Abrupt onset of hyperthyroidism Patients can die of cardiac arrhythmia

Develops in adults Generalized apathy and mental sluggishness (mimics depression) Cold-intolerance, obese Coarse facial features, enlargement of tongue, deepening of voice, constipation, late cardiac effects Accumulation of mucopolysaccharide-rich edema

endocrine Flashcards by Chris Stryker

pituitary adenoma may produce symptoms by _______ or _______

hormone production or by local mass effect

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local mass effect of pituitary adenoma

compression of optic nerve leading to visual disturbances

* increased intracranial pressure (headache, nausea, vomiting)

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Hypofunction (hypopituitarism)

• may manifest as a deficiency of one hormone or multiple hormones

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anterior pituitary lobe derived from the

primitive oral cavity (Rathke’s Pouch)

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posterior pituitary lobe derived from

neuroectoderm

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thyroid gland develops from an invagination of _______

which arises at the , in the region of the foramen cecum

endoderm,

base of the tongue

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thyroid gland then migrates _______to its location anterior to the thyroid cartilage

caudually

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histology of thyroid gland

follicles filled with colloid and lined by cuboidal follicular cell
small nests of C-cells scattered between the follicle

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most common cause of hyperthyroidism

o Graves disease (#1)
o ingestion of excessive exogenous thyroid hormone (TH)
o hyperfunctional multinodular goiter
o hyperfunctional thyroid adenoma

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clinical manifestations of hyperthyroidism

Hypermetabolic state, Overactivity of the sympathetic nervous system

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thyroid storm

Abrupt onset of hyperthyroidism

* Patients can die of cardiac arrhythmia

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diagnosis of hyperthyroidism

elevated levles of TH, decreased levels of TSH

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common causes of hypothyroidism

o Ablation by surgery or radiation therapy
o Hashimoto thyroiditis
o Iodine deficiency

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Cretinism

hypothyroidism.
children
Impaired development of skeleton and CNS
Coarse facial features

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Myxedema

Develops in adults
Generalized apathy and mental sluggishness (mimics depression)
Cold-intolerance, obese
Coarse facial features, enlargement of tongue, deepening of voice, constipation, late cardiac effects
Accumulation of mucopolysaccharide-rich edema

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hypothyroidism can be ____ or _____

primary or secondary

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TSH levels are ______ in primary

increased

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graves disease is a ______ disease

hyperthyroid

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Hashimoto Thyroiditis is a _______ disease

hypothyroid

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Most common cause of hypothyroidism where dietary iodine is sufficient

Hashimoto Thyroiditis

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• Most common manifestation of thyroid disease

goiters

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• Diffuse and multinodular goiters reflect impaired synthesis of _______

thyroid hormone

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goiters are most often caused by

dietary deficiencies

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Impairment of TH synthesis leads to……

increased serum TSH
hypertrophy and hyperplasia of thyroid follicular cells
gross enlargement of gland

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most thyroid nodules are

non-neoplastic

which nodules are more likely to be neoplastic

in younger people | in males

Follicular Adenoma

o solitary nodules, 3-5 cm in diameter | o grossly separated from the normal thyroid by a thin, discrete capsule

accounts for 70-80% of thyroid cancers

Papillary Thyroid Carcinoma

Follicular Carcinoma

o accounts for 10-20% of thyroid cancers o Older age than papillary; areas with dietary iodine deficiency o grossly may resemble an adenoma with a discrete capsule o Must see invasion through the capsule or into the blood vessels

this condition has lots of different nuclei affects

Papillary Thyroid Carcinoma

which have mutations in the RET proto-oncogene

Papillary Thyroid Carcinoma | Medullary Thyroid Carcinoma

Medullary Thyroid Carcinoma

derived from the parafollicular (C) cells

which has Increased serum calcitonin

medullary thyroid carcinoma

Medullary Thyroid Carcinoma

derived from the parafollicular (C) cells | uncommon

parathyroid embryology

Derived from the third and fourth pharyngeal pouches

parathyroid gland is composed of mostly

o composed mostly of chief cells (principal cells, clear cells), also oxyphil cells

chief cells secrete

PTH

function of PTH

increase serum calcium

Hyperparathyroidism causes

hypercalcemia

difference between primary and secondary hyperparathyroidism

primary- an autonomous spontaneous overproduction of PTH | secondary- associated with chronic renal failure

primary hyperparathyroidism

Caused by parathyroid adenomas or hyperplasia | Deposition of calcium in throughout body, including blood vessels

T/F secondary hyperparathyroidism doesnt have incrase Ca levels

TRUE

DiGeorge’s syndrome is a _______ disease. and associated with that

autoimmune. | Hypoparathyroidism

DiGeorge’s syndrome is

Hypoparathyroidism. dont have one

type 1 diabetes

Symptoms appear once 90% of beta cells have been destroyed | o Ketoacidosis

o Ketoacidosis

Since these people are using fat as their primary energy source, excess ketones in blood, decrease in blood pH

Ketoacidosis

Since these people are using fat as their primary energy source, excess ketones in blood, decrease in blood pH

• Normal glucose is ______

70-120mg/dL

total lack of insulin is associated with which type

type 1

insulin resistance is associated with which type of diabetes

type 2

o Responsible for 80% of DM-related deaths

vasculopathy

Responsible for 80% of DM-related deaths

vasculopathy

vasular disease then _____ disease are main problems with diabetes

kidneys. (diabetic nephropathy)

diabetic nephropathy

* Diffuse glomerulosclerosis * 90% of diabetics within 10 years; not specific to diabetics * Microangiopathy around glomerular capillaries and deposition of matrix * Proteinuria, total renal failure

Nodular glomerulosclerosis resuls from

diabetes

Insulinoma

Insulin Secreting Islet Cell Tumor • Beta cell tumor, hyperinsulinism, most are adenomas • Hypoglycemia quickly occurs from fasting or exercise

Zollinger-Ellison Syndrome

* Pancreatic islet cell tumor, hypersecretion of gastric acid, severe peptic ulcers * Most are malignant (60%), surgical resection

adrenal medulla is the source of

epinephrine

adrenal cortex 3 levels

o zona glomerulosa – mineralcorticoids (aldosterone) o zone fasciculata – glucocorticoids (cortisol) o zona reticularis – sex hormones (estrogen/androgen)

Cushing Syndrome

hypercortisolism | Primary adrenal hyperplasia or neoplasm (e.g. adrenal adenoma)

Hyperaldosteronism causes....

hypertension, hypokalemia

Primary Chronic Adrenocortical Insufficiency (Addison’s Disease)

progressive destruction of adrenal cortex | Serum ACTH may be elevated → skin and mucosal pigmentation

Primary Chronic Adrenocortical Insufficiency (Addison’s Disease)

progressive destruction of adrenal cortex Serum ACTH may be elevated → skin and mucosal pigmentation Potassium retention, sodium loss, hyperkalemia, hyponatremia, volume depletion, and hypotension

Secondary Adrenocortical Insufficiency

Any disorder of hypothalamus of pituitary that reduces output of ACTH Symptoms similar to Addison’s disease But no skin/mucosa pigmentation

Pheochromocytoma

neoplasm of chromaffin cells | in adrenal glands