Endocrine Diseases and Disorders Flashcards
Gigantism
ETIOLOGY:
1) anterior pituitary adenoma or genetic defect -> hypersecretion of somatotropin BEFORE epiphyseal plates close
S/S:
1) abnormal and accelerated growth of all tissues
TREATMENT:
1) transsphenoidal surgery with or without radiation and/or medication therapy
2) possible gonadal hormone replacement therapy
Acromegaly
ETIOLOGY:
1) anterior pituitary gland adenoma -> overproduction of GH AFTER epiphyseal closure
S/S:
1) abnormal growth of soft tissues
2) osteoarthritis
TREATMENT:
1) transsphenoidal surgery or radiation therapy
2) chemotherapy
BONUS FACTS:
1) risk of vascular disease
Hypopituitarism
ETIOLOGY:
1) neoplasm, trauma, congenital defect, ischemia -> decreased adenohypophysis secretion of TSH, ACTH, gonadotropin, and/or somatotropin
S/S:
1) possible hypothyroidism (fatigue, depression, cold intolerance), low salt levels, and/or impaired sexual function
TREATMENT:
1) surgery if neoplastic
2) replacement therapy of TSH, ACTH, gonadotropin, and/or somatotropin
BONUS FACTS:
1) Termed “PANhypopituitarism” if multiple hormones affected
Dwarfism
ETIOLOGY:
1) neoplasm, hemorrhaging, or congenital defect -> decreased adenohypophysis secretion of somatotropin
S/S:
1) delayed growth, short stature, underdeveloped secondary sex characteristics
2) possible IDD
TREATMENT:
1) GH replacement therapy until 5ft of height
2) hormone replacement therapy for linked deficiencies
Diabetes Insipidus
ETIOLOGY:
1) hereditary defect, insult to neurohypophysis -> decreased vasopressin and water resorption
2) nephron resistance to vasopressin
S/S:
1) polyuria, polydipsia
2) (Dehydration) hypotension, poor skin turgor, dizziness, dry mucosal membranes
TREATMENT:
1) vasopressin nasal spray or injections
2) Thiazide diuretics to reduce water volume -> stimulates sodium and water resorption
Hyperparathyroidism
ETIOLOGY:
1) low serum calcium or vitamin D levels OR parathyroid tumor -> over secretion of PTH
S/S:
1) osteoporosis
2) nerve dysfunction (arrhythmia, weakness)
3) calcium deposits (nephrolithiasis, arthritis)
TREATMENT:
1) parathyroidectomy
2) resorption-inhibiting drugs OR calcium-excreting drugs, followed by calcium supplementation
Hypoparathyroidism
ETIOLOGY:
1) Iatrogenic (drug-induced), trauma, ischemia, autoimmune activity, or radiation -> under secretion of PTH
S/S:
1) increased nerve sensitivity (tetany, muscular spasms, arrhythmia)
TREATMENT:
1) calcium replacement and vitamin D therapy
BONUS FACTS: risk of laryngospasm -> respiratory arrest
Thyroid Cancer
ETIOLOGY:
1) Risk factors include family history, radiation, tobacco use, iodine deficiency
2) Follicular, medullary, papillary, or anaplastic growth in thyroid
S/S:
1) (insidious) dysphasia, lymphadenopathy, enlarged thyroid
TREATMENT:
1) total thyroidectomy followed by T4 replacement therapy and regular physical exams
BONUS FACTS:
1) Papillary, medullary, and follicular 5-yr survival rates are >90%, while anaplastic is ~30%
Grave’s Disease
ETIOLOGY:
1) genetic factors -> autoantibodies stimulate thyroid gland to release triiodothyronine (T3) and thyroxine (T4)
S/S:
1) weight gain with increased appetite, easy fatigability, irritability, heat intolerance, tachycardia, diarrhea, onchylosis
2) grave’s opthalmopathy
TREATMENT:
1) antithyroid drugs to prevent hormone synthesis or subtotal thyroidectomy
2) beta-blockers for tachycardia
BONUS FACTS:
1) spontaneous resolution possible, but relapses common
Simple Goiter
ETIOLOGY:
1) iodine deficiency -> thyroid hormone deficiency -> negative feedback loop triggered (adenohypophysis releases TSH)
S/S:
1) enlarged thyroid
2) possible hyperthyroidism symptoms (weight loss, irritability, heat intolerance, sweating, anxiety, tachycardia)
TREATMENT:
1) potassium-iodide supplements
2) possible subtotal thyroidectomy
Hashimoto’s Thyroiditis
ETIOLOGY:
1) hereditary factors -> autoantibodies produced against thyroid gland -> inflammation and scar tissue replaces glandular tissue
S/S:
1) enlargement of thyroid gland
2) difficulty swallowing, weight gain, cold intolerance, bradycardia, lethargy, depression
TREATMENT:
1) levothyroxine to replace T3 hormone
Cretinism
ETIOLOGY:
1) maternal hypothyroidism or antithyroid drugs -> impaired gestational thyroid development
2) congenital defect -> lack of thyroid hormone synthesis
S/S:
1) delayed growth, underdeveloped sex characteristics, lack of muscle, IDD
2) short forehead, broad nose, thick tongue, protruding abdomen
TREATMENT:
1) thyroid hormone replacement therapy (REVERSIBLE IF DONE EARLY)
Myxedema (Hypothyroidism)
ETIOLOGY:
1) removal of thyroid gland, hypopituitarism, tumor, radiation -> impaired T4/T3 synthesis
S/S:
1) edema, dry skin, weight gain, cold intolerance, lethargy, bradycardia, constipation, depression
2) exacerbation of myxedema coma (hypothermia, slurred speech, lethargy or unconsciousness)
TREATMENT:
1) intravenous or oral thyroid hormone replacement therapy (levó thyroxine sodium)
BONUS FACTS:
1) mortality rate increases if myxedema coma develops
Diabetes Mellitus
ETIOLOGY:
1) (Type 1) hereditary factors -> autoantibodies produced against pancreatic beta-cells -> decreased insulin production
2) (Type 2) trauma, tumor, or inactive lifestyle with high-sugar diet -> decreased insulin production and/or sensitivity
S/S:
1) polydipsia, polyphagia, weight loss, fatigue, and weakened immune system
2) Risk of ketoacidosis
3) Risk of diabetic coma (lethargy, unconsciousness)
4) Iatrogenic risk of hypoglycemic shock
TREATMENT:
1) balanced diet and exercise
2) insulin-promoting or glycemia-decreasing medications (i.e. metformin, acarbose, sulfonylureas)
Gestational Diabetes
ETIOLOGY:
1) pregnancy -> placenta destroys insulin, estrogen, progesterone inhibits insulin, fetal consumption of glucose stresses maternal balance -> leading to hyperglycemia
S/S:
1) (about 24-28 weeks in) polyuria, polydipsia, and polyphagia
TREATMENT:
1) insulin administration and oral hypoglycemic agents
BONUS FACTS
1) spontaneous recovery common after birth
2) 30-40% chance of developing Type II diabetes 5 years later
