zero to final end conditions

Question 1

what does the anterior pituitary gland release

Answer 1

TSH, ACTH, FSH, LH, GH and prolactin

Question 2

what does posterior pituitary secrete

Answer 2

oxytocin- uterine contractions and lactation
ADH- maintains water balance

Question 3

thyroid results in primary hyperthyroidism

Answer 3

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

Question 4

thyroid results in secondary hyperthyroidism

Answer 4

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

Question 5

thyroid results in primary hypothyroidism

Answer 5

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

Question 6

thyroid results in secondary hypothyroidism

Answer 6

pituitary not behaving no low TSH and low T3 and T4

Question 7

typical symptoms of graves disease

Answer 7

exopthalamos
pretibial myxoedema
goitre

Question 8

symptoms of hyperthyroidism

Answer 8

weight loss and heat intolerance
anxiety
insomnia
brisk reflexes

Question 9

de quervains thyroiditis

Answer 9

thyrotoxicosis
hypothyroidism
return to normal

Question 10

what antibodies are associated with hashimotos thyroiditis

Answer 10

anti-thyroid peroxidase and anti-thyroglobulin

Question 11

presentation of hypothyroidism

Answer 11

weight gain and cold intolerance
coarse hair and hair loss

Question 12

what type of steroid is cortisol

Answer 12

glucocorticoids

Question 13

what type of steroid is aldosterone

Answer 13

mineralcorticoids

Question 14

cushings syndrome

Answer 14

prolonged high levels of glucocorticoids produced from adrenal glands

Question 15

cushings disease

Answer 15

pituitary adenoma secreting ACTH

Question 16

what disease do you use the dexamethasone test for

Answer 16

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

Question 17

24 urinary free cortisol

Answer 17

used for cushings

Question 18

how do you investigate aldosteronism

Answer 18

aldosterone to renin ratio

Question 19

how do you manage aldosteronism

Answer 19

aldosterone antagonists

Question 20

what is the most common cause of secondary hypertension

Answer 20

hyperaldosternism

Question 21

signs of adrenal insufficiency

Answer 21

bronze hyperpigmentation as ACTH stimulates melanocytes to produce melanin
hypotension

Question 22

what do you get hyponatraemia

Answer 22

adrenal insufficiency

Question 23

Other blood investigations from adrenal insufficiency

Answer 23

high potassium
low glucose
raised urea
hypercalaemia

Question 24

tests for adrenal insufficiency

Answer 24

short synacthen test

Question 25

management of adrenal insufficiency

Answer 25

hydrocortisone fludocortisone

Question 26

addisonain crisis symptoms

Answer 26

reduced consciousness hypotension hypoglycaemia hyponatraemia

Question 27

management of addisonain insufficiency

Answer 27

IV or IM hydrocortisone IV fluids

Question 28

most common cause of acromegaly

Answer 28

pituitary adenoma

Question 29

investigations for acromegaly

Answer 29

IGF-1 GH suppression test MRI of pituitary

Question 30

what hormone does somatostatin compress

Answer 30

GH

Question 31

which cells produce parathyroid hormone

Answer 31

chief cells

Question 32

how does PTH increase calcium

Answer 32

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

Question 33

symptoms of hypercalcaemia

Answer 33

kidney stones, painful bones, abdominal groans, psychiatric moans

Question 34

how do you get increased production of ADH

Answer 34

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

Question 35

what happens with excessive ADH

Answer 35

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

Question 36

what sort of urine do patients with SIADH have

Answer 36

high urine osmolarity and high urine sodium

Question 37

symptoms of SIADH

Answer 37

headache, fatigue, muscle aches and confusion

Question 38

how does diabetes insipidus occur

Answer 38

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

Question 39

presentation of diabetes insipidus

Answer 39

polyuria, polydipsia, dehydration, postural hypotension

Question 40

investigations for diabetes insipidus

Answer 40

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

Question 41

primary polydipsia vs diabetes insipidus

Answer 41

water deprivation test shows high urine osmolarity ruling out diabetes

Question 42

phaeochromocytoma disease

Answer 42

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

Question 43

Test for catecholamines

Answer 43

plasma free metanephrines 24 hr urine catecholamines

Question 44

Management of phaeochromocytoma

Answer 44

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