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Flashcards in Endocrinology Deck (150):
1

What will you cause if you prescribe your patient too much hydrocortisone?

Cushing's syndrome

2

Which layer of the adrenal cortex synthesises aldosterone?

Glomerulosa

3

Which half of the pituitary has a vascular link to the hypothalamus?

Anterior

4

What class of drug is propylthiouracil?

Thioamine

5

Which hormone mediates the effects of growth hormone?

IGFs

6

What is another name for somatotropin?

Growth hormone

6

Which half of the pituitary is the neurohypophysis?

Posterior

6

Where is oxytocin synthesised?

Hypothalamus

6

Where is ADH synthesised?

Hypothalamus

6

Which hypothalamic nuclei send axons to the posterior pituitary?

Supraoptic and paraventricular nuclei

6

Which hormone inhibits prolactin release?

Dopamine

6

What causes acromegaly?

Overproduction of growth hormone during adulthood

6

What effect does T3 have on basal metabolic rate?

Increases

6

What do the results of a dexamethasone suppression test typically show in someone with Cushing syndrome?

Dexamethasone fails to suppress cortisol levels

6

Give a 4 word definition of Hashimoto's thyroiditis

Autoimmune destruction of thyroid

6

What happens to TSH levels in Hashimoto's thyroiditis?

Increased

6

What is the gross pathology of the thyroid gland in Grave's disease

Diffuse symmetrical enlargement

6

What type of hypersensitivity is Grave's disease?

Type 2 = antibody mediated

6

What effects does cortisol have on carbohydrate metabolism?

Increases gluconeogenesis and increases serum glucose levels

6

Which cells secrete testosterone?

Leydig cells of testis

6

What does leuprorelin inhibit?

FSH and LH release

6

Give a 1-word definition of Cushing's syndrome

Hypercortisolism

6

What is pheochromocytoma?

Tumour of adrenal medulla causing hypersecretion of catecholamines

6

Which cells does cortisol act on?

Nearly every cell in the body

7

What causes cretinism?

Insufficient maternal iodine during pregnancy

8

What effect does long term treatment with cortisol have on ACTH?

Decreases it

9

What is another name for somatomedins?

IGFs

10

What is the autoimmune condition in which stimulatory autoantibodies cause increased secretion of thyroxine?

Grave's disease

10

Which hormones are released from the posterior pituitary?

ADH and oxytocin

10

Which gland releases insulin like growth factor?

Liver

10

What effect does T3 have on the sympathetic nervous system?

Sympathomimetic

10

If someone is hot all the time, what is their likely thyroid state?

Hyperthyroid

11

Where is the only place in the body that adrenaline is synthesised?

Adrenal medulla

12

What happens to TRH levels in Grave's disease?

Decreased

12

What happens to TSH levels in secondary hypothyroidism?

Decreases because of pituitary or hypothalamic damage

12

What happens to TSH levels in primary hyperthyroidism?

Decreased

13

How are thyroid hormones transported in the blood?

Bound to thyroid binding globulins (TBG)

14

Which organs primarily make oestrogen and progesterone?

Ovaries and placenta

16

What is the active ingredient in betadine?

Iodine

18

Which classes of hormones are lipophilic?

Steroids and thyroid hormones

19

Aldosterone increases excretion of which ion?

Potassium

21

Which amino acid are amine hormones derived from?

Tyrosine

22

Which inflammatory enzymes do glucocorticosteroids suppress the synthesis of?

PLA-2, iNOS and COX-2

24

What effect does cortisol have on the immune system?

Supresses it

25

Which hormone inhibits release of growth hormone?

Somatostatin

26

Name 3 visual signs on the body (not face) of someone with Cushing's syndrome

Striae (stretch marks). Fat pads behind neck. Abdominal adiposity.

27

What are three complications of treatment with thioamines?

Goitre, hepatotoxicity and agranulocytosis

28

What is the RDI for iodine?

150 ug

28

When do cortisol levels peak?

Morning

29

Which hormones does the adrenal medulla release?

Adrenaline and noradrenaline

30

What causes gigantism?

Overproduction of growth hormone before puberty

31

Which class of drugs can be used to treat hyperthyroidism?

Thioamines

32

What are the 2 gonadotropins?

LH and FSH

33

Which foods are particularly naturally rich in iodine?

Sea fish, crustaceans and kelp

34

How is Hashimoto's thyroiditis managed?

Thyroxine

36

Give a 4-word definition of Cushing's disease

Pituitary adenoma causing hypercortisolism

37

Which thyroid hormone is released in greater amounts?

T4

38

What happens to TSH levels in primary hypothyroidism?

Increases

40

Which hormone stimulates release of ACTH?

Corticotropin releasing hormone

42

Which hormones are decreased in Addison's disease?

Aldosterone and cortisol

43

Which hormone does growth hormone stimulate?

Insulin like growth factor 1 (IGF-1)

44

Which challenge test can be used for assessing adrenal gland function?

Dexamethasone suppression test

45

What effect does aldosterone have on sodium?

Increases sodium reabsorption

46

What effect will aldosterone deficiency have on potassium?

Increase in plasma [K+]

47

What will happen if you have too much iodine?

Goitre

48

List 4 main functions of glucocorticoids

Stimulate gluconeogenesis in liver. Mobilise amino acids from muscle. Stimulate lipolysis from adipose tissue. Immunosupression

49

Which organ does prolactin act on?

Breast

50

What is the pathway for thyroxine release?

TRH => TSH => T4

51

What may be the result of severe lack of maternal iodine during pregnancy?

Cretinism

52

What is cortisone?

A metabolite of cortisol that is almost biologically inactive

54

What is hydrocortisone?

Cortisol

55

Which hormones can increase the release of growth hormone?

Ghrelin and growth hormone release hormone

56

What happens to TSH levels in Grave's disease?

Decreased

57

What connects the pituitary to the hypothalamus?

Infundibulum

59

Which layer of the adrenal cortex produces sex steroids?

Reticularis

60

What happens to T4 levels in Grave's disease?

Elevated

61

Which hormone is used in the home pregnancy test?

human chorionic gonadotropin (hCG

62

Why don't we often do thyroid biopsies?

It is very vascular => risk of bleed

63

Which hormone stimulates prolactin release?

PRF = prolactin releasing factor

65

What is suggested by the presence of anti-thyroid peroxidase antibodies?

Hashimoto's thyroiditis

66

If someone is cold intolerant, what is their likely thyroid state?

Hypothyroid

67

Which antibodies are generated in Hashimoto's thyroiditis?

Anti-thyroglobulin and anti-thyroid peroxidase

68

In which condition is there autoimmune destruction of the adrenal cortex?

Addison's disease

70

Which cells of the adrenal medulla secrete catecholamines?

Chromaffin cells

71

What is the most common cause of hyperthyroidism?

Grave's disease

72

Which enzyme iodinates thyroglobulin?

Thyroid peroxidase

73

Which half of the pituitary is the adenohypophysis?

Anterior

74

What is the autoimmune condition in which the thyroid gland is attacked?

Hashimoto's thyroiditis

75

What is endogenous hydrocortisone called?

Cortisol

77

What do we call cortisol when it is given as a drug?

Hydrocortisone

79

Which hormone causes epiphyseal plates to close?

Oestrogen

80

Which layer of the adrenal cortex synthesises cortisol?

Fasciculata

82

What is the most active endogenous glucocorticoid?

Cortisol

83

Give a 3 word definition of goitre

Enlarged thyroid gland

84

Where in the body is hydrocortisone synthesised?

Nowhere - hydrocortisone is a drug so it's probably made in Germany

86

What are the 6 hormones released from the anterior pituitary?

TSH, LH, FSH, prolactin, growth hormone, ACTH

87

How is iodine taken up into thyroid cells from the bloodstream?

Sodium iodine symport

88

What are the 3 layers of the adrenal cortex from superficial to deep?

GFR Glomerulosa Fasciculata. Reticularis

90

What is the pathway for cortisol release?

CRH => ACTH => cortisol

91

Where is thyroid stimulating hormone synthesised?

Anterior pituitary

93

Which protein is iodinated to synthesise T3 and T4?

Thyroglobulin

94

What's the most common cause of goitre?

Iodine deficiency

95

Where is thyroid releasing hormone synthesised?

Hypothalamus

96

What is the half life of cortisol?

60-90 mins

98

Which reaction does HMG-coA reductase catalyse?

HMG-CoA => Melavonic acid + CoA

99

What effect does prolonged hypercortisolism have on blood pressure?

Raises it

100

Where are anterior pituitary hormones synthesised?

In the anterior pituitary

101

What does prolactin stimulate?

Milk production

103

Give a 4 word definition of Grave's thyroiditis

Autoimmune stimulation of thyroid

104

What is the half life of thyroxine?

7 days

105

Which cells of which organ secrete calcitonin?

Parafollicular (or C cells) of thyroid gland

106

What type of cells are in the anterior pituitary?

Glandular epithelium

107

What are thioamines used to treat?

Hyperthyroidism

108

How many carbons are there in cholesterol?

27

109

Which half of the pituitary has a neural link to the hypothalamus?

Posterior

110

What is the most abundant steroid in the body?

Cholesterol

112

Which receptor is the target of the autoimmune antibodies in Grave's disease?

Thyroid stimulating hormone receptor

113

Which hormone controls basal metabolic rate?

Thyroid hormones

114

Which hormones does gonadotropin releasing hormone stimulate?

LH and FSH

116

What are the two main functions of oxytocin?

Milk ejection from breast and uterine contractions during labour

117

In which bone does the pituitary sit?

Sphenoid bone

118

What type of cells are in the posterior pituitary?

Neural

119

What happens to follicular cells in Grave's disease?

Hypertrophy and hyperplasia

120

Name 3 visual signs in the face of someone with Cushing's syndrome

Red cheeks, acne and moon face

121

What are the 3 histological features of Hashimoto's thyroiditis?

1 Mononuclear inflammatory infiltrate 2 Abundant eosinophilic, granular cytoplasm in follicular cells 3 Intersititial fibrosis

122

Define myxoedema

Hypothyroidism causes mucopolysaccharide depositions, resulting in puffiness around eyes, chin, pretibial and exophthalmos

123

POMC is cleaved to yield what?

ACTH and beta endorphin

124

What does thyroid stimulating immunoglobulin target?

TSH receptor

125

What happens to TSH levels in iodine insufficiency?

Increases

126

What effect does aldosterone have on potassium?

Increases potassium excretion

127

What is the most potent synthetic glucocorticoid?

Dexamethasone

128

What do we call it when someone has too much cortisol?

Cushing's syndrome

129

What happens to plasma [glucose] in Cushing's syndrome?

Elevated

130

Which hormones does the adrenal cortex release?

Aldosterone, cortisol and androgens

132

What is the gold standard for diagnosing diabetes?

Glucose tolerance test

133

Which organ makes testosterone?

Testes

135

Aldosterone increases reabsorption of which ion?

Sodium

136

Which drug is used to treat hypothyroidism?

Thyroxine

137

Which half of the pituitary is linked to the hypothalamus via a capillary bed?

Anterior

138

Which thyroid hormone is more active?

T3

139

Give a 2-word definition of Conn's syndrome

Primary hyperaldosteronism

140

Where is prolactin released from?

Anterior pituitary

141

What class of drug is carbimazole?

Thioamine

142

Where is cortisol converted into cortisone?

kidney 

143

Where is cortisone converted into cortisol?

Liver

144

Which drug would be used to replace missing aldosterone?

Fludrocortisone

145

Where would you find a phaeochromocytoma?

Adrenal medulla

146

 

What type of epithelium normally lines the thyroid follicles?

 

simple cuboidal

147

 

What is the colour of the cut surface of the normal thyroid gland?

 

 

Pale brownish red  due to its iodine content and high vascularity

 

 

148

Follicles or Hürthle are typically seen in which condition?

Hashimoto's thyroiditis