book- endocrine system Flashcards
(153 cards)
1
Q
reproductive organs from which embryo layer
A
mesoderm
2
Q
endocrine tissue from which embryo layer
A
majority ectoderm
Ectoderm → Pituitary (ant & post), adrenal medulla, pineal, parafollicular cells
Mesoderm → Adrenal cortex, gonads
Endoderm → Thyroid follicular cells, parathyroids, pancreas
3
Q
which embryo layer does pancreas come from
A
endoderm
4
Q
where do the anterior pituitary and posterior pituitary come from embyrologically
A
neurohypophysis (posterior pituitary): infundibulum; evagination of diencephalon (ectoderm)
adenohypophysis (anterior pituitary): rathke pouch; evagination of roof of oral cavity (ectoderm)
5
Q
parathyroid glands from what emrbyo
A
endoderm; 3rd and 4th pharyngeal pouches
6
Q
where do thyroid C cells come from
A
neural crest cells (ectoderm) in 4th pharyngeal pouch
7
Q
3 endocrine cells of neural crest origin and their location in the body
A
chromatin cells- adrenal medulla
chief cells- extra adrenal paraganglia
C cells- thyroid
8
Q
chromatin cells location and function
A
adrenal medulla; secrete NE and Epi (SNS)
9
Q
chief cells location and function
A
extra-adrenal paraganglia; secrete catecholamines or act as chemoreceptors (O2/CO2 sensor)
10
Q
C cells (AKA parafollicular cells) location and function
A
thyroid gland; secrete calcitonin to lower blood calcium and inhibit osteoclasts
11
Q
Chromatin cells, chief cells, and C cells function
A
Chromaffin cells: sympathetic stress hormones (NE and Epi)
Chief cells (paraganglia): catecholamines or blood gas sensing (chemoreceptors)
C cells: regulate calcium (calcitonin)
12
Q
adrenal cortex vs adrenal medulla embryonic origin
A
cortex: mesoderm
medulla: neural crest; ectoderm
13
Q
layers of the adrenal cortex and their homrones
A
zona glomerulosa: aldosterone (mineralocorticoid)
–> Na+ reabsorb and K+ excrete and BP via RAAS
zona fasiculata: cortisol (glucocorticoid)
–> increase GNG
zona reticularis: androgens (DHEA, androstenedione)
–> secondary sex characteristics
pneumonic:
GFR = Salt, Sugar, Sex
(Superficial to deep: Glomerulosa → Fasciculata → Reticularis)
14
Q
adrenal medulla cells and hormones
A
chromaffin cells (from neural crest) make catecholamines (NE and Epi)
15
Q
endocrine pancreas cells and hormones
A
islet of lagerhans;
glucagon= alpha cells
insulin= beta cells
somatostatin= delta cells
gamma or PP cells= pancreatic peptide
E epsilon= ghrelin
16
Q
pineal gland; hormone?
A
pinealocytes secrete melatonin (at night)
serotonin secreted during the day
17
Q
parathyroid gland cells
A
chief cells and oxyphil cells
chief cells secrete PTH
18
Q
colloid function in thryoid
A
storage site for thyroglobulin and iodine
T3 and T4 are synthesized here too
19
Q
pituitary location
A
hypophyseal fossa of sella turcica of sphenoid bone. attached to hypothalamus
20
Q
pineal gland location
A
attached to midbrain by stalk
posterior to thalamus and superior to midbrain
21
Q
thyroid
A
inferior to cricoid cartilage overlying trachea
22
Q
anterior vs posterior pituitary hormones
A
anterior: ACTH, TSH, GH, LH, FSH, prolactin
posterior: ADH/vasopressin and oxytocin
23
Q
parathyroid blood supply, lymphs, innervation
A
artery: inferior thyroid arteries
veins: parathyroid veins
lymphs: deep cervical and paratracheal
innervation: cervical sympathetic ganglia
24
Q
thyroid location
A
C5-T1; below sternohyoid and sternothyroid muscles
25
T3 (triiodothyronine) vs T4 (thyroxine)
T3= more potent, mostly via peripheral conversion of T4 via deiodinase, shorter half life, high affinity for receptors, active hormone
T4= less potent, made in thyroid gland, longer half life, highly bound to TBG, albumin and transthyretin, lower affinity for receptors, the pro hormone for T3
26
T4 converted into T3 during peripheral conversion via
T4 → T3 via 5'-deiodinase in tissues like liver, kidney, and muscle.
Reverse T3 (rT3) is an inactive form also made from T4.
27
isthmus of the thyroid
a narrow band of tissue that connects the two lobes of the thyroid gland
28
secretions of thyroid
T3, T4, calcitonin
29
artery and vein of thryoid
arteries: superior and inferior thyroid
veins: superior, middle and inferior thyroid veins
--> superior and middle go from internal jugular vein to inferior thyroid vein
--> inferior goes to brachiocephalic vein
30
innervation of thryoid
cercvical sympathetic ganglia; vasomotor and cause blood vessel constriction
31
chromaffin system in the adrenal medulla
SNS control; secrete catecholamines (NE, Epi and dopamine)
32
artery and vein for adrenals
superior, meddle and inferior suprarenal arteries
suprarenal vein
33
innervation of adrenals
celiac plexus and thoracic splanchnic nerves
34
endocrine pancreas
retroperitoneal digest gland; posterior to the stomach
35
hepatopancreatic sphincter/ sphincter of oddi
in the hepatopancreatic ampulla
control secretion of pancreatic juice and bile into the duodenum
36
vasculature of the pancreas
body and tail: pancreatic arteries arising from splenic artery
head: superior and inferior pancreaticduodenal arteries
pancreatic veins --> splenic vein
37
innervation of pancreas
vagus and thoracic splanchnic nerves
SNS and PNS via celiac and superior mesenteric plexi
38
only part of the brain without effective BBB and what is able to pass?
hypothalamus; allows peptide hormones to pass
and hypothalamic neurohormones to reach neurohypophysis (posterior pituitary)
39
hypothalamo-hypophyseal portal system
connect hypothalamus to anterior pituitary; HPA axis
hypothalamus: CRH and TRH
AP: ACTH and TSH
40
hypothalamus functions
temperature regulation, thirst, satiety, micturition, breathing, cardiovascular, circadian rhythm, immune, depression, stress, joy
41
inputs of hypothalamus
amygdala (emotional) and thalamus (sensory)
42
hypothalamic homrones
GnRH (for FSH and LH)
GHRH (for GH)
CRH
TRH
43
LH vs FSH in males
LH increases testosterone secretion in leydig cells
FSH increases spermatogenesis by Sertoli cells
44
insulin
site of synthesis and effects and controls
beta cells in islets of langerhans in pancreas
effect is to lower serum sugar levels by increasing transport of glucose into cells
inhibits glycogenolysis and GNG
helps with AA uptake and protein synthesis
inhibited by somatostatin
45
glucagon
site of synthesis and effects and controls
alpha cells in islets of langerhans in pancreas
receptors in liver
hyperglycemic effect; promote glycogenolysis, GNG, release of glucose from storage
helps with declining blood sugar
inhibited by somatostatin
46
somatostatin
site of synthesis and effects and controls
in delta cells of islets of langerhans of pancreas, SI, stomach and hypothalamus
inhibits glucagon and insulin secretion
CNS: inhibits GH and TSH
GI: suppress gastrin, CCK, secretin, motion, VIP and GI --> decreased GI motility and secretion
stimulated by hypoglycemia, glucagon, fatty acids and amino acids
47
T3 and T4 effects
stimulate enzymes for glucose oxidation, increase body heat, metabolism, nerve conduction, CNS development, SNS, portion synthesis and degradation
48
enzyme for oxidation, organification and coupling rxn in T3 and T4 synthesis
thyroid peroxidase (TPO)
49
enzyme in peripheral tissue to converted T4 into T3 or reverse T3
deiodinases
50
T3 vs T4 composition
T3= MIT + DIT
T4= DIT + DIT
51
steps in T3 and T4 synthesis
1. iodide trapping via Na/I symporter
2. oxidize iodide into iodine via TPO
3. iodine added to tyrosine residues of thyroglobulin (organification)
- MIT (1 iodine)
-DIT (2 iodine)
4. coupling of MIT and DIT via TPO to make T3 and T4
5. endocytosis
6. proteolysis to cleave T3 and T4 from TG to release into blood
7. convert T4 to T3 in peripheral tissues via deiodinases
52
PTH impact
increase plasma Ca2+; increase bone resorption by osteoblasts; increase calcium and decrease phosphate reabsorption in kidneys, increase Ca2+ absorption in SI
opposite to calcitonin
53
calcitonin impact
from parafollicular cells in thyroid; respond to high plasma calcium levels
54
renin and angiotensin
juxtraglomerular apparatus (renin) and liver (angiotensinogen)
vasoconstriction, elevate BP
aldosterone; Na and H2O retention, stimulate ADH (angiotensin II)
stimulated by low BP and SNS
55
vasopressin/ADH
from hypothalamus via posterior pituitary
stimulates Na, K and water retention = urine concentration and thirst
stimulated by low plasma volumes and high plasma oncotic pressure
56
natriuretic hormones
atrial natriuretic factor (ANF), ouabain-like hormone (OLH)
made in cardiac atria and act on kidney and smooth muscle
effects: peripheral vasodilation, sodium excretion, inhibit renin and aldosterone, increase GFR with diuresis
57
what controls melatonin synthesis
NE from postganglionic neurons projecting from superior cervical ganglia stimulates beta-receptors in pineal to synthesize melatonin
58
GH effects and controls
stimulates production of IGF1; linear growth, collagen and protein synthesis, muscle growth, fat mobilization, lipolysis, beta oxidation
stimulated by GHRH and ghrelin
inhibited by somatostatin
59
pathway for light and dark exposure to reach the pineal gland
retina --> retinohypothalamic tract --> SCN --> PVN --> intermediolateral column --> preganglionic neuron --> superior cervical ganglion --> postganglionic nueon --> pineal
60
prolactin effects and controls
form breast milk, breast size, fertility, libido, increase PGE2
inhibited by hypothalamic dopamine and things that increase dopamine (thyroxine, corticosteroids, TSH)
increased by things that decrease dopamine (estrogen, progesterone, stress, nipple stimulation)
61
oxytocin effects
let down of milk into mammary ducts, uterine contractions, trust and love, orgasm
in breast, uterus, brain, male reproductive tract
62
GI hormone: gastrin
source
stimulus
main function
G cells (stomach)
proteins, distention
increase HCl secretion, increase gastric motility
63
GI hormone: CCK
source
stimulus
main function
I cells (duodenum)
fats, amino acids
increase pancreatic enzymes, increase bile, decrease gastric emptying
64
GI hormone: secretin
source
stimulus
main function
S cells (duodenum)
acid
increase bicarbonate, decrease gastric acid
65
GI hormone: GIP
source
stimulus
main function
K cells (duodenum)
glucose, fats
increase insulin (incretin) and decrease Hcl
66
GI hormone: motilin
source
stimulus
main function
M cells (SI)
fasting
increase migrating motor complex (MMC)
67
GI hormone: somatostatin
source
stimulus
main function
D cells (GI tract, pancreas)
acid
inhibits GI hormones and secretions
68
GI hormone: VIP
source
stimulus
main function
enteric neurons
distention
increase intestinal secretion, relaxes GI smooth muscle
69
GI hormone: ghrelin
source
stimulus
main function
stomach (P/D1 cells)
fasting
increase hunger, GH release
70
hormone that stimulates gastric acid secretion
vs what inhibits gastric acid secretion
gastrin
secretin, GIP, somatostatin
71
hormones that stimulate pancreatic secretion and impact bile and gallbladder
secretin, CCK
72
broad inhibition of stomach hormones (gastrin, CCK, secretin, insulin, glucagon, motility, acid)
somatostatin
73
leptin
synthesis? receptor? effect? control?
made in white adipose
receptor in CNS *esp hypothalamus
decrease hunger, decrease insulin, hypoglycemic, if defective can contribute to obesity
stimulated by insulin and glucocorticoids, decreased by fasting and low cal diets
74
incretins (GLP1 and GIP)
synthesis, receptors, effects, controls
made in duodenum and jejunum
receptors are beta cells
stimulate insulin secretion, inhibit glucagon, inhibit gastric Hcl, increase satiety
stimulated by food
75
what degraded GLP1 and GIP
dipeptidyl peptidase 4
76
which receptors do NE and Epi bind
NE binds alpha receptors, Epi binds both
77
impacts of NE and Epi
increase HR, peripheral vasoconstriction and increase BP, vasoconstriction kidneys, GI, and spleen, glyconolysis, lipolysis, bronchodilator, pupil dilation, alert/arousal
78
cortisol is stimulated by
ACTH
79
testosterone secretion
testes secrete testosterone at constant rate
GnRH is episodic pulses from hypothalamus
80
theca vs granulosa cells
what stimulates them and what hormone do they produce?
Theca cells (LH stimulation) → make androgens
Granulosa cells (FSH stimulation) → convert those androgens to estrogens
81
effects of estrogens
clear cervical mucus, fat deposition in female, bone growth and calcium deposits, increase HDL, decrease LDL
82
progesterone impacts
Prepares and maintains the endometrium for implantation; inhibits LH/FSH to prevent another ovulation
antagonizes estrogen and decrease uterine and myometrium contractions
breast growth
increase basal body temperature at ovulation
inhibit milk inducing effects of prolactin
--> need hCG to maintain pregnancy; if not then corpus luteum will degenerate --> menstruation
83
pregnenolone
synthesis site
precursor for?
adrenal cortex
precursor for cortisol. progesterone, aldosterone, DHEA
84
steps of vitamin D synthesis
skin: 7-dehydrocholesterol --> cholecalciferol (vitamin D2) via UVB
liver (first hydroxylation): cholecalciferol--> calcidiol (25-OHD) via 25-hydroxylase
kidney (second hydroxylation): calcidiol --> calcitriol (1,25 OHD) via 1alpha-hydroxylase
85
what enzymes turn cholecalciferol into calcidiol in the liver and calcidiol into calcitriol in the kidney
liver: 25-hydroxylase
kidney: 1alpha-hydroxylase
86
vitamin D final active form
1,25-dihydroxyvitamin D₃ (calcitriol)
87
vitamin D effects
increase Ca2+
helps PTH and opposes calcitonin
88
tyrosine is a precursor to
dopamine and thyroid hormones
89
dopamine, NE and E synthesis
from? steps?
1. tyrosine --> L-DOPA (via tyrosine hydroxylase)
2. L-DOPA --> dopamine (via l-amino acid decarboxylase with vitamin B6)
3. dopamine --> NE (via beta hydroxylase with vitamin C and copper)
4. NE --> Epi via PNMT
90
which cofactors are needed for the 5- deiodinase enzyme that converts T4 --> T3
iron and selenium
91
thyroglobulin role
Thyroglobulin serves as the scaffold for thyroid hormone synthesis:
Provides tyrosine residues where iodine binds
Forms MIT and DIT, which are then coupled to make T3 and T4
92
insulin synthesis
proinsulin --> insulin and C peptide (via carboxypeptidase E)
insulin is 2 peptide chains bound together by 2 disulfide bridges
93
what carry 75% of circulating thyroid hormones
TBG (thyroxine binding protein)
15% para-albumin
10% transthyretin
94
what Is estrogen broken down by and where
in liver by CYP450 enzymes
95
dangerous metabolizes of estrogens
16alpha metabolites ; linked with carcinogenesis and HPV
96
major stimulators of the following
aldosterone
cortisol
estradiol
progesterone
testosterone
aldosterone- ATI/II
cortisol- ACTH
estradiol- FSH
progesterone- LH
testosterone- LH
97
1st step in steroid synthesis and what enzyme
cholesterol --> pregnenolone
Side chain cleavage cytochrome p450 enzyme
98
how does cholesterol become aldosterone
cholesterol --> pregnenolone --> deoxycorticosterone (via 21 hydroxylase) --> corticosterone (via 11beta hydroxylase) --> aldosterone (via aldosterone synthase)
99
how does cholesterol become cortisol
cholesterol --> pregnenolone --> 17-hydroxypregnolone --> 17-hydroxyprogesterone (via 17 alpha hydroxylase)--> 11-deoxycortisol (via 21 hydroxylase) --> cortisol (via 11beta hydoxylase)
100
how does cholesterol become DHEA, androstenedione, testosterone and estrogens
cholesterol --> pregnenolone (via 17 alpha hydroxylase) --> 17-hydroxypregnenolone (via 17, 20 lyase) --> DHEA --> androstenedione --> testosterone
androstenedione --> estrone (via aromatase)
testosterone --> estradiol (via aromatase)
estrone --> estradiol --> estriol (via CYP450)
testosterone --> DHT (via 5 alpha reductase)
101
catabolism of estrogens
*main enzymes are CYPs to get to xOH estrone then to breakdown further is via COMT
🧪 Metabolites
Estrone → 2-hydroxyestrone, 4-hydroxyestrone, 16α-hydroxyestrone
via cytochrome P450 enzymes (e.g., CYP1A1, CYP1B1)
These hydroxylated metabolites can be further:
Methylated by COMT (catechol-O-methyltransferase)
Conjugated → excreted
102
what enzyme is unregulated at night causing high melatonin secretion
N-acetylserotonin transferase (NAT)
103
how is melatonin degraded
main metabolite that's excrete in urine?
degraded by CYP450
first step is hydroxylation at C6 followed by salvation or glucuronidation. main metabolite is 6-sulfatoxymelatonin
104
how is melatonin made
serotonin --> N-acetyl serotonin (serotonin N-acetyltrasnferase)--> melatonin (via hydroxyindole-O-methyltransferase)
105
bushings syndrome
excess cortisol
redistribution of body fat
iatrogenic (corticosteroids) or ACTH secreting adenoma
sx: moon face, dorsal buffalo hump, weak muscle, osteoporosis, hypertesnion, amenorrhea, hyperglycemia
106
conns syndrome
excess aldosterone --> excess potassium loss and more Na+ and H2O retention
sx: hypertesnion, renal failure, hypokalemia, fatigue, edema
107
conns vs cushing syndrome
cushing: excess cortisol
conns: excess aldosterone
108
congenital adrenal hyperplasia
deficiency in which enzyme is most common
mutation in genes for enzymes in steroidogenesis
*21-hydroxylase deficiency (95% of cases)
autosomal recessive
alter sex characterisitics, vitalization, hirsutism, menstural irregular, infertile, hypertesnion, salt wasting
109
hyperparathryoidism
high PTH causes mobilization of bone calcium; hypercalcemia or hypercalcuria
primary: parathyroid adenoma
secondary: renal failure, vitamin D deficient or paraneoplastic secretion of PTH
sx: hypercalcemia, hypercalcuira, weak, fatigue, myalgia, arthralgia, polyuria, polydipsia, elevated alkaline phosphatase levels
110
hyperpituitarism
usually adenoma; sx related to mass effect (headache, visual disturbance) or hormone excess (weight gain, gynecomastia, acromegaly)
111
hyperthyroidism (thyrotoxicosis)
most common type
sx
graves disease
sx: nervous, palpitations, rapid pulse, fatigue, weight loss, hair loss, loose stool, menstrual changes
thyroid storm or thyrotoxic crisis
112
graves disease sx
Hyperthyroid symptoms:
Weight loss, heat intolerance
Tachycardia, palpitations
Anxiety, insomnia
Tremor, hyperreflexia
Diarrhea
Menstrual irregularities
Specific to Graves:
Diffuse goiter (no nodules)
Exophthalmos (proptosis) – due to fibroblast activation behind the eye
Pretibial myxedema – localized dermopathy (non-pitting, scaly edema)
113
graves disease (hyperthyroid) labs
high T3/T4
low TSH
and has TSH receptor antibody (autoimmune)
114
toxic multi nodular goiter
can occur with graves (hyperthyroid), hashimotos (hypothyroid) etc
more prevalent in iodine-replete populations (or ionizing radiation)
115
graves disease
diffuse toxic goiter from autoimmune attack
AutoIgs against TSH receptor and could either activate or block its binding
risks: HLA-DR3
116
main sx of graves
hyperthyroid plus exophthalmos (protrusion of the eyes)
117
diabetes insipidus
cause
sx
decreased ADH
leads to polydipsia (thirst) and polyuria, anorexia, fatigue, polyuria
118
Addisons disease
impact on hormones
primary adrenal insufficiency; destroy adrenal cortex leads to low cortisol, low aldosterone and high ACTH
119
hypoadrenalism: Addisons disease (primary hypoadrenocorticism)
failure of adrenal glands to make cortisol, aldosterone, androgens
Addisons: idiopathic/ autoimmune or from TB
sx: fatigue, dizzy when stand, hypotension, hyperkalemia, hyponatremia, hypoglycemia, metabolic acidosis
120
addisonian crisis
adrenal insufficiency; hypotension, weak, vomit, diarrhea, dehydration, syncope, hypoglycemia, psychosis, confusion, lethargy, hypercalcemia, convulsions, fever
121
hypoadrenalism: secondary adrenocortical insufficiency
failure of ACTH secretion
122
primary vs secondary disease
primary: target organ itself is damaged
secondary disease: pituitary or hypothalamus (regulatory center) damage
123
hypoparathyroid impact on calcium and sx
hypocalcemia; increased neuromuscular excitability and tetany
-----------------
Calcium stabilizes voltage-gated Na⁺ channels in neurons and muscle cells.
Low serum calcium:
Makes Na⁺ channels more sensitive
Lowers threshold potential for depolarization
Leads to spontaneous firing of nerves and muscle fibers
124
hypopituitarism
adenoma causing low levels of 1+ anterior pituitary hormones; tumor puts pressure; sx when 75% of lobe is destroyed
i..e LH and FSH loss= amenorrhea, ovary and testicular atrophy
empty sella syndrome: pressure from CSF from obesity and hypertension causes pituitary to be not seen on MRI
hypothalamic lesion:
125
chromophobe adenomas
tumor of pituitary gland that doesnt produce hormones but produces sx from the pressure alone; i.e. compress optic chasm or cause hypopituitarism
126
myxoedema and cretenism
cretinism (infants) and myxoedema (adults) from insufficient thyroid hormone production (hypothryoid)
myxoedema from low iodine diet, drugs, autoimmune etc
sx: coarse skin and hair, edema, pale and cold skin, slow speech, reduce HR, lethargy, constipation, irregular menses, iodine deficiency causing goiter
127
congenital hypothyroidism (cretinism)
insufficient maternal intake of iodine impacts baby
dwarfism, lethargy, feeding problems, mental retardation
128
thyroiditis
enlarged thyroid from infection, sarcoidosis or autoimmune
most hashimotos
129
hashimotos thyroiditis
findings, genes
autoimmune hypothryoid
dense focal infiltrates of lymphocytes, HLA-DR5
sx: enlarged thyroid, elevated serum anti-thyroid peroxidase and anti-thyroglobulin autoIgs
130
diabetes mellitus findings
eyes: blurred vision
breath: acetone smell
gastic: N/V, ab pain
urinary: polyuria, glycosuria
respiratory: kussmaul breathing (hyperventilation)
systemic: weight loss
Central: polydipsia, polyphasic, lethargy, stupor
131
subacute thryoiditis
three types
self limiting; therapy not needed
granulomatous (painful)
silent (painless)
postpartum
granulomatous= lymphocytic and mononuclear cell infiltrates
granulomatous and silent = possible viral infection
silent and postpartum= possible autoimmune
132
3 phase of subacute thyroiditis
1: thyrotoxicosis (hyperthyroid) for 6-8wks
2: hypothyroid for 2-4months
3: euthyroid; recovery
133
diabetes mellitus type 1
autoimmune destruction of beta cells in pancreas; loss of ability to produce insulin without insulin resistance
MODY (mature onset diabetes of the young): autotosmal dominant
sx: ketoacidotic coma (hyperglycemia, metabolic acidosis, loss of consciousness), polydipsia, polyuria, hunger, weight loss, hyperglycemia, decreases serum insulin
134
diabetes mellitus type 2
insulin resistance
anti-islet cell, anti-insulin, anti-glutamic acid decarboxylase (GAS) antibodies are frequently present
complications: neuropathies, renal failure, retinopathy, skin ulcers, cataracts, atherosclerosis
sx: middle age onset, hyperglycemia, obesity, sugar hunger, high serum insulin
135
thyroglossal duct cyst
congenital; persistent remnants of thyroglossal duct which was formed by migration of thyroid gland inferiorly from tongue during embryo
masses could become infected --> abscesses and draining fistulas
136
Sheehans necrosis
hypopituitary from infection and necrosis of pituitary from postpartum hemorrhage with severe hypotension
hypoglycaemia, failure to lactate, hemodynamics instability, tachycardia, hypotension
137
Sheehans syndrome
Sheehan’s syndrome is postpartum hypopituitarism
caused by ischemic necrosis of the anterior pituitary, typically due to massive blood loss during or after childbirth.
138
adrenal cortical adenomas
which is hyperaldosteronism
which is hypercortisolism
hyperaldosteronism= Conn
hypercortisolism= Cushing
139
ganglioneuroma
non-secretory adrenal tumor; embryonal tumor of SNS; from neural crest cells
140
myelolipomas
non secretory adrenal tumor in adipose tissue around adrenal medulla
141
insulinoma
most common islet cell tumor; idiopathic beta cell tumor
increase insulin secretion
whipple's triad: episodic hypoglycemia, CNS dysfunction (confusion, anxiety, stupor, convulsions, coma) related to hypoglycemia, and reversal of CNS abnormalities with glucose administration
142
Whipple's triad in insulinoma (increased insulin secretion)
whipple's triad: episodic hypoglycemia, CNS dysfunction (confusion, anxiety, stupor, convulsions, coma) related to hypoglycemia, and reversal of CNS abnormalities with glucose administration
143
parathyroid carcinoma and parathyroid adenoma
result in hyperparathyroid
carcinoma: usually bone pain, renal stone, hypercalcemia
adenoma: asymptomatic of nausea, cosntripation, lethargy
144
somatotropin adenoma in kids vs adults
GH excess
kids= gigantism
adults= acromegaly
145
sx of pituitary adenoma
headaches, bilateral hemianopsia, diplopia, ptosis, ophthalmoplegia, decreased facial sensation, nausea, weak, amenorrhea, low libido, ED
146
craniopharyngiomas
cystic tumor in pituitary stalk; from remnants of pouch of Rathke or craniopharyngeal duct
intrasellar lesions: hypopituitary i.e. diabetes insipidus, hypothryoid, amenorrhea, growth fialure
suprasellar lesions: visual disturbance via optic chiasm pressure
147
4 types of thyroid neoplasm and which is most common
papillary, follicular, anaplastic, medullary
papillary 80%
148
euthyroid goiter
enlarged gland with normal function
usually from paucity of iodine in diet --> triggers compensatory hyperplasia
iodized salt helps
149
gastrinoma/ Zollinger Ellison syndrome
gastric secreting tumor in pancreas or intestinal wall
hyperchlorhydria, reflux esophagitis, peptic ulceration, hypergastrinemia
150
Multiple Endocrine Neoplasia (MEN) Type 1 vs Type 2
autosomal dominant
cause tumors in thyroid, parathyroid and adrenals
📋 Clinical Clues
MEN 1: Think hypercalcemia + ulcer (ZES) + pituitary symptoms
MEN 2A: Medullary thyroid cancer + pheochromocytoma + hyperparathyroidism
MEN 2B: Same as 2A but without hyperparathyroidism, and with neuromas + marfanoid body habitus
151
pheochromocytoma
which types of cells in which gland?
tumor in chromaffin cells of adrenal medulla
paroxysmal (episodic) or persistent hypertension with flushing from release of floods of NE and Epi
152
infectious thyroiditis
painful enlargement of thryoid from staph, strep, salmonella, fungi, rubella, cytomegalovirus
risk: trauma to neck, immunosuppression, septic spread
fever, chills, malaise, pain and hypo or hyperthyroid
153
waterhouse- friderichsen syndrome (purpura fulminans, fulminant menigococcemia)
cause
adrenal gland fail from hemorrhage by meningococcus bacteria (i.e. neisseria meningitides) or other bacteria
sx: fever, rigors, vomit, headaches, macular rash, low BP, dehydration, dizzy
