zero to final end conditions Flashcards
what does the anterior pituitary gland release
TSH, ACTH, FSH, LH, GH and prolactin
what does posterior pituitary secrete
oxytocin- uterine contractions and lactation
ADH- maintains water balance
thyroid results in primary hyperthyroidism
thyroid gland is not working so producing excess T3 and T4
TSH is suppressed by the high levels of T3 and 4
thyroid results in secondary hyperthyroidism
Pituitary gland isn’t working so produces lots of TSH
TSH will be high and so will T3 and T4
thyroid results in primary hypothyroidism
Thyroid isn’t behaving so no negative feedback so high TSH but low T3 and T4
thyroid results in secondary hypothyroidism
pituitary not behaving no low TSH and low T3 and T4
typical symptoms of graves disease
exopthalamos
pretibial myxoedema
goitre
symptoms of hyperthyroidism
weight loss and heat intolerance
anxiety
insomnia
brisk reflexes
de quervains thyroiditis
thyrotoxicosis
hypothyroidism
return to normal
what antibodies are associated with hashimotos thyroiditis
anti-thyroid peroxidase and anti-thyroglobulin
presentation of hypothyroidism
weight gain and cold intolerance
coarse hair and hair loss
what type of steroid is cortisol
glucocorticoids
what type of steroid is aldosterone
mineralcorticoids
cushings syndrome
prolonged high levels of glucocorticoids produced from adrenal glands
cushings disease
pituitary adenoma secreting ACTH
what disease do you use the dexamethasone test for
if cortisol isn’t suppressed then you have cushings
It should usually be suppressed by negative feedback
24 urinary free cortisol
used for cushings
how do you investigate aldosteronism
aldosterone to renin ratio
how do you manage aldosteronism
aldosterone antagonists
what is the most common cause of secondary hypertension
hyperaldosternism
signs of adrenal insufficiency
bronze hyperpigmentation as ACTH stimulates melanocytes to produce melanin
hypotension
what do you get hyponatraemia
adrenal insufficiency
Other blood investigations from adrenal insufficiency
high potassium
low glucose
raised urea
hypercalaemia
tests for adrenal insufficiency
short synacthen test
management of adrenal insufficiency
hydrocortisone
fludocortisone
addisonain crisis symptoms
reduced consciousness
hypotension
hypoglycaemia
hyponatraemia
management of addisonain insufficiency
IV or IM hydrocortisone
IV fluids
most common cause of acromegaly
pituitary adenoma
investigations for acromegaly
IGF-1
GH suppression test
MRI of pituitary
what hormone does somatostatin compress
GH
which cells produce parathyroid hormone
chief cells
how does PTH increase calcium
increasing osteoclast activity in bones
increasing calcium reabsorption
increasing Vit D so more calcium absorbed in the intestines
symptoms of hypercalcaemia
kidney stones, painful bones, abdominal groans, psychiatric moans
how do you get increased production of ADH
increased secretion by posterior pituitary
ectopic ADH by small cell lung cancer
what happens with excessive ADH
increased water reabsorption in the collecting ducts diluting the blood and reducing sodium concentration
what sort of urine do patients with SIADH have
high urine osmolarity and high urine sodium
symptoms of SIADH
headache, fatigue, muscle aches and confusion
how does diabetes insipidus occur
a lack of antiduiretic hormone and lack of response to the hormone
presentation of diabetes insipidus
polyuria, polydipsia, dehydration, postural hypotension
investigations for diabetes insipidus
low urine osmolarity
more than 3 litres on 24 hrs urine collection
primary polydipsia vs diabetes insipidus
water deprivation test shows high urine osmolarity ruling out diabetes
phaeochromocytoma disease
tumour in the chromatin cells that secrete unregulated and excessive amounts of adrenaline
Test for catecholamines
plasma free metanephrines
24 hr urine catecholamines
Management of phaeochromocytoma
- alpha blockers
- beta blockers
- surgical removal of the tumour
