Clinical biochemistry of endocrine disease

Question 1

Give an example of an endocrine disease

Answer 1

Diabetes

Question 2

What % of diabetes patients have type 1?

Answer 2

8%

Question 3

How is diabetes diagnosed?

Answer 3

Blood glucose

Question 4

What colour blood bottle is used to hold blood for diabetes tests?

Answer 4

Grey tubes, Due to flouride inhibiting metabolism of the glucose

Question 5

What is normal fasting plasma glucose?

Answer 5

> 7 mmol/L glucose

Question 6

How does the glucose tolerance test work?

Answer 6

A patients fasting level is measured, Then they’re given 75g of glucose and remeasured after 2 hours. If the levels are still raised they are likely diabetic

Question 7

What are the complications of diabetes?

Answer 7

Excessive insulin

Question 8

What is the thyroid?

Answer 8

The thyroid is a system which uses negative feedback in order to control hormone production

Question 9

Give an example of a thyroid disease

Answer 9

Hypothyroidism
Hyperthyroidism

Question 10

What are the symptoms of hypothyroidism?

Answer 10

Slowing of most metabolic processes
- Bradychardia, Weight gain, tiredness

Question 11

What is elevated in hypothyroidism?

Answer 11

TSH

Question 12

How is hypothyroidism treated?

Answer 12

Missing hormones are replaced

Question 13

What are the symptoms of hyperthyroidism?

Answer 13

Speeding up of most metabolic processes
- Tachycardia, Weight loss, tiredness

Question 14

What is elevated during hyperthyroidism?

Answer 14

T4 & T3

Question 15

What is the treatment for hyperthyroidism?

Answer 15

Remove oversecreting tumour

Question 16

What is the function of cortisol in the body?

Answer 16

Maintains blood volume and stimulates gluconeogenesis

Question 17

Where is cortisol secreted?

Answer 17

Within the adrenal cortex

Question 18

Give some examples of diseases caused by disfunction of the adrenal cortex

Answer 18

• Addisons disease
• Cushings syndrome
• Acromegaly
• Hyperprolactinaemia

Question 19

What is Addisons disease?

Answer 19

Failure/damage of adrenals resulting in insufficient corsitol production

Question 20

What are the symptoms of Addisons disease?

Answer 20

Lethargy, pigmentation, abdominal pain

Question 21

How does the short synacthen test work?

Answer 21

You give the patient a synthetic analogue of ACTH which should result in the production of cortisol. If no cortisol is produces after 30 mins there is a problem

Question 22

What is Cushings syndrome?

Answer 22

Excessive production of cortisol

Question 23

What are the symptoms of Cushings syndrome

Answer 23

Hypertension, Obesity, Thinning skin

Question 24

What typically causes Cushings syndrome?

Answer 24

Usually a tumour on the adrenal gland causing over secretion

Question 25

How do you diagnose Cushings syndrome?

Answer 25

Look at physical symptoms then measure ACTH

Question 26

What type of tumour would a supressed ACTH show?

Answer 26

Adrenal gland tumour

Question 27

What type of tumour would an elevated ACTH show?

Answer 27

Ectopic tumour

Question 28

What is acromegaly?

Answer 28

Excessive growth hormone

Question 29

What are the clinical features of acromegaly?

Answer 29

Corase facial features Increase in shoe size Excessive sweating