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[Y1] Pathology > Endocrinology and endocrine disorders > Flashcards

Endocrinology and endocrine disorders Flashcards

1
Q

what are 4 reasons for the endocrine and nervous systems?

A
  • Required for effective cell-cell communication in large, complex multicellular organisms (~1014 cells in human body)
  • Monitor and coordination internal environment and make appropriate adaptive changes (homeostasis)
  • Regulate growth, development, reproduction, senescence
  • Enable you to respond and adapt to changes in external environment
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2
Q

define hormone

A

A chemical messenger produced and secreted by a specialised endocrine gland that is transported in the bloodstream to a distant target organ/cell where it elicits a physiological response

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3
Q

give an example of a protein/peptide hormone

A

growth hormone (hydrophilic)

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3
Q

what are the three classes of hormones?

A
  • proteins/peptides
  • cholesterol derivatives
  • modified amino acids
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4
Q

give 2 examples of cholesterol derivative hormones

A
  • steriods (hydrophobic)
  • vitamin D (hydrophobic)
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5
Q

give 2 examples of modified amino acid hormones

A
  • adrenaline (hydrophilic)
  • thyroid hormones (hydrophilic)
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6
Q

what are the 3 things that influance the circulating hormone levels?

A
  • rate of secretion by endocrine system
  • rate of metabolism by target tissue, blood, liver, kidney
  • serum binding proteins? (transport in blood- solubility issue ect.)
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7
Q

what are 4 things about specific receptors in target cell recognition?

A
  • are proteins
  • have high affinity for hormones (10^-8 to 10^-10 M)
  • Binding starts chain of events that result in biological response
  • Receptor number is dynamic
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8
Q

what are 4 things that hormones can affect?

A
  • growth
  • development
  • metabolic activity
  • function of tissues
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9
Q

are hormones stimulatory, inhibatory or both?

A

both

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10
Q

do hormones act on several tissues, just on specific target tissue or both

A

both (depending on which hormone)

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11
Q

where are the 2 types of specific receptors found? and which is for water-soluble and lipid-soluble hormones?

A
  • on cell membranes (water-soluble hormones)
  • inside cells (lipid-soluble hormones)
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12
Q

what are the 2 ways in which hormone secretion is regulated?

A
  • by physiological changes
  • by feedback mechanisms
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13
Q

give an example of physiological changes leading to regulation of hormones

A
  • Blood glucose regulates insulin & glucagon release from pancreas
  • ‘Stress’ regulates adrenaline release from adrenal medulla
  • Blood calcium regulates parathyroids
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14
Q

what are the 2 types of feedback systems?

A
  • negative
  • positive
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15
Q

are there more negative or positive feedback systems in the body?

A

negative

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16
Q

what are the main role of negative feedback systems?

A

maintain homeostasis

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17
Q

what are the 4 main types of endocrine dysfunction?

A
  • hyposecretion
  • hypersecretion
  • ectopic hormone secretion (hormones made outside normal endocrine gland (e.g. tumour))
  • end organ insensitivity/ resistance
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18
Q

what are 6 causes of hormone hyposecretion?

A
  • genetic
  • dietary
  • immunological
  • cancer/tuberculosis
  • latrogenic (doctor caused)
  • idiopathic (unknown)
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19
Q

what is the treatment for hormone hyposecretion?

A

hormone replacement

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20
Q

state 3 things about steroid or thyroid hormone replacement

A
  • straightforward
  • absorbed in GI. tract
  • high success
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21
Q

state 3 things about protein hormone replacement

A
  • difficult
  • must be injected
  • specific species (human GH only for humans)
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22
Q

what are 4 reasons for hormone hypersecretion?

A
  • functional tumor
  • ectopic hormone-secreting hormone
  • immunological
  • substance abuse
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23
Q

what are 3 possible treatments of hormone hypersecretion?

A
  • surgical removal of the gland that is hyper-secreting
  • irradiation of gland (reduce function)
  • antagonists of the hypersecreted hormone
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24
Q

what is the major role of the hypothalamic-pituitary system?

A
  • Plays major role in coordinating whole endocrine system
  • Pituitary gland= “conductor of the endocrine orchestra”
  • Together with nervous system …. Is principle interface between BRAIN and PERIPHERY
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25
Q

explain the anatomy of the pituitary gland

A
  • Sits in bony cavity in base of brain case called the Sella Turcica
  • Comprises 2 distinct lobes with different embryological origins
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26
Q

what are the 5 hormones released from the anterior pituitary? and functions?

A
  • Gonadotrophins (regulate reproductive function)
  • Thyrotrophin (regulates thyroid)
  • Growth hormone
  • Prolactin (regulates milk production)
  • Adrenocorticotrophin (regulates adrenals)
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27
Q

what re the 2 hormones released from the posterior pituitary? and functions?

A
  • oxytocin (prostate and uterine function)
  • vasopressin (ADH- anti diaretic hormone) (kidney function)
28
Q

what are the progressing effects of a slow growing pituitary tumour?

A
  • Often first affects gonadotrophins
  • Followed by growth hormone deficiency
  • Finally low TSH and low ACTH
    • Pan-hypopituitarism (under secretion of multiple pit. Hormones & reduced end-organ function
  • Pressure on the optic chiasm –> visual field loss
29
Q

what is the treatment for hypopituitarism?

A
  • tumour removal
  • multiple hormone replacement therapy (gonadal steriods, adrenal steriods, thyroid hormones)
30
Q

where is the thyroid gland located?

A

a butterfly-shaped gland at the base of the neck

31
Q

what are the 3 effects of thyroid hormone?

A
  • Calorigenic (heat producing)
    • CO2 production and heat production increased
    • Increased basal metabolic rate (BMR)
  • Cardiovascular system
    • Increases heart rate and force of contraction
  • Growth and maturation (essential)
    • Embryo development
      • CNS development
      • Linear growth (promotes effects of growth hormone)
32
Q

what is hypothyroidism?

A

lack of thyroid hormone

33
Q

how much more likely is it for a woman to have hypothyroidism?

A

4x

34
Q

what are the symptoms of hypothyroidism in adults?

A

weight gain, cold intolerance, lethargy, depression, peffiness of skin and muscles (myxoedma), sluggish reflexes, muscular weakness, reduced cardiac output

35
Q

what are the symptoms of hypothyroidism in foetus or children?

A
  • cretinism
  • Foetal brain development may be irreversible
  • Shortness, obesity, mental retardation
36
Q

how do you check for neonatal hypothyroidism?

A

routine neonatal screening for elevated TSH.
Raised due to reduced negative feedback of T3/T4 on hypo. And pit.

37
Q

what are the 3 causes of hypothyroidism?

A
  • Primary failure of thyroid gland, such as autoimmune damage
  • Secondary due to hypothalamic or anterior pituitary failure
  • Secondary due to lack of dietary iodine
38
Q

what is the treatment of hypothyroidism?

A

lifelong replacement therapy with T4

39
Q

what is the dosage of T4 for adults?

A

~150µg / day

40
Q

what is hyperthyroidism?

A

excess thyroid hormone

41
Q

what percentage of woman does hyperthyroidism effect?

A

~2%

42
Q

what are symptoms of hyperthyroidism?

A

weight loss, nervousness, heat intolerance, high cardiac output, hand tremors

43
Q

what are the primary and secondary causes of hyperthyroidism?

A
  • Primary: due to hypersecreting thyroid tumour
  • Secondary: due to excess hypothalamic (THR) or anterior pituitary (TSH) secretion
44
Q

what is a condition that commonly causes hyperthyroidism?

A

graves disease (~50% of all cases)

45
Q

give 3 features of graves disease

A
  • peculiar form of autoimmune disease
  • Thyroid-stimulating antibodies that mimic TSH
  • Often have protrusion of eyeballs (exophthalmos)
46
Q

what are 3 treatments for hyperthyroidism?

A
  • “anti-thyroid drugs” that interfere with T3/T4 synthesis
  • Surgical removal or resection of thyroid
  • Thyroid ablation using radioactive iodine
47
Q

what hormone is secreted from the adrenal medulla?

A

Adrenaline (epinephrine: USA)

48
Q

when is adrenaline secreted?

A

in a response to stress and exercise

49
Q

what 2 hormones are secreted from the adrenal cortex?

A
  • cortisol
  • aldosterone
50
Q

what is the function of cortisol?

A
  • Essential for adaptation to stress
  • Mobilizes glucose
  • Anti-inflammatory actions (at high levels)
51
Q

what is the function of aldosterone?

A

maintains balance of Na/K in blood

52
Q

what is the H-P-A axis?

A

negative feedback loop controlling cortisol secretion from the adrenal cortex

53
Q

what is addison’s disease?

A

a deficiency of adrenocortical hormones

54
Q

1 in how many people are affected by addison’s disease?

A

1 in 50,000 people

55
Q

what are the causes of addison’s diease?

A
  • ~70% due to autoimmune destruction of adrenal cortex
  • Can be caused by infectious disease (e.g. TB)
56
Q

what are the symptoms of addison’s disease?

A
  • Occurs in all age groups- afflicts both sexes equally
  • Weight loss, muscle weakness, fatigue, low BP
  • Often darkening of the skin and gums
57
Q

what is the treatment for addison’s disease?

A

Replacement therapy with cortisol (and mineralocortisol if needed)

58
Q

what is cushing’s syndrome?

A

hypersecretion of cortisol

59
Q

what causes cushing’s syndrome?

A
  • Raised pituitary ACTH secretion (= Cushing’s disease)
  • Inappropriate ACTH secretion from tumour (pituitary or elsewhere)
  • Raised cortisol secretion from tumour in adrenal cortex
  • (BUT most common cause of CS is exogenous cortisol medication = iatrogenic)
60
Q

what are the symptoms of cushing’s syndrome?

A
  • Raised blood glucose levels –> polyuria, polydipsia
  • Loss of muscle mass due to protein breakdown for gluconeogenesis
  • Deposition of new fat around abdomen, face, shoulders
  • Cardiovascular disease
61
Q

what are the treatment options for cushing’s disease?

A
  • Surgical removal of tumour
  • Irradiation of tumour
  • Inhibitors of steroids biosynthesis
62
Q

after how many years of untreated cushing’s disease is it fatal?

A

within 5 years

63
Q

what is Conn’s syndrome?

A

adrenal cortex adenoma found in patient with hypertension

64
Q

give 3 features of Conn’s syndrome

A
  • Aldosterone-secreting tumour
  • Accounts for about 30% cases of primary hyperaldosteronism
  • Salt/water retention –> high BP
65
Q

what is a pheochromocytoma?

A

a tumour of the adrenal medulla

66
Q

what is the treatment for a pheochromocytoma?

A
  • Alpha and beta adrenoceptor blockers
  • Tumour removal
67
Q

what does a pheochromocytoma lead to?

A

episodic hypertension due to excessive secretion of adrenaline & noradrenaline

68
Q
A

[Y1] Pathology (10 decks)

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