Principles of Endocrinology Flashcards

1
Q

most diverse hormone subtype?

A

proteins and peptides

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2
Q

what are prehormones?

A

large inactive hormones that undergo proteolytic change

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3
Q

name the 4 main hormone receptors

A

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

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4
Q

what hormone receptor does insulin use?

A

tyrosine kinase receptor

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5
Q

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

A

cAMP

IP3

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6
Q

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

A

GPCR

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7
Q

what happens to TK receptors when insulin binds?

A

undergo a conformational change

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8
Q

name 2 hormones that perform signalling via TK activity?

A

prolactin receptor

growth hormone receptor

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9
Q

are steroid hormone reeptors usually intra or extra cellular?

A

intracellular

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10
Q

where in the cell are steroid receptors typically located?

A

cytoplasm

nucleus

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11
Q

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

A

to change gene transription

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12
Q

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

A

via hypothalamic releasing hormones

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13
Q

main determinant of hormone concentration?

A

rate of secretion

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14
Q

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

A

prolactin

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15
Q

what hormones should be tested regularly?

A
thyroid
steroid
GH
reproductive and sex hormones
prolactin
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16
Q

2 types of negative feedback?

A

short or long acting loop

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17
Q

what would a normal TSH indicate?

A

normal thyroid

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18
Q

what would a raised TSH indicate?

A

hypothyroid

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19
Q

what would a suppressed TSH indicate?

A

hyperthyroid

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20
Q

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

A

if you have pituitary disease eg secondary hypothyroidisim or pituitary cancer

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21
Q

what is your first line hormone test?

A

TSH levels

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22
Q

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

A

T3/4 levels

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23
Q

are thyroid levels affected in illness?

A

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

24
Q

what are the most important hormones for survival?

A

cortisol

thyroid hormones

25
Q

what are the least important hormones in terms of survival?

A

sex

growth hormone

26
Q

what hormones are lost first in pituitary dysfunction?

A

sex

GH

27
Q

what hormone is affected in diabetes insipidus?

A

ADH

28
Q

what imaging can be used to look at the thyroid?

A

MRI

29
Q

what is a synacthen test?

A

tests the adrenal gland for ACTH production (synACTHen)

30
Q

how is cortisol made

A

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

31
Q

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

A

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

32
Q

measurement of what protein can indicate GH hypersecretion?

A

IGF-1

33
Q

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

A

via negative feedback

34
Q

when is the best time to measure testosterone?

A

9am

35
Q

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

A

around ovulation (all depends on menstrual cycle)

36
Q

what cells in the anterior pituitary gland release prolactin?

A

lactotroph cells

37
Q

what hormone inhibits prolactin?

A

dopamine

38
Q

does an ncrease or decrease in prolactin affect fertility?

A

too much

39
Q

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

A

hypogonadism

40
Q

what drugs are a particular cause of hyperprolactinaemia?

A

dopamine antagonists

41
Q

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

A

angiotensin 1

42
Q

how does vasopressin increase arterial pressure?

A

contricts blood vessels

increases fluid reabsorption at kidneys

43
Q

what part of the pituitary secretes vasopressin?

A

posterior

44
Q

what hormones are derived from cholesterol?

A

aldosterone
cortisol
sex hormones

45
Q

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

A

suppression test

46
Q

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

A

stimulation test

47
Q

should you do imaging or biochemical testing first?

A

biochemical testing

48
Q

where is the pathology in cushing’s disease?

A

pituitary gland

49
Q

is cushings from an excess or deficiency in cortisol?

A

excess

50
Q

what test would you do for cortisol excess?

A

dexamethasone suppression test

51
Q

what test would you do for cortisol deficiency?

A

synacthen test

52
Q

clinical presentation of cushings?

A
moon face
acne
testicular atrophy
fat pads on back (hump)
proximal myopathy
53
Q

what causes pituitary cushings?

A

tumour from corticotroph cells in anterior pituitary

54
Q

what causes ACTH independent cushings?

A

adrenal adenoma

55
Q

what can cause ectopic ACTH production?

A

malignancy

56
Q

1st line screening test for excess cushings?

A

1mg overnight dexamethasone suppression test

57
Q

1st line screening test for ACTH?

A

ACTH