Endocrine Flashcards
How does GH excess differ in pre/post puberty?
If present in childhood, growth plates still active –> gigantism
If present after —> acromegaly
What is cushing’s syndrome and causes
Anterior pituitary not responding to negative feedback due to tumour.
- Excess ACTH
- Adrenal cortical neoplasms
- Excessive use of glucocorticoids
What are some of the primary cancers that can occur in the skin & eye?
Skin - melanoma (melanocyte), basal cell carcinoma (caused by UV exposure), squamous cell carcinoma (caused by UV exposure)
Eye - retinoblastoma: good prognosis
What is a functional tumour
It is still making the hormone
Non-functional lesion - leads to lack of hormone
Functional lesion - well-differentiated. Leads to excess of hormone
Common causes of hyperthyroidism
- Caused by increased level of circulating T3 and T4
Caused by autoimmune disease called grave’s disease - autoimmune disease produces antibodies that mimics the stimulus
Common causes of hypothyroidism
- Decreased levels of T4 and T3
- Congenital - cretinism
- Hashimoto disease (autoimmune)
- Initial increase in gland and activity (hyperthyroidism)
- Later chronic inflammation and atrophy
- Females impacted more
- Decreased metabolic rate
Symptoms of hyperthyroidism
- Anxiety and irritability
- Fine tremor
- Proptosis
- Increased metabolic rate
- Goitre
- Hair loss
- Osteoporosis
Weight loss
Symptoms of hypothyroidism
- Weight gain
- Dry hair
- Heat tolerant
- Bradycardia
Constipation
Causes of Type 1 Diabetes
- Starts in childhood and presents in early teenage years
- autoimmune destruction of pancreatic beta cells
- acute presentation, tissues cannot pick up blood glucose
Type 1 Diabetes pathogenesis
autoimmune- losing beta cells, genetic predisposition and environmental factors
Type 2 Diabetes - Clinical Presentation
Onset for Type 2 is low (symptoms are non-specific, chronic)
Type 2 patient enough insulin to prevent ketoacidosis (prevents breakdown of fat stores)
- inactive
- thirst
- lethargy
- changes in nerve conduction
Type 1 diabetes consequences
- Lack of insulin despite high serum glucose, cells starving
- Renal effects including appearance of glucose in urine
- Energy depots broken down - fat and muscle
- Ketones and by product of metabolism reduce pH –> Acidosis
Type 2 Diabetes pathogenesis
lifestyle and environmental factors. Weight loss important. Genetic factors more important
No evidence of autoimmune source of disease
Type 1 Diabetes - Clinical Presentation
Onset for type 1 is rapid (symptoms are acute)
- Underweight or normal weight
- Unconsciousness
- Diabetic coma
Type 2 Diabetes - Long Term Complications
- Diabetic neuropathies - myelin sheath are damaged. Axons are no longer insulated, messages are lost.
-Sensory neuropathy: loss of sensation, occurs in hands and feet -Autonomic neuropathy - constipation, neurogenic bladder. - Aneurysms in eyes
- Microvascular disease - retinopathy and nephropathy
- Macrovascular disease - coronary artery disease, atherosclerosis, cerebrovascular accidents, peripheral vascular disease
Infection
