MRCOG Part 1 > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

what action does cortisol have on the fetus?

A

surfactant production
normal development of CNS, retina, skin, GI tract, and lungs

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2
Q

inheritance of CAH?

A

autosomal recessive

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3
Q

pathology in CAH?

A

defect in enzyme responsible for steroidogenesis in fetal adrenal gland
results in androgen excess

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4
Q

most common enzyme defect in CAH?

A

21 hydroxylase (CYP21A2)

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5
Q

what causes secondary hyperparathyroidism?

A

fall in Ca (vit D def)

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6
Q

blood results in secondary hyperparathyroidism?

A

PTH high
P low

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7
Q

what causes secondary hypoparathyroidism?

A

increase in Ca levels
e.g excessive vit D intake

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8
Q

blood results in secondary hypoparathyroidism?

A

high Ca
Low PTH
High P

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9
Q

what is acromegaly?

A

excess GH after epiphyseal plate closure
if before this, causes gigantism

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10
Q

commonest cause of acromegaly?

A

GH secreting pituitary adenoma -> increased IGF1

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11
Q

investigations for acromegaly?

A

serum IGF1
OGTT (non supression)
MRI pituitary

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12
Q

treatment for acromegaly?

A

surgery
somatostatin analogues
dopamine agonist

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13
Q

what causes addison’s disease?

A

primary adrenal insufficiency (destruction of adrenal cortex)

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14
Q

what is secondary adrenal insufficiency?

A

originates from pituitary
low ACTH
usually caused by prolonged steroid courses

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15
Q

what happens to hormones in addison’s ?

A

destroyed adrenal cortex
no GCT/MCT/Androgens
increased ACTH as no cortisol to cause negative feedback

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16
Q

biochemical disturbances in addisons?

A

high K
low Na
High Ca
low BM

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17
Q

Ix for addisons?

A

synacthen test

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18
Q

what does aldosterone do?

A

upregulated Na/K pumps in DCT and CD
Na reabsorbed, K lost

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18
Q

site of aldosterone production?

A

zona glomerulosa
MCT

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19
Q

how is aldosterone production stimulated?

A

Raised K
justaglomerular cells of the kidney release renin -> stimulated aldosterone

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19
Q

what causes conn’s?

A

primary hyperaldosteronism
adrenal hyperplasia/adenoma

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20
Q

what happens in hyperaldosteronism?

A

high BP
reabsorption of Na

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21
Q

what causes secondary hyperaldosteronism?

A

increased renin (e.g RAS, tumour production)

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22
Q

how is DHEA producted?

A

made from cholesterol via pregnenolone by the adrenal glands

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23
how is DHEA used in fetal development?
travels to placenta and converted to oestrogens supports uteroplacental blood flow prepares uterus and cervix for labour promotes fetal organ maturation
24
when does DHEA production stop/start?
stops at birth resumes at adrenarche, peaks early adulthood, then stops
25
where is glucagon produced?
alpha cells of pancreas
26
what does glucagon do?
stimulates glycogenolysis (glycogen to glucose) and gluconeogenesis (make glucose from AA) inhibits glycolysis (glucose to pyruvate)
27
what hormones are structurally similar to prolactin?
GH hPL
28
what are hormones structurally similar to TSH?
FSH LH HCG
29
what is peri menopause?
>45 year olds vasomotor instability irregular periods
30
what is menopause?
absense of periods for 12 months and not taking contraception
31
Tx for HRT?
combined if pt has a uterus oestrogen alone if no uterus
32
T scores for osteopenia?
<-1 but >-2.5
33
T scores for osteoporosis?
< or equal to -2.5
34
T scores for severe osteoporosis?
< -2.5 + fragility fracture
35
what is the two cell transformations in the menstrual cycle? in what stages?
follicular = theca and granulosa cells luteal = thecal lutein cells, granulosal lutein cells
36
what do theca cells, in each form, do?
follicular = produce androgen luteal = produce progresterone
37
what do granulosa cells, in each form, do?
follicular = convert androgen to estradiol via aromatase luteal = produce progesterone
38
what does LH cause theca cells to do?
androgen production contraction of SM cells -> increases pressure -> oocyte rupture
39
what does FSH do to granulosa cells?
triggers aromatase production
40
what does oxytocin do?
SM uterine contraction contraction of myoepithelial cells (milk) maternal bonding postpartum uterine involution
41
where does a phaechromocytoma occur?
medulla of the adrenal glands
42
what is classed as precocious puberty?
<8
43
what is classed as delayed puberty?
abscence of breasts in girls >13yrs old absence of testicular development/testicular volume <4ml in >14yrs old
44
synthetic GCT vs MCT?
GCT - prednisolone MCT - fludrocortisone
45
how does oxytocin cause myometrial contractions?
activates phospholipase C to produce inositol 1,4,5-trisphosphate (IP3), which releases Ca2+ from intracellular stores
46
what inhibits glucagon?
somatostatin insulin uraemia inccreased fatty acids/keto acids
47
percentage of testosterone bound to what?
70% to SHBG 25-30% to albumin 1.5-3% unbound
48
what conditions can cause a drop in SHBG?
weight gain PCOS Anabolic steroids obesity cushing's acromegaly
49
what percentage of kids have delayed puberty?
3%
50
what is glycolysis?
glucose -> pyruvate
51
what is gluconeogensis?
making glucose from AA
52
what is glycogenolysis?
glycogen to glucose
53
most common cause worldwide of hypothyroidism?
iodine deficiency
54
what do islet cells secrete?
alpha cells secrete glucagon beta cells secrete insulin delta cells secrete somatostatin gamma cells secrete pancreatic polypeptide
55
what is premature menopause defined as?
premature menopause is defined as menopause at or before 40 years of age.
56
what cells do phaeochromocytoma originate from?
chromaffin cells
57
finding on addison's FBC?
eosinophilia lymphocytosis
58
drug to induce lactation?
domperidone
59
what inhibits TSH?
somatostatin
60
what test is done for conn's?
saline suppression test aldosterone to renin ratio
61
drugs to reduce milk production?
cabergoline bromocriptine
MRCOG Part 1
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