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CP > Diseases of Endocrine System > Flashcards

Diseases of Endocrine System Flashcards

1
Q

where is the pituitary gland situated?

A

in the Sella Turcica

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2
Q

how many parts of the pituitary gland are there and what percentage of the pituitary gland does it pertain?

A

Anterior and Posterior

75% = anterior lobe
25% = posterior lobe
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3
Q

what is the function of the Adenohypophysis?

A

produces

  • prolactin
  • adenocorticotropic
  • growth hormone
  • thyroid stimulating
  • follicle-stimulating
  • luteinsing
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4
Q

what is the function of the Neurohypophysis?

A

Produces

  • Oxytocin
  • antidiuretic peptide
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5
Q

what are the causes of anterior pituitary hypo function?

VITAMIN D3

A
  • Vascular - Infarction
  • Inflammation - granulomatous
  • Trauma
  • Autoimmune - Pituitary autoimmune disease
  • Metabolic
  • Infection
  • Neoplasia - Non-secretory adenoma, metastatic carcinoma
    D3 - Doctors
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6
Q

what type of primary pituitary tumours is most common?

A

most = adenomas

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7
Q

what are the types of Anterior Pituitary Adenomas?

A
  • Prolactinoma - commonest, galactorrhoea and menstrual disturbance
  • Growth Hormone Secreting - Gigantism in children, acromegaly in adults
  • ACTH secreting - Cushing’s syndrome
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8
Q

where is the thyroid located?

A

located at the level of 5th - 7th vertebra

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9
Q

how does the thyroid get to its position?

A
  • The main part migrates from foregut to anterior neck

- Ultimobranchial body forms in branchial arches and fuses with main gland laterally

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10
Q

what is Chronic Lymphocytic Thyroiditis?

A

Autoimmune chronic inflammatory disorder that affect females more than males with a peak age at 59 years old

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11
Q

what are the increased risks of Hashimoto’s?

A
  • 80-fold increased risk of thyroid lymphoma

- Increased risk of papillary carcinoma of the thyroid

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12
Q

what is Diffuse Hyperplasia (GRAVES DISEASE)

A

An autoimmune process, a diffuse hyperplasia of the follicular epithelium

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13
Q

what is the cause of most cases of hyperthyroidism?

A

responsible for 80% of cases is diffuse hyperplasia (Graves’ Disease)

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14
Q

what are the physical findings of GRAVES’ DISEASE?

A 
Pretibial myxoedema, 
hair loss,
 wide-eyed stare or proptosis, 
tachycardia,
 hyperactive reflexes
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15
Q

what are the clinical findings of Diffuse Hyperplasia?

A

Thyroid diffusely enlarged
T3 and T4 elevated.
TSH markedly suppressed
Thyroid autoantibodies - thyroid stimulating immunoglobin

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16
Q

what is Multinodular Goitre?

A

Enlargement of thyroid +/- nodularity

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17
Q

what is multinodular goitre often mistaken for?

A

Large ‘dominant’ nodules may be mistaken clinically for thyroid carcinoma

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18
Q

what is follicular adenoma?

A

Benign encapsulated tumour with evidence of follicular cell differentiation

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19
Q

what groups are more likely affected by follicular adenoma?

A

Females > Males

wide age range, usually fifth to sixth decade

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20
Q

what are the % of malignant tumours of the thyroid?

A
  • 1.1% of new cancers
  • 0.32% of cancer deaths
  • 85% are differentiated thyroid carcinoma
  • 5-9% are medullary carcinoma
  • 1-2% are anapaestic carcinoma
  • 1-3% are malignant lymphoma
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21
Q

what is the commonest type of thyroid carcinoma?

A

papillary carcinoma - 70%

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22
Q

who is most at risk for papillary carcinoma?

A

Female predominance 2.5:1

wide age range mean 43 years

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23
Q

what is papillary Carcinoma?

A

Familial, autosomal dominant non-medullary thyroid carcinoma

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24
Q

what % of all thyroid cancer are follicular carcinomas?

A

10-20% of all thyroid cancers

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25
Q

how do most follicular carcinoma present?

A

90% present with solitary nodule in thyroid

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26
Q

what are the groups most affected by Hurthle Cell Carcinomas?

A

Median age 53 (range 24-85 years)

Sex ratio of F:M 7:3

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27
Q

what is the main difference between follicular carcinoma?

A

Hurthle cell carcinomas have a significant incidence of cervical lymph node metastases compared to follicular carcinoma

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28
Q

what are the common haematogenous sites for hurthle cell carcinoma?

A

Bone, Liver and Lung

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29
Q

what is Primary Hyperparathyroidism?

A

excessive secretion of parathyroid hormone from one or more glands (PHPT)

30
Q

what is secondary Hyperparathyroidism?

A

hyperplasia of glands with elevated PTH in response to hypocalcemia

31
Q

what is tertiary hyperparathyroidism?

A

in association with longstanding secondary hyperparathyroidism

32
Q

what is the incidence of primary hyperparathyroidism?

A
  1. 25 - 28 cases per 100,000 population

2. Caucasian women over 60 - 190/100,000

33
Q

what is the pathogenesis of primary hyperparathyroidism?

A
  1. Aging, tumorigenesis in general
  2. Association with ionising irradiation
  3. MEN 2a
34
Q

what are the signs of Hypercalcemia/Hyperparathyroidism?

Bones, Stones, Groans, Moans

A
  1. Painful bones
    - painful bone condition
  2. Renal Stones
    - Kidney Stones
  3. Abdominal Groans
    - Gi symptoms: Nausea, Vomiting, Constipation, Indigestion
  4. Psychiatric Moans
    - Effects on nervous system: lethargy, fatigue, memory loss, psychosis, depression
35
Q

what is parathyroid Adenoma?

A

An encapsulated benign neoplasm of parathyroid cells

36
Q

what is parathyroid adenoma associated with?

A

has an association with MEN1 and MEN2 syndrome and hyperparathyroidism and jaw tumour syndrome

37
Q

what occurs during secondary and tertiary hyperparathyroidism

A

non-neoplastic increase in parathyroid parenchymal cell mass within all parathyroid tissue with a known stimulus

38
Q

what is parathyroid carcinoma?

A

malignant tumour derived from parathyroid parenchymal cells

39
Q

what is the survival rating for parathyroid carcinoma?

A

50% 10 year survival

40
Q

what are the exogenous causes of Cushing’s Syndrome?

A

excessive glucocorticoid medication

41
Q

what are the endogenous causes of Cushing’s Syndrome?

A

Adrenal Cortical tumours,
adrenal cortical hyperplasia,
ACTH secreting pituitary adenoma

42
Q

what is cushing’s syndrome due to?

A

due to prolonged exposure to cortisol

43
Q

what are the signs and symptoms of cushing’s syndrome?

A 
Hypertension
moon face
central obesity 
buffalo hump
weak muscles
osteoporosis 
insomnia
excess sweating
mood swings
headaches
chronic fatigue
women may have hirsutism and irregular menstruation
44
Q

what is Conn’s syndrome?

A

EXCESS PRODUCTION OF THE HORMONE ALDOSTERONE LEADING TO LOW RENIN LEVELS

45
Q

What are the causes of primary Conn’s syndrome?

A

adrenal cortical hyperplasia,
adenoma
familial hyperaldosteronism

46
Q

what are the causes of secondary Conn’s syndrome?

A

low circulating volume

poor renal circulation

47
Q

who is most at risk of getting conns syndrome?

A

Women > Males

30-50 year olds

48
Q

what are the signs and symptoms of Conn’s syndrome?

A 
High BP
Headache
Muscular weakness
Muscle spasms
Cardiac ARRYTHMIAS
Excessive urination
49
Q

what is Addisons Disease?

A

Adrenal cortical insufficency

50
Q

what are the causes of primary addisons disease?

A

Adrenal dysgensis,
adrenal destruction. autoimmune adrenalitis
TB

51
Q

what are the causes of secondary addisons disease?

A

Failure of ACTH secretion

52
Q

what are the triad of symptoms for addisons disease

A
  1. Hyperpigmentation
  2. Postural Hypotension
  3. Hyponatraemia
53
Q

how do you treat addisons disease?

A

treat with long term steroid replacement

54
Q

what is adrenal cortical nodule?

A

Benign non-function nodules of adrenal cortex

55
Q

what % of the population is affected by adrenal cortical nodules?

A

between 1.5% and 3% of the population

56
Q

Which groups are affected by adrenal cortical nodules?

A

Elderly, hypotensive and diabetic patients

57
Q

how was adrenal cortical nodules discovered?

A

it was incidentally discovered on radiographic studies

58
Q

what is adrenal cortical adenoma?

A

A benign neoplastic proliferation of adrenal cortical tissue

59
Q

what is the incidence of adrenal cortical adenomas in the population?

A

incidence from 1-5% of the population

60
Q

what are the signs and symptoms of adrenal cortical adenoma?

A

symptoms are related to endocrine hyper function

-aldosterone-producing tumours cause Conn’s syndrome

cortisol producing tumours cause cushing’s syndrome

  • rare tumours cause virilisation
61
Q

what is adrenal cortical carcinoma

A

its the malignant counterpart of adrenal cortical

62
Q

What are the signs and symptoms of adrenal cortical carcinoma?

A

symptoms are related to hormone excess

abdominal mass is present

63
Q

what is the survival rate for adrenal cortical carcinoma?

A

5 year survival about 70%

the prognosis is age and stage dependent

64
Q

what is phaeochromcytoma?

A

Catecholamine-secreting tumour arising from adrenal medulla

65
Q

what is the rate of pheochromocytoma is the population?

A

8/100000 are affected

66
Q

what is the rule of 10’s in relation to phaeochromocytoma?

A 
it means 10% of tumours are:
10% bilateral 
10% extra-adrenal
10% malignant
10% familial 
and q0% in children
67
Q

what are some associations with pheochromocytoma?

A

MEN2A/2B
Von Recklinghausen’s disease
von Hippel/indau disease

68
Q

what are some symptoms of phaeochromocytoms?

A

hypertension
palpitations
headaches
anxiety

69
Q

what are some clinical features of pheochromocytoma?

A

elevated urine catecholamines, adrenaline and noradrenaline

70
Q

what is the prognosis of benign pheochromocytoma?

A

excellent prognosis when its benign and properly managed surgically

71
Q

what is the prognosis of malignant phaeochromocytoma?

A

not as good of a prognosis as tumour may pursue an aggressive course

CP (14 decks)

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