GPT 2.07 Notes

Question 1

What is the role of the hypothalamic-pituitary axis?

Answer 1

Regulates endocrine glands via releasing/inhibiting hormones from the hypothalamus acting on the anterior pituitary

Question 2

What hormone regulates the adrenal cortex via the pituitary?

Answer 2

ACTH (Adrenocorticotropic hormone)

Question 3

What stimulates ACTH release from the pituitary?

Answer 3

CRH (Corticotropin-releasing hormone) from the hypothalamus

Question 4

What are the layers of the adrenal cortex and what do they produce?

Answer 4

Zona glomerulosa: aldosterone; Zona fasciculata: cortisol; Zona reticularis: androgens

Question 5

What does the adrenal medulla secrete?

Answer 5

Adrenaline and noradrenaline (catecholamines)

Question 6

What is the function of cortisol?

Answer 6

Stress response, ↑ gluconeogenesis, ↑ BP, ↓ immune response

Question 7

What is the function of aldosterone?

Answer 7

Na+ retention, K+ excretion, water retention → ↑ BP

Question 8

What are the endocrine functions of the pancreas?

Answer 8

Secretes insulin (β-cells), glucagon (α-cells), somatostatin (δ-cells)

Question 9

What is adrenal overactivity called?

Answer 9

Hyperadrenalism (e.g. Cushing’s syndrome, Conn’s syndrome)

Question 10

What is adrenal insufficiency called?

Answer 10

Hypoadrenalism (e.g. Addison’s disease)

Question 11

What are causes of Cushing’s syndrome?

Answer 11

Exogenous steroids, pituitary adenoma (Cushing’s disease), adrenal adenoma, ectopic ACTH

Question 12

What are clinical features of Cushing’s syndrome?

Answer 12

Central obesity, moon face, buffalo hump, striae, hypertension, osteoporosis

Question 13

What are causes of Addison’s disease?

Answer 13

Autoimmune (most common), TB, adrenal metastases

Question 14

What are clinical features of Addison’s disease?

Answer 14

Fatigue, weight loss, hypotension, hyperpigmentation, hyponatremia, hyperkalemia

Question 15

What test is used to diagnose adrenal insufficiency?

Answer 15

Short Synacthen test (ACTH stimulation test)

Question 16

What is first-line treatment for Addison’s disease?

Answer 16

Hydrocortisone (glucocorticoid) and fludrocortisone (mineralocorticoid)

Question 17

What are risks of chronic steroid therapy?

Answer 17

Adrenal suppression, Cushingoid features, osteoporosis, infections, diabetes

Question 18

What is steroid-induced adrenal insufficiency?

Answer 18

Suppression of HPA axis due to prolonged exogenous steroid use → adrenal atrophy

Question 19

What drugs can mimic endocrine disease?

Answer 19

Steroids (Cushing’s), amiodarone (thyroid), lithium (thyroid), antipsychotics (hyperprolactinemia)

Question 20

What is type 1 diabetes mellitus?

Answer 20

Autoimmune destruction of pancreatic β-cells → absolute insulin deficiency

Question 21

What is type 2 diabetes mellitus?

Answer 21

Insulin resistance with relative insulin deficiency

Question 22

What are typical features of type 1 diabetes?

Answer 22

Polyuria, polydipsia, weight loss, ketoacidosis, young onset

Question 23

What are typical features of type 2 diabetes?

Answer 23

Often asymptomatic, fatigue, recurrent infections, middle-aged/older onset, obesity

Question 24

What is the basic management of type 1 diabetes?

Answer 24

Insulin therapy, glucose monitoring, education, carb counting

Question 25

What is the basic management of type 2 diabetes?

Answer 25

Lifestyle change, metformin, other oral agents, ± insulin

Question 26

What lifestyle changes help manage diabetes?

Answer 26

Diet modification, weight loss, increased physical activity

Question 27

How does diabetes cause microvascular complications?

Answer 27

Chronic hyperglycemia → endothelial damage → retinopathy, nephropathy, neuropathy

Question 28

How does diabetes cause macrovascular complications?

Answer 28

Atherosclerosis → MI, stroke, peripheral vascular disease

Question 29

What is diabetic ketoacidosis (DKA)?

Answer 29

Type 1 emergency: ketone production due to insulin deficiency → acidosis, dehydration

Question 30

How does TB cause Addison’s disease?

Answer 30

TB infects and destroys adrenal glands → primary adrenal insufficiency

Question 31

How does TB-induced Addison’s present?

Answer 31

Same as Addison’s: fatigue, hypotension, hyperpigmentation, electrolyte disturbances