Endocrine system

Question 1

Where is the pituitary gland?

Answer 1

It sits in the sella turcica in the center of the sphenoid bone

Question 2

What is the adenohypophysis?

Answer 2

Anterior pituitary gland.

It comes from the facial area called rathke’s pouch

Question 3

What is neurohypophysis?

Answer 3

The posterior pituitary gland.

It comes from the neuroectoderm of the forebrain.

Question 4

Remember

Answer 4

Posterior pituitary will have neurological tubes called secretory axons.
This tube would take ADH and oxytocin to the posterior pituitary for storage

Question 5

Remember

Answer 5

Anterior pituitary has venous system called portal venous system

Question 6

What are the hormones in the anterior pituitary?

Answer 6

Prolactin
Adrenocorticotropic hormone  (ACTH)
Growth hormone
leutinizing hormone (LH)
Follicle-stimulating hormone
Thyroid-stimulating hormone

Question 7

Hypopituitarism

Answer 7

Lesions in hypothalamus or adenohypophysis

Sheehan’s syndrome, empty sella

Question 8

Sheehan’s syndrome

Answer 8

Postpartum pituitary gland necrosis
Disorder where cells in the pituitary gland of a new mother start to die
Because of excess blood loss during childrbirth

Question 9

Diabetes Insipidus

Answer 9

no ADH from posterior pituitary
Cannot concentrate urine
Thirst wakes from sleep due to electrolyte disturbances

Question 10

Hyperpituitarism

Answer 10

Adenoma secreting one hormone

Question 11

Prolactinoma

Answer 11

Most common hyperpituitarism

Unneeded lactation

Question 12

Somatotropic adenomas

Answer 12

Excess GH

Acromegaly in adults or giantism in children

Question 13

Corticotroph tumors

Answer 13

Secrete ACTH

Reason for Cushing’s disease (overproduction of cortisol)

Question 14

What are the molecules that make thyroid hormone?

Answer 14

Tyrosine and iodine

Question 15

What enzyme converts T4 to T3?

Answer 15

Type I deiodinase appears to be responsible for most of the T3 in the bloodstream. The type I enzyme catalyzes the conversion of T4 to T3 within the thyroid gland.

Question 16

What is thyroglobulin?

Answer 16

Protein made by the follicular cells of the thyroid gland

Question 17

are thyroid hormones anabolic or catabolic?

Answer 17

Anabolic

Question 18

After de-iodination of thyroid hormones, what happens to them?

Answer 18

Urine or recycles towards the thyroid gland

Question 19

Hypothyroid

Answer 19

Myxedema - Myxedema is another term for severely advanced hypothyroidism. This is a condition that occurs when your body doesn’t produce enough thyroid hormone.
causes of hypothyroid:
- Hashimotos (most common)
- Iodine def

Symptoms
Fatigue, lethargy, constipation, cold intolerance, slowed mentation, cardiomyopathy, dry skin, periorbital edema.

Question 20

Hashimoto’s Thyroiditis

Answer 20

Autoimmune
Most euthyroid then hypothyroid
Transient hyperthyroid is possible

Question 21

Hyperthyroid/thyrotoxicosis

Answer 21

Grace's disease 
Women > men
Unintended weight loss, tachycardia, heat intolerance
lid retraction, lid lag, proptosis 
Goiter, increased T3 and T4, low TSH

Question 22

Grave’s disease

Answer 22

Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism).

Question 23

De Quervain’s Subacute Granulomatous Thyroiditis

Answer 23

Self-limted painful inflammation of thyroid

Question 24

Reidel’s Thyroiditis

Answer 24

R to Rock
Rock hard, woody thyroid,, mimics carcinoma
older women
Fibrotic proliferation
may cause hypothyroidism

Question 25

Goiters

Answer 25

A goiter is used to describe any enlarged thyroid gland. Simple = def of iodine or too many goitrogens (calcium and fluorine in water, brassicas, polluted water) Multinodular goiter = very large, often mistaken for cancer The patient can have goiter due to grave's disease, low iodine, swelling's goiter that are benign

Question 26

Adenomas of Thyroid

Answer 26

90-99% of nodules are benign adenomas May cause pressure symptoms post-menopausal women

Question 27

Malignant Tumors of Thyroid

Answer 27

Most papillary carcinoma Estrogen receptors, well differentiated Low mortality, solitary nodules more likely to be cancer Men < 40 more likely cancer

Question 28

Calcitonin

Answer 28

Produced in the parafollicular cells of the thyroid Lower blood Ca+ preserves Bone calcium Acts on BONE and KIDNEY

Question 29

What are the germinal layers of the adrenal gland?

Answer 29

Cortex and the medulla

Question 30

How many layers is the cortex divided into?

Answer 30

3 layers: - Zona Glomerulosa - mineralcorticoids (Aldosterone) - Zona Fasciculata - glucocorticoids (cortisol) - Zona Reticularis- glucocorticoids (sex hormones)

Question 31

What is made in the cortex of the adrenal gland?

Answer 31

Mineralcorticoids (aldosterone) | Glucocorticoids ( Cortisol and sex steroids)

Question 32

What is made in the medulla?

Answer 32

Epinephrine and norepinephrine

Question 33

What stimulates the medulla?

Answer 33

Sympathetic nervous system

Question 34

Aldosterone

Answer 34

Sodium and potassium manipulator

Question 35

Cortisol

Answer 35

Cortisol can help control blood sugar levels, regulate metabolism, help reduce inflammation, and assist with memory formulation. It has a controlling effect on salt and water balance and helps control blood pressure

Question 36

Hyperparathyroidism

Answer 36

Primary: - Adenoma of parathyroid gland - Elevated calcium Secondary hyperparathyroidism: - Hyperplasia due to hypocalcemia or hyperphosphatemia, renal failure, vitamin D def Serum calcium often low

Question 37

Hypoparathyroidism

Answer 37

Low serum calcium and high serum phosphate Chvostek's sign, Trousseau's sign Spontaneous spasm

Question 38

Pheochromocytoma

Answer 38

Tumor in the medulla Secretes catecholamines (too much epinephrine and norepinephrine) Hypertension, arrhythmias Hyperglycemia and hypermetabolism

Question 39

Neuroblastoma

Answer 39

Childhood tumor of adrenal medulla Most occur sporadically Large abdominal mass Course variable, some fatal

Question 40

Addison's

Answer 40

in Addison's diseases, you need to ADD cortisol Hypoadrenalism most often due to autoimmune adrenalitis Sometimes TB or idiopathic atrophy, medulla unaffected Weakness, fatigue, weight loss, diarrhea, vomiting Hyperpigmentation from increased ACTH, low NA, CL, cortisol hypoglycemia hyponatremia

Question 41

Cushing's

Answer 41

Hyperadrenalism | Iatrogenic, pituitary adenoma, ectopic ACTH production by neoplasm, thyroid carcinoma, adrenal cortex tumor

Question 42

Conn's syndrome

Answer 42

Solitary aldosterone secreting adenoma in the adrenal cortex | causes hyperaldosteronism

Question 43

What are the cofactors for converting epinephrine to epinephrine in the medulla?

Answer 43

Vitamin B12, folate, and SAMe

Question 44

What is the parent steroid?

Answer 44

Pregnenolone

Question 45

What makes pregnenolone?

Answer 45

cholesterol

Question 46

How does aldosterone work?

Answer 46

Acts in the distal tubule to reabsorb Na + | Pumps K and H out into urine

Question 47

How is aldosterone stimulated?

Answer 47

ACTH HYPERKALEMIA ANGIOTENSIN - 2

Question 48

Alpha cells secrete what/?

Answer 48

Secrete glucagon

Question 49

Beta cells secrete what?

Answer 49

secrete insulin

Question 50

Delta cells

Answer 50

secrete somatostatin

Question 51

PP cells

Answer 51

Secrete pancreatic polypeptide