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Flashcards in Miscellaneous Deck (105):
1

what causes increased urination?

type 1 diabetes
type 2 diabetes
diabetes insipidus
UTI
hypercalcaemia

2

groans (constipation
moans (depression, fatigue)
bones (sore bones0
kidney stones

hypercalcaemia

3

if you suspect diabetes insipidus what test should you do and what would be the result?

fluid deprivation test

if fluid output doesnt decrease then its a positive test

4

at what level is HbA1c considered elevated?

>48mmol/L

5

what happens to glucose in kidneys?

passively secreted then actively reabsorbed

6

what is the ideal glucose plasma conc?

3.6-5.8mmol/L

7

what is Kaussmaul breathing and where do you see it?

deep laboured breathing occurs in presence of excessive ketone bodies in blood

in type 1 diabetes only!

8

do babies of diabetic mothers have a larger birth weight?

yes but they are of normal length

9

why are babies of diabetic mother heavier ?

cause glucose can cross the placenta but insulin cant. so baby has more glucose than normal so there is increased fat

10

what should pregnant diabetic mother supplement theri diet with?

folic acid

11

what are babies of diabetic mothers are risk of?

CNS deformities e.g spina bifida

12

what is acromegaly?

excess growth hormone
can cause diabetes

13

what is cushings syndrome?

excess cortisol

can stop uptake of glucose in muscles

14

bag of bones appearance on X ray?

Charcot Foot

15

are the adrenal glands retroperitoneal structures>

yes

16

what are the 2 parts of the adrenal glands?

medulla

cortext

17

what are the 5 zones of the adrenal glands?

connective tissue
zona glomerulosa
zona fasciculate
zona reticularis
medualla

18

what hormones does the medulla secrete?

adrenalin and noradrenaline

19

what hormones does the zona reticularis secrete?

aldosteronee
dehydroepiandrosterone

20

what hormones does the zona fasciculate secrete?

cortisol
cortisone
corticosterone

21

what are adrenaline and noradrenaline derived from?

tyrosine within the chromaffin cellss

22

can medulla hormones be made early and stored?

yes

23

what stimulates the synthesis and release of aldosterone?

angiotensin 2

24

what does aldosterone do on the kidneys?

increases NaCl retention+reabsorption

due to osmosis, water is also reabsorbed and there is an increase in blood volume and therefore an increase in BP

25

name 2 types of primary aldosteronism?

conn;s syndrome

adrenal hyperplasia

26

what is conn's syndrome?

excess amounts of aldosterone is secreted by a tumour in in the cells of the zona glomerulosa

27

increase NaCl
increase water
decrease potassium
signs of hypertension and hypokalaemia?

conn's syndrome

28

how do you diagnose conn's and adrenal hyperplasia?

aldosterone to renin ratio

if >750 then do saline suppression test

29

what is the treatment for Conn's/ adrenal hyperplasia?

if unilateral-remove gland

aldosterone receptor anatgonist-spironolactone

30

what are the side effects of spironolactone?

nausea
rashes
gynaecomastia

31

what is cushings syndrome?

excess cortisol

32

functions of cortisol?

maintain normal plasma glucose levels

help produce fuel when stressed
increase responsiveness of adrenoreceptors to adrenaline

33

affect on cortisol on fat tissue?

increase lipolysis

34

affect of cortisol on tissue (except brain)

decrease glucose uptake

35

affect of cortisol on liver?

increase gluconeogenisis

36

affect of cortisol on muscle?

increase proteolysis

37

what happens to the body if there is excess cortisol?

cardiac output and blood flow increase
reduced osteoblast activity

moon face
conjunctival oedema
thin skin
purpura
prox muscle wasting
central obesity
easily bruised
recurrent skin infections
always thirsty
peeing more
kyphosis
insomnia
lethargic

38

looks like a lemon on sticks/

excess cortisol

39

cardiac output and blood flow increase
reduced osteoblast activity

moon face
conjunctival oedema
thin skin
purpura
prox muscle wasting
central obesity
easily bruised
recurrent skin infections
always thirsty
peeing more
kyphosis
insomnia
lethargic

excess cortisol

40

what makes the adrenal glands release cortisol?

ACTH

41

what is the most common type of cushings?

ACTH dependent

42

what can cause ACTH independent cushings?

adrenal adenoma
adrenal carcinoma
nodular hyperplasia

43

what controls secretion of the sex hormones?

ACTH

44

which part of pituitary is ACTH from?

anterior

45

what happens if too much dehydroepiandrosterone in females?

acne
amenorrhea
frontal balding
facial growth

because it causes increased levels of testosterone

46

definitive test for cushings?

low dose dexamethasone test

47

what is the medical /surgical therapy for cushings?

metyrapone/ketoccnazole

stop cortisol being produced

can also cut out the lesion causing hypersecretion of cortisol

48

what affects does adrenaline have on the heart


increase HR and SV via B1 receptors

49

what affect does adrenaline have on BP?

increased it

50

what affect does adrenaline have on skeletal muscle?

vasodilation via B2 receptors

51

what affect does adrenaline have on blood vessles

vasonconstriction via alpha 1 receptors

52

what affect does adrenaline have on insulin secretion?

decreased insulin secretion via alpha 2 receptors

53

what is the triad for hypersecretion of adrenaline?

hypertension
sweating
headaches

54

name some signs/symptoms of hypersecretion of adrenaline?

heart arrhythmias
hypertension
pallor
excessive sweating
flushing
anxiety
peeing alot
drinking alot
constipation
headaches

55

what is phaectomocytoma caused by?

by catecholamine secreting tumours which arise from sympathetic paraganglia cells

56

what are paraganglia cells?

collections of adrenaline secreting chromaffin cells

57

10% tumour

phaechromomocytomas - 10% extra adrenal, malignant, bilateral, in children, part of an inherited syndrome

58

treatment of phaechromomocytomas

alpha and beta blockers

tumour removed as soon as possible!!

chemo if malignant

59

what do the follicular cells of the thyroid produce?

thyroglobulin

60

what do the parafollicular cells of thyroid produce?

calcitonin

61

what is taken up by follicular cells?

iodine

62

where is thyroglobulin stored?

colloid

63

what 2 hormones are produced by thyroid?

T3-trriodothyronine
T4-thyroxine

64

what is needed for production of thyroid hormones?

iodine

65

what does idodine attach to on thyroglobulin molecules and what does this produce?

attaches to tyrosine residues to produce MIT and DID which are the building blocks of the thyroid hormones

66

true or false

majority of secreted hormones is T4

true

67

true or false

T3 is more biochemically active in bodt

true

68

true or false

unbound thyroid hormones are in their active state

true

69

true or false

T4 is converted to T3 by liver and kidneys

true

70

true or false

T3 and T4 are hydrophilic

true

71

true or false
the majority of inactive thyroid hormones are bound to albumin

false

72

what are the thyroid hormones responsible for?

metabolsim
behaviour

reproduction
growth
development

73

affect of thyroid hormone son protein syntheses and glucose and lipolysis?

increase protein synthesis
increase blood glucose
increase lipolysis

74

affect of thyroid on heart?

increase HR and SV

75

what causes the thyroid to release T3 and T4?

TSH

76

tremor in hands
excessive body movements
HR and SV increase
heat intolrenace-may get moist itchy skin
increase BMR-lose weight but bigger appetite
agitation-always on edge
irregular periods
loss of libido

hyperthyroidism

77

what does graves disease cause?

hyperthyroidism

78

what is graves disease?

an autoimmune disease
thyroid cant be suppressed by high levels of T3 and T4

79

who usually gets graves disease/

middle aged women

80

normal TSH value

0.4-4

81

normal T3 value

9.9-22

82

normal T4 level

0.9-2.6

83

what hormone is always raised in graves?

T4

84

what is exopthalamus?

eyes seemed pushed forward due to water build up and retro orbital swelling

85

"orange peel "look

preibial myxoedema

86

what is pretibial myxodema

bilateral plaque formation on anterior surface of leg
non pitting

complication of graves/hyperthyroidism

87

what is a goitre?

swelling of thyroid gland so that it is easily seen and palpated

88

2nd most commen cause of hyperthyroidism?

toxic multinodular goitre

89

what is toxic multinodular goitre?

large nodules secreting lots of thyroid hormones

90

what is de Quervains thyroiditis?

show to suffer from hyperthyroidism but also have

fever
malaise
local tenderness

91

what causes Quervains thyroiditis?

initiated by an acute inflammatory process (usually viral origin)

92

reduced BMR
loss of appetite but weight gain
slow reflexes
fatigue and lethargy
coarse sparse hair
expressionless face
cool doughy skin
obstructive sleep apnoea

HYPO thyroidism

93

what can cause hypothyroidism?

goitre

iodine deficiency
hashimoto's thyroiditis

94

what is hashimoto's thyroiditis?

an autoimmune disease
antibodies attack thyroid peroxidase
antibodies attack thyroglobin leading to destruction of follicular cells

95

increased TSH decreased T4

hypothyroidism

96

decreased TSH increased T3 or increased T4

hyperthyroidism

97

decreased TSH, normal T3 and T4

subclinical hyperthyroidism

98

increased TSH normal T4

treated hypo

99

decreased TSH T3 and T4

pituitary disease

100

if there is goitre what should you do management wise?

fine needle aspirate
US or thryoid scan

101

how do you investigate thyroid disease?

thyroid function tests
anti-thyroid antibodies

102

what medical treatment is there for hyperthyroidism?

carbimazole and propylthiouracil

these inhibit the production of thyroid hormone

beta blockers can also be given for hyper

103

what is the major side effect of carbimazole

agranulocytosois

104

what surgical treatment is there for hyperthyroidism?

remove the gland

105

treatment for hypothyroidism?

replacement therapy- analogue of thyroxine is taken for life (levothyroxine)