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Pathology Year 2 > 14. The Endocrine System…. The rest ! > Flashcards

14. The Endocrine System…. The rest ! Flashcards

1
Q

The endocrine system

A

Multiple organs.

Highly integrated.

Secrete hormones to cause the effect

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2
Q

Endocrine diseases

A

Underproduction

Overproduction

Mass lesions

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3
Q

Areas to be covered

A 
Hypothalamus
Pituitary
Thyroid
Parathyroid
Adrenals
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4
Q

Hypothalamus

A

Located in the brain – above brain stem

Links the Central Nervous system to the Endocrine system

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5
Q

Pituitary gland

A

Anterior

Posterior

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6
Q

Anterior

A 
Growth hormone
Thyroid Stimulating Hormone
Adreno-corticotrophic hormone
Follicle stimulating hormone
Lutenising hormone
Prolactin
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7
Q

Posterior

A

Antidiuretic hormone

Oxytocin

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8
Q

Pituitary Diseases

A

Hyperpituitarism-related effects
Adenomas
Hypopituitarism-related effectsInjury, surgery, radiation, inflammation
Local mass effectcompressing the optic chiasm

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9
Q

Hyperpiuitarism

A

Most common cause is an adenoma in anterior lobe.

Other causes:CancerHyperplasia

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10
Q

Pituitary Adenoma (1)

A

Functional- prolactinoma

Non Functional

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11
Q

Pituitary Adenoma (2)

A

Macroadenomas ( > 1 cm in diameter )

Microadenomas (

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12
Q

ACTH

A

Cushing’s disease

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13
Q

Growth hormone

A

Gigantism (children)

Acromegaly (adults)

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14
Q

Prolactin

A

Galactorrhea/ amenorrhea
sexual dysfunction
infertility

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15
Q

TSH

A

Hyperthyroidism

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16
Q

FSH, LH

A

Hypogonadism, mass effects/hypopituitarism

17
Q

Hypopituitarism

A

Occurs with loss of 75% or more of the anterior pituitary parenchyma.

18
Q

Hypopituitarism: causes

A

Ischemic necrosis of the pituitary: Sheehan’s syndrome

Non functioning adenomas

Surgery or irradiation

Inflammatory lesions

19
Q

Grave’s disease (Autoimmune)

A

Over treatment by thyroxine
Infective – De Quervain’s thyroiditis
Toxic multinodular goitre
Toxic adenoma

20
Q

Hyperthyroidism: Management

A 
Testing: Clinical + thyroid function tests
Treat the cause
Carbimazole/propylthiouracil
Radioiodine
Thyroidectomy
21
Q

Hypothyroidism causes

A 
Iodine deficiency
Autoimmune – Hashimoto’s thyroiditis
Iatrogenic: Surgery, radioiodine
Pituitary defects
Congenital
22
Q

Hashimoto’s thyroiditis

A

Autoimmune destruction of the thyroid gland.

Women > men

45 – 60 years old

23
Q

Hypothyroidism: Management

24
Q

Hyperthyroidism symptoms

A 
Intolerance to heat
Fine, straight hair
Bu;ging eyes
Facial flushing
enlarged thyroid
tachycardia
Increase systolic BP
Breast enlargement
weight loss
muscle wasting
finger clubbing
tremors
diahrrhea
menstrual changes (amenorrhea)
localised edema
25
Q

Hypothyroidism symptoms

A 
Intolerance to cold
receding hair line
facial and eyelid edema
dull blank expression
extreme fatigue
thick tongue - slow speech
anorexia
brittle nails and hair
menstrual disturbances
hair loss
apathy
lethargy 
dry skin
muscle aches and weakness
constipation

Late clinical manifestations:
subnormal temp, bradycardia, weight gain, decrease LOC, thickened skin, cardiac complications

26
Q

Thyroid Cancer

A

Relatively uncommon

Most common type is Papillary carcinoma.

Papillary thyroid carcinoma is a non-functional tumour.

27
Q

Hypoparathyroidism: Causes

A

Removal by surgery (Thyroidectomy)
Congenital
Hereditary (autoimmune)

28
Q

Hypoparathyroidism: Symptoms

A

Due to low calcium;- Irritability- Tetany- Seizures

29
Q

Hyperparathyroidism

A 
PRIMARY = Adenoma
SECONDARY = Chronic renal failure
TERTIARY = After renal transplant
30
Q

Hyperparathyroidism: Symptoms

A

Due to hypercalcemia:ConstipationDepressionSeizuresMuscle wastingPolyuriaBone fracturesKidney stones

31
Q

Hyperaldosteronism

A

Primary ( Conn’s Disease in > 50 %)

Secondary (due to high renin)

32
Q

Conn’s Disease: Symptoms

A

Oedema
Hypertension
High Sodium
Low Potassium

33
Q

Glucocorticoids: Cortisol

A 
Essential to life
Regulates blood sugar
Inhibits inflammation
Stress response
Release is by circadian rhythm (normal)
Stress
Excess release ------ Cushing’s Syndrome
34
Q

Cushing’s Syndrome: Causes

A

ACTH releasing tumour (pituitary/lung)

Steroids

35
Q

Addison’s disease (adrenal insufficiency)

A

Multiple causes:
Autoimmune
Infection
Neoplasms

36
Q

Addison’s disease: Symptoms and signs

A

GI Symptoms (Anorexia, nausea, vomiting and diarrhoea)

Weight loss

Hyperpigmentation

Low Sodium, High Potassium

37
Q

Gonadocorticoids (sex hormones)

A

Testosterone

Oestrogen

Both are also secreted from the gonads

38
Q

Phaeochromocytoma: Presentation

A 
Hypertension
Sweating
Palpitations
Nervousness
Increased metabolic ratio
Rapid heart rate
39
Q

Multiple Endocrine Neoplasia (MEN)

A

Group of inherited diseases resulting in proliferative lesions of multiple endocrine organs

Different types

Pathology Year 2 (22 decks)

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