Flashcards in Endocrine disease Deck (81)
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1
list the major endocrine glands in the human body
- pineal
- pituitary
- thyroid
- pancreas
- adrenal
2
what hormone does the pineal gland secrete
melatonin
3
what does melatonin (secreted by the pineal gland) regulate
circadian rhythm or sleep wake cycles
4
what are the chances of getting a pineal tumour
extremely rare
<1:200,000
but can be serious if do get the tumour
5
what % of pineal tumours comprises of inter cranial tumours
<1%
6
what age do pineal tumours develop
adults 35-60 years of age peak
7
list the presentations of pineal tumours
- headaches - hydrocephalus (due to enlarged ventricles which pushes)
- nausea
- blurred vision
- upward gaze palsy (parano syndrome)
- gait
- insomnia/sleep disturbances
- hearing loss
8
where is the pituitary gland situated
sits above the thalamus & hypothalamus
9
what cells are located anterior to the pituitary gland
- TRH = thyrotropin releasing hormone
- TSH = thyroid stimulating hormones
- PIF = prolactin inhibitory factor or dopamine
- PRL = prolactin
- CRH = corticotropin releasing hormone
- ACTH = adrenocorticotropic hormone (cortitropin)
10
what cells are located posterior to the pituitary gland
- GHRH = growth hormone releasing hormone (somatotrophin)
- GIH - growth hormone inhibitory factor (somatostatin)
- GnRH = gonadotropin
- FSH = follicle stimulating hormone
- LH = luteinizing hormone
11
how many % of intracranial neoplasms do pituitary tumours account for
10-15% (1 in 10)
12
what action of hormones occurs during pituitary tumours
presence of hormones, hyper secretion of hormones
13
what does destruction of pituitary i.e. ischemia (taking blood away from pituitary gland), iatrogenic cause to hormone secretion
absence or diminution of hormone secretion
14
what do pituitary tumours cause to adjacent structures
direction and extent of local expansion and invasion of adjacent structures i.e. non functioning adenoma
15
list the types of common adult pituitary tumours
- prolactinomas
- growth hormone secreting adenoma
- non secreting adenomas
- corticotroph adenoma (ACTH)
- TSH, FSH, LH are all rare (sex hormones)
16
what do ~15% of pituitary adenomas secrete
>hormone with prolactin + growth hormone the most common combination
17
what % of tumours do prolactinomas account for
30%
18
what do prolactinomas (pituitary tumours) do
DDX - dopamine inhibition (hypothalamus neurons) 2 degrees trauma
19
what do prolactinomas (pituitary tumours) usually cause in women
- amenorrhea - periods stop
- galactorrhea - 'witch's' milk
20
what do prolactinomas (pituitary tumours) usually cause in men
- testicular atrophy - dry up
- gynecomastia = man boobs
- diminished body hair
- impotence
21
what are the signs and symptoms of growth hormone secreting tumours in a pituitary tumour
acromegaly
patients report gradual enlargement and coarsening of facial features, hand and feet. Tumour may be large at time of diagnosis as signs and symptoms are slow
Gh stimulates IGF-1
if child gets gigantism
if adult gets acromegaly
22
what syndrome is associated with corticotrophin secreting adenomas (ACTH) as a result of pituitary tumours and what are the symptoms
cushing syndrome
Females : Males = 4:1
so more common in males
- truncal obesity
- abdominal stress
- moon faces
- thin skin
- high blood pressure
- glucose intolerance
- fatigue
23
who does the FSH, LH & TSH type of pituitary hormone occur mostly in
middle aged men and women
24
what symptoms does FSH, LH & TSH type of pituitary hormone cause
- visual field loss
- headache
- diplopia
25
what does FSH, LH & TSH type of pituitary hormone cause in men
decreased libido/energy
26
which pituitary hormone is are <1%
TSH
27
what does a pituitary tumour rarely cause
hyperthryroidism
28
what are the appearance of non secreting adenomas, tumours without endocrine symptoms at time of diagnosis
large but usually asymptomatic except headaches
29
what symptom do patients with non secreting adenomas (tumours without endocrine symptoms) have
severe frontal headaches, about 50% of patients
30
