Diseases of endocrine Flashcards
define these terms
autocrine
endocrine
paracrine
cell secretes messenger which targets the same cells
glandular - secrete products into blood and act systemically
hormones or messenger which act locally
where do you find the pituitary gland
sella turcica just below hypothalamus
what are the differences in the two lobes of the pituitary gland
anterior - 75% - rathkes pouch
responsable for adenohyphosis hormones such as GH, prolactin, FSH, LH, TSH, adrenocorticotropic (ACTH)
posterior - 25%, responsable for neurohypophosis, oxytocin and vasopressin (ADH)
what are some causes of anterior primary hypofucntion
tumours (benign adenomas), trauma, infarction, inflammation
what can causes visual defects from compression on optic chiasma
tumour of the anterior pituitary
what are three examples of anterior pituitary adenoma (hyperfucntion)
prolactinoma - most common, galactorrhea, menstrual
GH secreting - gigantism in children, acromegaly in adults
ACTH secreting - cushings
describe the structure and eco;ation of the thyroid gland
butterfly, bilobed in neck joined by an isthmus
located at C5,6,7 in front of trachea
where does the thyroid gland come from
migrates from the foregut to the anterior neck
ultimobranchial body from branchial arches and fuses with the main part laterally
what is a thyroglassoal duct cyst
if thyroglossal tract remains in thyroid gland after it reaches its terminal location
what is hashimotos thyroiditis, who does it affect more commonly and what are some tell signs
chronic, lymphocytic thyroiditis - autoimmune chronic inflammatory = hypothyroidism
more common in females which peak at 59 y/o
serum thyroid antibodies raised
what is graves disease, who does it affect more commonly and what are some tell signs
diffuse hyperplasia - autoimmune - hyperthyroidism
most common fore hyperthyroidism cases
females more than men in 30’s/40’s
increased T3 and T4 with deceased TSH
increased thyroid antibodies
orange peel skin, hair loss, wide eyed stare, tachycardia
describe the physical manifestations of mulitnodular goitre of the thyroid
enlargement with nodularity
can be normal functioning
may develop tracheal compression or dysphasia
describe a follicular adenoma of the the thyroid gland
benign encapsulated tumour affecting follicular epithelium
more common in females in 50/60’s
painless neck mass
seen as cold nodule on radioactive iodine imaging
what is papillary carcinoma, casques and presentation
malignant
most common differentiated thyroid carcinoma, familial inheritance, more common in females
associated with cowdens syndrome or FAP
caused by exposure to radiation therapy, cystic mass or nodule
macroscopic fingerlike projections and calcification
what is a follicular neoplasm of the thyroid
adenoma - benign
carcinoma - malignant
2nd most common cancer of thyroid
RAS mutation
what is hurtle cell carcinoma
poorer prognosis - type of follicular neoplasm of the thyroid
has a greater incidence of cervical lymph node metastasis
what is the structure and location of parathyroid glands
superio/inferior lateral to thyroid - 4 parathyroid glands
what is primary hyperparathyroidism and what are some clinal manifestations
excessive secretion of parathyroid hormone from one or more glands - pathology lies within gland
arterial HT, hypercalcaemia, decreased renal function, psychiatric problems
what is secondary / tertiary hyperparathyroidism
which types of patients does it commonly affect
2nd - hyperplasia of glands with elevated PTH in response to hypocalcaemia
3rd - long standing secondary hyperparathyroidism
patients with renal failure
what is parathyroid adenoma and what are the associated risks
primary hyperparathyroidism, benign neoplasm - secrete PTH
hypercalcaemia
MEN1 and MEN2 syndrome associations
usually a single enlarged parathyroid gland
describe the physiology of parathyroid carcinoma
rare primary hyperparathyroid
PTH and Ca high than normal adenoma
symptoms of excess Ca
what is the structure and location of the adrenal glands
superior to kidneys
with adrenal cortex and medulla
cortex - (outer) zona glomerulosa, zona fasiculata (thickest), zona reticularis, medulla
what hormones are made in the different layers of the adrenal cortex and medulla
glomerulosa - aldosterone
fasiculata - cortisone
reticularis - androgens
medulla - catecholamines
what is virilisation
increased secretion of androgens from the zona reticularis = women develop male like features
what is cushings syndrome, causes and symptoms
prolonged exposure to cortisol ie from zona fasiculata or adrenal cortex
exogenous - excessive glucocorticoid medication
endogenous, adrenal cortical tumours/hyperplasia, ACTH secreting tumour of pituitary
hypertension, central obesity, muscle wakens, fatigue, headaches
what is conns syndrome, cases and manifestations
hyperaldosternism - from zona glomerulosa
low renin levels
hypertension, weakness, spasms, high urine, cardiac arrhythmia
what is Addisons diseases causes, manifestations and treatment
primary adrenal cortex insufficiency, autoimmune or adrenal destruction
secondary from lack of ACTH
autoimmune most common
hyperpigmentation, postural hypotension and hyponatreamia (triad)
treat with long term steroids
what is an adrenal cortical nodule and treatment
benign may be functional or not
commonly seen in elderly and diabetics
no treatment if no symptoms
what is adrenal cortical adenoma with associated symptoms
benign proliferation of adrenal cortical tissue
depending on where in the cortex is the tumour is it can cause conns (aldosterone - glomerlusoa), cushing (cortisol - fasciulata), virulisation (andorgens - reticularis)
what is phaechromocytoma, symptoms and prognosis
catecholamine secreting tumour arising from adrenal medulla
rule of 10&, bilateral, extradrenal, malignant, familial, children
hypertension, headaches, anxiety, elevated urine catecholamines, adrenaline and NA
aggressive necrosis
