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Yr 1 - Endocrinology > Clinical Abnormalities of Glands > Flashcards

Clinical Abnormalities of Glands Flashcards

1
Q

What is hyper-

A

Hormone over secretion

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2
Q

What is hypo-

A

Hormone under secretion

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3
Q

What is primary in relation to hyper-

A

Too much hormone coming from gland itself

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4
Q

What is secondary in relation to hyper-

A

One gland secretes too much of the hormone that controls the other gland, make it overactive

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5
Q

What is primary in relation to hypo-

A

Too little hormone coming from gland itself

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6
Q

What is secondary in relation to hypo-

A

One gland secretes too little of the hormone that controls the other gland, making it underactive

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7
Q

How can tumours affect glands?

A

Can destroy the gland and cause underactive gland (often occurs in pituitary, compresses tissue as cannot expand)

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8
Q

What is over-secretion usually caused by?

A

Usually benign tumours

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9
Q

What is under-secretion usually caused by?

A

Gland destruction due to:

  • Inflammation (including autoimmune)
  • Infarction (blood supply stops and tissue dies)
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10
Q

How can tumours/nodules contribute to endocrine gland diseases?

A

Have hormone production

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11
Q

What is prolactin over-secretion caused by?

A
  • Usually due to a pituitary tumour secreting prolactin (prolactinoma)
  • Can be due to a tumour sitting between pituitary gland and hypothalamus, suppressing the interaction between the two. Prolactin levels increase as no inhibitory effect
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12
Q

What is the clinical presentation of prolactin over-secretion?

A
  • Galactorrhoea (breast milk production)
  • Amenorrhoea (periods stop in women, sexual dysfunction in men)
  • Headaches and visual field problems in large tumours
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13
Q

How can you diagnose prolactin over-secretion?

A

Use a static test

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14
Q

What can mildly raised prolactin be due to?

A
  1. Sex (nipple stimulation)
  2. Stress
  3. Drugs (antipsychotics and antidepressants)
  4. Non-functioning pituitary tumours
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15
Q

How do non-functioning pituitary tumours cause mildly raised prolactin?

A

Compress the hypothalamus and interfere with the inhibitory effect on prolactin secretion

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16
Q

How can prolactinomas be treated?

A

Are the only over-secreting pituitary tumour that can be treated medically (rarely require surgical intervention)

17
Q

What is consequence of GH over-secretion in children?

A
  1. Excessive growth spurt
  2. Increased size of hands and feet
  3. If left untreated, can lead to gigantism
18
Q

What is consequence of GH over-secretion in adults?

A
  1. Affects skin, soft tissue and skeleton (acromegaly)
  2. Increased sweating
  3. Wide and large hands/feet
19
Q

How can you diagnose GH over-secretion?

A

Suppression test is necessary:

  1. Glucose is given
  2. GH measurements taken at different times
  3. In healthy people, glucose suppresses GH production
20
Q

How can presence of pituitary tumour be confirmed?

A

MRI (imaging)

21
Q

How can tumour causing GH over-secretion be treated?

A

Surgical removal of tumour. Radiotherapy and medical therapy may also be needed as surgery doesn’t always remove whole tumour

22
Q

What are the clinical presentations of Cushing’s syndrome?

A
  1. Growth arrest in children
  2. Round, moon-like face
  3. Acne
  4. Hirsutism (growth of hair on woman’s face and body)
  5. Fat redistribution - truncal obesity and thin extremities
  6. Thin skin and easy bruising
  7. Striae on abdomen
23
Q

What are the complications of Cushing’s syndrome?

A
  1. Hypertension
  2. Diabetes mellitus
  3. High risk of infections
  4. Poor wound healing
24
Q

What is treatment for pituitary and adrenal related Cushing’s?

A

Surgery (radiotherapy and medical treatment may also be required)

25
Q

What is treatment for cancer related Cushing’s?

A

Treat original cancer

26
Q

What is Cushing’s syndrome?

A

Condition caused by excess production of cortisol in the body, regardless of the cause

27
Q

What is Cushing’s disease?

A

When Cushing’s syndrome is caused by pituitary tumour secreting excess amounts of ACTH

28
Q

What’s the most common cause of Cushing’s syndrome?

A

Pituitary tumour secreting ACTH (Cushing’s disease)

29
Q

What are the other causes of Cushing’s syndrome?

A
  • Non pituitary tumours that produce ACTH (ectopic) e.g. lungs
  • Benign or malignant tumours of the adrenal gland which produce excess cortisol leading to low ACTH levels (negative feedback)
30
Q

What test can be used to diagnose Cushing’s?

A

Suppression test using dexamethasone

31
Q

What is dexamethasone?

A

Man-made steroid similar to cortisol that is used to confirm the failure of cortisol production

32
Q

What is the effect of dexamethasone in normal people?

A

Reduces ACTH release (negative feedback), therefore reducing cortisol

33
Q

What are the 2 types of dexamethasone tests?

A

Low-dose and high-dose

34
Q

What are results of dexamethasone test in Cushing’s syndrome caused by pituitary tumours (Cushing’s disease) or cancers?

A

Low dose test

  • No decrease in blood cortisol
  • Detectable/high ACTH

High dose test
- Decrease in blood cortisol as production of ACTH by pituitary adenomas usually suppressed

35
Q

What are results of dexamethasone test in Cushing’s syndrome caused by adrenal tumour?

A

Low dose test

  • No decrease in blood cortisol
  • Low/undetectable ACTH

Yr 1 - Endocrinology (14 decks)

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