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Syst Path 600 > Endocrine > Flashcards

Endocrine Flashcards

(60 cards)

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1
Q

Pituitary hormones: anterior

A

Somatotrophs –> HGH

Thyrotrophs –> TSH

Gonadotrophs –> FSH/LH

Lactotrophs –> prolactin

Corticotrophs –> ACTH and MSH

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2
Q

Pituitary hormones: posterior

A

NOT produced in posterior pituitary; merely stored and secreted there

Oxytocin
ADH

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3
Q

Pituitary gigantism

A

GH hypersecretion before epiphyseal plates close

Increased stature but little bony deformity.

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4
Q

Hypersomatotropism

A

Excessive GH secretion

Gigantism
Acromegaly

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5
Q

Acromegaly

A

Excessive GH in adulthood

Distinctive coarsening features, joint degeneration, peripheral neuropathies

Increased risk of cardiac disease, GI cancer, hypertension

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6
Q

Prolactinoma

A

Benign tumour of the pituitary gland causing excess prolactin secretion

Symptoms caused by excess circulating prolactin or by pressure of tumour on surrounding tissues

Idiopathic. May be stress related

40% pituitary tumours produce prolactin

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7
Q

Prolactinoma: Sx

A

Hyperprolactaemia

Pain, visual disturbances from macroprolactinoma

Amenorrhea (hyperprolactinaemia disrupts gonadotropin secretion –> hypogonadism)

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8
Q

ACTH Secreting Pituitary Adenoma

A

Tumour of pituitary gland

Causes Cushing’s disease (hyperadrenalism)

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9
Q

Generalized Hypopituitarism

A

Endocrine deficiency syndromes resulting from partial or complete loss of anterior pituitary lobe function.

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10
Q

Generalized Hypopituitarism: Sx

A

Usually insidious. Depends on hormones affected.

Most commonly GH lost first, then gonadotropins, then TSH and ACTH.

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11
Q

Hyperpituitarism

A

Overproduction of any of the pituitary hormones

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12
Q

Low gonadotropins: Sx

A

In kids: delayed puberty

In premenopausal women/ amenorrhea, reduced libido, regression of secondary sexual characteristics, infertility.

In men: erectile dysfunction, testicular atrophy, regression of secondary sexual characteristics, infertility. Decreased muscle mass.

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13
Q

Low GH: Sx

A

Decreased energy, muscle mass, central obesity, impaired attention and memory.
Usually asymptomatic and clinically undetectable

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14
Q

Low TSH: Sx

A

Hypothyroidism: facial puffiness, hoarse voice, bradycardia, cold intolerance. Weight gain. Hair loss. Slowed thinking.

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15
Q

Low ACTH: Sx

A

Hypoadrenalism: fatigue, hypotension, stress and infection intolerance

–> does not result in hyperpigmentation characteristic of primary adrenal failure.

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16
Q

Hypopituitarism: appetite

A

Can affect appetite (resemble anorexia nervosa or conversely hyperphagia–> obesity)

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17
Q

Low ADH: Sx

A

Diabetes insipidus.

Extreme thirst, dehydration, hyperatremia.

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18
Q

Low oxytocin

A

Generally few symptoms if not birthin’ or nursin’

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19
Q

Cushing’s Syndrome

A

Chronic high cortisol

Excess pituitary production of ACTH, usually secondary to pituitary adenoma.

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20
Q

Cushing’s syndrome: Sx

A 
Moon facies 
Truncal obesity with thin limbs
Buffalo hump
Muscle wasting
Thin skin
Poor wound healing 
Purple straie
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21
Q

Cushings disease

A

Cushings syndrome caused by excessive pituitary production of ACTH

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22
Q

ACTH-dependent hyper function of the adrenal cortex can result from:

A

1 hypersecretion of ACTH by pituitary gland

  1. Secretion of ACTH by nonputuitary tumour
  2. Administration of exogenous ACTH
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23
Q

Test to differentiate between pituitary and adrenal hypercortisol disorders.

A

Dexamethasone suppression test

(Suppresses ACTH release by pituitary; if cortisol levels still high then problem is adrenal).

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24
Q

Central Diabetes insipidus

A

Neurogenic diabetes insipidus

Low levels of ADH (vasopressin) produced by hypothalamus, or failure or pituitary gland to release it.

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25
Diabetes insipidus: Sx
Polydypsia | Polyuria
26
Diabetes insipidus: Dx
Urine test for glucose (to rule out diabetes mellitus) Water deprivation test (Water deprivation followed by injection of ADH --> positive for insipidus if symptoms relieved.
27
Glucocorticoids
Cortisol, cortisone, corticosterone Make energy available for immediate use. Low glucocorticoid levels/high demand --> pituitary gland releases CRH Released by adrenal cortex (zona fasicularis)
28
ADH
Antidiuretuc hormone Made by hypothalamus, released posterior pituitary in response to high blood osmotic pressure (dehydration) Kidneys retain more water Decreased sweat production Vasoconstriction --> increase BP
29
hGH
Human growth hormone Released by anterior pituitary gland continually (especially during sleep); increases in response to hypoglycemia Promotes synthesis and secretion of IGFs throughout body --> cell growth, lipolysis, glucose sparing
30
Aldosterone
Mineralocorticoid Produced by the adrenal cortex (zona glomerulosa) in response to angiotensin II, and increased circulating K+ Angiotensin II (RAA Pathway) is a response to dehydration/trauma/decreased Na+ levels Acts on kidneys to increase reabsorption of H2O
31
PTH
Parathyroid hormone Released by parathyroid gland in response to decreased levels of Ca+. Increase osteoclast activity, plus acts on kidneys to release calcitriol
32
T3/T4
Thyroid hormones Released by follicular thyroid cells in response to TSH, which js released by the anterior pituitary in response to low levels of circulating T3/T4, or low BMR Increases BMR, increases number of Na+/k+ pumps, up regulate beta receptors.
33
Insulin
Produced by beta cells in the pancreatic islet Response to hyperglycemia Pushes glucose into cells (increase GluT transporters)
34
Hyperthyroidism
Overactivity of the thyroid gland --> high thyroid hormones Most common in women during menopause and after childbirth
35
Graves' disease
Most common form of hyperthyroidism Autoimmune stimulation of thyroid follicles Affects entire gland
36
Hyperthyroidism: Sx
``` Increased heart rate, BP Abnormal heart rhythms Increased sweat Anxiety Insomnia Weight loss Goitre ```
37
Hyperthyroidism: causes
Graves' disease Thyroiditis Toxic adenoma (secretes hormone without TSH) Plummers disease (toxic multinodular goitre) Overactive pituitary (rare) Excess iodine
38
Symptom unique to Graves
``` Eye symptoms Puffiness Increased tear formation Irritation Light sensitivity Diplopia Exophthalmos ``` Also orange-peel skin, especially over shin.
39
Hashimoto's disease
Aka Hashimoto's thyroiditis Chronic autoimmune inflammation of the thyroid Usually results in hypothyroidism (most common cause)
40
Most common form of thyroiditis
Hashimoto's
41
Most common cause of hypothyroidism
Hashimoto's
42
Hashimoto's: in the beginning
50% underactive thyroid | In some people, initial hyperthyroidism or normal function, followed by hypothyroidism.
43
Hashimoto's: comorbidities
Other endocrine and/or autoimmune disorders, or certain chromosomal conditions. (downs, turners, klinefelters)
44
Hashimoto's: Sx
Painless enlargement of thyroid Cold intolerant Fatigue
45
Type 1 vs Type 2 diabetes: Sx
Type 1: fatigue, malaise, fruity ketone breath Weight loss. Atherosclerosis Vision problems Type 2: polydypsia polyuria
46
Type 1 vs Type 2 diabetes: | Underlying path
Type 1: destruction of pancreatic beta cells --> not enough insulin produces Type 2: down-regulation of insulin receptors --> body can't deal with the glucose.
47
Hormones produced by adrenal cortex
Zona glomerulosa: Mineralocorticoids (aldosterone) Zona fasculata: glucocorticoids (cortisone, cortisol, corticosterone) Zona reticularis: androgens (DHEA)
48
Adrenal medulla
Centre of adrenal gland. Nervous tissue (not endocrine) Release catecholamines (NE, epinephrine, DA)
49
Epinephrine (hormone)
Increases heart rate and force of contractions Smooth muscle relaxation Glycogen To glucose conversion in liver
50
Norepinephrine (hormone)
Vasoconstrictive (increase BP)
51
Addison's disease
Chronic adrenal insufficiency, hypocortisolism Adrenal gland doesn't produce enough steroid hormones. (Mineralocorticoids and glucocorticoids) Usually (70%) autoimmune. Also cancer, infection (TB), genetics Rare
52
Addison's disease: Sx
Weak Tired DizZy Dark skin patches. Dehydration Excess K+, not enough Na+ Insulin sensitivity --> hypoglycemia
53
Secondary adrenal insufficiency
Symptoms similar to addisons but the problem is that the pituitary isn't releasing ACTH
54
Conn's syndrome
Primary (hyper)aldosteronism Overproduction of aldosterone by adrenal gland
55
Conn's syndrome: Sx
``` Increased BP Weakness (hypo mm) Periods of paralysis Muscle cramps (hyper neuron) Metabolic alkalosis Hypocalcemia ```
56
Conn's syndrome: causes
50-60% Adrenal adenoma (benign) 40-50% adrenal hyperplasia RAA disorders (rare)
57
Hypothyroidism
Underactivity of thyroid gland Common
58
Myxedema
Very severe hypothyroidism Can lead to coma
59
Secondary hypothyroidism
Pituitary gland fails to produce enough TSH
60
Cretinism
Congenital hypothyroidism Stunted mental and physical growth.

Syst Path 600 (5 decks)

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