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Tuesday, 28 October 2025

Quiz TV week 2

 

 Theres a new quiz video running on the TV screen in the breakout area / common room today!

Here's last weeks in case you missed it. 





Sunday, 19 October 2025

"Quiz TV" - last week's video

 

Did you catch the quiz question video running all last week on the TV screen in the breakout area / common room at Shoalhaven campus? I sent it up to Moss Vale and Wollongong, so hopefully you caught it too. 
In case you missed it or want to watch it again : 

I have a new video hot off the press that should be up on a screen near you tomorrow so look out for it ! :)

Saturday, 11 October 2025

🧠 The Gonadal axis - Part 2 : Male physiology

 In males, the HPG axis governs testicular development, spermatogenesis, and testosterone production. These processes begin in foetal life, pause in childhood, and reactivate at puberty — shaping not only fertility, but muscle mass, libido, voice, and bone health. 


Understanding normal male physiology is essential before exploring disorders like hypogonadism, delayed puberty, or infertility.

🧠 The Gonadal Axis — Part 1 - Normal Physiology Across the Lifespan

 The Hypothalamic–Pituitary–Gonadal (HPG) axis governs the development and regulation of reproductive physiology, including puberty, gametogenesis, menstrual cycles, and sexual function. It’s a dynamic system that responds to internal cues (like age and energy availability) and external signals (like stress and illness).



 Its activity varies dramatically across the lifespan, from foetal differentiation to puberty, reproductive maturity, and eventual decline. Understanding this baseline physiology is essential before exploring disorders of puberty, fertility, or sexual function.


Friday, 10 October 2025

ECG Interpretation: A Reasoning-Based Revision Guide πŸ«€

Interpreting an ECG isn’t just about spotting abnormalities — it’s about understanding the heart’s electrical story in the context of the patient. This guide breaks down the process step by step. 

If you need a reminder of the electrophysiology of the heart you can find that here 


Tuesday, 7 October 2025

🧠 The Growth Axis - Part 2 : Famous faces of endocrinology

Robert Wadlow — Tallest man in history  


Robert Pershing Wadlow (1918–1940), known as the “Alton Giant,” holds the record as the tallest verified human in history. He reached a height of 2.72 m (8'11") and weighed over 220 kg at the time of his death — the result of uncontrolled growth hormone excess due to a pituitary adenoma.

🧠 The Growth Axis - Part 1 : physiology and disorders of height and growth

 Growth isn’t just about getting taller, it’s about coordinated development across tissues, organs, and systems. The hypothalamic-pituitary-somatomedin (HPS) axis governs this process, linking brain signals to liver output and peripheral tissue response. It’s a slow axis, but a powerful one - and when it fails, the consequences are lifelong.



Monday, 6 October 2025

🧠 The Adrenal Axis - Adrenal insufficiency, Cushing's syndrome and Adrenal crisis.

 The hypothalamic-pituitary-adrenal (HPA) axis is your body’s central stress-response system. It’s not just about cortisol, it’s about how the brain, pituitary, and adrenal glands coordinate to keep you alive under pressure. Whether you’re managing infection, trauma, or emotional strain, the HPA axis is quietly adjusting your metabolism, blood pressure, and immune response.



 

Ten patients: clinical cases in endocrinology - the thyroid axis

 The thyroid axis is a finely tuned system that regulates metabolism, growth, and energy balance. Disturbances in this axis can present subtly or dramatically, and understanding them requires more than memorizing hormone levels, it demands clinical reasoning.


In the following 10 cases, you’ll explore a spectrum of thyroid dysfunctions, from common presentations to critical emergencies.

πŸ” Common Causes of Hypothyroidism: Hashimoto's thyroiditis

Hashimoto’s thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions — and a classic example of destructive autoimmunity. Unlike Graves’ disease, which stimulates the thyroid, Hashimoto’s gradually damages and disables it. The immune system mistakes thyroid tissue for a threat, and over time, hormone production declines.


This post will walk you through:

  • How the immune system targets the thyroid
  • What antibodies and histology reveal
  • How to reason through the progression from normal to low hormone states
  • What to look for on imaging
  • How to manage the condition clinically

πŸ”Ί Pathophysiology of HYPOthyroidism

 In the last few posts, we explored what happens when thyroid hormone levels are too high and how Graves’ disease, toxic nodules, and thyroiditis each disrupt the HPT axis in different ways. Now we turn to the opposite problem: hypothyroidism.

What happens when there’s not enough thyroid hormone in the body?

Unlike hyperthyroidism, where everything speeds up, hypothyroidism causes a gradual slowing of metabolic processes across multiple systems. Patients may feel tired, cold, constipated, and foggy - but these symptoms often creep in slowly, and are easy to miss unless you understand the underlying physiology.


Thyroid hormone (especially T3) acts as a metabolic accelerator. It increases mitochondrial activity, oxygen consumption, and protein turnover. It also sensitises tissues to catecholamines, regulates lipid and carbohydrate metabolism, and supports normal growth and development. So when levels fall, the whole system downshifts.


Sunday, 5 October 2025

πŸ” Common Causes of Hyperthyroidism: Graves’ Disease, Toxic Multinodular Goitre, and Thyroiditis

 In the last post, we explored what happens when thyroid hormone levels are too high — and how to reason through the possible causes using the HPT axis. Now, we turn our focus to the three most common conditions that medical students are likely to encounter in practice: Graves’ disease, toxic multinodular goitre (TMNG), and thyroiditis.



These conditions may all present with elevated T3 and T4, but they arise from fundamentally different mechanisms (autoimmune stimulation, nodular autonomy, and inflammatory leakage) and require very different approaches to diagnosis and management.

In this post, we’ll walk through each condition in detail, exploring the pathophysiology, clinical features, investigations, and reasoning that help distinguish them. By the end, you’ll be able to interpret thyroid function tests, understand scan results in context, and explain to patients why their thyroid is misbehaving !


πŸ”Ί Pathophysiology of HYPERthyroidism

 What happens when there’s too much thyroid hormone in the body?

When thyroid hormone levels are elevated, the body doesn’t just “speed up”, it becomes overstimulated across multiple systems. This isn’t a random collection of symptoms; it’s a predictable physiological response to excess T3 and T4.



Saturday, 4 October 2025

🧠 The Thyroid Axis

 The thyroid axis is one of the most common clinically encountered endocrine systems. It regulates metabolism, temperature, energy, and mood. Understanding how it works helps you reason through symptoms like fatigue, weight change, palpitations, constipation, and menstrual irregularities.



🧠 The Hypothalamic–Pituitary Axis: Physiology, Reasoning, and Clinical Relevance

 Welcome to endocrine! This post is designed to help you reason through the hypothalamic–pituitary axis (HPA), not just memorise it. You don’t need to know everything yet. What matters is understanding how the system works, how it regulates itself, and how that explains common clinical presentations.



Thursday, 2 October 2025

Preparing for exams - how to make the next two months work best for you

 Exams are just under eight weeks away - close enough to feel real, but still enough time to prepare steadily without panic. The key now is consistency. Small, regular efforts will carry you much further than bursts of late-night cramming. 


This post pulls together some evidence-based strategies, links back to resources you already have, and sets out how you can use the coming weeks to your advantage.


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