15 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
Growth hormone
Thyroid Stimulating Hormone
Adreno-corticotrophic hormone
Follicle stimulating hormone
Lutenising hormone
Prolactin

Posterior:
Antidiuretic hormone
Oxytocin

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6
Q

Pituitary Diseases

A

Hyperpituitarism-related effects
Adenomas

Hypopituitarism-related effectsInjury, surgery, radiation, inflammation

Local mass effectcompressing the optic chiasm

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7
Q

Hyperpiuitarism

A

Most common cause is an adenoma in anterior lobe.

Other causes:CancerHyperplasia

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8
Q

Pituitary Adenoma

A

Functional- prolactinoma

Non Functional

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9
Q

Pituitary Adenoma

A

Macroadenomas ( > 1 cm in diameter )

Microadenomas (

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10
Q

Pituitary adenomas

A

Hormone - Syndrome
ACTH - Cushings Disease

Growth hormone -
Gigantism (children)
Acromegaly (adults)

Prolactin - Galactorrhoea/amenorrhea
sexual dysfuntion
infertility

TSH - Hyperthyroidism

FSH, LH - Hypogonadism,
mass effects,
hypopituitarism

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11
Q

Hypopituitarism

A

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

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12
Q

Hypopituitarism: causes

A

Ischemic necrosis of the pituitary: Sheehan’s syndrome

Non functioning adenomas

Surgery or irradiation

Inflammatory lesions

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13
Q

Hyperthyroidism causes

A
Grave’s disease (Autoimmune)
Over treatment by thyroxine
Infective – De Quervain’s thyroiditis
Toxic multinodular goitre
Toxic adenoma
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14
Q

Hyperthyroidism: Management

A

Testing: Clinical + thyroid function tests

Treat the cause

Carbimazole/propylthiouracil

Radioiodine

Thyroidectomy

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15
Q

Hypothyroidism causes

A
Iodine deficiency
Autoimmune – Hashimoto’s thyroiditis
Iatrogenic: Surgery, radioiodine
Pituitary defects
Congenital
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16
Q

Hashimoto’s thyroiditis

A

Autoimmune destruction of the thyroid gland.

Women > men

45 – 60 years old

17
Q

Hypothyroidism: Management

A

Thyroxine

18
Q

Thyroid Cancer

A

Relatively uncommon

Most common type is Papillary carcinoma.

Papillary thyroid carcinoma is a non-functional tumour.

19
Q

Hypoparathyroidism: Causes

A

Removal by surgery (Thyroidectomy)
Congenital
Hereditary (autoimmune)

20
Q

Hypoparathyroidism: Symptoms

A

Due to low calcium;- Irritability- Tetany- Seizures

21
Q

Hyperparathyroidism

A

PRIMARY - Adenoma

SECONDARY - Chronic renal failure

TERTIARY - After renal transplant

22
Q

Hyperparathyroidism: Symptoms

A

Due to hypercalcemia:ConstipationDepressionSeizuresMuscle wastingPolyuriaBone fracturesKidney stones

23
Q

Hyperaldosteronism

A

Primary ( Conn’s Disease in > 50 %)

Secondary (due to high renin)

24
Q

Conn’s Disease: Symptoms

A

Oedema
Hypertension
High Sodium
Low Potassium

25
Q

Glucocorticoids: Cortisol

A

Essential to life

Regulates blood sugar

Inhibits inflammation

Stress response

26
Q

Glucocorticoids: Cortisol

A

Release is by circadian rhythm (normal)

Stress

Excess release —— Cushing’s Syndrome

27
Q

Cushing’s Syndrome: Causes

A

ACTH releasing tumour (pituitary/lung)

Steroids

28
Q

Addison’s disease (adrenal insufficiency)

A

Multiple causes:
Autoimmune
Infection
Neoplasms

29
Q

Addison’s disease: Symptoms and signs

A

GI Symptoms (Anorexia, nausea, vomiting and diarrhoea)

Weight loss

Hyperpigmentation

Low Sodium, High Potassium

30
Q

Gonadocorticoids (sex hormones)

A

Testosterone

Oestrogen

Both are also secreted from the gonads

31
Q

Phaeochromocytoma: Presentation

A
Hypertension
Sweating
Palpitations
Nervousness
Increased metabolic ratio
Rapid heart rate
32
Q

Multiple Endocrine Neoplasia (MEN)

A

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

Different types

33
Q

Summary

A
Hypothalmus
Pituitary
Thyroid
Parathyroid
Adrenals