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mrcog part 1 > Revision notes: 6. Endocrinology > Flashcards

Revision notes: 6. Endocrinology Flashcards

1
Q

Ovulation occurs how long after LH surge

A

24-36 hours after commencement of LH surge

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2
Q

What happens to level of Sex hormone binding globulin during pregnancy

A

Levels increase

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3
Q

Treatment for gestational DI

A

DDAVP (Vasopressinase-resistant 1-deamino-8-D-arginine vasopressin)

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4
Q

Where is oxytocin synthesised

A

Paraventricular nucleus of hypothalamus

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5
Q

Which layer of the endometrium is shed during menstruation

A

Stratum Functionalis

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6
Q

Blood supply to endometrium

A

Spiral arterioles (originate from radial branches of arcuate arteries, which in turn arise from uterine arteries)

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7
Q

Which gene variant of LH reported in patients with PCOS

A

LH beta-subunit

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8
Q

Inheritance pattern of vit D resistant rickets

A

X-linked dominant

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9
Q

what are the three oestrogens

A

E1 Oestrone - MENOPAUSE
E2 Oestradiol - Non-pregnant state
E3 Oestriol - Pregnant

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10
Q

How does oestrogen increase coagulability

A

Decreases anti-thrombin 3
Increases levels of II, VII, IX, X
Increases plasminogen
Increases platelet adhesiveness

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11
Q

GI oestrogen effects

A

Reduced GI motility
Increased bile production

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12
Q

How much progesterone does placenta produce at term

A

250mg/day

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13
Q

Progesterone effects on uterus, cervix and vagina

A

Converts endometrium from proliferative to secretory
Withdrawal causes menstruation
Inhibits uterine contraction until term

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14
Q

What cell type secretes inhibin

A

Ovarian Granulosa cells

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15
Q

Inhibin selectively inhibits secretion of?

A

FSH

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16
Q

Where is testosterone secreted

A

Leydig cells of testes
Theca cells of ovary
Zona reticularis of adrenals
Placenta

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17
Q

Which enzyme catalyses conversion of testosterone to DHT (dihydrotestosterone)

A

5a reductase

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18
Q

Features of 5a reductase deficiency

A

High testosterone
Low DHT
Gynaecomastia
Ambiguous genitalia at birth

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19
Q

Sex-hormone binding globulin - which chromosome

A

17

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20
Q

Two types of neurones in paraventricular nucleus

A

Magnocellular
Parvocellular

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21
Q

Magnocellular neurones produce

A

Oxytocin
ADH

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22
Q

Parvocellular neurones produce

A

CRH
ADH
TRH

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23
Q

Dopamine inhibits

A

Prolactin

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24
Q

GnRH gene location

A

Chromosome 8

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25
Structure of FSH
``` Alpha subunit (chromosome 6) Beta subunit (chromosome 11) ```
26
Function of FSH in women
Stimulates ovary to produce Graafian follicle
27
Structure of LH
``` Alpha subunit (chromosome 6) Beta subunit (chromosome 19) ```
28
LH function
Stimulates oestrogen and progesterone production Induces ovulation Prevents apoptosis of corpus luteum
29
Features of Kallmann syndrome
Delayed/absent puberty Impaired sense of smell
30
Oxytocin causes smooth muscle contraction of:
1. Uterine muscle 2. Myoepithelial cells surrounding breast alveoli
31
Zona glomerulosa produces?
Mineralocorticoids e.g. aldosterone
32
Zona fasciculata produces
Glucocorticoids e.g. cortisol
33
Name of modified neural crest cells in adrenal medulla
Chromaffin cells
34
Angiotensinogen is secreted by the
Liver
35
Renin catalyses conversion of
Angiotensinogen to Angiotensin I
36
Drug causes of SIADH
SSRI Carbamazepine Thiazide Vinblastine
37
Demeclocycline treats SIADH because...
It induces nephrogenic DI
38
Test for congenital hypothyroidism
Guthrie test
39
Carbimazole and Propylthiouracil are treatments for
hyperthyroidism
40
Diagnosis of phaeochromocytoma
measuring urinary levels of vanillylmandelic acid (VMA) & metanephrine
41
Treatment of prolactinoma
dopamine agonists
42
How does the fetus cause parturition
Fetal pituitary releases corticotrophin, acts on fetal adrenals fetal adrenals release cortisol & DHEAS Fetal adrenal DHEAS metabolised in placenta leading to increased oestrogen levels, which provoke release of prostaglandin F from decidua causing myometrial contractions
43
What neuronal reflex triggered by pressure on the cervix causes oxytocin release
Ferguson reflex
44
Lactational amenorrhoea is reliable form of contraception if:
Baby exclusively breastfed Amenorrhoea (\<6 months post-partum)
45
Which hypothalamic hormone stimulates release of prolactin
TRH Thyrotrophin-releasing hormone
46
What inhibits glucagon release
Free fatty acids
47
What is the ratio of testosterone bound to sex hormone-binding globulin (SHBG) and albumin respectively?
1% free, 19% albumin-bound and 80% SHBG-bound
48
Most common cause of hyperprolactinaemia
Primary hypothyroidism
49
What is an appropriate endocrine response to low, detected serum calcium levels?
Increased PTH, increased phosphate excretion, increased calcitriol and reduced calcitonin
50
With regard to the renin-angiotensin system, where are the juxtaglomerular cells located?
Afferent arteriole in the kidney
51
What are the classical blood test results in Addison’s disease?
Hyperkalaemia, hyponatraemia, uraemia, hypercalcaemia and eosinophila
52
Treatment of hyperthyroidism during pregnancy
Propylthiouracil
53
Most common cause of delayed puberty
Constitutional delay
54
Which three hormones consist of almost identical alpha chains?
HCG, FSH, LH
55
Hormone secreted by acidophil cells in anterior pituitary
Growth Hormone
56
Hormone significantly increased on day 0 of menstrual cycle
FSH
57
Finite life span of corpus luteum
14 days
58
Where in the body is calcidiol produced?
Liver
59
How does oestrogen cause salt and water retention
stimulates renin and angiontensin --\> inc aldosterone secretion
60
hcg is produced by
syncytiotrophoblast
61
when does hcg take over from LH in supporting corpus luteum
8 days after ovulation (1 day after implantation)
62
Progesterone .......... HCG secretion
inhibits
63
hcg level at 1) first missed period and 2) peak (10 weeks gestation)
100IU/L 100,000IU/L They then fall to 10-20K at 18-20 weeks and remain this level to term HIGHER IN FEMALE FOETUS
64
The main placental oestrogen is
oestriol Fetal DHEA-S is hydroxylated by foetal liver to 16-alpha-hydroxy-DHEA-S. This is used by placenta to make OESTRIOL First detected at 9 weeks gestation
65
relative levels of oestrogens during pregnancy
oestriol levels increase 1000 fold oestradiol and oestrone increase 100 fold MUM has more OESTRADIOL BABY has more oestriol
66
progesterone is produced by corpus luteum until
10 weeks gestation Placenta starts making progesterone at 7 weeks gestation and is exclusive producer from 10 weeks onwards
67
Biological half life of LH
20 minutes
68
What stimulates granulosa cell proliferation
FSH
69
half life of FSH
3-4 hours
70
the zona pellucida seperates the ...... from the ......
oocyte granulosa cells
71
inhibin effects on androgens and aromatisation
stimulates androgen secretion reduces aromatisation capacity of granulosa cells
72
Presence of what stops menstrual blood from clotting
fibrinolysin
73
AMH is produced by
granulosa cells of the preantral and small antral follicles it aids selection of the dominant follicle
74
progesterone receptor type
nuclear receptor
75
Sperm concentration in semen
20million/ml
76
Erection : nerve supply
parasympathetic impulses from nervi erigentes (S2, 3, 4)
77
Ejaculation: nerve supply
sympathetic via L1-L2 through hypogastric plexus
78
Testosterone to oestrogen conversion happens in
sertoli cells
79
thick inner foetal zone of foetal adrenal cortex produces DHEA-S. What is this converted to in placenta
oestradiol and oestrone
80
Early growth of fetal adrenal gland is independent of
ACTH
81
Activin ........... fetal ACTH stimulated steroidogenesis
enhances
82
Where is Human Placental Lactogen secreted
Trophoblast It is NOT influenced by somatostatin or growth hormone releasing hormone
83
HPL effects
Decreases insulin sensitivity Stimulates insulin release Stimulates lipolysis Decreases glucose utilisation RESULT: increased glucose and free fatty acid concentrations which can be transferred to fetus
84
somatostatin production .......... with increasing gestation
decreases
85
At what gestation does placental GH replace pituitary GH
15-20 weeks
86
Gestational diabetes insipidus is caused by
excessive vasopressinase activity (enzyme expressed by placental trophoblasts It metabolises ADH
87
How does aspirin inhibit platelets
blocks thromboxane formation in platelets
88
Dinoprostone is synthetic preparation identical to
PGE2
89
Misoprostol is methyl ester analogue of
PGE1
90
macroadenoma usually associated with prolactin levels greater than
5000
91
medical management of prolactinoma
bromocriptine (dopamine agonist) Cabergoline
92
Most common cause of Conn's syndrome
Idiopathic adrenal hyperplasia
93
ratio of T4:T3 secreted from the thyroid gland
13:1
94
where is calcitonin produced
parafollicular cells of THYROID gland
95
Where is PTH produced
CHIEF cells of PARATHYROID (as a pre-prohormone)
96
steroid hormone biosynthesis: diagram for review
97
Fatty acids have what effect on insulin secretion
fuck all
98
Which two amino acids stimulate insulin AND glucagon secretion
Alanine and arginine
99
first hormone affected in sheehan syndrome
Growth hormone
100
which tissues produce oxytocin
hypothalamus, ovary, testis
101
half-life oxytocin
1 minute
102
ADH is produced by
supra-optic nucleus of hypothalamus
103
increased cortisol levels during pregnancy are caused by
placental corticotrophin releasing hormone (CRH)
104
Thyrotrophin releasing hormone is a
tri-peptide hormone
105

mrcog part 1 (14 decks)

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