72 Questions
What is the primary underlying cause of an Addisonian crisis?
Inadequate cortisol levels
What is the effect of cortisol on systemic adrenaline in the vascular shunting exercise?
Cortisol potentiates systemic adrenaline
What is a common clinical feature of Addison's disease?
Hypotension
What is the purpose of the Short Synacthen test in diagnosing Addison's disease?
To assess the function of the adrenal glands
What is the typical dosage of hydrocortisone used to manage Addison's disease?
20mg mane & 10mg nocte
What is a possible cause of secondary hypoadrenalism?
Hypothalamic-pituitary axis disease
What is the effect of a growth hormone deficiency in childhood?
Pituitary dwarf
What is the primary function of growth hormone in childhood?
Regulating growth and development
What is the term for excessive growth hormone production in adulthood?
Acromegaly
What is the most common cause of acromegaly?
Pituitary tumour
What is the term for a visual field defect that can result from acromegaly?
Bitemporal hemianopia
What is the primary mechanism of action of the thyroid?
TRF stimulates TSH, which stimulates T4 and T3 production
What is the primary disease of hypothyroidism?
Thyroid tissue
What is the most common aetiology of hypothyroidism?
Atrophic autoimmune hypothyroidism
What is the primary treatment for hypothyroidism?
Lifelong replacement therapy with thyroxine
What is a common clinical feature of hypothyroidism?
Macroglossia
What is the primary reason Addisonian patients are unable to respond appropriately in stressful situations?
They cannot produce enough cortisol to accompany the adrenaline to facilitate vascular shunting.
What is recommended for a steroid-dependent Addison's disease patient before major dental surgery like an extraction?
100mg hydrocortisone IM just before anaesthesia
What is the primary function of mineralocorticoids in the body?
To regulate electrolyte balance and blood pressure
What is the term for excess aldosterone production in the adrenal gland?
Hyperaldosteronism
What are the consequences of primary adrenal adenoma in Conn's syndrome?
Hypokalemia, excess fluid retention, and secondary hypertension
What is the mechanism of secondary hyperaldosteronism in Conn's syndrome?
Excess stimulation through the renin-angiotensin axis
What is the typical cause of congenital adrenal hyperplasia?
Defect in steroid-21 hydroxylase enzyme
What occurs to young boys with congenital adrenal hyperplasia?
Precocious puberty
What is the recommended management for hypertension in Conn's syndrome due to adrenal hyperplasia?
Hypertension can be combatted using spironolactone
What is the typical presentation of congenital adrenal hyperplasia in young females?
Infertile and hirsute young hypotensive females with salt-losing kidneys
What is a common symptom of severe hypothyroidism?
Hypothermia
What is the most common cause of hyperthyroidism?
Grave's disease
What is the primary function of parathyroid hormone?
Regulation of serum calcium levels
What is the primary cause of primary hyperparathyroidism?
Adenoma in the parathyroid gland
What is a common presentation of primary hyperparathyroidism?
Renal stones
What is a characteristic feature of the eye in Grave's disease?
Exophthalmos
What is the purpose of a CT scan in Grave's disease?
To exclude retro-orbital tumor
What is the role of beta blockers in the management of hyperthyroidism?
To control sympathetic symptoms
What is the most common gender affected by goitre?
Female
What is the cause of dysphagia or stridor in goitre?
Pressure on the larynx
What is the primary mechanism by which cortisol influences the body's response to stress?
By potentiating systemic adrenaline in the vascular shunting exercise
What is the most common electrolyte imbalance observed in patients with Addison's disease?
Hyponatremia and hyperkalemia
What is the primary purpose of fludrocortisone in the management of Addison's disease?
To regulate electrolyte balances and blood pressure
What is the most common presentation of Addison's disease in patients?
Insidious development of lethargy, anorexia, and weight loss
What is the primary role of the Short Synacthen test in diagnosing Addison's disease?
To measure cortisol levels in response to ACTH stimulation
What is the primary underlying cause of secondary hypoadrenalism?
Hypothalamic-pituitary axis disease
What is the result of a growth hormone excess in childhood?
Gigantism
What is the primary cause of visual field defects in acromegaly?
Adenoma pressing on the optic chiasm
What is the term for the condition where the body's bones and tissues grow excessively due to an overproduction of growth hormone in adulthood?
Acromegaly
What is the primary function of TSH in the mechanism of action of the thyroid?
Driving the production of T4 and T3
What is the most common variation of hypothyroidism?
Atrophic autoimmune hypothyroidism
What is the purpose of the TSH test in managing hypothyroidism?
To monitor the effectiveness of thyroxine replacement therapy
What is the result of a growth hormone deficiency in childhood?
Pituitary dwarfism
What is the primary mechanism of action of octreotide in managing acromegaly?
Shrinking inoperable tumours to resectable proportions
What is the result of a benign anterior pituitary acidophil adenoma in adulthood?
Acromegaly
What is the primary purpose of glucose tolerance test in diagnosing acromegaly?
To test the body's ability to suppress growth hormone production
What is the primary cause of Graves' disease?
IgG autoantibody acting against TSH receptors
What is the primary mechanism of action of carbimazole in the management of hyperthyroidism?
Inhibiting the formation of thyroid hormones
What is the primary indication for radioiodine therapy in the management of hyperthyroidism?
Relapsed hyperthyroidism after drug therapy
What is the primary effect of hyperparathyroidism on the bone?
Generalized porosis of bone
What is the primary mechanism of action of parathyroid hormone in the regulation of serum calcium levels?
Acting with vitamin D to defend serum ionized calcium
What is the primary underlying cause of primary hyperparathyroidism?
Unstimulated PTH excess by adenoma inappropriate to serum calcium levels
What is the primary reason for the use of beta blockers in the management of hyperthyroidism?
To control sympathetic symptoms
What is the primary cause of dysphagia or stridor in patients with goitre?
Pressure on the larynx
What is the primary indication for surgical management of goitre?
Pressure symptoms such as dysphagia or stridor
What is the primary biochemical feature of primary hyperparathyroidism?
Elevated serum calcium levels and elevated PTH
What is the primary function of mineralocorticoids in the body?
To promote renal sodium reabsorption and potassium excretion
What is the recommended management for a steroid-dependent Addison's disease patient before dental surgery like a root canal?
Double normal dose of hydrocortisone one hour prior to surgery
What is the typical cause of congenital adrenal hyperplasia?
A congenital defect in steroid synthesis, typically caused by a defect in the steroid-21 hydroxylase enzyme
What is the primary mechanism of action of congenital adrenal hyperplasia?
17-hydroxylase progesterone accumulates and is processed to androgens in the zona fasciculata
What is the primary underlying cause of Conn's syndrome?
A primary adrenal adenoma or hyperplasia
What is the recommended management for hypertension in Conn's syndrome due to adrenal hyperplasia?
Medication with spironolactone, an aldosterone antagonist
What is the primary consequence of primary adrenal adenoma in Conn's syndrome?
Hypokalemia and hypertension
What is the term for excess aldosterone production in the adrenal gland?
Hyperaldosteronism
What is the primary mechanism of action of secondary hyperaldosteronism in Conn's syndrome?
Excess stimulation through the renin-angiotensin axis
What is the group of people more commonly affected by congenital adrenal hyperplasia?
Infertile and hirsute young hypotensive females with salt-losing kidneys
This quiz covers the causes and consequences of Addisonian crisis, including its effects on cortisol levels, blood sugar, and blood pressure. It also explores the clinical features of Addison's disease, such as lethargy, anorexia, and weight loss.
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