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gen path final > Endocrine > Flashcards

Endocrine Flashcards

1
Q

list the 6 hormones produced by the ANTERIOR pituitary

A

TSH: Thyroid-stimulating hormone or thyrotropin
PRL: Prolactin
ACTH: adenocorticotropic hormone or corticotropin
GH: Growth hormone
FSH: Follicle stimulating hormone
LH: Luteinizing hormone

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2
Q

the ______ pituitary is composed of modified glial cells and axonal processes extending from hypothalamic neurons

A

posterior

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3
Q

which hormones are produced by the posterior pituitary gland?

A 
Oxytocin
antidiuretic hormone (ADH)
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4
Q

Anterior pituitary hyperfunction is almost always associated with _______

A

adenoma

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5
Q

what conditions are associated with Hyperfunction of ACTH?

A

Cushings syndrome

Nelson syndrome

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6
Q

what conditions are associated with Hyperfunction of Growth hormone?

A
  • Gigantism (children)

- Acromegaly (adults)

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7
Q

overproduction of Prolactin causes what conditions?

A
  • Galactorrhea and amenorrhea (females)

- Sexual dysfunction, infertility

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8
Q

overproduction of TSH causes what condition?

A

Hyperthryoidism

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9
Q

overproduction of FSH and LH causes what conditions?

A
  • Hypogonadism
  • mass effects
  • hypopituitarism
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10
Q

what are the 3 possible causes of Pituitary hypo-function?

A

A) Nonfunctional pituitary adenoma

B) Postpartum ischemic necrosis
(Need over 75% destruction)

C)Ablation/destruction by surgery, radiation, or adjacent tumor

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11
Q

What conditions result from a LACK of GH? Prolactin ? TSH ? ACTH ?

A

GH- dwarfism

Prolactin- no post-partum lactation

TSH- hypothryoidism

ACTH- Hypoadrenalism

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12
Q

what conditions can occur due to a lack of Gonadotropin production?

A
  • Amenorrhea and infertility in women

- Decreased libido, impotence, and lack of pubic/axillary hair in men

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13
Q

there is no clinical manifestations for a lack of which hormone?

A

Oxytocin

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14
Q

a lack of ADH is associated with what disease?

A

Diabetes insipidus

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15
Q

Hypothalamic neurons produce which 2 hormones?

A

oxytocin

antidiuretic hormone (ADH)

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16
Q

the ________ pituitary is derived from neuroectoderm

A

posterior

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17
Q

_________ cells of the anterior pituitary produce growth hormone

A

somatotroph

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18
Q

Gigantism occurs before closure of what structures?

A

epiphyseal plates (growth plates) in the long bones

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19
Q

clinical features of gigantism:

A

Generalized increase in the size of the body

Arms and legs are disproportionately long

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20
Q

how is gigantism/acromegaly treated?

A

surgical removal of the adenoma

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21
Q

clinical features of acromegaly:

A
  • Enlarged bones of the hands, feet, and face
  • Prognathism, development of a diastema
  • Hypertension and congestive heart failure may be seen
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22
Q

T/F: the prognosis for acromegaly is generally better than gigantism

A

FALSE

  • acromegaly can cause congestive heart failure
  • acromegaly = guarded prognosis
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23
Q

name the causes and features of dwarfism:

A

Causes:

  • Failure of pituitary gland to produce growth hormone
  • Lack of response to growth hormone by the patient’s tissues

Treatment:

  • Short stature
  • Small jaws and teeth
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24
Q

how can dwarfism be treated?

A

if lack of production of growth hormone is the problem, then hormone replacement therapy works

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25
Q

what is the normal histology of the thyroid glad?

A

Follicles filled with colloid

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26
Q

the thyroid gland Produces hormones that regulate what?

A

the RATE at which the body carries out its necessary functions

  • “the bodies thermostat”
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27
Q

where is the thyroid gland located?

A

Located in the middle of the LOWER NECK, below the larynx and above the clavicles

  • has bow-tie shape
28
Q

T/F: You can’t always palpate a normal thyroid gland

A

True

29
Q

how is PRIMARY hyperthyroidism diagnosed?

which hormones are reduced/increased

A
  • Elevated TH

- decreased TSH

30
Q

what causes Synthroid ?

A

Ingestion of exogenous thyroid hormone

31
Q

what is graves disease?

AKA what is its etiologic characteristic

A

Diffuse toxic hyperplasia of the thyroid tissue

32
Q

clinical features of hyperthyroidism are the result of what?

A

due to hypermetabolic state and overactivity of the sympathetic nervous system

33
Q

clinical features of hyperthyroidism:

A 
A) Hypermobility  
B) G-I hypermotility, malabsorption  
C) Tachycardia
D) Nervousness, tremor, irritability 
E) Heat intolerance and excessive sweating
F) Soft, warm, flushed skin
34
Q

what clinical sign is indicative of Graves Disease?

A

Exophthalmos

bulging of the eyes

35
Q

What is a “thyroid storm”? why can it be deadly?

A
  • sudden onset of severe hyperthyroidism, usually triggered by stress.
  • A medical emergency—patients often die of cardiac arrhythmias if untreated
36
Q

______________ can be used to destroy overactive thyroid tissue

A

reactive iodine

37
Q

_____________ is also known as diffuse toxic hyperplasia of the thyroid gland

A

Graves Disease

38
Q

what groups are at risk for Graves disease?

A

** females

= 7X more likely

39
Q

manifestations of graves disease:

A

A) Hyperthyroidism
B) Exophthalmos (40%)
C) Skin lesions
** pretibial myxedema ** (rash below knee)

40
Q

what 3 things can cause a decrease in thyroid hormone production?

A

1) Iodine deficiency
2) Autoimmune destruction of thyroid
3) Ablation by surgery or radiation therapy

41
Q

Autoimmune destruction of the thyroid leads to what disease?

A

Hashimoto’s thyroiditis

42
Q

clinical features of hypothyroidism:

A

1) creatinism - if infant or early childhood

2) Mydxema - older children and adults

43
Q

features of Myxedema:

late childhood & adult hypothyroidism

A 
Generalized apathy
Mental sluggishness—can mimic depression
Obesity
Cold intolerance
Enlarged tongue
44
Q

In HYPOthyroidism, when are serum TSH levels increased? when are they not increased?

A

A) Increased in primary cases

B) Not increased in cases caused by hypothalamic or pituitary disease

45
Q

why must hypothyroidism be treated quickly in younger patients?

A

The damage to skeletal and nervous systems could become permanent

(creatinism)

46
Q

characteristics of Hashimoto Thyroiditis :

A
  • Female predominance (older women, genetic risk)
  • Autoimmune; progressive destruction of gland
  • Patients usually at risk for other autoimmune diseases and B-cell Non-Hodgkin lymphomas
47
Q

characteristics of Hashimoto Thyroiditis :

A
  • Female predominance (older women, genetic risk)
  • Autoimmune; progressive destruction of gland
  • Patients usually at risk for other autoimmune diseases and B-cell Non-Hodgkin lymphomas
48
Q

T/F: patients with Hashimoto Thryoiditis have no established risk of development of thyroid neoplasm

A

True

49
Q

__________ are the most common manifestation of thyroid disease

A

Goiters

enlargements of the thyroid gland

50
Q

what causes goiters?

A

impaired synthesis of thyroid hormone

  • Most often due to dietary deficiency of iodine
51
Q

what are the most common clinical features of goiters?

A

** due to mass effects ** (growth of tissue masses)

Cosmetic problem
Airway obstruction
Dysphagia
Compression of vessels

52
Q

what causes a “toxic goiter”?

A

occur when a hyper-functioning nodule develops within a longstanding goiter

  • results in HYPERthyroidism
53
Q

Characteristics of Thyroid neoplasms:

A
  • Thyroid nodules are common
  • Most nodules are non-neoplastic disease
  • 1% of nodules are carcinomas
54
Q

T/F: Thyroid Nodules in females and young patients are more likely to be neoplastic

A

FALSE

  • males and young patients more likely to be neoplastic
55
Q

what is the only known environmental link for thyroid neoplasms?

A

exposure to radiation in first 2 decades

56
Q

what groups are at the highest risk for PAPILLARY Thyroid Carcinoma’s?

A
  • ** Most common type of thyroid cancer
    • FEMALES
    • peaks in 30s-50s
57
Q

which onconogene is mutated in patients with Papillary Thyroid Carcinomas?

A

RET proto-oncogene mutation

58
Q

PATHOLOGY of Papillary Thyroid Carcinomas:

A

A) microscopically characterized by papillary projections

B) nuclear clearing - ORPHAN ANNIE nuclei

C) nuclear grooves

59
Q

Follicular Thyroid Carcinoma s make up ___% of all thyroid neoplasms

A

10-20%

60
Q

characteristics of Follicular Thyroid carcinomas:

A
  • Older age than papillary; areas with dietary iodine deficiency
  • May resemble a Follicular Adenoma
61
Q

what type of thyroid neoplasm is Derived from the parafollicular (C) cells?

A

Medullary Thyroid Carcinoma

62
Q

the course of Medullary thyroid carcinomas may be _____ or familial

A

sporadic

63
Q

Both _________ and ___________ thyroid carcinoma types will show a mutation of the RET proto-onconogene

A

1) Papillary thyroid carcinoma

2) Medullary Thyroid Carcinoma

64
Q

Patients with Medullary Thyroid Carcinomas will show an elevation of what hormone?

A

Increased serum calcitonin

makes sense- medullary carcinomas derived from PARAFOLLICULAR cells….. they secrete calcitonin

65
Q

to diagnose FOLLICULAR thyroid carcinoma, you must see invasion through ____________, or into the _____________

A
  • through the capsule

- into the blood vessels

gen path final (8 decks)

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