?

Answer 31

excess cortisol

Question 32

functions of cortisol?

Answer 32

maintain normal plasma glucose levels help produce fuel when stressed increase responsiveness of adrenoreceptors to adrenaline

Question 33

affect on cortisol on fat tissue?

Answer 33

increase lipolysis

Question 34

affect of cortisol on tissue (except brain)

Answer 34

decrease glucose uptake

Question 35

affect of cortisol on liver?

Answer 35

increase gluconeogenisis

Question 36

affect of cortisol on muscle?

Answer 36

increase proteolysis

Question 37

what happens to the body if there is excess cortisol?

Answer 37

cardiac output and blood flow increase reduced osteoblast activity ``` moon face conjunctival oedema thin skin purpura prox muscle wasting central obesity easily bruised recurrent skin infections always thirsty peeing more kyphosis insomnia lethargic ```

Question 38

looks like a lemon on sticks/

Answer 38

excess cortisol

Question 39

cardiac output and blood flow increase reduced osteoblast activity ``` moon face conjunctival oedema thin skin purpura prox muscle wasting central obesity easily bruised recurrent skin infections always thirsty peeing more kyphosis insomnia lethargic ```

Answer 39

excess cortisol

Question 40

what makes the adrenal glands release cortisol?

Answer 40

ACTH

Question 41

what is the most common type of cushings?

Answer 41

ACTH dependent

Question 42

what can cause ACTH independent cushings?

Answer 42

adrenal adenoma adrenal carcinoma nodular hyperplasia

Question 43

what controls secretion of the sex hormones?

Answer 43

ACTH

Question 44

which part of pituitary is ACTH from?

Answer 44

anterior

Question 45

what happens if too much dehydroepiandrosterone in females?

Answer 45

acne amenorrhea frontal balding facial growth because it causes increased levels of testosterone

Question 46

definitive test for cushings?

Answer 46

low dose dexamethasone test

Question 47

what is the medical /surgical therapy for cushings?

Answer 47

metyrapone/ketoccnazole stop cortisol being produced can also cut out the lesion causing hypersecretion of cortisol

Question 48

what affects does adrenaline have on the heart

Answer 48

increase HR and SV via B1 receptors

Question 49

what affect does adrenaline have on BP?

Answer 49

increased it

Question 50

what affect does adrenaline have on skeletal muscle?

Answer 50

vasodilation via B2 receptors

Question 51

what affect does adrenaline have on blood vessles

Answer 51

vasonconstriction via alpha 1 receptors

Question 52

what affect does adrenaline have on insulin secretion?

Answer 52

decreased insulin secretion via alpha 2 receptors

Question 53

what is the triad for hypersecretion of adrenaline?

Answer 53

hypertension sweating headaches

Question 54

name some signs/symptoms of hypersecretion of adrenaline?

Answer 54

``` heart arrhythmias hypertension pallor excessive sweating flushing anxiety peeing alot drinking alot constipation headaches ```

Question 55

what is phaectomocytoma caused by?

Answer 55

by catecholamine secreting tumours which arise from sympathetic paraganglia cells

Question 56

what are paraganglia cells?

Answer 56

collections of adrenaline secreting chromaffin cells

Question 57

10% tumour

Answer 57

phaechromomocytomas - 10% extra adrenal, malignant, bilateral, in children, part of an inherited syndrome

Question 58

treatment of phaechromomocytomas

Answer 58

alpha and beta blockers tumour removed as soon as possible!! chemo if malignant

Question 59

what do the follicular cells of the thyroid produce?

Answer 59

thyroglobulin

Question 60

what do the parafollicular cells of thyroid produce?

Answer 60

calcitonin

Question 61

what is taken up by follicular cells?

Answer 61

iodine

Question 62

where is thyroglobulin stored?

Answer 62

colloid

Question 63

what 2 hormones are produced by thyroid?

Answer 63

T3-trriodothyronine | T4-thyroxine

Question 64

what is needed for production of thyroid hormones?

Answer 64

iodine

Question 65

what does idodine attach to on thyroglobulin molecules and what does this produce?

Answer 65

attaches to tyrosine residues to produce MIT and DID which are the building blocks of the thyroid hormones

Question 66

true or false majority of secreted hormones is T4

Answer 66

true

Question 67

true or false T3 is more biochemically active in bodt

Answer 67

true

Question 68

true or false unbound thyroid hormones are in their active state

Answer 68

true

Question 69

true or false T4 is converted to T3 by liver and kidneys

Answer 69

true

Question 70

true or false T3 and T4 are hydrophilic

Answer 70

true

Question 71

true or false | the majority of inactive thyroid hormones are bound to albumin

Answer 71

false

Question 72

what are the thyroid hormones responsible for?

Answer 72

metabolsim behaviour reproduction growth development

Question 73

affect of thyroid hormone son protein syntheses and glucose and lipolysis?

Answer 73

increase protein synthesis increase blood glucose increase lipolysis

Question 74

affect of thyroid on heart?

Answer 74

increase HR and SV

Question 75

what causes the thyroid to release T3 and T4?

Answer 75

TSH

Question 76

``` tremor in hands excessive body movements HR and SV increase heat intolrenace-may get moist itchy skin increase BMR-lose weight but bigger appetite agitation-always on edge irregular periods loss of libido ```

Answer 76

hyperthyroidism

Question 77

what does graves disease cause?

Answer 77

hyperthyroidism

Question 78

what is graves disease?

Answer 78

an autoimmune disease | thyroid cant be suppressed by high levels of T3 and T4

Question 79

who usually gets graves disease/

Answer 79

middle aged women

Question 80

normal TSH value

Answer 80

0.4-4

Question 81

normal T3 value

Answer 81

9.9-22

Question 82

normal T4 level

Answer 82

0.9-2.6

Question 83

what hormone is always raised in graves?

Answer 83

T4

Question 84

what is exopthalamus?

Answer 84

eyes seemed pushed forward due to water build up and retro orbital swelling

Question 85

"orange peel "look

Answer 85

preibial myxoedema

Question 86

what is pretibial myxodema

Answer 86

bilateral plaque formation on anterior surface of leg non pitting complication of graves/hyperthyroidism

Question 87

what is a goitre?

Answer 87

swelling of thyroid gland so that it is easily seen and palpated

Question 88

2nd most commen cause of hyperthyroidism?

Answer 88

toxic multinodular goitre

Question 89

what is toxic multinodular goitre?

Answer 89

large nodules secreting lots of thyroid hormones

Question 90

what is de Quervains thyroiditis?

Answer 90

show to suffer from hyperthyroidism but also have fever malaise local tenderness

Question 91

what causes Quervains thyroiditis?

Answer 91

initiated by an acute inflammatory process (usually viral origin)

Question 92

``` reduced BMR loss of appetite but weight gain slow reflexes fatigue and lethargy coarse sparse hair expressionless face cool doughy skin obstructive sleep apnoea ```

Answer 92

HYPO thyroidism

Question 93

what can cause hypothyroidism?

Answer 93

goitre iodine deficiency hashimoto's thyroiditis

Question 94

what is hashimoto's thyroiditis?

Answer 94

an autoimmune disease antibodies attack thyroid peroxidase antibodies attack thyroglobin leading to destruction of follicular cells

Question 95

increased TSH decreased T4

Answer 95

hypothyroidism

Question 96

decreased TSH increased T3 or increased T4

Answer 96

hyperthyroidism

Question 97

decreased TSH, normal T3 and T4

Answer 97

subclinical hyperthyroidism

Question 98

increased TSH normal T4

Answer 98

treated hypo

Question 99

decreased TSH T3 and T4

Answer 99

pituitary disease

Question 100

if there is goitre what should you do management wise?

Answer 100

fine needle aspirate | US or thryoid scan

Question 101

how do you investigate thyroid disease?

Answer 101

thyroid function tests | anti-thyroid antibodies

Question 102

what medical treatment is there for hyperthyroidism?

Answer 102

carbimazole and propylthiouracil these inhibit the production of thyroid hormone beta blockers can also be given for hyper

Question 103

what is the major side effect of carbimazole

Answer 103

agranulocytosois

Question 104

what surgical treatment is there for hyperthyroidism?

Answer 104

remove the gland

Question 105

treatment for hypothyroidism?

Answer 105

replacement therapy- analogue of thyroxine is taken for life (levothyroxine)