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Endocrinology > Endocrine 1 > Flashcards

Endocrine 1 Flashcards

1
Q

What is known as the “Master Gland”?

A

Pituitary gland (hypophysis)

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2
Q

What makes up the Pituitary gland?

A

Two Lobes:

- Anterior and Posterior

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3
Q

The 2 lobes that make up the pituitary gland suspend from what?

A

Hypothalamus via pituitary stalk

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4
Q

What is the size of the pituitary gland and where is it located?

A
  • Garden pea size

- Located in sphenoid bone at base of brain

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5
Q

What are the 6 hormones that are produced, stored, and secreted by the anterior pituitary lobe?

A
  • TSH
  • ACTH
  • FSH and LH
  • GH
  • PRL
  • Endorphins
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6
Q

What are the 2 hormones stored and secreted by the posterior pituitary lobe?

A
  • ADH

- Oxytocin

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7
Q

What 2 hormones are produces by the hypothalamus?

A
  • ADH (vasopressin)

- Oxytocin (Pictocin)

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8
Q

GH is responsible for what?

A

Growth, physical, and muscle development

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9
Q

TSH is responsible for what?

A

Stimulation of thyroid gland (T3, T4, calcitonin)

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10
Q

Prolactin is responsible for what?

A

Mammary glands- milk production

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11
Q

ACTH-Adrenocorticotropic Hormone is responsible for what?

A

Stimulates adrenal glands to release Cortisol

- important for Addisons dx and Cushings

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12
Q

FSH is responsible for what?

A

Gonadotropin- stimulates testes –> sperm

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13
Q

LH is responsible for what?

A

Stimulates Ovaries –> eggs

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14
Q

ADH - Antidiuretic Hormone (vasopressin) is responsible for what?

A

Water regulation and retention

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15
Q

Oxytocin (Pictocin) is responsible for what?

A
  • Uterine contraction before and after deliver
  • Let down of milk in mammary glands
  • given in ER for bleeding postpartum
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16
Q

What is Acromegaly?

A
  • Disorder d/t excess GH that occurs after growth plate cartilage fused in adulthood
  • Enlarged hands and feet, widening teeth and face
  • Widening as opposed to lengthening
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17
Q

What is Sheehan Syndrome?

A
  • Hypopituitarism caused by blood loss during childbirth

- Post-partum pituitary gland necrosis

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18
Q

What is postpartum pituitary gland necrosis?

A

Ischemic in nature, hypovolemic insult to mother during or immediately after child birth

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19
Q

What is orange peel skin? and what is it caused by?

A
  • Cause: hyperthyroidism
  • Cellular buildup around pores that enhances shadows making pore appear larger
  • Dehydration adds cellophane like sheen to skin and rough texture.
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20
Q

What is gigantism? and when does it occur

A
  • Abnormally high linear growth d/t excessive action of GH

- Occurs when epiphyseal growth plates are open during child birth

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21
Q

What is hypogonadism?

A
  • The body’s sex gland produce little to no hormones
  • Men: testes
  • Women: Ovaries
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22
Q

What is the cause of dwarfism and how is it treated?

A
  • GH deficiency

- Tx w/ GH

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23
Q

What is disproportionate in regards to dwarfism?

A
  • Average size torso w/ shorter limbs
    OR
  • Shortened trunk w/ longer limbs
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24
Q

What is proportionate in regards to dwarfism?

A

Body parts are in proportion but shortened

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25
Q

What are striae?

A

“Stretch marks”

  • Form of scarring on the skin w/ an purplish color
  • Caused by tearing of the dermis
  • Often a result of rapid stretching or rapid weight changes.
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26
Q

Striae may be influenced by hormonal changes associated with what?

A
  • Puberty
  • Pregnancy
  • Bodybuilding
  • HRT
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27
Q

What is the overview of pituitary disease process?

A
  • Gradual insidious progression over long period of time

- Generally a single hormone vs several involved.

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28
Q

In general what is the etiology of Hypopituitarism or Hyperpituitarism? and is usually a dysfunction of what?

A
  • Tumors (adenomas)
  • Trauma
  • Malfunctions
  • Inflammatory dz
  • Dysfunction: hypothalamus or pituitary gland
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29
Q

Sxs in pituitary disease depends on what?

A

The hormones that are involved

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30
Q

What are the dx test for pituitary disease?

A
  • Blood
  • CT
  • MRI
  • XR
31
Q

What are the tx options for pituitary disease?

A
  • HRT

- Tx underlying cause: surgery, chemo or radiation

32
Q

What is the basic thyroid process including the hormones?

A

Hypothalamus –> TRH –> Pituitary gland –> TSH –> Thyroid –> T3, T4, Calcitonin

33
Q

What are sxs of hypothyroidism?

A
  • Temp sensitivity
  • Unexplained wt gain
  • Increase cholesterol
  • Hoarse voice
  • Dry Skin
  • Heavier menstrual flows
34
Q

What are sxs of hyperthyroidism?

A
  • Hyperactivity
  • Anxiety
  • Cardiac irritability (AF/VT)
  • Wt loss w/ increased appetite
  • N/V/D
35
Q

What is the the MCC of primary hypothyrodisim? and what age group is affected?

A

Hashimotos Dz/Thyroditis

45-65 yo

36
Q

What occurs if Hashimotos dz/thyroiditis is not treated?

A

Myxedema/Myxedema coma

- rare but can be life threatening d/t hypoTN and hypothermia

37
Q

What is the MCC of hyperthyroidism?

A

Graves dz- autoimmune response

38
Q

What are S/Sx of Graves dz?

A
  • Goiter
  • Exopthalmosis
  • Orange peel skin
  • Anxiety/Irritability
  • Fine tremors in hands
  • Wt. loss despite normal appetite
  • Fatigue
  • Heat sensitivity
39
Q

What is the 2nd MCC of Hyperthyroidism?

A

Plummers Dz- multinodular adenomas

40
Q

What is basic adrenal process including the hormones?

A

Hypothalamus –> Corticotropin releasing hormone –> Anterior Pituitary –> ACTH –> Adrenals Corticosteroids –> cortisol

41
Q

What does Cortisol do?

A
  • Maintain BP, CV fxn
  • Regulates metabolism
  • Weakens immune system and body’s response to stress
  • Reduce histamine secretion
42
Q

In Addisons disease are cortisol levels low or high? and what are the S/Sxs?

A
  • Low cortisol levels
  • Insidious onset
  • Salt cravings
  • Hyperpigmentation
  • Mood/personality changes
  • Joint and muscle pain
  • Hypoglycemia
43
Q

In Cushings syndrome are cortisol levels low or high? and what are the S/Sxs?

A
  • High cortisol level
  • Fatty deposite between shoulders (buffalo hump)
  • Round face: moon face
  • Striae
  • Psych disturbances
44
Q

What is the tx for addisons?

A

Oral hydrocortisone

45
Q

What is endogenous cushings disease?

A

Abnormal secretion of cortisol (caused by factors within the body)

46
Q

What is pituitary cushings?

A

A benign pituitary adenoma secreting large amounts of ACTH which elevates cortisol levels (MCC)

47
Q

What is adrenal cushings?

A

Excess cortisol produced by adrenal gland tumors

48
Q

What is the MCC exogenous cushings disease?

A

Iatrogenic- caused by factors outside the body, ie) meds for medical conditions:
- Glucocorticoids: dexamethasone, prednisone, hydrocortisone.

49
Q

How do you diagnose Cushings disease?

A 
- Dexamthasone suppression test
OR
- 24 hr urinary measurement of cortisol levels 
OR
- 24hr Saliva cortisol levels
- CT, MRI
50
Q

What is the tx of cushings?

A
  • Carefully taper off medication causing sxs

- Surgical removal of space occupying lesions w/ subsequent prednisone or hydrocortisone replacement therapy.

51
Q

What is primary hypogonadism?

A

The ovaries or testes do not function properly

52
Q

What is central hypogonadism?

A

The centers in the brain that control the gonads (hypothalamus or pituitary) do not function properly

53
Q

What is the primary causes of hypogonadism?

A
  • Autoimmune disorders
  • Genetic/Development disorder
  • Infxn
  • Liver and kidney disease
  • Radiation
  • Surgery
54
Q

What is the MC genetic disorder that cause primary hypogonadism?

A
  • Turner syndrome (in women)

- Klinefelter syndrome (in men)

55
Q

What are the causes for central hypogonadism?

A
  • Bleeding
  • Medication: steroids and opiates
  • Genetics
  • Infxn
  • Nutritional deficiencies
  • Iron excess hemochromatosis
  • Radiation
  • Rapid wt loss
  • Surgery
  • Trauma
  • Tumors
56
Q

If a brain tumor is present causing central hypogonadism there may be what?

A
  • HA or vision loss
  • Milky breast discharge (prolactinoma)
  • Hypothyroidism
57
Q

What are some clinical presentations that are seen in girls who have hypogonadism?

A
  • Will not begin menstruating

- Will affect breast development and height in girls

58
Q

What are the sxs of hypogonadism that occurs after puberty in women?

A
  • Hot flashes
  • Loss of body hair
  • Low libido
  • Menstruating stops
59
Q

What are some clinical presentations that are seen in boys who have hypogonadism?

A
  • Will have muscle and beard development issues

- Growth problems

60
Q

What are the sxs of hypogonadism that occurs in adult men?

A
  • Breast enlargement
  • Decreased beard and body hair
  • Muscle loss
  • Sexual problems
61
Q

What are the diagonstic test for hypogonadism?

A
  • Estrogen level (women)
  • FSH and LH level
  • Testosterone level (men)
  • many other lab test
  • CT of head, MRI, and US of gonads
62
Q

What is the tx for hypogonadism?

A
  • Girls and women: estrogen an progesterone
  • Boys and men: testosterone
  • Surgery
  • Radiation therapy
  • consult and refer
63
Q

What are the target organs for prolactin?

A

Mammory glands

  • increases breast size during pregnancy
  • increases milk production
64
Q

What is the major prolactin inhibitor?

A

Dopamine

65
Q

What is witches milk? and when does it resolve?

A
  • Infants response to prolactin
  • May grow breast and milk production
  • Normal response
  • Self resolves 1-2 wks
66
Q

What are common complaints in a pt with prolatinemia?

A
  • Amenorrhea
  • Galactorrhea
  • Erectile dysfunction
  • Decreased libido
67
Q

What is required in any pt you suspect has prolactinemia?

A

A pregnancy test

- unless pt is postmenopausal or has had a hysterectomy.

68
Q

What is the tx for prolatinemia?

A
  • Meds: dopamine
  • Surgery
  • Chemo/Radiation
  • Never forget to consult early and often
69
Q

What is the neuro effects of oxytocin?

A

Increased oxytocin promotes bonding and maternal behaviors at birth

70
Q

What systems does ADH (vasopressin) regulate?

A
  • Renal
  • CV
  • CNS
71
Q

What does ADH do on the renal system?

A

Water regulation

- increases permeability to H2O in distal tubules

72
Q

What does ADH do on the CV system?

A

Increase vascular resistance of peripheral vessels = increased arterial pressure

73
Q

What does ADH do on the CNS system?

A

Implicated in memory formation of both short and long term

Endocrinology (18 decks)

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