Test 2 Endocrine Flashcards
(51 cards)
What inhibits Growth Hormone and TSH release
Somatostatin
Pitiuitary adenomas DX/TX
dx: MRI
tx: tumor resection
Sx: vision loss/ displopia, H/A
Multiple Endocrine Neoplasia. Tumors are on what endocrine glands?
Pituitary Parathyroid Pancreas GI tumors can cause Zollinger Ellison syndrome- the tumor starts secreting hormones
Acromegaly- Adult
MCC / Sx
excess GH secretion. common cause somatotroph adenoma
Sx: prognathia (big jaw), bossing of forehead, big hands/feet. NO change in height. HTN, cardiomegaly
Acromegaly- Adult
Lab/ TX
labs)
- Increase GH after glucose intake. (normally glucose intake suppresses GH)
- High serum GH & IGF-1 (formed when GH stimulates liver)
Tx: pituitary microsurgery
Gigantism- before puberty
GH hypersecretion before the closing of epipyseal endplates. height affected
Dwarfism Tx
GH deficiency. proportional dwarfism.
tx: recombinant GH
GH deficiency in adults
SX
HYPERlipidemia, HTN, Reduced exercise capacity. change in body comp, metabolism, CV fx, reduced lean body mass.
GH deficiency in adults DX/TX
DX: give GHRH, if evokes GH < 3, then GH deficiency
TX: GH replacement
Prolactinoma si/sx
premenopausal woman: hypogonads= infertility, galactorrhea
Postmenopausal: dx when adenoma gets to big causes vision changes
men: hypogonads, low libido, gynecomastia, galactorrhea
Prolactinoma DX/ TX
dx: if serum prolactin is greater than 20
tx: dopamine agonist (Cabergoline) - decreases serum prolactin and size of adenomas
What inhibits and stimulates Prolactin production
Inhibits: dopamine
Stimulates: TRH
What does Prolactin inhibit?
GnRH …so ultimately this will reduce FSH/ LH
Diabetes Insipidus 2 types
they have increased urination and thirst. Caused by decreased ADH. 2 types:
Central: Post pit has decreased ADH release. Serum ADH will be low
Nephrogenic: kidney resistant to ADH. Serum ADH will be high
Diabetes Insipidus DX/TX
dx: specific gravity <1.005 (dilute) . urine osmolality of <200
tx: desmopressin or argine vasopressin
SIADH
increased ADH secretion, causing dec urination, swelling. dilutional hyponatremia
DX: hyponatremic serum sodium <135 .
Aldosterone what does it do?
secreted by Adrenal Cortex (zona glomerulosa), its a mineralcorticoid. Keeps MAP up, secreted when low BP. Takes in Na (and water), lets K+/H+ out. It is stimulated by increased K+ levels in blood.
Adrenal Insufficiency
Addison’s Disease
lack of aldosterone and cortisol. hyperKalemia (arrythmias), hypoglycemia, hyponatremia, hypotension, salt cravings
Dx: ACTH stimulation test. give cosyntropin to see if prob is at pit or hypothal
Tx: hydrocortisone
Hypercortisolism
sx/dx
increased cortisol secreted from adrenal cortex (zona fasiculata).
sx: moon face, buffalo hump, abdominal purple striae, hair thinning, obesity
dx: high serum cortisol after dexamethasone admin , which normally should shut down cortisol via neg feedback
Hypercortisolism- Cushing syndrome (primary)
prolonged exposure to extreme high cortisol. can be caused by gluccocorticoid drugs or disease.
serum ACTH levels is lower
Hypercortisolism- Cushing disease (secondary)
a tumor in pituitary causes large amts of ACTH
tx: pituitary resection. ACTH will be higher bc cortisol is stimulated by ACTH, so a tumor would hyper secrete ACTH
Pheochromocytoma
tumor in adrenal medulla. secretes Epi/NE.
sx: hypertension, tachyarrthmia, H/A, sweating,
dx: elevated plasma free metanephrines
tx: alpha blockers, calcium channel blockers. removal of pheochromacytoma
What inhibits and stimulates TSH
Inhibits- Somatostatin
Stimulates - TRH
What is the active form of Vit D called
calcitriol
