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Endocrine > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

what causes increased urination?

A 
type 1 diabetes
type 2 diabetes
diabetes insipidus
UTI
hypercalcaemia
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2
Q

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

A

hypercalcaemia

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3
Q

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

A

fluid deprivation test

if fluid output doesnt decrease then its a positive test

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4
Q

at what level is HbA1c considered elevated?

A

> 48mmol/L

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5
Q

what happens to glucose in kidneys?

A

passively secreted then actively reabsorbed

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6
Q

what is the ideal glucose plasma conc?

A

3.6-5.8mmol/L

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7
Q

what is Kaussmaul breathing and where do you see it?

A

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

in type 1 diabetes only!

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8
Q

do babies of diabetic mothers have a larger birth weight?

A

yes but they are of normal length

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9
Q

why are babies of diabetic mother heavier ?

A

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

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10
Q

what should pregnant diabetic mother supplement theri diet with?

A

folic acid

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11
Q

what are babies of diabetic mothers are risk of?

A

CNS deformities e.g spina bifida

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12
Q

what is acromegaly?

A

excess growth hormone

can cause diabetes

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13
Q

what is cushings syndrome?

A

excess cortisol

can stop uptake of glucose in muscles

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14
Q

bag of bones appearance on X ray?

A

Charcot Foot

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15
Q

are the adrenal glands retroperitoneal structures>

A

yes

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16
Q

what are the 2 parts of the adrenal glands?

A

medulla

cortext

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17
Q

what are the 5 zones of the adrenal glands?

A 
connective tissue
zona glomerulosa
zona fasciculate
zona reticularis
medualla
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18
Q

what hormones does the medulla secrete?

A

adrenalin and noradrenaline

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19
Q

what hormones does the zona reticularis secrete?

A

aldosteronee

dehydroepiandrosterone

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20
Q

what hormones does the zona fasciculate secrete?

A

cortisol
cortisone
corticosterone

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21
Q

what are adrenaline and noradrenaline derived from?

A

tyrosine within the chromaffin cellss

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22
Q

can medulla hormones be made early and stored?

A

yes

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23
Q

what stimulates the synthesis and release of aldosterone?

A

angiotensin 2

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24
Q

what does aldosterone do on the kidneys?

A

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

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25
Q

name 2 types of primary aldosteronism?

A

conn;s syndrome

adrenal hyperplasia

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26
Q

what is conn’s syndrome?

A

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

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27
Q

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

A

conn’s syndrome

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28
Q

how do you diagnose conn’s and adrenal hyperplasia?

A

aldosterone to renin ratio

if >750 then do saline suppression test

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29
Q

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

A

if unilateral-remove gland

aldosterone receptor anatgonist-spironolactone

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30
Q

what are the side effects of spironolactone?

A

nausea
rashes
gynaecomastia

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31
Q

what is cushings syndrome?

A

excess cortisol

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32
Q

functions of cortisol?

A

maintain normal plasma glucose levels

help produce fuel when stressed
increase responsiveness of adrenoreceptors to adrenaline

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33
Q

affect on cortisol on fat tissue?

A

increase lipolysis

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34
Q

affect of cortisol on tissue (except brain)

A

decrease glucose uptake

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35
Q

affect of cortisol on liver?

A

increase gluconeogenisis

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36
Q

affect of cortisol on muscle?

A

increase proteolysis

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37
Q

what happens to the body if there is excess cortisol?

A

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
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38
Q

looks like a lemon on sticks/

A

excess cortisol

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39
Q

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
A

excess cortisol

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40
Q

what makes the adrenal glands release cortisol?

A

ACTH

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41
Q

what is the most common type of cushings?

A

ACTH dependent

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42
Q

what can cause ACTH independent cushings?

A

adrenal adenoma
adrenal carcinoma
nodular hyperplasia

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43
Q

what controls secretion of the sex hormones?

A

ACTH

44
Q

which part of pituitary is ACTH from?

A

anterior

45
Q

what happens if too much dehydroepiandrosterone in females?

A

acne
amenorrhea
frontal balding
facial growth

because it causes increased levels of testosterone

46
Q

definitive test for cushings?

A

low dose dexamethasone test

47
Q

what is the medical /surgical therapy for cushings?

A

metyrapone/ketoccnazole

stop cortisol being produced

can also cut out the lesion causing hypersecretion of cortisol

48
Q

what affects does adrenaline have on the heart

A

increase HR and SV via B1 receptors

49
Q

what affect does adrenaline have on BP?

A

increased it

50
Q

what affect does adrenaline have on skeletal muscle?

A

vasodilation via B2 receptors

51
Q

what affect does adrenaline have on blood vessles

A

vasonconstriction via alpha 1 receptors

52
Q

what affect does adrenaline have on insulin secretion?

A

decreased insulin secretion via alpha 2 receptors

53
Q

what is the triad for hypersecretion of adrenaline?

A

hypertension
sweating
headaches

54
Q

name some signs/symptoms of hypersecretion of adrenaline?

A 
heart arrhythmias
hypertension
pallor
excessive sweating
flushing
anxiety
peeing alot
drinking alot
constipation
headaches
55
Q

what is phaectomocytoma caused by?

A

by catecholamine secreting tumours which arise from sympathetic paraganglia cells

56
Q

what are paraganglia cells?

A

collections of adrenaline secreting chromaffin cells

57
Q

10% tumour

A

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

58
Q

treatment of phaechromomocytomas

A

alpha and beta blockers

tumour removed as soon as possible!!

chemo if malignant

59
Q

what do the follicular cells of the thyroid produce?

A

thyroglobulin

60
Q

what do the parafollicular cells of thyroid produce?

A

calcitonin

61
Q

what is taken up by follicular cells?

A

iodine

62
Q

where is thyroglobulin stored?

A

colloid

63
Q

what 2 hormones are produced by thyroid?

A

T3-trriodothyronine

T4-thyroxine

64
Q

what is needed for production of thyroid hormones?

A

iodine

65
Q

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

A

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

66
Q

true or false

majority of secreted hormones is T4

A

true

67
Q

true or false

T3 is more biochemically active in bodt

A

true

68
Q

true or false

unbound thyroid hormones are in their active state

A

true

69
Q

true or false

T4 is converted to T3 by liver and kidneys

A

true

70
Q

true or false

T3 and T4 are hydrophilic

A

true

71
Q

true or false

the majority of inactive thyroid hormones are bound to albumin

A

false

72
Q

what are the thyroid hormones responsible for?

A

metabolsim
behaviour

reproduction
growth
development

73
Q

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

A

increase protein synthesis
increase blood glucose
increase lipolysis

74
Q

affect of thyroid on heart?

A

increase HR and SV

75
Q

what causes the thyroid to release T3 and T4?

A

TSH

76
Q 
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
A

hyperthyroidism

77
Q

what does graves disease cause?

A

hyperthyroidism

78
Q

what is graves disease?

A

an autoimmune disease

thyroid cant be suppressed by high levels of T3 and T4

79
Q

who usually gets graves disease/

A

middle aged women

80
Q

normal TSH value

A

0.4-4

81
Q

normal T3 value

A

9.9-22

82
Q

normal T4 level

A

0.9-2.6

83
Q

what hormone is always raised in graves?

A

T4

84
Q

what is exopthalamus?

A

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

85
Q

“orange peel “look

A

preibial myxoedema

86
Q

what is pretibial myxodema

A

bilateral plaque formation on anterior surface of leg
non pitting

complication of graves/hyperthyroidism

87
Q

what is a goitre?

A

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

88
Q

2nd most commen cause of hyperthyroidism?

A

toxic multinodular goitre

89
Q

what is toxic multinodular goitre?

A

large nodules secreting lots of thyroid hormones

90
Q

what is de Quervains thyroiditis?

A

show to suffer from hyperthyroidism but also have

fever
malaise
local tenderness

91
Q

what causes Quervains thyroiditis?

A

initiated by an acute inflammatory process (usually viral origin)

92
Q 
reduced BMR
loss of appetite but weight gain
slow reflexes
fatigue and lethargy
coarse sparse hair
expressionless face
cool doughy skin
obstructive sleep apnoea
A

HYPO thyroidism

93
Q

what can cause hypothyroidism?

A

goitre

iodine deficiency
hashimoto’s thyroiditis

94
Q

what is hashimoto’s thyroiditis?

A

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

95
Q

increased TSH decreased T4

A

hypothyroidism

96
Q

decreased TSH increased T3 or increased T4

A

hyperthyroidism

97
Q

decreased TSH, normal T3 and T4

A

subclinical hyperthyroidism

98
Q

increased TSH normal T4

A

treated hypo

99
Q

decreased TSH T3 and T4

A

pituitary disease

100
Q

if there is goitre what should you do management wise?

A

fine needle aspirate

US or thryoid scan

101
Q

how do you investigate thyroid disease?

A

thyroid function tests

anti-thyroid antibodies

102
Q

what medical treatment is there for hyperthyroidism?

A

carbimazole and propylthiouracil

these inhibit the production of thyroid hormone

beta blockers can also be given for hyper

103
Q

what is the major side effect of carbimazole

A

agranulocytosois

104
Q

what surgical treatment is there for hyperthyroidism?

A

remove the gland

105
Q

treatment for hypothyroidism?

A

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

Endocrine (29 decks)

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