[M] Week 7: Endocrine System - Part 2

Question 1

• derived developmentally from pharyngeal pouches that also give rise to the thymus.
• Located at the back of the thyroid

Answer 1

Parathyroid Gland

Question 2

There are 4 parathyroid glands what are those

Answer 2

2 superior and 2 inferior

Question 3

Function of parathyroid gland

Answer 3

regulate calcium homeostasis

Question 4

The activity of the parathyroid is in the?

Answer 4

bloodstream

Question 5

The four parathyroid glands are composed of two cell types are?

Answer 5

chief and oxyphil cells

Chief cells predominate

Question 6

Normally, decreased levels of free calcium stimulate the synthesis and secretion of?

Answer 6

Parathyroid Hormone (PTH)

Question 7

HYPERPARATHYROIDISM

Primary, Secondary, and Tertiary

1. compensatory hypersecretion of PTH in response to prolonged hypocalcemia, most commonly from chronic renal failure
2. an autonomous overproduction of parathyroid hormone (PTH), usually resulting from an adenoma or hyperplasia of parathyroid tissue
3. persistent hypersecretion of PTH even after the cause of prolonged hypocalcemia is corrected, for example after renal transplant

Answer 7

1. Secondary
2. Primary
3. Tertiary

Question 8

what are their main causes

Thyroid ::
Parathyroid ::

Answer 8

Thyroid - Hyperplasia
Parathyroid - Adenoma

Question 9

Parathryoid

• one of the most common endocrine disorders, and it is an important cause of hypercalcemia
• CAUSES:
  1. Adenoma - 85 to 95%
  2. Primary hyperplasia - 5-10%
  3. Parathyroid carcinoma - 1%

Answer 9

Primary Hyperparathyroidism

Question 10

Parathryoid

What is the most common cause of primary hyperparathyroidism

Answer 10

a solitary parathyroid adenoma arising sporadically

Question 11

Parathryoid

• caused by any condition that gives rise to chronic hypocalcemia, which, in turn, leads to compensatory overactivity of the parathyroid glands.
• Renal failure is by far the most common cause

Answer 11

Secondary Hyperparathyroidism

Question 12

Parathyroid

• far less common than is
  hyperparathyroidism.
• Due to deficient PTH
• Causes:
  1. Surgically Induced
  2. Congenital absence of all glands
  3. Familial isolated hypoparathyroidism
  4. Autosomal dominant hypoparathyroidism

Answer 12

Hypoparathyroidism

Question 13

• In this condition, hypoparathyroidism occurs because of end-organ resistance to the actions of PTH
• Serum PTH: normal or elevated - sometimes, the serum PTH is normal but the organ itself is not responsive
• PTH resistance is the most obvious clinical manifestation
• TSH resistance is generally mild, while LH/FSH resistance manifests as hypergonadotropic hypogonadism in females.
• ORGAN ITSELF REJECTS THE HORMONES

Answer 13

Pseudohypoparathyroidism

Question 14

Pancrease have how much islets of langerhans?

Answer 14

1 million

Question 15

What are the fourmajor cell types found in the pancrease?

Answer 15

1. Beta (68%)
2. Alpha (20%)
3. Delta (10%)
4. PP Cells (2%)

Beta and Alpha are most important

Question 16

Pancrease

MATCH

1. Insulin - Induce hypoglycemia
2. Pancreatic polypeptide - Stimulate secretion of gastric and intestinal enzymes and inhibit intestinal motility
3. Glucagon - Induce hyperglycemia
4. Somatostatin - Suppresses both insulin and glucagon secretion

A. Alpha
B. Delta
C. PP Cells
D. Beta

Answer 16

1. D
2. C
3. A
4. B

Question 17

Pancreas

Match

1. Elaborate vasoactive intestinal polypeptide (VIP), which is a hormone that induces glycogenolysis and hyperglycemia
2. Synthesize serotonin and are the
   source of pancreatic tumors that
   cause the carcinoid syndrome.

A. DI Cells
B. Eneterochromaffin Cells

Answer 17

1. A
2. B

Question 18

DISORDERS OF ISLET CELLS

• a systemic disease or group of metabolic disorders characterized by hyperglycemia– the increase in blood sugar
• Arises from defects due to insulin secretion, insulin action or both

Answer 18

Diabetes Mellitus

Question 19

Diagnosis - Diabete Mellitus

According to the ADA and WHO diagnostic criteria for diabetes include the following:
1. A random glucose ____, with classical signs and symptoms
2. A fasting glucose ____ on more than one occasion
3. An abnormal OGTT in which the glucose is 2 hours after a standard carbohydrate load

Answer 19

1. > 200 mg/dL
2. > 126 mg/dL
3. > 200 mg/dL

Question 20

DISORDERS OF ISLET CELLS

• Results from severe lack of insulin caused by an immunologically mediated destruction of B-cell
• Commonly develops in childhood, manifest at puberty, and progresses with age
• An autoimmune disease where genetic susceptibility and environmental factors play important role

Answer 20

Type 1 Diabetes Mellitus

Question 21

DISORDERS OF ISLET CELLS

Infections, e.g., viruses, coxsackievirus B, mumps, CMV, rubella, & IM → Tissue damage & inflammation or produce proteins that mimic self-antigen (molecular mimicry) or viral “de ja vu” with predisposing and precipitating virus

Answer 21

Environmental Factors of TYPE 1 DM

Question 22

DISORDERS OF ISLET CELLS

Genetic factors even more important role than in type 1 diabetes

Answer 22

Type 2 Diabetes Mellitus

Question 23

MORPHOLOGY OF DIABETES

Pancreas:
1. Type 1: reduced number & size of islets, ____, beta-cell degranulation
2. Type 2: subtle reduction of islet cell mass, ____ ____

Answer 23

1. insulitis
2. amyloid replacement

Question 24

TREATMENT OF DIABETES MELLITUS

what type of Diabetes can be prevented?

Answer 24

Type 2 by lifestyle and dietary alterations

Question 25

# TREATMENT OF DIABETES MELLITUS Type 1 cannot be prevented because it is autoimmune however it can be cured, how?

Answer 25

Islet cell transplantation

Question 26

- are **paired** endocrine organs consisting of a cortex and a medulla, which differ in their development, structure, and function. * Glands located on top of the kidney. * Also called as **Suprarenal Glands**

Answer 26

ADRENAL GLAND

Question 27

# Cortex of the ADRENAL GLANDS Match 1. Zona glomerulosa 2. Zona fasciculata 3. Zona reticularis A. secretes **glucocorticoids** in the form of cortisol B. secretes **sex steroids** in the form of androgen and estrogen C. secretes **mineralocorticoid** in the form of aldosterone

Answer 27

1. C 2. A 3. S

Question 28

Medulla of adrenal secretes?

Answer 28

catecholamines; epinephrine

Question 29

# Adrenal Glands What disorder can be acquired by conditions that produce elevated glucocorticoid levels

Answer 29

CUSHING SYNDROME (HYPERCORTICOLISM) | pabasa nalang ng shits dito

Question 30

# Adrenal Glands the generic term for a group of closely related conditions characterized by **chronic excess aldosterone secretion**

Answer 30

HYPERALDOSTERONISM

Question 31

# HYPERALDOSTERONISM Chronic excess of aldosterone→ Na+ retention and K+ excretion→?

Answer 31

- High sodium = hypertension - Low potassium = hypokalemia

Question 32

# Type of HYPERALDOSTERONISM Match 1. **autonomous** overproduction of aldosterone, with resultant hypertension, suppression of the renin-angiotensin system, and decreased plasma renin activity 2. **RAAS activation**, which occurs when there is a drop in blood pressure, a decrease in blood pressure, reduced renal perfusion, hypovolemia, or sometimes even during pregnancy. A. Primary Hyperaldosteronism B. Secondary Hyerperaldosteronism

Answer 32

1. A 2. B

Question 33

# Adrenal Glands Disorders of **sexual differentiation**, such as virilization or feminization, can be caused by primary gonadal disorder and several primary adrenal disorders

Answer 33

ADRENOGENITAL SYNDROME

Question 34

# ADRENOCORTICAL INSUFFICIENCY This **uncommon** but catastrophic syndrome is characterized by the following: - Overwhelming bacterial infection, classically Neisseria meningitidis septicemia but occasionally caused by other highly virulent organisms, such as Pseudomonas species, pneumococci, Haemophilus influenzae, or even staphylococc

Answer 34

PRIMARY ACUTE ADRENOCORTICAL INSUFFCIENCY **WATERHOUSE-FRIDERICHSEN SYNDROME**

Question 35

# ADRENOCORTICAL INSUFFICIENCY * Decreased stimulation of the adrenals due to a deficiency of ACTH * An uncommon disorder resulting from the progressive destruction of the adrenal cortex. In the Philippines, the primary cause of chronic adrenocortical insufficiency is **tuberculosis**. * Clinical manifestations appear when 90% of adrenal cortex is destroyed

Answer 35

PRIMARY CHRONIC ADRENOCORTICAL INSUFFCIENCY (**ADDISON DISEASE**)

Question 36

# MULTIPLE ENDOCRINE TUMOR - a rare heritable disorder with a prevalence of about 2 per 100,000. - characterized by abnormalities involving the parathyroid, pancreas, and pituitary gland; thus the mnemonic device, the **three P’s.**

Answer 36

MEN-1, or Wermer syndrome,

Question 37

# MULTIPLE ENDOCRINE TUMOR is characterized by pheochromocytoma, medullary carcinoma of the thyroid, and parathyroid hyperplasia.

Answer 37

MEN-2A, or Sipple syndrome

Question 38

# MULTIPLE ENDOCRINE TUMOR - has significant clinical overlap with MEN-2A - accompanied by neuromas or ganglioneuromas involving the skin, oral mucosa, eyes, respiratory tract, and gastrointestinal tract, and a marfanoid habitus, with long axial skeletal features and hyperextensible joints

Answer 38

MEN, TYPE 2B

Question 39

# MULTIPLE ENDOCRINE TUMOR - Variant of MEN-2A, no other clinical manifestations; genetic testing done among kindred; RET mutation → prophylactic thyroidectomy * It arises in the family, so we need to counsel the family to undergo screening because they will eventually develop medullary thyroid cance

Answer 39

FAMILIAL MEDULLARY THYROID CANCER

Question 40

It is a minute, pinecone-shaped organ (hence its name), weighing 100 to 180 mg and lying between the superior colliculi at the base of the brain

Answer 40

PINEAL GLAND

Question 41

- It is composed of a loose, neuroglial stroma enclosing nests of epithelial-appearing pineocytes, cells with photosensory and neuroendocrine functions - "Third Eye"

Answer 41

PINEAL GLAND