Basic Principles Flashcards Preview

SM Endocrine > Basic Principles > Flashcards

Flashcards in Basic Principles Deck (61):
1

At what stage in pregnancy is a goitre seen

Perinatal period

2

Many endocrine disorders are associated with defects in what

GPCRs

3

What do GPCRs act as

Biological sensors

4

What is a good example of intrinsic tyrosine kinase activity

Insulin receptor

5

What are 2 examples of cytokine receptors

Prolactin receptor and growth hormone

6

What are cytokine receptors linked to

Tyrosine kinase activity

7

Steroid hormones are typically intracellular or extracellular

Intracellular

8

Where exactly are steroid hormone receptors located

either in the cytoplasm or the nucleus

9

What are included in the nuclear receptor family

Oestrogen, androgen receptos

10

What do steroid/receptor complexes do ?

Bind DNA response elements

11

When do receptors translocate to the nucleus

Only when a hormone or a ligand is present

12

Give an example of a steroid hormone receptor and what it does

Testosterone
It causes alterations in gene transcriptions with interactions with DNA

13

What can a circulating corticosteroid that is bound to by either a hormone or a ligand cause

Transactivation or transrepression

14

What is the master regulator of hormones

Pituitary gland

15

At what sites can the pathways be disrupted

Hypothalamus
Pituitary gland
Peripheral glands e.g. thyroid, adrenal, cortex or gonad

16

What does a disruption in a pathway result in

Endocrine problems

17

Where is the site of central regulation from the hypothalamus

Anterior pituitary gland

18

What are the 5 hormones secreted by the anterior pituitary gland

Growth hormone
LH/ FSH
Adrenocorticotropic hormone
Thyroid stimulating hormone
Prolactin (PRL)

19

What is secreted by the posterior pituitary gland

ADH or vasopressin

20

What factors affect the ability to accurately measure hormone levels

Pattern of secretion
The presence of carrier proteins
Interfering agents
Stability of hormone (consider 1/2 life)
Absolute concentrations

21

What is a major determinant of hormone concentration?

Rate of secretion

22

Measuring hormones is typically determined by highly refined by what

Feedback loops - ie. need to know the right time to measure the right hormone levels (circadian rhythm)

23

What types of hormones are commonly evaluated

Thyroid hormones
Steroid hormone production (e.g. cortisol)
Growth hormone evaluation
Reproductive and sex hormone (e.g. testosterone)
Prolactin
Calcium and parathyroid homrone

24

Why might reproductive hormones be evaluated

Infertility
Puberty
Loss of libido
Erectile dysfunction

25

What is the function of renin and aldosterone and what gland are the associated with

Adrenal gland
They regulate salt and water balance

26

When might TSH not be a reliable marker of Thyroid status

If the patient had a primary hypothalamic pituitary problem e.g. a tumour and was therefore unable to secrete TSH

27

What does the thyroid axis rely on

highly regulated feedback control

28

What does the patient have if they have a raised TSH

Hypothyroid

29

What does the patient have if they have a suppressed TSH

Hyperthyroid

30

What hormone has the strongest circadian rhythm in humans

Cortisol

31

When are the cortisol levels highest

First thing in the morning

32

When should cortisol be measured

First thing in the morning when they should be at their peak

33

Describe the release of growth hormone from the pituitary

Under pulsatile release from and short lived in the blood

34

What happens if there is excess growth hormone before puberty was complete

Marked elongation within the long bones of the body

35

What happens if the growth hormone was in too little quantities around puberty

Dwarfism

36

Describe the relationship between gamete production and sex hormone synthesis

These are coordinated so there is a close relationship

37

What is prolactin secreted by

Lactotroph cells of the anterior pituitary

38

The effects of Prolactin are mediated by what

The prolactin receptor (PRLR)

39

Where is thirst tightly regulated within

The hypothalamus

40

What are the 3 main steroid hormones that can lead to specific endocrine disorders

Aldosterone
Cortisol
Testosterone

41

What happens if the body can't produce the precursors of steroid hormones

There will be an excess of the hormone

42

When is biochemical testing typically perfumed with regards to imaging

Before imaging

43

To test for hormone excess, what test do we do

Suppression test

44

To test for hormone deficiency, what test do we do

Stimulation test

45

In what situation might there be a need for combined imaging/ biochemical testing

Adrenal vein sampling or petrosal sinus sampling

46

If there is a cortisol deficiency, what does this mean

You have adrenal insufficiency

47

If there is primary adrenal failure, what disease is this known as

Addison's disease

48

Cortisol excess is more commonly known as what

Cushing's syndrome

49

Stimulation test with cortisol is known as what

Synacthen tes

50

What is the cortisol suppression test known as

Dexamethasone suppression test

51

What are some symptoms of Cushing's syndrome

Cushingoid facies
Acne
Hirsutism
Abdominal striae and centripetal obesity
Inter scapular and supraclavicular fat pads
proximal myopathy
osteoporosis
hypertension
impaired glucose tolerance

52

What is important to know before removing any adnreal gland

Whether it is unilateral or bilateral

53

What are some causes of Cushing's syndrome

High levels of ACTH
Increased production of cortisol
Ectopic ACTH
Exogenous steroids (causing ACTH to be switched on)

54

Investigation for Cushings can be done as an outpatient or always an inpatient

Outpatient

55

If there is a failure to suppress in a low dose dexamethasone suppression test what does this indicate

Cushing's syndrome

56

If the ACTH is low, what does this indicate

Adrenal origin is likely

57

What can be lost if there is a pituitary tumour or an adrenal tumour

The circadian rhythm

58

What is MEN

Multiple endocrine neoplasia

59

What gene is affected in MEN1

MEN 1 gene - 11q

60

What gene is affected in MEN2

RET gene - 10q

61

What are 2 of the most important things to try and avoid with patients with MEN1

Premature morbidity and mortality