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Biomedicine I > 9. Endocrine System Pathologies > Flashcards

9. Endocrine System Pathologies Flashcards

1
Q

Acromegaly and Gigantism

A
  • Gigantism: Excess growth hormone while the bones are still developing –results in the person growing tomassive heights.
  • Acromegaly: Excess growth hormone post-puberty (after growth plates closed). Patient grows ‘outwards’as opposed to ‘upwards’.
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2
Q

Acromegaly and Gigantism: Cause

A

A pituitary tumour hyper-secreting growth hormone.

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3
Q

Acromegaly and Gigantism: Signs and Symptoms

A
  • Large, prominent facial features, increased size hands & feet.
  • Tiredness, deep voice, impotence, joint pain, bone deformities, soft-tissue swellings
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4
Q

Acromegaly and Gigantism: Treatment

A

• Surgery to remove tumour. Lifelong medications may be needed.

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5
Q

Acromegaly and Gigantism: Complications

A
  • Hypertension, cardiomegaly.
  • Type 2 diabetes (growth hormone increased blood glucose levels -> insulin resistance).
  • Osteoarthritis, vertebral collapse (back pain).
  • Bowel polyps.
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6
Q

Hyperprolactinaemia

A

Excessive prolactin production

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7
Q

Hyperprolactinaemia: Causes

A

• Pituitary tumour, acromegaly, pharmacologic (antipsychotics).

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8
Q

Hyperprolactinaemia: Signs and Symptoms

A
  • Galactorrhoea.
  • Amenorrhoea (absence of menses –because prolactin inhibits GnRH).
  • Decreased libido/sexual dysfunction.
  • Subfertility.
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9
Q

Diabetes Insipidus

A

Deficiency of ADH production or recognition causing the kidneys to over excrete water.

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10
Q

Diabetes Insipidus: Causes

A
  • Cranial: Brain trauma, tumour, encephalitis.
  • Renal (Kidney): Chronic kidney disease, hypercalcaemia & hypokalaemia (too much calcium, too little potassium) damages kidney.
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11
Q

Diabetes Insispidus: Signs and Symptoms

A
  • Polydipsia (extreme thirst) -large consumption.
  • Polyuria: excess urine production (dilute).
  • Weight loss.
  • decresed BP, syncope (“fainting” due to hypovolaemia).
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12
Q

Diabetes Insipidus: Diagnosis

A
  • 24 hrurine collection (quantity of urine measured over 24 hours).
  • Urine specific gravity –low (i.e. urine is more diluted than normal).
  • Blood biochemistry (increased Na).
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13
Q

Diabetes Insipidus: Treatment

A
  • Treat cause.
  • ADH replacement
  • Rehydration: water & electrolytes
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14
Q

Hypothyroidism

A

A condition of thyroid hormone deficiency (an “underactive thyroid”).

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15
Q

Hypothyroidism: Signs and Symptoms

A

SYMPTOMS:
• Tiredness, malaise, weight gain, cold intolerance, constipation, depression.
• Slow cognitively, poor memory, low libido, deep voice, menstrual changes, muscle aches, arthralgia (joint pain)
SIGNS:
• Goitre, dry, brittle skin & thin hair, loss of eyebrows.
• ‘Myxoedema’ (swelling) often around the eyes (deposition of polysaccharides which attract water).
• Physical exam: Slow tendon reflexes, bradycardia.
• Bloods tests: High TSH, low thyroid hormones.

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16
Q

Hypothyroidism: Causes

A
  • Hashimoto’s thyroiditis(autoimmune).

* Iodine deficiency, thyroid destruction (radioactive iodine, surgery, medications, tumour).

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17
Q

Hypothyroidism: Treatment

A

• Levothyroxine–thyroid hormone replacement

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18
Q

Hyperthyroidism (‘Grave’s disease’)

A
  • Hyperthyroidism is characterised by hyper-metabolism and elevated serum levels of free thyroid hormones (also known as thyrotoxicosis).
  • More common in women (10:1).
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19
Q

Hyperthyroidism: Causes

A
  • Graves disease (85%): Autoimmune. Increased IgG antibodies bind to TSH receptor and stimulate production of thyroid hormones.
  • Excessive iodine supplementation.
  • Tumour (hypothalamic, pituitary).
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20
Q

Hyperthyroidism: Signs and Symptoms

A
  • Nervousness, irritability, hyperactivity, unexplained weight loss.
  • Insomnia, palpitations, muscle weakness, frequent bowel & bladder movements, diarrhoea, fatigue.
  • Heat sensitivity, increased sweating.
  • Signs:Goitre, exophthalmos, tachycardia, tremor, brisk tendon reflexes, lid lag.
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21
Q

Hyperthyroidism

A

• Allopathic:Carbimazole, radioactive iodine, β-Blockers, surgery.

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22
Q

Barnes Temperature Test

A
  1. Prepare the thermometer before going to bed.
  2. On waking, before getting out of bed, with as little movement as possible, place the thermometer under your arm.
  3. Leave it in position for 10 minutes.
  4. Test for 5 consecutive days and make a note of the 3 lowest readings. If menstruating do the test starting the second day of menses.
  5. 36.6 -36.8OC (97.8 -98.2OF) is normal. Below 36.6OC (97.8OF) = Might indicate hypothyroidism. Above 37OC (98.6OF) = Might indicate hyperthyroidism.
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23
Q

Hyperparathyroidism

A

• Hyperparathyroidism is characterised by elevated blood levels of parathyroid hormone and improper calcium regulation.

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24
Q

Hyperparathyroidism: Causes

A

• Usually a tumourof the parathyroid gland.

25
Q

Hyperparathyroidism: Signs and Symptoms

A
  • Often no/few symptoms.
  • Hypercalcaemia -> increased risk of kidney stones, osteoporosis (or osteopenia), low energy, depression.
  • In some cases: nausea, vomiting, constipation, anorexia, muscle paralysis.
26
Q

Hypoparathyroidism

A

Hypoparathyroidism is characterised by hypo-metabolism and reduced serum levels of parathyroid hormone (PTH).

27
Q

Hypoparathyroidism: Causes

A

Usually surgery or radiation (treating thyroid).

28
Q

Hypoparathyroidism: Signs and Symptoms

A

Hypocalcaemia -> Muscle cramps & spasms (“tetany”), tingling lips, fingers and toes, dry hair, brittle nails, dry scaly skin, cataracts, weakened tooth enamel (in children).

29
Q

Cushing Syndrome/Disease

A

Syndrome
• A cortisol excess from any cause (glucocorticoid drugs, adrenal, tumour).
Disease
• Excess production of ACTH causing excess glucocorticoid production from the adrenal cortex.

30
Q

Cushing Syndrome/Disease: Causes

A

Syndrome

  1. Corticosteroid therapy
  2. Adrenal adenoma
  3. Pituitaryadenoma (Cushing’s disease)

Disease
1. Pituitary tumour

31
Q

Cushing Syndrome / Disease: Signs and Symptoms

A
  • Central weight gain, moon face, buffalo hump, insulin resistance.
  • Depression, insomnia, psychosis, poor libido, hirsutism, amenorrhoea (also releases some androgens).
  • Easy bruising, thin skin, abdominal stretch marks(due to protein taken from collagen and lowered immunity).
  • Reduced immunity.
  • Muscular weakness, back pain.
  • Bone fractures, osteoporosis.
  • Hypertension.
32
Q

Cushing Syndrome / Disease: Treatment

A

• Drugs inhibiting cortisol production, surgery (for tumours).

33
Q

Cushing Syndrome / Disease: Complications

A

• Lowered immunity, fragile skin, bone fractures, diabetes mellitus.

34
Q

Addison’s Disease

A

Adrenal insufficiency: hypo-functioning of the adrenal cortex causing a deficiency of mineralocorticoids and glucocorticoids.

35
Q

Addison’s Disease: Causes

A
  • Atrophy of the adrenal gland (often autoimmune) (85%).

* Secondary to a disease or abrupt cessation of steroids.

36
Q

Addison’s Disease: Signs and Symptoms

A
  • Weakness, fatigue and hypotension.
  • Hyperpigmentation of skin and mucous membranes.
  • Diarrhoea, weight loss, anorexia, malaise, muscle weakness, depression, increased thirst.
  • Impotence/amenorrhoea, nausea/vomiting.
  • Adrenal failure leads to lack of adrenal hormone production and a failure of the normal negative feedback mechanism.
  • The hypothalamus produces an excess of corticotrophin releasing hormone (CRH), which causes the pituitary to erroneously produce melanocyte stimulating hormone.
  • This causes the skin colour to darken, hence hyperpigmentation.
37
Q

Addisonian Crisis

A

• A complication of Addison’s disease when the individual has no capacity to cope with stress (e.g. psychological, infection etc.)

38
Q

Addisonian Crisis: Signs and Symptoms

A
  • Severe lethargy and low blood pressure(low sodium).
  • Hypoglycaemic, syncope (fainting).
  • Severe pain, renal failure, fever.
39
Q

Diabetes Mellitus

A
  • A metabolic disorder associated with hyperglycaemia, characterised by a deficiency of insulin due to impaired production or insulin resistance.
  • Causes a disruption of carbohydrate & fat metabolism & elevated blood glucose levels -> hyperglycaemia.
40
Q

Types of Diabetes Mellitus

A

Type I: Autoimmune
Type II: Insulin resistance
Secondary (1-2% of cases): Due to certain medications (cortisone), pancreatitis
Gestational: During pregnancy as a result of placental hormones (i.e. human placental lactogen). Usually disappears after delivery, but elevated rish of Type II years later

41
Q

Type I Diabetes

A

Previously called juvenile-onset or insulin-dependent (IDDM).

42
Q

Type I Diabetes: Causes

A
  • An auto-immune condition causing destruction of pancreatic ß-cells.
  • Likely due to the environment in genetically susceptible people.
  • Viruses (e.g. polio, rotavirus), dietary factors –infant exposure to dairy products (cow’s milk and the milk protein β casein), vitamin D deficiency, omega-3 deficiency, early exposure to gluten.
43
Q

Type I Diabetes: Signs and Symptoms

A
  • Glycosuria (sweet urine), polyuria (lots of urine), polydipsia (thirst).
  • Weight loss, weakness, fatigue, and mental status changes.
  • Blurred vision, slow healing of cuts/infections.
  • Ketoacidosis: Fruity smelling breath (exhaled acetone), shortness of breath.
44
Q

Type I Diabetes: Treatment

A

Insulin

45
Q

Type II Diabetes

A
  • Previously called adult-onset or non–insulin-dependent diabetes.
  • Cells have developed insulin resistance and glucose cannot enter cells.
  • Hyperglycaemia develops when pancreatic beta cells can no longer secrete insulin to compensate for insulin resistance.
  • 1/3 adults over 65 and increasing numbers of children have impaired glucose tolerance.
46
Q

Type II Diabetes: Causes

A
  • Genetic: strong hereditary link, American Indians, Hispanics, African American & Asians.
  • Lifestyle: Obesity & weight gain, poor diet, lack of exercise. Other risk factors include: history of gestational diabetes.
47
Q

Type II Diabetes: Signs and Symptoms

A
  • Polydipsia (excessive thirst).
  • Polyuria (excess urination).
  • Polyphagia (excessive appetite)
  • Often asymptomatic because of mild hyperglycaemia (unlike in type I diabetes).
  • Initial symptoms are often complications, indicating the disease has been present for some time.
  • Ketoacidosis in rare, severe cases (same complications as type I).
48
Q

Type II Diabetes: Diagnosis

A
  • Fasting / random blood glucose test.
  • Oral glucose tolerance test.
  • Glycated Haemoglobin (HbA1c) > 48mmol/mol = diabetes.
  • Urine test (assistsdiagnosis only).
49
Q

Type II Diabetes: Treatment

A
  • Diet (low GI & GL), exercise, oral anti-hyperglycaemics(e.g. metformin), insulin, or both.
  • Statins & anti-hypertensives to prevent complications.
50
Q

Diabetic Complications

A

Chronic hyperglycaemia causes complications: micro and macro-vascular disease:
• Heart disease, hypercholesterolaemia, hypertension.
• Retinopathy.
• Nephropathy (diabetic kidney disease).
• Peripheral neuropathy.

51
Q

Ketoacidosis

A
  • When glucose supply is low or when cells cannot utilise glucose, the mitochondria can use ketones to make energy.
  • Ketones are derived from the break down of fatty acids.
  • Ketones (or keto-acids) are acidic and can be toxic if they accumulate to excessive levels.
  • May result in coma or death.
  • Ketones can be tested using a urine dipstick.
  • Breath smells fruity (acetone) & increased thirst are key signs.
52
Q

Hypoglycaemia

A

• Hypoglycaemia can affect diabetics in
response to treatment (e.g. insulin or
other glucose lowering drugs).

53
Q

Hypoglycaemia: Signs and Symptoms

A
  • Shaking and trembling.
  • Sweating.
  • Pins and needles in the lips and tongue.
  • Extreme hunger and irritability.
  • Headache.
  • Slurred speech, confusion, tiredness.
  • Ketoacidosis & coma.
54
Q

Histamine

A

Secreted by: Basophils, mast cells

Action: Inflammation - vasodilation and increased blod vessel permeability

55
Q

Prostaglandins, Leukotrienes and Thromboxane

A

Secreted by: most tissues

Action: Chemical messengers involved in many different body processes

56
Q

Serotonin

A

Secreted by: intestines and brain

Action: Blood clotting, temperature regulation, appetite, sleep

57
Q

Dopamine

A

Secreted by: Brain mostly

Action: Muscle tone and some movements

58
Q

Erythropoietin

A

Secreted by: Kidneys

Action: Red blood cell production

59
Q

CCK

A

Secreted by: GI Tract

Action: Stimulates bile and pacreatic juice secretion

Biomedicine I (18 decks)

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