Endocrine- the rest

Question 1

The hypothalamus is split in to the anterior pituitary and the posterior pituitary. What hormones are secreted from these?

Answer 1

ANTERIOR - multiple hormone
 - growth hormone 
- thyroid stimulating hormone (TSH)
- adreno-corticotrophic hormone (ACTH)
- FSH 
LH 
- prolactin 

POSTERIOR - oxytocin (uterus contractions)
ADH( reabsorption of water from urine)

Question 2

Hyperpituitarism related effects normally happen due to adenomas, cancer or hyperplasia . What are hypopituitarism related causes?

Answer 2

• ischaemic necrosis of the pituitary: Sheehans syndrome
• non functioning adenomas
• surgery or irradiation
• inflammatory lesions

Question 3

What are the symptoms of hyper-pituitarisms and hypo-pituitary problems?

Answer 3

• compressing the optic chiasm
• visual problems
• treated by scapping away adenoma

Question 4

When a pituitary adenoma occurs what does each of these hormone increases lead to:

• ACTH
• Growth hormone
• Prolactin
• TSH
• FSH/LH

Answer 4

ACTH - crushings disease

growth hormone - gigantism (children)
- acromegaly (adults) (facial features)

Prolactin - galactorrhea/ amenorrhea

• sexual dysfunction
• infertility

TSH - hyperthyroidism

FSH/LH - hypogonadism

• mass effects
• hypopituitarism

Question 5

What causes hyperthyroidism?

Answer 5

• Graves disease (auto immune )
• over treatment by thyroxine
• infective - De Quervains thyroiditis (viral infection)
• toxic multinodular goitre
• toxic adenoma

Question 6

What are the symptoms of hyperthyroidism?

Answer 6

• heat intolerance
• muscle wasting
• localised oedema
• tremors
• weight loss
• enlarged thyroid
• finger clubbing
• menstrual changes
• bulging eyes

Question 7

What causes graves disease?

Answer 7

• unregulation overproduction of thyroid hormones
• antibody sits on receptor
• so switches off THS production - thyroxine increases

Question 8

*Hyperthyroidism must be managed and treat the cause. What drugs will do this?

Answer 8

• carbimazole/ propylthioracil (down regulate thyroid gland)
• Radioiodine therapy (kills thyroid gland) (must be isolated from children)
• thyroidectomy

Question 9

What causes hypothyroidism?

Answer 9

• iodine deficiency
• Autoimmune - Hashimoto’s thyroiditis
• lacrogenic: surgery, radioiodine
• pituitary defects
• congenital

Question 10

What are the symptoms of hypothyroidism?

Answer 10

• intolerance to cold
• receding hairline
• facial and eyelid oedema
• weight gain
• lethargy
• muscle aches and weakness
• constipation

Question 11

What is Hashimotos thyroiditis?

Answer 11

• autoimmune destruction of the thyroid gland

Question 12

How do you manage hypothyroidism?

Answer 12

• thyroxine

Question 13

What is the most common type of thyroid cancer?

Answer 13

• papillary carcinoma

- however normally non-functional tumour

Question 14

What causes hypo-parathyroidism?

Answer 14

• removal by surgery (thyroidectomy)
• congenital
• hereditary (autoimmune)

Question 15

What are the functions of the parathyroid glands?

Answer 15

• 4 in total

- to help calcium and phosphate regulation

Question 16

What are the symptoms of hypo-parathyroidism?

Answer 16

• symptoms normally due to low calcium
• irritability
• tetany (muscle spasms)
• seizures

Question 17

Hyper-parathyroidism are caused by ?

Answer 17

• adenoma
• chronic renal failure
• after renal transplant

Question 18

What are the symptoms of hyper- parathyroidism

Answer 18

• due to hypercalcemia
• constipation
• depression
• seizures
• muscle wasting
• polyuria
• bone fractures
• kidney stones
  (bones, stones, abdominal groans & psychic moans )

Question 19

What are the symptoms of conns disease which is caused by hyperaldosteronism ?

Answer 19

• oedema
• hypertension
• high sodium
• low potassium

Question 20

Glucocorticoids: corticol may increase due to stress, using steroids. What is caused when there is excess release?

Answer 20

• cushings syndrome
• due to ACTH releasing tumours
• or steroid use

Question 21

What are the symptoms of cushings syndrome/ long term steroid use ?

Answer 21

• moon face
• buffalo hump
• thin, wrinkled skin
• adrenal tumour or hyperplasia
• muscle weakness
• poor wound healing

Question 22

What is cushings disease?

Answer 22

• increase in corticol levels

Question 23

Addisons disease is an adrenal insufficiency. What are the causes of it?

Answer 23

• autoimmune
• infection
• secondary to neoplasms

Question 24

What are the symptoms of Addison’s disease?

Answer 24

• GI symptoms (anorexia, nausea, vomiting, diarrhoea)
• weight loss
• hyperpigmentation ((black in the gums ect. ) due to low circulating adrenal levels, ACTH increases)
• low sodium , high potassium
• Addison’s crisis (acute adrenal insufficiency ) - can be due to coming off steroids quickly

Question 25

What is a phaeochromocytoma ?

Answer 25

tumour of the adrenal medulla which secrets adrenaline and noradrenaline
- increases heart rate, BP and metabolic rate

Question 26

What are the presentations of phaeochromocytoma ?

Answer 26

Hypertension
Sweating
Palpitations
Nervousness
Increased metabolic ratio
Rapid heart rate

Question 27

What is multiple endocrine neoplasia? (MEN)

Answer 27

• Group of inherited diseases resulting in proliferative lesions of multiple endocrine organs
• there are different type