Endocrine

Question 1

A benign tumor
(adenoma) of the
pituitary gland made of
prolactin secreting cells

Answer 1

Prolactinoma

Question 2

A benign tumor
(adenoma of the
pituitary gland made
of growth hormone
secreting cells

Answer 2

Somatotrophic Adenomas

Question 3

• Gigantism (Pre-puberty)
  – Longitudinal skeletal growth
• Acromegaly (Post-puberty)
  – Enlargement of acral parts of
  the extremities (fingers, hands,
  toes, tongue, jaw and nose)
  – Enlarged internal organs
  (heart)
  – Metabolic disturbances (mass
  effects)
  – Headaches (mass effects)

Answer 3

Somatotrophic Adenomas
Signs & Symptoms

Question 4

Most microadenoma’s are recognized by the
signs and symptoms of

Answer 4

Cushing’s Disease

Question 5

A benign tumor (adenoma) of the pituitary gland
made of ACTH secreting cells.
– Unknown cause

Answer 5

Corticotrophic Adenomas

Question 6

Endocrine disorder of the
posterior pituitary affecting the
metabolism of water in the
body (lack of ADH)
Most commonly caused form
decrease blood flow to the
pituitary.
* Tumor compression, infection
of brain or meninges,or
hemorrhage

Answer 6

Diabetes Insipidus

Question 7

Def”n: disorder in which part of the skull where the
pituitary gland is housed (sella turcica) is partially or
fully filled with CSF (cerebrospinal fluid)
* Causes: Most are unknown

Answer 7

Empty Sella Syndrome

Question 8

S&S Usually none, however many patients suffer with
chronic headaches

Answer 8

Empty Sella Syndrome

Question 9

Caused by excess of thyroid hormones
(specifically T3 and T4)
* The causes of hyperthyroidism are due to:
– Autoimmunity (Grave’s Disease) 85% of all cases
– Idiopathic nodular hyperplasia of thyroid
– Tumors (hyperfunctioning thyroid adenoma)

Answer 9

Hyperthyroidism

Question 10

Condition resulting from an
overproduction of
thyroid hormones
Autoimmune Disease
* Antibodies to the TSH
receptor on the surface of
the follicular cells which
stimulate production of
thyroid hormones.

Answer 10

Graves Disease

Question 11

Hyperthyroidism—Graves
Disease
Signs and Symptoms

Answer 11

• Intolerance to heat
• Bulging eyes (Only occurs with Graves
  Disease and not other types of
  hyperthyroidism)
  Massage Considerations
• Heat intolerance

Question 12

Enlargement of the thyroid
gland and is nodular
Cause:
* Iodine deficiency
* Neoplasm
* Unknown
Less common cause of
hyperthyroidism

Answer 12

Nodular Goiter

Question 13

Nodular Goiter S&S

Answer 13

Symptoms are related to the
compression of the adjacent
structures
– Coughing, hoarseness,
– Difficulty breathing, swallowing

Question 14

Cause:
* Uncontrolled cell growth
without any invasion into
normal tissues and without any
spread

Answer 14

Thyroid Adenomas

Question 15

– Thyroiditis—Hashimoto’s disease
* Often immune mediated
– Thyroidectomy
– Iodine deficiency (rare in Western
culture)

Answer 15

Hypothyroidism

Question 16

Autoimmune Disease
* Thyroid gland is
destroyed by
immunologic process
* Gland becomes infiltrated
with lymphocytes that
destroy the thyroid
follicles

Answer 16

Thyroiditis (Hashimoto’s)

Question 17

Cause:
* Thyroid has been
infiltrated by a tumor.

Answer 17

Thyroidectomy
Surgical removal of the
thyroid

Question 18

Signs and Symptoms
* Children
– Stunted growth
– Mental Retardation
– Metabolic
disturbances
– Dry skin
– Intolerance to cold
* Adults
– Myxedema (edetamous, puffy
skin) dough like
– Pt. tires easily
– Bracycardia (slow heart rate)
– Constipation (intestines lose
mobility)
– Dry skin
– Intolerance to cold
– Lacks mental alertness
– Sleepy
– Skeletal muscles are weak
and aching

Answer 18

Hypothyroidism

Question 19

Benign tumor of the
thyroid gland
Most adenomas are small,
well encapsulated with
fibrous tissue
composed of thyroid
follicles

Answer 19

Adenomas

Question 20

– Causes disturbances in Calcium
Homeostasis

Answer 20

Parathyroid Diseases

Question 21

Definition: parathyroid hyperfunction due to
increased levels of PTH
Cause:
* Benign parathyroid adenoma (Primary and Secondary)
* Hyperplasia of parathyroid glands
* Parathyroid carcinoma

Answer 21

Hyperparathyroidism

Question 22

Signs and Symptoms
* Bones are prone to fracture due to
decalcification.
* Formation of Kidney stones and calcium salt
deposits in kidney due to hypercalcemia
(stimulates calcium absorption in the intestine).
* Muscle weakness due to excess Ca2+
* Conduction defects in the heart.
* Formation of urinary stones
* Ocular and skin calcifications

Answer 22

Hyperparathyroidism

Question 23

• Rare condition!
  Definition: parathyroid hypofunction or a complete
  loss of function of the parathyroid glands.
  Cause:
• May be caused by developmental disorder,
  autoimmune disease, or inadvertent surgical
  removal of parathyroids
  Signs and Symptoms:
• Presents with hypocalcemia, tetany (muscles
  become spastic), irregular heartbeat, variable
  neurologic symptoms from hyperexcitability to
  depression
• Severe get cardiac arrest

Answer 23

Hypoparathyroidism

Question 24

Massage Considerations:
* Muscle spasms

Answer 24

Hypoparathyroidism

Question 25

* aka Conn’s syndrome Rare Definition: * hypersecretion of mineralcorticoids (aldosterone) Signs and symptoms * Hypertension * Retain Na+ and H2O and lose K+

Answer 25

Hyperaldosteronism

Question 26

* aka Cushings syndrome Defintion: * Increased secretion of glucocorticoids Cause: * Adrenal hyperplasia * Adrenal neoplasia * Exogenous Steroid administration

Answer 26

Hypercortisolism

Question 27

* 70% due to hypersecretion of ACTH due to pituitary adenoma in endogenous hypercotisolism * Exogenous steroids is the most common cause of hypercortisolism

Answer 27

Causes of Hypercortisolism

Question 28

Signs and Symptoms * Central trunk obesity * Moon Face * Buffalo hump * Striae of Skin (stretch marks) * Pt’s red in face b/c of lots blood, hypertension and thin skin * Glucose intolerance, diabetes * Fatigue * Mentally unstable

Answer 28

Adrenocortical Hyperfunction Cushings Syndrome

Question 29

Rare * Typically found in female patients. Neonatal and adults Definition: * Hypersecretion of adrenal sex hormones (androgens) Cause: * Congenital or may develop in adulthood. In neonatal caused by inborn errors in steroid metabolism Signs and Symptoms * Females experience virilizaiton of external genitalia

Answer 29

Adrenogenital Syndrome (also known as adrenal virilism)

Question 30

Definition: * Insufficient secretion of corticosteriods and mineralcorticoids from adrenal gland Cause: * Autoimmune * Infections (TB, fungal)

Answer 30

Addison’s Disease

Question 31

Signs and Symptoms: * Fatigue * Weight loss * Nausea * Hyperpigmentation of skin * Hypotensive * Syncope (loss of consciousness b/c of fall of bp)

Answer 31

Addison’s Disease

Question 32

Massage Considerations: * Extremely susceptible to infections * Cannot tolerate stress or maintain many of the usual daily routines * Low NaCl, high K+ and low glucose

Answer 32

Addison’s Disease

Question 33

* Palpable mass in abdomen * Very RAPIDLY GROWING therefore suddenly palpable.

Answer 33

Neuroblastoma

Question 34

Definition * Benign solid tumor originating from the adrenal medulla

Answer 34

Pheochromocytoma

Question 35

Signs and Symptoms * Hypertension * Light headed, dizziness * Heart lesion due to exposure to epinephrine and norepinephrine.

Answer 35

Pheochromocytoma

Question 36

Is a consequence of absolute or relative insulin deficiency or an abnormal response of target tissues to insulin.

Answer 36

Diabetes Mellitus

Question 37

Signs and Symptoms (hyperglycemia) * Polyuria (excessive urination) * Polydypsia (excessive thirst) b/c of excessive loss of urine * Polyphagia (consuming large quantities of food) – Abnormal use of CHO, proteins and lipids causes poor energy balance, therefore increased appetite * Prone to bacterial infections (bacteria love all that glucose)

Answer 37

Diabetes Mellitus

Question 38

* Rare * Can originate from any of the cell types in the Islets of Langerhans * The most common tumors are: – Insulinomas * Composed of insulin secreting beta cells, small tumours, solitary and benign –Gastrinomas

Answer 38

Tumors of the Endocrine Pancreas

Question 39

Signs and symptoms * Hypoglycemia, syncope ( fainting after drop in bp) * Profuse sweating, especially after fasting * Tx with surgery

Answer 39

Insulinomas

Question 40

Signs and symptoms * Peptic Ulcers (resistant to standard medical therapy)

Answer 40

Gastrinomas (Malignant)