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IMS > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What are the main endocrine glands

A 
Hypothalmus/pituitary
Thyroid
Parathyroid
Pancreas
Adrenal
Ovaries/testicles
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2
Q

What is the main endocrine gland and how is it split

A

Pituitry gland
Anterior pituitary produces hormones
Posterior pituitary stores hormones

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3
Q

What hormones does the anterior pituitary produce

A 
Growth hormone
Adrenocorticotrophic hormone
Gonadotrophins
Thyroid stimulating hormone
Prolactin
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4
Q

Growth hormone

A

For skeletal growth

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5
Q

Adrenocorticotrophic hormone

A

Stimulates the adrenals to produce steroids

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6
Q

Gonadotrophins (FSH and LH)

A

Stimulate the testicles or ovraies to produce sex hormones

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7
Q

Thyroid stimulating hormone

A

Stimulates the thyroid to produce thyroid hormones

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8
Q

Prolactin

A

Stimulates breast milk production

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9
Q

What hormones does the posterior pituitary store

A

Antidiuretic hormone

Oxytocin

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10
Q

Antidiuretic hormone (ADH)

A

Stimulates water reabsorption by the kidneys

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11
Q

Oxytocin

A

Helps uterine contractions during labour

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12
Q

What controls the anterior pituitary

A

The hypothalamus which secretes releasing hormones that stimulate secretion of anterior pituitray hormones

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13
Q

Which hormone does not require a releasing hormone

A

Prolactin - Prolactin is under the inhibitory effect of the hypothalamus

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14
Q

How are pituitary hormones switched off

A

Negative feedback - e.g Cortisol switches off ACTH and CRH

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15
Q

Which glands are not controlled by the pituitary

A

Adrenal medulla
Parathyroid
Pancreas
Gut hormones

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16
Q

Adrenal medulla

A

Produce adrenaline and noradrenaline

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17
Q

Parathyroid

A

Controls calcium levels

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18
Q

Thyroid anatomy

A

A right lobe and a left lobe connected by a midline isthmus

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19
Q

C cells

A

Cells in the thyroid which produce calcitonin - needed for calcium metabolism

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20
Q

Control of thyroid hormone secretion

A
  • Hypothalamus secretes TRH
  • This stimulates the Pituitary to secrete TSH
  • This causes the thyroid to relsease T3 and T4
  • T3 and T4 control hormone secretion by negative feedback
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21
Q

How is calcium metabolism controlled

A

4 parathyroid glands sitting behind the thyroid

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22
Q

What are the other orgas involved in calcium metabolsim

A

Kidneys - calcium absorption
Gut - Calcium absoprtion
Bone - storage of calcium
Thyroid - C cells - calcitonin

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23
Q

Adrenal gland anatomy

A

Adreal cortex - 90%

Adrenal medulla - 10%

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24
Q

Adrenal cortex hormones

A

Cortocosteroids (cortisol)
Androgens (male hormones)
Mineralocorticoid (aldosterone)

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25
Q

Adrenal medulla hormones

A

Catecholamines - adrenaline, noradrenaline and dopamine

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26
Q

Which hormones in the adrenal glands are not controlled by the pituitary

A 
Catecholamines
Mineralocorticoid (aldosterone)
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27
Q

Control of female hormone secretion

A
  • Hypothalamus secretes GnRH
  • Causes pituitary to secrete FSH and LH
  • Stimulates ovaries to produce Oestradiol, inhibin and progesterone
  • Inhibin tells pituitary to switch off
  • Oestradiol tells pituitary and hypothalamus to switch off
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28
Q

Testes anatomy

A

Intersitial cells - Produce testosterone
Seminiferous tubules - produce sperm
Sertoli cells - Produce inhibin

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29
Q

Control of male hormone production

A
  • Hypothalamus produces GnRH
  • Stimulates pituitary to produce FSH and LH
  • Causes testes to produce inhibin and testosterone
  • Inhibin controls pituitary
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30
Q

Clinical abnormlaities

A

Hormonal over-secretion
Hormonal under-secretion
Tumour/nodules in the gland

31
Q

Static tests

A

Diagnose abnormalities of thyroid and sex glands - blood sample

32
Q

Stimulation tests

A

For suspected hormonal under-secretion - if individual fails to respond to stimulation test then gland failure is diagnosed

33
Q

Suppression test

A

For suspected hormonal over-secretion

- Giving steroids and testing for endogenous steroid production

34
Q

Primary over/under secretion

A

Problem is in the gland itself, pituitary function is normal

35
Q

Secondary over/under secretion

A

Problem is with the pituitary gland

36
Q

Prolactin oversecretion

A
  • Due to a pituitary tumour secreting prolactin (prolactinoma)
37
Q

Cinical presentation of prolactin oversecretion

A
  • Galactorrhoea (breast milk production)
  • Amenorrhoea (stops period) in women, sexual dysfunction in men
  • Headaches and visual fiels problems
38
Q

Treatment of prolactinomas

A

Treated medically without operation

39
Q

Growth hormone oversecretion clinical presentation - childhood/adolescents

A
  • excessive growth spurt and increased size of feet and hands
  • Gigantism
40
Q

Growth hormone oversecretion clinical presentation - Adult

A
  • Acromegalic face
  • wide and large hands/feet
  • Increased sweating
41
Q

Diagnosis of growth hormone over secretion

A

Suppression test

- glucose is given followed by GH measurements - if there is no drop in levels then diagnosis is confirmed

42
Q

Cushing’s syndrome

A

Caused by Pituitary secreting ACTH tumour

  • adrenal tumours secreting cortisol
  • Cancers producing ACTH
43
Q

Cushing’s clinical presentation

A
  • Growth arrest in children
  • Round face
  • Truncal obesity, thin extremities
  • Thin skin and easy bruising
44
Q

Test for Cushing’s

A

Suppression tests are required - Dexamethasone used to confirm failure to suppress cortisol production

45
Q

Treatment of Cushing’s syndrome

A

Surgery

Radiotherapy/medical treatment

46
Q

Reasons for thyoid hormone overproduction

A

Primary hyperthyroidism - very common

Secondary Hyperthyroidism - very rare

47
Q

Causes of thyroidism

A

Graves disease - autoimmune condition
Toxic nodule or toxic MNG
Thyroiditis

48
Q

Clinical presentation of hyperthyroidism

A
  • Hyperactivity, insomnia
  • Heat intolerance and sweating
  • Palpitations
  • Weight loss
  • Menstrual problems
49
Q

Signs of Thyrotoxicosis

A
  • Hand tremor
  • Increased sweating
  • Fast pulse
50
Q

Inspection of the thyroid

A

smooth - Graves disease
Nodular - Toxic nodule
Tender - thyroid inflammation

51
Q

Thyroid eye disease signs

A
  • Swelling around the eyes
  • Protrusion of the eye ball
  • Paralysis of eye muscles
52
Q

Growth hormone under secretion signs

A

Failure of growth
Tiredness
Depression

53
Q

Steriod under secretion (cortisol) clinical presentation

A
  • Failure to grow
  • Severe tiredness
  • Dizziness due to low blood pressure
  • Abdominal pain
54
Q

Hypothyroidism

A

Primary - inability to produce thyroid hormones

Secondary - Inability to produce TSH

55
Q

Clinical presentation of Hypothyroidism

A
  • Weakness and dry skin
  • Impaired memory
  • Constipation
  • Weight gain
  • Hair loss
56
Q

Clinical presentation of sex hormone deficiency

A

Male - erectile dysfunction
- Loss of labido
Female - Menstrual abnormalities - amenorrhoea

57
Q

Amenorrhoea causes

A
  • Uterine problems
  • Ovarian problems
  • Pituitary problems
  • Hypothalamic problem
58
Q

What is amenorrhoea

A

Absence of menstruation

59
Q

Diagnosis and treatment of amenorrhoea

A

Static test

  • Hormone replacement therapy
  • Pituitary Hormone replacement
60
Q

Pituitary failure causes

A
  • Large tumour

- Infarction

61
Q

Diagnosing Pituitary failure

A

MRI - Imaging - Endocrine tests - Basal and dynamic tests - Static and stimulatory tests

62
Q

Clinical presentation

A
  • Thirst and passing too much urine
  • Constipation
  • Abdominal pain
63
Q

Hormones that act inside a cell

A

Steroid hormones - derived from cholesterol

Thyroid hormones - Derived from tyrosine within thyroglubin

64
Q

How do steroid hormones work

A
  • Cross the cell membrane
  • Bind to intracellular recpetor which moves into nucleus
  • Hormone receptor acts as a transcription factor
  • mRNA is transcribed
65
Q

Nuclear hormone receptor structure

A
  • amino terminus has a transcription regulation domain
  • Next there is a DNA binding domain with zinc fingers that bind to the DNA helix
  • Hormone binding domain at the carboxyl terminus
66
Q

Zinc fingers structure

A

Loops of protein that contain a zn2+ atom and are coordinated with 4 cysteine residues

67
Q

Healthy breast tissue structure

A

Healthy breast tissue normally expresses more ERB than ERA

68
Q

Effect of oestrogen on breast cancer cells

A

Oestrogen promotes the rapid division of ERA-positive breast cancer cells

69
Q

How can spread of breast cancer be stopped

A

Administering anti-oestrogen drugs such as tamoxifen - acts as a competitive imhibtor to estrogen molecules

70
Q

Fromation of thyroid hormones (T4)

A
  • Tyrosine molecules on the protein thyroglobulin are iodinated
  • Iodotyrosine molecules are cross-linked
  • Thyroxine molecule is cut out of thyroglobulin
71
Q

Thyroid hormone recpetors

A
  • Two seperate genes
  • Different actions to one another
  • Thyroid hormone response element
72
Q

Thyroid hormone recpetors mechanism

A

In the nucleus TR’s bind to response elements with or without the hormone. Without the hormone this switches off transcription

73
Q

TR without hormone

A

Binds to repressor molecule to switch off transcription

74
Q

TR with hormone

A

Co-repressor leaves, coactivator binds to the receptor and transcription starts

IMS (4 decks)

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