Random Endocrine questions Flashcards
Common symptoms of hyperthyroidism
Tremor
Diarrhoea
Weight loss and heat intolerance
Symptoms of Cushing’s syndrome
Weight gain
Acne
Stretch marks
Easy bruising
Common age group for acromegaly
30-50yrs
Dipsogenic diabetes insipidus
Defect or damage to the hypothalamus causing malfunction of the thirst mechanism
Individual is excessively thirsty regardless of their fluid status and consumes large volumes of fluid which suppresses secretion of vasopressin and increases urine output
Antibodies seen in Grave’s disease and Hashimoto’s thyroiditis
Thyroglobulin antibody
Thyroid peroxidase antibody
Antibody specific to Grave’s disease
TSH receptor antibody
Main function of aldosterone
Reabsorption of sodium and water as well as causing excretion of potassium to increase blood volume
Symptoms of hypothyroidism
Weight gain
Dry skin
Hyporeflexia
Hair loss
Cushing’s disease
Results from a benign pituitary adenoma secreting excess ACTH
High levels of ACTH in turn causes increased production of cortisol from the adrenal cortex
Acromegaly signs
Oily skin Visual defects e.g. bitemporal hemianopia Prominent supraorbital ridge Increased jaw prominence Enlargement of tongue (macroglossia) Enlargement of hands &; fingers Enlargement of feet
Sensitive measure of thyroid function
TSH shows if T4 and T3 is adequate for the patient
Useful for identifying hypothyroidism and ensuring an appropriate amount of thyroxine is administered
What stimulates the release of FSH and LH?
GnRH
What is produced by the adrenal cortex?
Cortisol, aldosterone and weak androgens such as 5-DHEA
What is produced by the adrenal medulla?
Noradrenaline
Adrenaline
What are Sertoli cells responsible for producing due to FSH stimulation?
Androgen binding globulin
What hormone stimulates Leydig cells?
LH
What is an Addisonian crisis?
Severe adrenal insufficiency resulting in dangerously low serum cortisol levels
Causes of nephrogenic diabetes insipidus
Inability for the kidneys to respond appropriately the vasopressin (ADH) caused by:
Post-obstructive uropathy
Mutations in the vasopressin (ADH) receptor gene
Lithium
Amyloidosis
Gold standard for diagnosing acromegaly
Oral glucose tolerance test + Growth hormone measurement
Serum IGF-1 can also be useful for acromegaly screening but not ideal for diagnosis
Cushing’s syndrome
Excess cortisol
More common in women
Hashimoto’s disease
A destructive autoimmune disease caused by auto-reactive antibodies against thyroglobulin
Addison’s disease
A long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones
Diabetes Insipidus
Passage of large volumes of dilute urine
Cause of Addison’s disease
Autoimmune destruction of adrenal cortex
Tuberculosis
Adrenoleukodystrophy (rare inherited disorder)
Neurogenic diabetes insipidus
Mutations in the ADH receptor gene
Polycystic kidneys
Most common cause of Cushing’s syndrome
Long term use of glucocorticoid treatments (steroids) which are commonly used to suppress inflammation
Acromegaly
Increased levels of growth hormone stimulate overproduction of IGF1 from the liver
IGF1 stimulates overgrowth of tissues and alters blood glucose / lipid metabolism
Symptoms of Addison’s disease
Weight loss
Fatigue
Postural hypotension
Hyperpigmentation
Grave’s disease
An autoimmune disease directed against thyroid stimulating hormone (TSH) receptors. The autoantibodies stimulate the TSH receptors causing increased T3 and T4 production
Hormones produced by the anterior pituitary gland
ACTH FSH LH TSH Growth hormone Prolactin
Prevalence of acromegaly
Equally distributed between sexes
Hormones produced by the posterior pituitary
Oxytocin
Vasopressin/ADH
Symptoms of acromegaly
Headache Visual changes Paresthesia and weakness in the hands Increased finger ring size Deepening voice Excessive sweating
Underlying problem in neurogenic diabetes insipidus
Underproduction of vasopressin by posterior pituitary
Common cause of acromegaly
Pituitary adenoma due to overgrowth of somatotrophe cells
Rarely caused by ectopic production of growth hormone by carcinoid tumours
Toxic thyroid adenoma
A benign tumour of the thyroid gland which produces excessive amounts of thyroid hormones
Arise from follicular cells of the thyroid
What is the most likely cause of cardiac arrest in a patient with ketoacidosis?
Hypokalaemia therefore need to monitor potassium levels and pt must be attaching to an ECG when administering insulin
Symptoms of pelvic inflammatory disease
Lower abdominal pain (generally bilateral) Deep dyspareunia Dysuria Nausea Vomiting Purulent vaginal discharge
Normal foetal heart rate
110-150bpm
Progesterone and breast
Promotes breast development but inhibits lactation
Endometriosis
A chronic oestrogen-dependent condition characterised by the growth of endometrial tissue in sites other than the uterine cavity, most commonly in the pelvic cavity
Common symptoms include subfertility, dysmenorrhoea, pelvic pain (worse at the time of menstruation or just prior to it), and dyspareunia
Hormone change in menopause
Rise in FSH
Cervical ectropion
Columnar epithelial cells of the cervix are found at the vaginal part of the cervix
Most common cause of post-coital bleeding
What does compression of the pituitary stalk result in?
Hypersecretion of prolactin
What structure lies posterior to the bifurcation of internal iliac artery into anterior and posterior divisions?
Greater sciatic foramen
What condition is associated with syndactyly?
HOX genes
What condition is associated with high TSH levels?
Primary hypothyroidism
What occurs due to the malformation of a first pharyngeal cleft?
Failure of external auditory meatus
Clinical features of hypocalcaemia
Spasms (e.g. Trousseau's Sign) Perioral paraesthesia Anxious, irritable, irrational Seizures Muscle tone increase in smooth muscle (wheeze, dysphagia, colic) Orientation impairment, confusion Dermatitis Impetigo herpetiformis Chvostek's Sign
Other causes of hypocalcaemia
chronic kidney disease, pseudohypoparathyroidism, acute rhabdomyolysis, vitamin D deficiency, hypomagnesaemia, osteomalacia, acute pancreatitis, over-hydration, respiratory alkalosis
Physiological actions of Thyroid hormones
Increase basal metabolic rate - increased carbohydrate metabolism, lipid degradation, protein synthesis, oxygen consumption by different organs, increase effects of insulin and catecholamines
Normal CNS development - myelination of nerves
Normal growth and development
