Therapeutics of endocrinology

Question 1

What hormone does the anterior and posterior pituitary release?

Answer 1

The anterior releases trophic hormones such as ACTH, GH, FSH/LH, TSH and prolactin
The posterior releases ADH and oxytocin

Question 2

What are some features of acromegaly?

Answer 2

Coarse features
Carpal tunnel syndrome
Big hands and feet
Sweating
Headaches

Question 3

What are some features of ACTH oversecretion?

Answer 3

Round face
Increased weight
Thin Skin
Easy bruising
mood disturbance
hypertension

Question 4

How are pituitary tumours resected?

Answer 4

Through a transphenoidal approach

Question 5

What does graves disease cause?

Answer 5

it is autoimmune attack of the thyroid that causes hyperthyroidism
Can cause problems with eyelid retraction and proptosis

Question 6

What are the symptoms of increased thyroid hormone?

Answer 6

The increased thyroid hormone leads to increased metabolic rate and sympathetic drive – weight loss, increased appetite, heat intolerance, weakness, diarrhoea, sweating, tachycardia (and arrhythmia), and tremor

Question 7

How is hyperthyroidism treated?

Answer 7

With symptomatic relief from beta blockers
Can be treated with carbimazole that decrease the activity of the thyroid peroxidase enzyme so less thyroid hormones are produced – generally takes 12-18 months
If this fails surgical resection or radioactive iodine can be used

Question 8

What are some of the causes of hypothyroidism? How is it treated?

Answer 8

Autoimmune
Iatrogenic
Iodine deficiency
Congenital

Treated with levothyroxine

Question 9

What are the four main classes of diabetes drugs?

Answer 9

• Insulin sensitisers such as metformin
• Insulin releasers such as sulphoyureas - take effect faster than metformin
• Insulin replacement
• Increased glucose excretion - drugs targeting SGLT2 in the proximal tubule