1
Q
ambigious external genitalia - mineralocorticoid deficiency and androgen excess
A
congenital adrenal hyperplasia
2
Q
congenital adrenal hyperplasia results in deficiency of what
A
enzyme 21- alphahydroxylase
3
Q
how does congenital adrenal hyperplasia present in males
A
precocious puberty in males
4
Q
how does congenital adrenal hyperplasia present in females
A
unable to tell if female or male by genitals
5
Q
there is an increased risk of what cancer in patients who take pioglitazone
A
bladder
6
Q
how does glp-1 do to insulin and glucagon
A
increase insulin ad reduce glucagon secretion
7
Q
drug prescribed for exacerbations of copd that can worsen diabetes as it up regulates glucagon
A
prednisolone
8
Q
under physiological stress eg surgery or appendicitis is insulin or glucagon increased
A
glucagon - to increase levels of glucose
9
Q
what happens to cortisol, acth and t4 in times of stress
A
cortisol and acth are increased and t4 reduced
10
Q
what does cortisol do
A
in the stress response it releases glucose from fat storage
11
Q
what is used to readily reverse the effects of hypoglycaemia in diabetics
A
glucagon
12
Q
does sglt2i increase or reduced glucose reabsorption in the renal tubules
A
reduce so more glucose can be released in the urine
13
Q
what causes secretion of water and electrolytes
A
secretin
14
Q
what causes enzyme secretion
A
Cholecystokinin
15
Q
what decreases the volume of secretions
A
somatostatin
16
Q
what tends to conserve electrolytes
A
aldosterone
17
Q
what drug decreases hepatic gluconeogenesis
A
metformin
18
Q
insulin and sulphonlyureas does what do weight
A
increases it
19
Q
does metformin have a direct effect on insulin secretion
A
no so it cannot cause significant hypoglycaemia
20
Q
what have minimal glucocorticoid activity and very high mineralcorticoid
A
fludrocortisone
21
Q
what has glucortociod activity and high mineral corticoid
A
hydrocortisone
22
Q
what has predominant glucorticoid activity and low mineralocorticoid
A
prednisolone
23
Q
what can happen if you abruptly stop long term corticoid
A
addisonian crisis as - natural production of endogenous steroids is surpasses
24
Q
what drives growth in infants
A
nutrition and insulin
25
what drives growth in childhood
growth hormone and thyroxine
26
what drives growth in adolescents
growth hormone and sex steroid
27
acromegaly is often produced by
pituitary adenoma
28
when does growth hormone stop being secreted
throughout life- as needed for maintaneece of muscles
29
conns effect on sodium and potassium
increased sodium and decreased potassium as too much adh
30
most common cause of conns
bilateral adrenal hyperplasia
31
signs of conns
hypertension and hypokalaemia
32
what does hypokalaemia cause
muscle weakness
33
what should aldosterone/ renin ration show in primary hyperaldosteronism or conns
high aldosterone with low renin
34
what do you do after aldosterone/ renin ration
CT abdomen and adrenal vein sampling to differentiate unilateral and bilateral sources of aldosterone
35
management if there is an adrenal adenoma
surgery
36
management id there is bilateral adrenocortical hyperplasia
aldosterone antagonist eg spironolactone
37
what does dpp4 breakdown
GLP-1 and GIP
38
what is an uncontrolled lipolysis
DKA as results in an excess of free fatty acid that are ultimately converted to ketones
39
formation of IgG antibodies to the TSH receptors on the thyroid gland
graves
40
is t3 or t4 more biologically active
T3
41
what does calcitonin do
lowers plasma calcium
42
how is osteoporosis associated with excessive pituitary adenomas
due to excessive PTH causing bone resorption
43
why would phosphate be low in primary hyperparathyroidism
as PTH decreases renal phosphate reabsorption
44
PTH causes what
activation of vitamin D and increases phosphate absorption in the GI tract and increases osteoclast activity
45
what cells secrete PTH
chief cells of the parathyroid gland
46
effects go pTH in kidneys
increases reabsorption of calcium and magnesium and decreases reabsorption of phosphate
47
PTh effect on. bone
binds to osteoblasts which signals to osteoclasts to cause resorption of bone and release calcium
48
effect of pTH on intestine
increases calcium absorption by increases vitamin d and
49
Di is unable to concentrate urine so urine osmolality is --- after fluid deprivation and is low after desmospression in Nephrogenic DI
low
50
adh helps to
concentrate urine
51
how would adrenaline affect secretion of insulin
inhibits it as insulin lowers blood glucose
52
how do beta blockers affects insulin
they inhibit it
53
mody has mutation on what gene
HNF4alpha
54
body results in
reduced endogenous insulin secretion
55
what hormone regulated feelings of satiety and fullness
leptin
56
what hormone regulates feelings of hunger
ghrelin
57
insulin is produced where
pancreatic beta cells
58
pancreatic alpha cells secrete
glucagon
59
pancreatic delta cells secrete somatostatin
yes
60
gastric chef cells secrete
pepsinogen
61
gastric g cells secrete
gastrin
62
what most commonly causes Waterhouse - friderichsen syndrome
neisseria meningitidis
63
what is a syndrome that is adrenal gland failure due to bleeding into the adrenal gland
waterhouse - friderichsen
64
what secretes adrenaline
adrenal medulla
65
what is a malignancy affecting the adrenal medulla
phaechromocytoma
66
malignancy in the adrenal medulla causes what
excess adrenaline production so tachycardia, headaches, sweating
67
hypospadias is on what surface of the p
distal ventral
68
abnormal urine steam
hypospadias
69
does PTH have an effect on potassium levels
NO
70
PTH inhibits what
osteoblasts so there is an increase in calcium and decrease in phosphate
71
PTH does what to phosphate
hypophosphataemia - decrease in renal phosphate reabsorption
72
what can steroids do to blood glucose levels
increase them - not good for diabetics
73
what comes first in females pubic hair or axillary hair
pubic hair
74
what is the first hormone secreted in response to hypoglycaemia
glucagon
75
what is used to screen for medullary thyroid cancer recurrence
calcitonin ( thyroglobulin for papillary and follicular thyroid cancer)
76
prolactin inhibits what activity
gonadal
77
what is the potassium levels when insulin is deficient
hyperkalaemia
78
what should be monitored when giving management of DKA
potassium levels due to risk of hypokalaemia from treatment
79
if got LADA or Type 1 then what transporter has decreased expression
80
if got LADA or Type 1 then what transporter has decreased expression
GLUT4- reduced uptake of glucose into skeletal and adipose tissue
81
hyperglycaemia with low c peptide could be
LADA or type 1
82
half life of insulin
less than 30 mins
83
a rise in what protein is seen in pregnancy
TBG
84
what thyroid changes are normal in pregnancy
increase in TBG causing an increase in total thyroxine but does not affect free thyroxine level
85
a somatostatin analogue
octreotide
86
somatostatin does what
inhibits growth hormone secretion and inhibits insulin and glucagon
87
how does adh cause hyponatraemia
insertion of aquaporin 2 channels
88
prolactin has an inhibitory effect on what
GRH and LH
89
how do beta blockers affect insulin
inhibit the release of insulin
90
low --- can cause hypocalcemia
magnesium
91
difference between klinefelters and kallmans
LH and FSH is low in kallmans but raised in klinefelters
92
what receptor causes increase in heart rate
beta 1
93
calcium is low or normal in
secondar hyperparathyroism
94
what is the most common thyroid cancer
papillary
95
what di would someone develop after trasphenoidal surgery
cranial
96
in cranial di what results after fluid deprivation and desmopression
low after fluid and high after desmopressin
97
nephrogenic di would cause
low and low after both water deprivation and desmopressin
98
primary ketone in DKA
acetoacetate
99
In HHS, give
saline
100
when can insulin be given in HHS
not till after given fluids and potassium replacement- don't want to give insulin immediately
101
hormones that are decreased in the stress response
insulin, testosterone and oestrogen
102
what hormones do not change in the stress response
sex related hormones
103
fruity smell to breath
DKA
104
in aka what kind of insulin do you give
short acting
105
what insulin for dka
short acting insulin
106
what increases simulation of insulin secretion by pancreatic beta cells and decreases hepatic clearance of insulin
sulphonylureas
107
difference between primary and tertiary hyperparathyroidism
in tertiary phosphate is low
108
what is present in 10% of patients with hypospadias
cryptorchidism
109
hasimotos thyroiditis cause hypo/hyper thyroidism
HYPO
110
side effects of too much glucocorticoid activity
depression, hyperglycaemia, peptic ulceration, osteoporosis
111
somatostatin only decreases
insulin
112
orphan Annie eyes with psammoma bodies
papillary thyroid cancer
113
saromatoid appearance with spindle cells and giant cells
anapaestic carcinoma
114
how does alcohol cause a hypo
alcohol inhibits glycogenolysis
115
what is the goitre like in hashimotos
smooth
116
posterior pituitary produces
ADH and oxytocin
117
how long does propylthiouracil take before it has an effect
6 weeks
118
lack of --- causes hyperkalaemia
aldosterone
119
most common cause of addisons
autoimmunity
120
how does insulin decrease potassium
stimulates the Na/K ATPase pump
121
does cortisol increase or decrease gluconeogensis
increase leading to an increase in blood glucose levels
121
does cortisol increase or decrease gluconeogensis
increase leading to an increase in blood glucose levels
122
does cortisol dampen the immune system
yes
123
does cortisol cause upregualton of alpha 1 adrenoceptors on arterioles
yes as it causes high blood pressure
124
does cortisol decrease osteoblast and fibroblasts
yes so get weak bones and delayed wound healing
125
abdo striae in cushings is due to decreased synthesis of what due to high cortisol levels
collagen
125
abdo striae in cushings is due to decreased synthesis of what due to high cortisol levels
collagen
126
main component of the colloid in the thyroid gland
thyroglobulin
127
desmopression - where is the mechanism of action
collecting ducts of the kidney
128
where does the majority of water reabsorption occur
collecting ducts
129
rash and diabetes
glucagonoma
130
what is among the top causes of gynaecomastia
liver disease
131
what is among the top causes of gynaecomastia
liver disease
132
type 1 diabetes is associated with other autoimmune disorders such as
addisons, graves, coeliac
133
where does PTH act in the kidney to increase calcium reabsorption
distal consulted tubule
134
glucagon increases the secretion of what
somatostatin
135
what is known as the growth hormone inhibiting hormone
somatostatin
136
somatostatin inhibits the secretion of
insulin and glucagon
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