Physiology Endocrine Book

Question 1

Factors promoting GH production

Answer 1

Hypoglycaemia
Deep sleep- circadian pattern
Trauma
Haemorrhage
Fever
Exercise
Pain

Question 2

GH metabolic functions

Answer 2

Anti insulin
Glycogenolysis
Lipolysis

Question 3

Metabolic function of cortisol

Answer 3

Gluconeogenesis
Lipolysis

Question 4

Cortisol effect on immune system

Answer 4

Inhibits complement
Inhibits T cell reproduction

Question 5

Levels of cortisol throughout the day

Answer 5

Diurnal
Highest in morning
Lowest at midnight

Question 6

What stimulates cortisol

Answer 6

Stress (trauma, infection, fear, pain)

Question 7

ANP effect on aldosterone

Answer 7

Inhibits renin and therefore aldosterone

Question 8

Where aldosterone takes effect and what metabolic effect it causes

Answer 8

DCT
Metabolic alkalosis

Question 9

Difference in biochem of primary and secondary hyperaldosteronism

Answer 9

1- high aldo low renin
2- high renin

Question 10

Which organ can freely uptake glucose without inuslin

Answer 10

Brain

Question 11

Other stimulants of insulin release

Answer 11

Fatty acids
Ketone bodies
Parasympathetic
Gastrin
CCK
Prostaglandin

Question 12

Insulin effects on metabolism

Answer 12

Protein synthesis
Inhibits protein breakdown
Inhibits lipolysis

Question 13

Proportion of K that is intracellular

Answer 13

98%

Question 14

Production of Vit D

Answer 14

7 dehydrocholesterol to cholecalciferol by UV
Converted to 25 in liver and 1,25 in kidney

Question 15

Where ADH is produced and where it effects

Answer 15

Posterior pituitary
Effects DCT

Question 16

Physiological effects of GH, prolactin and oxytocin

Answer 16

GH- secretion of ILGF1
Prolactin- milk production and breast development
Oxytocin- uterine contraction and milk secretion

Question 17

Cushing disease vs syndrome

Answer 17

Disease- pituitary - ACTH high/normal in dex suppression
Syndrome- any cause of high cortisol

Question 18

Ectopic vs Cushing disease vs adrenal adenoma dex suppression

Answer 18

Ectopic- high ACTH, high cortisol (since produces ACTH that doesn’t have neg feedback)
Disease- normal ACTH, low cortisol only on high dex
Adenoma- low ACTH, high cortisol

Question 19

Production of ACTH and MSH

Answer 19

POMC cleaved to form MSH and ACTH

Question 20

Systemic complications of burns

Answer 20

Hypovolaemia
Hyperkalaemia and hypocalcaemia
Hypothermia
SIRS
Gastric ulceration
Coagulopathy
Haemolysis

Question 21

What electrolyte disturbances are associated with high Mg

Answer 21

Hyperkalaemia and hypercalaemia

Question 22

Causes of high Mg

Answer 22

CKD
Hypothyroid
Addisons

Question 23

Tx of High Mg

Answer 23

Calcium gluconate- protects cardiac and neuromuscular (can cause resp depression)
Diuretics

Question 24

Causes of low Mg

Answer 24

Malnutrition
Diarrhoea
Excessive Alcohol
Loop diuretics
Acute pancreatitis

Question 25

ECG effects of low Mg

Answer 25

Prolonged PR Prolonged QT Broad flat T

Question 26

Normal range of Mg

Answer 26

0.7- 1

Question 27

Where is majority of Mg located

Answer 27

Bone

Question 28

Sx of hyperMg

Answer 28

Bradycardia Sluggsih tendon reflexes

Question 29

ECG changes of hyperK

Answer 29

Tented T waves small p Wide QRS

Question 30

ECG changes of low K

Answer 30

Small/intverted T waves U waves Prolonged PR ST depression

Question 32

Serotonin effects

Answer 32

Vasodilation and bronchoconstriction

Question 33

Insulin relation to injury

Answer 33

Low in ebb phase Increase in flow phase Hyperglycaemia due to resistance

Question 34

CV, neural and endo effects of cortisol

Answer 34

Increase vascular tone with vasopressors Euphoria Increase effect of T3- maintain body temp

Question 35

Effects of histamine

Answer 35

Bronchoconstriction Blood vessel dilation and permeability increase Increase gastric acid

Question 36

Example of stressors that increase cortisol

Answer 36

Prolonged exercise Prolonged starvation

Question 37

Cortisol effect on glucose

Answer 37

Increase glucagon Decrease insulin

Question 38

Cortisol effect on nitrogen

Answer 38

Increased protein breakdown Increased excretion

Question 39

Metabolic effects of catabolic state

Answer 39

Glycogen stores broken Insulin falls- resistance Cortisol raised Increased urinary nitrogen due to protein breakdown Increase FA oxidation- lipolysis

Question 40

Composition of Ca in body

Answer 40

99% bone Of free 40% bound to albumin 60%- importance Normal levels 2.2-2.6

Question 41

Which hormone does dopamine effect

Answer 41

Inhibits Prolactin

Question 42

Water and sodium in hypo, euvolaemic and hyper hyponatraemia and causes

Answer 42

Hypo- lower water but sodium lower- diarrhoea, Addisons Euv- Water levels increase but sodium remains the same - SIADH, hypothyroid, cushing Hyper- sodium increases but water increases more- cirrohis, HF, nephrotic