Endo Imaging Flashcards
(44 cards)
What “end organs” are affected by alterations in the pituitary?
- Thyroid
- Adrenals
- Gonads
- Breasts
Give 2 examples of altered trophic hormone (TH) production
- increased levels of TH’s leads to altered target gland function
- increased pituitary size leads to encroachment and/or pressure causing vision changes and HA
List the 6 hormones produced by the anterior pituitary
-Growth Hormone
-Prolactin
-Adrenocorticotropic Hormone
-Thyroid Stimulating Hormone (TSH)
-Luteinizing Hormone (LH)
♂ - Leydig cells/testosterone
♀ - Ovulation/corpus luteum
-Follicle Stimulating Hormone (FSH)
♂ - Spermatogenesis
♀ - Follicle development/estrogen
List the 2 hormones produced by posterior pituitary
- Arginine Vasopressin (ADH)
- Oxytocin
What is the name of the anatomical location of the pituitary gland?
Sella turcica
Causes of pituitary failure
-idiopathic
- Usually infiltrative process
- Lymphoma, Hodgkin’s, Sarcoid
Causes of pituitary failure
-Sheehan’s syndrome
Postpartum Hypotension: pressures drop low enough and for long enough to infarct the pituitary
-Could affect only a portion of the pituitary
Causes of pituitary failure
-Pituitary Apoplexy
- Infarct
- Fever: likely viral infection rather than fever itself
List the hormones produced by the thyroid
- TSH-Controlled (from Anterior Pituitary)
- T3 – active hormone
- T4 – primary product
- rT3 – not physiologically active
Which conditions can cause development of a goiter?
- hyperthyroidism
- hypothyroidism
- euthyroidism
Symptoms of hyperthyroidism
- Diaphoresis
- Heat Intolerance
- Cardiac Awareness (palpitations)
- Weight Loss
- Hair Thinning
- Skin Hyperpigmentation
Physical findings of hyperthyroidism
- Goiter – diffuse enlargement
- Nodule – Hot vs. Cold
- Tachycardia
- Hair Thinning
- Exophthalmos
- -Extra-ocular muscle and retro-ocular connective tissue volume increased (uni/bilateral)
- -Fibroblast proliferation, inflammation, and the accumulation of hydrophilic glycosaminoglycans (GAG), mostly hyaluronic acid
Symptoms of hypothyroidism
- Fatigue &/o Lethargy
- Weight Gain
- Cold Intolerance
- Paresthesias
- Sexual Dysfunction (primarily in men)
Physical findings of hypothyroidism
- Hair Loss
- Skin thickening
- Can be more difficult to discern in men
- Low Pitched Voice
- Facial edema
- Slow DTR (deep tendon reflex) return
Thyroid nodules
-cyst vs. solid
Proper vocabulary to use is:
- Solid = nodule
- Cyst = fluid-filled bump
- Solid is more likely to be cancer
- Evaluate posterior structures such as the parathyroids
What do you see on a normal Thyroid I123 or I131 Scan?
- 2 lobes
- Homogenous activity
- Isthmus
“Marker”
- -At the SC Notch
- -Check for mediastinal extension
Your patient has I123 administered. The radiologist contacts you to state that the nodule you felt is a “cold” nodule. What does this mean?
- Cold means it didn’t take up the iodine and it’s a nodule.
- The patient has an increased risk of thyroid cancer in the cold nodule.
Etiology of “cold” thyroid nodule
- ~ 90% of “lumps” are benign cysts or nodules
- 75-90% of all nodules are “cold”
- Most cancers are “cold” (~5-10% of cold nodules)
Will a cold nodule or a cyst take up the iodine for I123 scan?
No, neither will take it up. You must FNA “cold” nodule or excise the entire lobe.
Etiology of thyroid “hot” nodule
- aka “autonomous” nodule
- right lobe
- low risk of cancer
Will a hot nodule take up the iodine for I123 scan?
Yes, but reduced overall I123 update d/t suppressed TSH
Dx of hot nodule
FNA vs. surgical excision
Tx of hot nodule
I131 “burns” out nodule or multinodular goiter
Parathyroid adenoma is usually a disease of…
overactivity (i.e. increased PTH)
