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endocrinology Flashcards

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1
Q

what is the role of the posterior pituitary gland?

A

storing hormones

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2
Q

what is the role of the anterior pituitary gland?

A

producing hormones

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3
Q

what glands are controlled by the pituitary gland?

A 
parathyroid
thyroid 
adrenal cortex
pancreas
ovaries/testes
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4
Q

what glands are not controlled by the pituitary gland?

A

parathyroid (calcium storage)
adrenal medulla - adrenaline and noradrenaline
pancreas (sugar)
gut hormones

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5
Q

what is CRH and what does it do?

A

corticotrophin released hormone, it stimulates ACTH secretion which in turn stimulates the adrenal gland

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6
Q

what is GHRH and what does it do?

A

growth hormone releasing hormone and it stimulates CH

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7
Q

what is TRH and what does it do?

A

thyrotrophin releasing hormones which stimulates TSH secretion

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8
Q

what 5 hormones does the anterior pituitary gland produce?

A 
GH
ACTH
LH and FSH 
TSH 
PRL
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9
Q

what is GH? and what does it do?

A

growth hormone

stimulates skeletal growth

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10
Q

what is ACTH?

A

adrenocorticotrophic hormone

stimulates the adrenal gland to produce steroids

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11
Q

What are LH and FSH?

A

gonadotrophin hormones

stimulates the testes and ovaries to produce sex hormones

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12
Q

what is TSH?

A

thyroid stimulating hormone

stimulates the thyroid to produce thyroid hormones

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13
Q

what is PRL?

A

prolactin

stimulates breast milk production

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14
Q

what do adrenal steroids inhibit?

A

ACTH and CRH

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15
Q

what does thryroid hormones inhibit?

A

TRH and TSH

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16
Q

what do sex hormones inhibit?

A

GnRH, LH and FSH

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17
Q

what does Gh inhibit?

A

GHRH

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18
Q

what do C-cells do and where are they?

A

in thyroid gland, they produce calcitonin for calcium metabolism

not under control of pituitary but by the 4 parathyroid glands sitting behind the thyroid

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19
Q

what is calcium metabolism controlled by?

A

parathyroid glands

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20
Q

what 4 things take part in calcium metabolism?

A

kidneys

gut

bones

thyroid

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21
Q

how do the kidneys help with calcium metabolism?

A

they excrete calcium and produce active vitamin D which increases the absorption of calcium

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22
Q

how does the gut help with calcium metabolism?

A

involved in the absorpiton of calcium

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23
Q

how does the thyroid help with calcium metabolism?

A

c-cells in the thyroid produce calcitonin for calcium metabolism.
not under the control of the pituitary

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24
Q

how do bones help with calcium metabolism?

A

storage of caclium

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25
what does the adrenal cortex produce?
corticosteroids - cortisol androgens - male sex hormones mineralcorticord - aldosterone
26
what does the adrenal medulla produce?
catecholamines - adrenaline, noradrenaline and dopamine
27
what part of the adrenal gland is not controlled by the pituitary?
the adrenal medulla or production of mineralcorticord by the cortex. this is renin-angiotensin system which controls blood pressure
28
in primary hyperthyroidism what levels of thyroid hormone and TSH would you expect to see?
high levels of thyroid hormone but low levels of TSH as it is a problem in the thyroid not the pituitary
29
what can you use static tests for?
diagnose problems in thyroid and sex glands
30
what can you use stimulation tests for?
hormonal undersecretion where static tests are not enough as results are ambiguous
31
what can you use surpression tests for?
hormonal oversecretion
32
what is the synacthin test?
giving patient CTH to test for adrenal insufficiency | failure to respond to CTH suggests failure of the gland
33
give 2 examples of surpression tests?
giving steroids to test for endogenous steroid production | giving glucose to test for GH secretion - as glucose should switch off GH secretion
34
what is a prolactinoma?
a pituitary tumour secreting prolactin
35
what are the symptoms of prolactin over-secretion?
galactorrhoea amenorrheoa in women sexual dysfunction in men headaches and visual feild problems
36
which kind of over-secreting pituitary tumour can be treated non-surgically?
prolactinoma
37
what are the symptoms of excess growth hormone in adults?
acrmegalic face wide and large hands/feet increased sweating
38
what is the diagnosis of growth hormone excess?
surpression tests are neccessary glucose is given, this should decrease palsma levels of GH but not in those with GH excess imaging is neccessary to confirm presence of pituitary gland tumour
39
what is the treatment of oversecreting GH tumour?
surgical removal of the tumour radiotherapy and medical therapy sometimes needed as surgery does not always remove whole tumour
40
what are 3 cuases of cortisol oversecretion?
pituitary secreting ACTH tumour - cushing disease adrenal tumour screting cortisol cancer producing ACTH - lung cancer?
41
symptoms of cortisol over secretion
``` growth arrest in children typical face: round face, acne, hirsuitism fat redistribution = truncal obesity skin abnormalities = thin skin, brusing, stretch marks hypertension diabetes increased risk of infection worsening wound healing ```
42
how do you test for over secretion of cortisol?
surpression tests - dexamethanosome surpession test | this tests for failure to surpress endogenous cortisol production
43
how do you treat cortisol over secretion?
for pituitary or adrenal: surgery and radiotherpay/medical treatment cancer related: treat original cancer first
44
what is the most common cause of hyperthyroidism?
graves disease | an autoimmune condition that results in the body attacking the thyroid gland, causing it to over secrete
45
what are 5 causes of hyperthyroidism?
``` graves disease toxic nodule/toxic MNG thyroiditis drug induced - e.g. aminodorane rarities ```
46
name 5 clinical presentations of hyperthyroidism
``` hyperactivity/irritability/insomnia palpitations weightloss menstrual probs thyroid eye disease ```
47
what can be seen in examination of someone with hyoerthyroidism?
hand tremor increased sweating fast pulse enlarged thyroid
48
what does a smooth enlarged thyroid suggest?
graves disease
49
what does a nodular enlarged thyroid suggest?
toxic nodules
50
what does a tender enlarged thyroid suggest?
thyroiditis
51
how can you test for hyperthyroidism?
blood test
52
what are 3 ways to treat hyperthyroidism?
antithyroid drugs radioactive iodine surgery
53
symptoms of GH undersecretion in children and adults
children = failure to grow adults = not always any symptoms, but can show as tiredness and depression
54
test for GH under secretion?
stimulation test: glucagon stimulation test insulin stress test
55
treatment for GH under secretion?
growth hormone replacement
56
what can cause steroid undersecretion?
adrenal or pituitary failure
57
what are 4 clinical presentation sof steroid under secretion
failure of growth in children severe tiredness dizziness - low BP abdominal pain - V+D
58
How do you treat steroid undersecretion?
replace missing hormones with tablets
59
how do you test for steroid undersecretion?
stimulation testing synacthen test (ACTH) if primary adrenal failure is suspected GST or IST if secondary adrenal failure is suspected
60
what are the cuases of hypothyroidism - primary and secodnary?
primary = autoimmune or drug induced secondary = complete pituitary failure
61
what are some symptoms of hypothyroidism?
``` weakness and dry skin cold and less sweating imparied memory constipation weight gain hair loss ```
62
how do you test for hypothyroidism?
static thyroid function test
63
how do you treat hypothyroidism?
thyroid hormone replacement
64
what are the causes of primary sex hormone undersecretion and secondary?
``` primary = ovarian failure or testicular failure secondary = pituitary failure ```
65
what is the presentation of sex hormone under secretion in men and women?
``` men = erectile dysfunction and decreased libido women = menstrual abnormalities ```
66
how do you test for sex hormone under secretioN?
Static test testosterone in men oestradiol in women FSH/LH in both
67
how do you treat sex hormone under secretioN?
hormone replacement therpay | pituitary hormone replacement
68
what are 2 causes of pituitary failure?
large tumour | infarction
69
how do you test for pituitary failure?
combination of static and stimulatroy tests as it involves multiple hormones
70
what is the cuase of endocrine problems that are not to do with the pituitary?
parathyroid issues primary hyperparathyroidism cancer certain drugs
71
clinical presentation of hypercacaemia?
thirst and increased urine output constipation abdominal pain
72
what is the structure of steroid hormones?
3 six sided carbon rings and 1 five sided carbon ring
73
how do steroid hormones work?
move through cell membrane and bind to receptors in the nucleus or cytosol the hormone receptor complex acts as a transcription factor causing mRNA to be transcribed
74
what is conns syndrome?
when adrenal gland makes too much aldosterone | leads to high blood pressure

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