W2L2 Inv End Case

Question 1

Glands of the Endocrine System

Answer 1

1. Hypothalamus
2. Posterior Pituitary
3. Anterior Pituitary
4. Thyroid
5. Parathyroids
6. Adrenals
7. Pancreatic islets
8. Ovaries and testes

Question 2

Hypothalamus hormone?

Answer 2

1. Corticotropin-releasing hormone (CRH)
2. Thyrotropin-releasing hormone (TRH)
3. Growth hormone-releasing hormone (GHRH)
4. Gonadotropin-releasing hormone (GnRH)
5. Somatostatin=inhibits GH and TSH

Question 3

Anterior Pituitary hormone?

Answer 3

1. Growth Hormone (GH)
2. Adrenocorticotropic hormone (ACTH)
3. Thyroid stimulating hormone (TSH)
4. Follicle stimulating hormone (FSH)
   - dev & matur ova
   - coz spermatogenesis
5. Luteinizing hormone (LH)
   - corpus luteum(F), secrete testosterone(M)
6. Prolactin-female breasts/lactation

Question 4

Posterior Pituitary

Answer 4

1. Anti-diuretic Hormone (ADH) (vasopressin)

2. Oxytocin-contract uterus, milk ejection from breasts

Question 5

Thyroid

Answer 5

1. Follicular cells
   - excrete T3 & T4
2. Thyroid C cells
   - Calcitonin

Question 6

Parathyroid

Answer 6

1. Parathyroid hormone (PTH):

- Regulate s calcium & phosphate lvl

Question 7

Adrenal Cortex

Answer 7

1. Mineralocorticoid (aldosterone): -Affect Na+ abs, loss K+ by kidney
2. Glucocorticoids (cortisol):
   - Affects meta & growth, regulate bl sugar lvl, anti-infl action,
3. Adrenal androgens:
   - Dehydroepiandrosterone (DHEA-S) & Androstenedione, Converted to testosterone in periphery

Question 8

Adrenal Medulla

Answer 8

1. Epinephrine & Norepinephrine (NE):

- Neurotransmitter for sympa sys

Question 9

Ovaries

Answer 9

1. Estrogen
2. Progesterone:
   - imp in menstrual cycle
   - maintain preg

Question 10

Testes

Answer 10

1. Androgens, testosterone:

- Male 2ry sex char, sperm production

Question 11

Thymus

Answer 11

• Release thymosin & thymopoietin horm

- Aff maturation T lymphocetes

Question 12

Pineal gland

Answer 12

1. Produce Melatonin (serotonin derived hormone)

2. Modulate sleep patterns, ++ by darkness & - - by light

Question 13

Pancreatic Islet cells

Answer 13

1. Insulin
2. Glucagon
3. Somatostatin

Question 14

ADA Criteria for the Diagnosis of Diabetes

Answer 14

• Fasting plasma glucose(FPG) ≥126 mg/dl OR
• 2H post prandial plasma gluc(PPPG) ≥200 mg/dl OR
• HbA1c ≥ 6.5% OR
• Classic diabetes (polys) sym + RBG ≥ 200 mg/dl

Question 15

Diagnosis of type of DM

Answer 15

1. C-peptide lvl
   - inc in T2DM, dec in T1DM
2. Auto-antibodies
   - (Anti-GAD, Anti islet cell Abs) +ve in T1DM

Question 16

Routine investigation for diagnosis of complication of DM

Answer 16

1. Diabetic retinopathy
   - Fundus exam
2. Diabetic nephropathy
   - Spot urinary albumin/creatinine ratio (UACR), SCr, eGFR
3. Diabetic neuropathy
   - Assess pressure sensation by 10g monofilament testing
   - Assessment of vibration sensation