Endocrinology is the study of the endocrine system in the human body. This is a system of glands which secrete hormones. Hormones are chemicals which affect the actions of different organ systems in the body. Examples include thyroid hormone, growth hormone, and insulin. Medicos Library has provided high standard Endocrinology Notes by Dr. Yousif Abdallah Hamad.
Summary of Notes:
Dynamic pituitary function tests
A dynamic pituitary function test is used to assess patients with suspected primary pituitary dysfunction Insulin, TRH and LHRH are given to the patient following which the serum glucose, cortisol, growth hormone, TSH, LH and FSH levels are recorded at regular intervals. Prolactin levels are also sometimes measured* A normal dynamic pituitary function test has the following characteristics:
- GH level rises > 20mu/l
- cortisol level rises > 550 mmol/l
- TSH level rises by > 2 mu/l from baseline level
- LH and FSH should double
*dopamine antagonist tests using metoclopramide may also be used in the investigation of hyperprolactinaemia. A normal response is at least a twofold rise in prolactin. A blunted prolactin response suggests a prolactinoma
Adult growth hormone deficiency
low peak growth hormone levels in response to insulin-induced hypoglycaemia
Features – mix low ACTH: tiredness, postural hypotension. (Postural hypotension is related to adrenal failure regardless of cause)
low gonadotrophins: amenorrhoea
low TSH: constipated
- Antidiuretic hormone (ADH) is secreted from the posterior pituitary gland.
- It promotes water reabsorption in the collecting ducts of the kidneys by the insertion of aquaporin-2 channels
- ADH binds to V2 receptors which are found on the peritubular surface of cells in the distal convoluted tubule and medullary collecting duct. This leads to insertion of aquaporin channels into the luminal membrane, enhancing permeability to water.
- ADH (vasopressin) is known to increase platelet aggregation, as such it may be considered prothrombotic at high dose.
- increase factor VIII production, and as such may be of utility in treating some patients with haemophilia A.
- It leads to uterine and GI smooth muscle contraction and indirectly leads to a reduction in coronary artery blood flow.
Advice form Dr. Yousif Abdallah Hamad
How to use the notes to study for MRCP:
- Initially, you need to skim through the notes at least twice to build up an idea about the syllabus of MRCP. Highlight any portion that is difficult so that you can concentrate on that during your revision.
- Next proceed to the question banks. You can choose to do Passmedicine, onexamination or Pastest. I usually recommend students to do Passmedicine and the Pastest.
- As you go through the questions make a super-revised notes of your own. Write down in one sentence what you learned from the question you just attempted.
- If you get any question wrong or you get confused then return to the notes and re-read one more time before attempting the question again. And write down the point in red in you revision notes so that you can skim through it easily during your revision.
- I have highlighted some points in yellow and green to help you concentrate on those points. As you go through passmedicine and pastest, you can highlight the points further to help in your revision.
- During your revision before the main exam, only read the highlighted portions including those that you highlighted when practicing the question bank. And also read your super-revised notes that you made from the question banks.
I believe these method has worked for many students and will help you in your journey to be successful in MRCP part 1 and as well as build your basics for Part 2.
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