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

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
Glucocorticoids: Cortisol
Essential to life Regulates blood sugar Inhibits inflammation Stress response
26
Glucocorticoids: Cortisol
Release is by circadian rhythm (normal) Stress Excess release ------ Cushing’s Syndrome
27
Cushing’s Syndrome: Causes
ACTH releasing tumour (pituitary/lung) Steroids
28
Addison’s disease (adrenal insufficiency)
Multiple causes: Autoimmune Infection Neoplasms
29
Addison’s disease: Symptoms and signs
GI Symptoms (Anorexia, nausea, vomiting and diarrhoea) Weight loss Hyperpigmentation Low Sodium, High Potassium
30
Gonadocorticoids (sex hormones)
Testosterone Oestrogen Both are also secreted from the gonads
31
Phaeochromocytoma: Presentation
``` Hypertension Sweating Palpitations Nervousness Increased metabolic ratio Rapid heart rate ```
32
Multiple Endocrine Neoplasia (MEN)
Group of inherited diseases resulting in proliferative lesions of multiple endocrine organs Different types
33
Summary
``` Hypothalmus Pituitary Thyroid Parathyroid Adrenals ```