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MRCPCH TAS > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Where is the inferior parathyroid derived from?

A

Third pharyngeal pouch

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2
Q

Where is the superior parathyroid derived from?

A

Fourth pharyngeal pouch

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3
Q

Most common cause of congenital adrenal hyperplasia?

A

21-hydroxylase deficiency

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4
Q

Features of 21-hydroxylase deficiency in CAH?

A

Virilisation of girls
Precocious puberty in boys

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5
Q

Features of 11-beta hydroxylase deficiency in CAH?

A

Virilisation in female genitalia
Precocious puberty in boys
Hypertension
Hypokalaemia

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6
Q

Features of 17-hydroxylase deficiency?

A

Non-virilising in females
Inter-sex in boys
Hypertension

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7
Q

What happens to the electrolytes in Cushing’s syndrome?

A

High sodium
Low potassium

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8
Q

Where is melatonin synthesised from?

A

Melatonin is synthesised in the pineal gland from serotonin

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9
Q

What is the age range for normal puberty in boys?

A

9-14 years

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10
Q

What is the age range for normal puberty in girls?

A

8-14 years

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11
Q

Outline the normal sequence of puberty in girls?

A

Breast development
Height spurt
Menarche

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12
Q

What is the normal sequence of puberty in boys?

A

Testicular growth
Enlargement of the penis
Pubic hair development
Facial hair
Height growth

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13
Q

What are the causes of advanced bone age?

A

Endocrine causes - precocious puberty, adrenal pathology (CAH, adrenocorticol tumour), intracranial lesions (astrocytoma, craniopharyngioma), Cushing’s syndrome, hyperpituitarism, hyperthyroidism

Genetic causes - Soto’s syndrome, McCune Albright, Beckwith-Wiedemann, Homocystinuria, Marshall-Smith

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14
Q

Causes of delayed bone age?

A

Constitutional growth delay
Chronic disease
Neglect
IUGR
Genetic disorders (trisomy 21, trisomy 18, Turner syndrome)
Congenital dwarfism
Endocrine (hypothyroidism, hypopituitarism, hypogonadism, Cushing disease, diabetes, Addison’s disease, hypoparathyroidism)

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15
Q

Hormone profile in Kallman’s syndrome?

A

Reduced testosterone
Reduced LH/ FSH

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16
Q

Where is PTH secreted from?

A

Chief cells in the parathyroid hormone

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17
Q

What are the actions of PTH?

A

Bone - Binds to osteoblasts which signal to osteoclasts to cause resorption of bone and release calcium

Kidney - Active reabsorption of calcium and magnesium from the distal convoluted tubule. Decreases reabsorption of phosphate

Intestine - Increases intestinal calcium absorption by increasing activated vitamin D. Activated vitamin D increases calcium absorption

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18
Q

Where is glucagon released?

A

Alpha cells in the Islet of Langerhans

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19
Q

Where is Insulin released?

A

Beta cells in the Islet of Langerhans

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20
Q

Where is Somatostatin released?

A

Delta cells in the Islet of Langerhans

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21
Q

Which hormone DECREASES prolactin secretion?

A

Dopamine

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22
Q

Which hormone INCREASES prolactin secretion?

A

Thyrotropin releasing hormone

(also pregnancy, oestrogen, breastfeeding, sleep, stress, metoclopramide, antipsychotics)

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23
Q

Congenital adrenal hypoplasia =

A

Children often present in the neonatal phase with an adrenal crisis (hyponatraemia, hyperkalaemia, hypotension, dehydration, hypoglycaemia)

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24
Q

Where is secretin released?

A

Mucosal cells in the duodenum and jejunum

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25
Q

What are the likely blood results for adrenal insufficiency e.g. Addisons disease?

A

Low cortisol
High renin
Low sodium
High potassium
Hypoglycaemia
Metabolic acidosis

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26
Q

Which amino acid are all catecholamines derived from?

A

Tyrosine

27
Q

Where is adrenaline and noradrenaline secreted from?

A

The chromaffin cells of the adrenal medulla

28
Q

What is the most common thyroid malignancy?

A

Papillary carcinoma

29
Q

What is the hormone profile for PCOS?

A

Raised LH:FSH ratio
Insulin resistance
High dehydroepiandrosterone (DHEA-S)
High free and total testosterone
Normal oestrogen

30
Q

Causes of hypokalaemia with hypertension?

A

Conn’s syndrome
Cushing’s syndrome
Liddle syndrome
11 beta hydroxyls deficiency (cause of CAH)

31
Q

Causes of hypokalaemia without hypertension?

A

Diuretics
GI losses
Renal tubular acidosis (type 1 and 2)
Bartter’s syndrome
Gitelman syndrome

32
Q

Which drugs cause gynaecomastia?

A

Spironolactone
Digoxin
Cimetidine
Cannabis
Oestrogen
Anabolic steroids
Finesteride

33
Q

What are the properties of octreotide?

A

Mimics somatostatin
Inhibits growth hormone and insulin

34
Q

Function of ADH?

A

Purely concerned with water reabsorption therefore SIADH leads to normovolaemic hyponatraemia

35
Q

What are psammoma bodies?

A

Clusters of microcalcifications - typically seen in papillary carcinomas (thyroid)

36
Q

Which two hormones are released from the posterior pituitary?

A

ADH
Oxytocin

37
Q

What are the criteria for diagnosis of McCune Albright syndrome?

A

Polyostotic fibrous dysplasia
Cafe-au-lait skin pigmentation
Autonomous endocrine hyperfunction (manifesting as hyperthyroidism, acromegaly, Cushing syndrome)

38
Q

Where in the adrenal gland is cortisol produced

A

Zona fasciculata of the adrenal

39
Q

Adrenal insufficiency causes…?

A

Hyponatraemia and Hyperkalaemia

40
Q

Which cells produce testosterone?

A

Leydig cells secrete testosterone in response to LH stimulation

41
Q

Treatment of minimal change disease?

A

Steroids (prednisolone)
ACEi
Diuretics
Immunosuppresants (cyclophosphamide)

42
Q

Where does the left testicular vein drain into?

A

Left renal vein

43
Q

Where does the right testicular vein drain into>

A

Inferior vena cava

44
Q

Which pump defect is associated with distal renal tubular acidosis?

A

H+/K+ ATPase

45
Q

Which abnormality predisposes to testicular torsion?

A

A patent processus vaginalis

46
Q

Triad of thrombocytopenia, renal failure and microangiopathic haemolytic anaemia?

A

Haemolytic uraemia syndrome

47
Q

What are the blood results for HUS?

A

Low platelets
High WCC
Increased urea
Increased creatinine
Increased LDH

Urine dipstick will show haematuria and proteinuria

48
Q

Renal scarring investigation?

A

DMSA

49
Q

Vesico-ureteric reflux disease?

A

Micturating cystourethrogram

50
Q

Which nerve innervates the posterior skin of the scrotum?

A

Pudendal nerve

51
Q

In what manner is growth hormone released?

A

Pulsatile manner

52
Q

Features of hypercalcaemia?

A

Bones, stones, moans, groans

53
Q

What are the features of polyglandular endocrinopathy type 1?

A

Mucocutaneous candidiasis
Addison’s disease
Parathyroid gland dysfunction

54
Q

What are the features of polyglandular endocrinopathy type 2?

A

Most common type

Addisons disease and thyroid dysfunction +/- T1DM

55
Q

What is the typical finding on a muscle biopsy in patients with thyroid disease?

A

Checkerboard pattern of necrosis and regeneration

56
Q

What is somatostatin also known as?

A

Growth hormone inhibiting hormone

57
Q

What does 5 alpha reductase deficiency cause?

A

XY males but have external female genitalia - androgen insensitivity syndrome

58
Q

Which hormones are decreased in a stress reponse?

A

Insulin
Testosterone
Oestrogen

59
Q

Causes of hypogonodotrophic hypogonadism?

A

Kallman’s syndrome
Prader-Willi syndrome
Bardet-Biedl syndrome

60
Q

Causes of Hypergonadotrophic hypogonadism?

A

Noonan’s
Turners
Prader-Willi
Klinefelters

61
Q

Identical twin risk of T1DM?

A

30-50%

62
Q

Alcohol …. glucogenolysis?

A

Alcohol inhibits glycogenolysis

63
Q

Which mutations account for MODY?

A

Glucokinase mutations

MRCPCH TAS (8 decks)

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