Diseases of Organ systems ENDOCRINE -34% Flashcards
What is gigantism due to
Excess growth hormone from the pituitary before 18 years
Gigantism may be associated with functioning _________ adenoma and presents with:
Adenoma
- overgrowth of tissues in the entire body-large hands and protruding jaw
- headache
- visual disturbance
What is acromegaly due to
Excess GH from pituitary after growth plate has closed
Acromegaly is associated with a functioning ________ adenoma presenting with:
- protruding jaw, large spatulate hands and large feet
- headache
- visual disturbance
What is Cushing’s disease caused by? This causes ____ resulting in ______
Excess ACTH from a functioning pituitary adenoma
- excess cortisol production by the adrenal cortex resulting in:
- moon-face, buffalo hump, truncal obesity and hypertension
- purple striae on the abdomen and hyperpigmented skin creases
- muscle wasting in the extremities, recurrent infections
What is a GH deficiency in children called?
Pituitary dwarfism
- may be related to a non-functioning pituitary tumor presenting with growth retardation
What is Sheehan’s syndrome? What does it result in
Ischemic necrosis of anterior pituitary lobe following a severe postpartum hemorrhage
- after, there is no secretions from the anterior lobe resulting in amenorrhea, cessation of lactation and loss of axillary pubic hair
What is hyperprolactinemia? What does it present with?
Secreting prolactin pituitary adenoma
- golactorrhea (Milkey discharge from a non-lactating breast)
- amenorrhea (absent menstraution, prolactin inhibits GnRH release form the hypothalamus)
- infertility
What is golactorrhea
Milky discharge from a non-lactating breast
What is amenorrhea
Absent menstruation
What is diabetes insipidus? What can cause it? What does it present with?
ADH deficiency
- head injury, pituitary tumors, kidney disease and sarcoidosis
- polyuria (frequent copious diluted colorless urine)
- polydyspia (excessive water consumption)
- constant specific gravity of urine <1.006 in spite of dehydration
What is hypothyroidism called in adults? Children?
Myxedema
Cretinism
What are primary hypothyroidism levels of T3, T4 and TSH? What does it present with?
Low T3, T4 and high TSH
- fatigue, constipation, brittle hair, slow to relax reflexes, weight gain
What are secondary hypothyroidism levels of T3, T4 and TSH?
Low T3, T4 and low TSH: pituitary hypofunctioning
What is hashimoto’s thyoiditis?
Anti-thyroglobulin antibodies, goiter and hypothyroidism
What is reidel’s thyroiditis?
Lymphocytic fibrotic thyroid disease leading to hypothyroidism
What are primary hyperthyroidism levels of T3, T4 and TSH
Elevated T3, T4, low TSH
What is Grave’s disease?
Most common form of hyperthyroidism
- autoimmune disorder-IgG antibodies bind to TSH receptors
What are some signs of Grave’s disease?
exophthalmos (bilateral building eyes), goiter, fine tremors of the hands, nervousness, diarrhea,
weight loss despite increased appetite, HLA B8 predisposition
What is Plummer’s disease?
Toxic multinodular goiter and no exopthalmos
What are secondary hyperthyroidism levels of T3, T4 and TSH?
Elevated T3, T4 and high TSH: TSH secreting pituitary tumor
What causes a hyperparathyroidism? what are the signs
Functioning parathyroid adenoma
- hypercalcemia
- fatigue
- brown bone cysts due to decomposed blood and hemosiderin pigment
What causes hypoparathyroidism? What are the sings
Incidental removal of the parathyroid in total thyroidectomy.
- causes hypokalemia and tetany and muscle twitching
What is Chvostek test?
Tapping the facial nerve in front of the ear causing facial twitching
- positive with hypoparathyroidism
What is Addison’s disease? What are the blood levels? What are the signs?
Chronic underfunctioning of the adrenal cortex. May be an autoimmune disorder or associated with TB infection
- low Na, low BP, high K, high ACTH, low glucocorticoids and aldosterone
- hyperpigmented skin creases and bronze skin
What is waterhouse-friderichsen syndrome?
Acute adrenal bleeding secondary to neisseria meningitides septicemia
Results in shock and hemorrhagic rash
What is Conn’s disease? What are levels?
Overfunctioning of the zona glomerulosa layer of the adrenal cortex due to adrenal adenoma which produces excess mineralocorticoids
- low K, low renin, metabolic alkalosis and high BP
What is Cushing’s syndrome
May be due to exogenous steroids or a tumor of the adrenal cortex
- truncated obesity, moon face and buffalo hump, hypertension, hyperglycemia, poor wound healing purple abdominal striae but no hyperpigmentation
What is a neuroblastoma?
Most common adrenal medulla tumor in children, associated with the N-myc oncogene
What is a pheochromocytoma?
Adrenal medulla tumor
- palpitation, perspiration, pressure headache, periodic hypertension
- vanilla mandelic acid is found in excess in urine
The 10% tumor,
- 10% are bilateral, 10% are malignant, 10% occur outside of the adrenal gland, 10% are familial
