Principles of Endocrinology

Question 1

most diverse hormone subtype?

Answer 1

proteins and peptides

Question 2

what are prehormones?

Answer 2

large inactive hormones that undergo proteolytic change

Question 3

name the 4 main hormone receptors

Answer 3

GPCR
receptor tyrosine kinase
steroid hormone receptors
cytokinase receptors (linked to TK activity)

Question 4

what hormone receptor does insulin use?

Answer 4

tyrosine kinase receptor

Question 5

what are the main chemicals involved in signalling cascades within GPCR?

Answer 5

cAMP

IP3

Question 6

what receptors are seen as the main sensors of the internal environment?

Answer 6

GPCR

Question 7

what happens to TK receptors when insulin binds?

Answer 7

undergo a conformational change

Question 8

name 2 hormones that perform signalling via TK activity?

Answer 8

prolactin receptor

growth hormone receptor

Question 9

are steroid hormone reeptors usually intra or extra cellular?

Answer 9

intracellular

Question 10

where in the cell are steroid receptors typically located?

Answer 10

cytoplasm

nucleus

Question 11

what is the main aim of hormones that signal via steroid hormone receptors?

Answer 11

to change gene transription

Question 12

how does the hypothalamus control release of hormones from the anterior pituitary?

Answer 12

via hypothalamic releasing hormones

Question 13

main determinant of hormone concentration?

Answer 13

rate of secretion

Question 14

what is the only hormone not to be triggered by hypothalamic secretion?

Answer 14

prolactin

Question 15

what hormones should be tested regularly?

Answer 15

thyroid
steroid
GH
reproductive and sex hormones
prolactin

Question 16

2 types of negative feedback?

Answer 16

short or long acting loop

Question 17

what would a normal TSH indicate?

Answer 17

normal thyroid

Question 18

what would a raised TSH indicate?

Answer 18

hypothyroid

Question 19

what would a suppressed TSH indicate?

Answer 19

hyperthyroid

Question 20

when would TSH not be a reliable marker of thyroid status?

Answer 20

if you have pituitary disease eg secondary hypothyroidisim or pituitary cancer

Question 21

what is your first line hormone test?

Answer 21

TSH levels

Question 22

what hormone test would you do if the first line test was normal?

Answer 22

T3/4 levels

Question 23

are thyroid levels affected in illness?

Answer 23

yes, you get low free T3/4 and low/normal TSH

Question 24

what are the most important hormones for survival?

Answer 24

cortisol

thyroid hormones

Question 25

what are the least important hormones in terms of survival?

Answer 25

sex | growth hormone

Question 26

what hormones are lost first in pituitary dysfunction?

Answer 26

sex | GH

Question 27

what hormone is affected in diabetes insipidus?

Answer 27

ADH

Question 28

what imaging can be used to look at the thyroid?

Answer 28

MRI

Question 29

what is a synacthen test?

Answer 29

tests the adrenal gland for ACTH production (synACTHen)

Question 30

how is cortisol made

Answer 30

hypothalamus secretes corticotropin releasing hormone anterior pituitary secretes ACTH reaches the adrenal cortex stimulates adrenal cortex to release cortisol

Question 31

when is the best time to measure cortisol levels in suspected cushing's syndrome and why?

Answer 31

midnight, should be virtually 0 in normal people but will be high in cushings

Question 32

measurement of what protein can indicate GH hypersecretion?

Answer 32

IGF-1

Question 33

how do hormones regulate their own secretion once they are released?

Answer 33

via negative feedback

Question 34

when is the best time to measure testosterone?

Answer 34

9am

Question 35

where are a female's sex hormones at their highest?

Answer 35

around ovulation (all depends on menstrual cycle)

Question 36

what cells in the anterior pituitary gland release prolactin?

Answer 36

lactotroph cells

Question 37

what hormone inhibits prolactin?

Answer 37

dopamine

Question 38

does an ncrease or decrease in prolactin affect fertility?

Answer 38

too much

Question 39

a decrease in prolactin puts you at risk of what disease?

Answer 39

hypogonadism

Question 40

what drugs are a particular cause of hyperprolactinaemia?

Answer 40

dopamine antagonists

Question 41

does angiotensin 1 or 2 act on the hypothalamus to get it to release vasopressin?

Answer 41

angiotensin 1

Question 42

how does vasopressin increase arterial pressure?

Answer 42

contricts blood vessels | increases fluid reabsorption at kidneys

Question 43

what part of the pituitary secretes vasopressin?

Answer 43

posterior

Question 44

what hormones are derived from cholesterol?

Answer 44

aldosterone cortisol sex hormones

Question 45

what kind of test would you do for a hormone excess?

Answer 45

suppression test

Question 46

what kidn of test would you do for a hormone deficiency?

Answer 46

stimulation test

Question 47

should you do imaging or biochemical testing first?

Answer 47

biochemical testing

Question 48

where is the pathology in cushing's disease?

Answer 48

pituitary gland

Question 49

is cushings from an excess or deficiency in cortisol?

Answer 49

excess

Question 50

what test would you do for cortisol excess?

Answer 50

dexamethasone suppression test

Question 51

what test would you do for cortisol deficiency?

Answer 51

synacthen test

Question 52

clinical presentation of cushings?

Answer 52

``` moon face acne testicular atrophy fat pads on back (hump) proximal myopathy ```

Question 53

what causes pituitary cushings?

Answer 53

tumour from corticotroph cells in anterior pituitary

Question 54

what causes ACTH independent cushings?

Answer 54

adrenal adenoma

Question 55

what can cause ectopic ACTH production?

Answer 55

malignancy

Question 56

1st line screening test for excess cushings?

Answer 56

1mg overnight dexamethasone suppression test

Question 57

1st line screening test for ACTH?

Answer 57

ACTH