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endocrine > zero to final end conditions > Flashcards

zero to final end conditions Flashcards

1
Q

what does the anterior pituitary gland release

A

TSH, ACTH, FSH, LH, GH and prolactin

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2
Q

what does posterior pituitary secrete

A

oxytocin- uterine contractions and lactation
ADH- maintains water balance

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3
Q

thyroid results in primary hyperthyroidism

A

thyroid gland is not working so producing excess T3 and T4
TSH is suppressed by the high levels of T3 and 4

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4
Q

thyroid results in secondary hyperthyroidism

A

Pituitary gland isn’t working so produces lots of TSH
TSH will be high and so will T3 and T4

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5
Q

thyroid results in primary hypothyroidism

A

Thyroid isn’t behaving so no negative feedback so high TSH but low T3 and T4

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6
Q

thyroid results in secondary hypothyroidism

A

pituitary not behaving no low TSH and low T3 and T4

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7
Q

typical symptoms of graves disease

A

exopthalamos
pretibial myxoedema
goitre

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8
Q

symptoms of hyperthyroidism

A

weight loss and heat intolerance
anxiety
insomnia
brisk reflexes

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9
Q

de quervains thyroiditis

A

thyrotoxicosis
hypothyroidism
return to normal

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10
Q

what antibodies are associated with hashimotos thyroiditis

A

anti-thyroid peroxidase and anti-thyroglobulin

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11
Q

presentation of hypothyroidism

A

weight gain and cold intolerance
coarse hair and hair loss

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12
Q

what type of steroid is cortisol

A

glucocorticoids

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13
Q

what type of steroid is aldosterone

A

mineralcorticoids

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14
Q

cushings syndrome

A

prolonged high levels of glucocorticoids produced from adrenal glands

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15
Q

cushings disease

A

pituitary adenoma secreting ACTH

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16
Q

what disease do you use the dexamethasone test for

A

if cortisol isn’t suppressed then you have cushings
It should usually be suppressed by negative feedback

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17
Q

24 urinary free cortisol

A

used for cushings

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18
Q

how do you investigate aldosteronism

A

aldosterone to renin ratio

19
Q

how do you manage aldosteronism

A

aldosterone antagonists

20
Q

what is the most common cause of secondary hypertension

A

hyperaldosternism

21
Q

signs of adrenal insufficiency

A

bronze hyperpigmentation as ACTH stimulates melanocytes to produce melanin
hypotension

22
Q

what do you get hyponatraemia

A

adrenal insufficiency

23
Q

Other blood investigations from adrenal insufficiency

A

high potassium
low glucose
raised urea
hypercalaemia

24
Q

tests for adrenal insufficiency

A

short synacthen test

25
Q

management of adrenal insufficiency

A

hydrocortisone
fludocortisone

26
Q

addisonain crisis symptoms

A

reduced consciousness
hypotension
hypoglycaemia
hyponatraemia

27
Q

management of addisonain insufficiency

A

IV or IM hydrocortisone
IV fluids

28
Q

most common cause of acromegaly

A

pituitary adenoma

29
Q

investigations for acromegaly

A

IGF-1
GH suppression test
MRI of pituitary

30
Q

what hormone does somatostatin compress

A

GH

31
Q

which cells produce parathyroid hormone

A

chief cells

32
Q

how does PTH increase calcium

A

increasing osteoclast activity in bones
increasing calcium reabsorption
increasing Vit D so more calcium absorbed in the intestines

33
Q

symptoms of hypercalcaemia

A

kidney stones, painful bones, abdominal groans, psychiatric moans

34
Q

how do you get increased production of ADH

A

increased secretion by posterior pituitary
ectopic ADH by small cell lung cancer

35
Q

what happens with excessive ADH

A

increased water reabsorption in the collecting ducts diluting the blood and reducing sodium concentration

36
Q

what sort of urine do patients with SIADH have

A

high urine osmolarity and high urine sodium

37
Q

symptoms of SIADH

A

headache, fatigue, muscle aches and confusion

38
Q

how does diabetes insipidus occur

A

a lack of antiduiretic hormone and lack of response to the hormone

39
Q

presentation of diabetes insipidus

A

polyuria, polydipsia, dehydration, postural hypotension

40
Q

investigations for diabetes insipidus

A

low urine osmolarity
more than 3 litres on 24 hrs urine collection

41
Q

primary polydipsia vs diabetes insipidus

A

water deprivation test shows high urine osmolarity ruling out diabetes

42
Q

phaeochromocytoma disease

A

tumour in the chromatin cells that secrete unregulated and excessive amounts of adrenaline

43
Q

Test for catecholamines

A

plasma free metanephrines
24 hr urine catecholamines

44
Q

Management of phaeochromocytoma

A
  1. alpha blockers
  2. beta blockers
  3. surgical removal of the tumour

endocrine (3 decks)

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