Disorders of Endocrine Control of Growth and Development Flashcards
What is a primary hormone disorder?
Disorder of the gland producing the hormone.
What is a secondary hormone disorder?
A disorder of the pituitary.
What is a tertiary hormone disorder?
Hypothalamic dysfunction.
Which hormones are produced by the pituitary gland?
TSH, ACTH (Adrenocorticotropic hormone), Gonadotropin, LH, FSH, GH, Prolactin
What are hyperpituitarism and pituitary adenomas?
Usually benign. They cause an over-secretion of hormone. Adenoma is the most common type.
What are the manifestations of hyperpituitarism and pituitary adenomas?
Can be insidious. Enlargement of the hands/feet/tongue etc. And it raises the blood glucose as it counteracts the action of insulin.
What are the causes of hypopituitarism?
Congenital. Benign tumor compressing pituitary gland. Radiation.
What is the action of GHRH?
GHRH acts on the anterior pituitary to release Growth Hormone (Somatotropin).
What inhibits the release of Growth Hormone (Somatotropin)?
Somatostatin.
What does growth hormone affect?
Linear bone growth. Rate of protein synthesis by all cells. Fatty acid mobilization and use. Blood glucose levels.
What are the three causes of dwarfism?
Idiopathic short stature. Psychosocial dwarfism. Growth hormone deficiency.
What causes growth hormone deficiency?
Lack of GHRH.
What is somatopause?
GH decline with age.
What are the manifestations of GH deficiency in adults?
Decreased lean mass, increased fat mass. Decreased bone density.
What is the cause of gigantism?
Due to pituitary adenoma causing GH excess. Epiphyses of long bone aren’t fused.
What is acromegaly?
Abnormal growth of the hands, feet, and face, caused by overproduction of growth hormone by the pituitary gland.
What are the features of acromegaly?
Growth at the end of extremities and small bones (fingers, hands, toes, jaw, forehead). Vertebral changes (kyphosis). Soft tissue/cartilage growth (nose, larynx, respiratory tract).
What is precocious puberty?
Early activation of hypothalamus, pituitary and gonadal hormones causing early emergence of secondary sexual characteristics and fertility
What are the causes of precocious puberty?
Idiopathic. CNS tumor. Gonadal, adrenal, hypothalamic disorder.
List the thyroid hormones.
TSH (Thyroid stimulating hormone). T4. T3.
Where is TSH produced?
Anterior pituitary.
What are the CNS manifestations of hypothyroidism?
Weight gain, cold intolerance, fatigue, weakness, mental dullness.
What are the CVS manifestations of hypothyroidism?
Bradycardia, myocardial dilation.
What are the GI manifestations of hypothyroidism?
Enlarged tongue, voice changes, constipation, flatulence, distension.
What are the musculoskeletal manifestations of hypothyroidism?
Myalgia, arthralgia.
What are the integumentary manifestations of hypothyroidism?
Dry rough skin, coarse brittle hair.
What is Cretinism?
Form of primary hypothyroidism. Congenital. Occurs at birth and first sign is prolongation of physiologic jaundice.
What is Hashimoto’s Thyroidosis?
The most common hypothyroidism. Autoimmune, lymphocytic infiltration of thyroid gland.
Causes of primary hypothyroidism:
Hyperthyroid medication. Iodine deficiency (necessary for TH synthesis). Post-surgical damage/removal. Radiotherapy with iodine.
What is myxedema?
Severe hypothyroidism. Non-pitting mucous type of edema due to accumulation of mucopolysaccharide substance throughout connective tissue.
What is a myxedema coma?
Life-threatening. Primary symptoms are altered mental status and hypothermia. Hypoglycemia, hypotension, hyponatremia, hypercapnia, hypoxia, bradycardia, and hypoventilation may also occur.
What are the causes of secondary hypothyroidism?
Infection. Inflammation. Infiltration. Hemorrhage. Tumor.
What is Grave’s disease?
Most common type of hyperthyroidism. Autoimmune antibodies bind to TSH receptors in the thyroid gland and stimulate release of T3 and T4.
What are the manifestations of Grave’s disease?
Goiter. Bulging eyes. Palpitations. Weight loss.
What is thyroid storm?
s a life-threatening condition that develops in cases of untreated thyrotoxicosis.
What can trigger thyroid storm?
Infection. DKA. Trauma: physical or emotional. Thyroid stimulation during surgery.
Manifestations of thyroid storm:
fever
dehydration
rapid heart rate
nausea/vomiting
diarrhea
irregular heart beat
weakness
heart failure
confusion/disorientation
deathWhat are the treatments for hyperthyroidism?
Beta-blockers. Meds to decrease circulating TH. Surgical removal. Radioactive iodine to destroy tissue.
Which hormones are released by the adrenal cortex?
Aldosterone, Glucocorticoids, Androgens.
Which hormones are released by the adrenal medulla?
Epinephrine, Norepinephrine.
What is congenital adrenal hyperplasia?
An autosomal recessive trait resulting in deficiency of enzymes that synthesize cortisol.
What hormone does congenital adrenal hyperplasia affect?
Increases ACTH (adrenocorticotropic hormone) , which causes adrenal hyperplasia and overstimulation of adrenal androgen production.
What is Addison Disease?
Primary Adrenal Cortical Insufficiency caused by destruction of the adrenal gland.
What is the treatment for Addison Disease?
Lifetime mineralocorticoid replacement.
What are the causes of Addison Disease?
Autoimmune (most common). Tuberculosis, metastasis, fungal (all rare).
What are the manifestations of Addison diease?
Loss of aldosterone, Loss of glococorticoids, and hyperpigmentation.
What does loss of aldosterone cause?
Loss of Na, Cl, H2O via kideys. Retention of potassium.
What does loss of glucocorticoids cause?
Hypoglycemia. Decreased immunity. Fever.
What are causes of secondary adrenal cortical insufficiency?
Hypopituitarism. Removal of pituitary. Hypothalamic defect. Rapid withdrawal of glucocorticoids. (
What is acute adrenal crisis?
Addison disease + stress. A life-threatening condition that occurs when there is not enough cortisol.
What are the manifestations of acute adrenal crisis?
Slow or fast onset. Nausea and vomiting. Weakness. Hypotension, dehydration, vascular collapse. Hemorrhage due to septicemia, trauma, anticoagulants, thrombosis, metastasis.
What causes Chushing Syndrome?
Excess production of ACTH by pituitary tumor or adrenal tumor.
What are manifestations of Cushing syndrome?
Altered fat metabolism. Muscle protein breakdown. Bone protein breakdown. Altered cortisol. Altered glucose metabolism. Hypokalemia. Hypernatremia. Increased androgens. Emotional instability.
