Endocrine Flashcards by asw asw

list the 6 hormones produced by the ANTERIOR pituitary

TSH: Thyroid-stimulating hormone or thyrotropin
PRL: Prolactin
ACTH: adenocorticotropic hormone or corticotropin
GH: Growth hormone
FSH: Follicle stimulating hormone
LH: Luteinizing hormone

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the ______ pituitary is composed of modified glial cells and axonal processes extending from hypothalamic neurons

posterior

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which hormones are produced by the posterior pituitary gland?

Oxytocin
antidiuretic hormone (ADH)

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Anterior pituitary hyperfunction is almost always associated with _______

adenoma

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what conditions are associated with Hyperfunction of ACTH?

Cushings syndrome

Nelson syndrome

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what conditions are associated with Hyperfunction of Growth hormone?

Gigantism (children)

- Acromegaly (adults)

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overproduction of Prolactin causes what conditions?

Galactorrhea and amenorrhea (females)

- Sexual dysfunction, infertility

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overproduction of TSH causes what condition?

Hyperthryoidism

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overproduction of FSH and LH causes what conditions?

Hypogonadism
mass effects
hypopituitarism

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what are the 3 possible causes of Pituitary hypo-function?

A) Nonfunctional pituitary adenoma

B) Postpartum ischemic necrosis
(Need over 75% destruction)

C)Ablation/destruction by surgery, radiation, or adjacent tumor

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What conditions result from a LACK of GH? Prolactin ? TSH ? ACTH ?

GH- dwarfism

Prolactin- no post-partum lactation

TSH- hypothryoidism

ACTH- Hypoadrenalism

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what conditions can occur due to a lack of Gonadotropin production?

Amenorrhea and infertility in women

- Decreased libido, impotence, and lack of pubic/axillary hair in men

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there is no clinical manifestations for a lack of which hormone?

Oxytocin

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a lack of ADH is associated with what disease?

Diabetes insipidus

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Hypothalamic neurons produce which 2 hormones?

oxytocin

antidiuretic hormone (ADH)

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the ________ pituitary is derived from neuroectoderm

posterior

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_________ cells of the anterior pituitary produce growth hormone

somatotroph

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Gigantism occurs before closure of what structures?

epiphyseal plates (growth plates) in the long bones

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clinical features of gigantism:

Generalized increase in the size of the body

Arms and legs are disproportionately long

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how is gigantism/acromegaly treated?

surgical removal of the adenoma

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clinical features of acromegaly:

Enlarged bones of the hands, feet, and face
Prognathism, development of a diastema
Hypertension and congestive heart failure may be seen

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T/F: the prognosis for acromegaly is generally better than gigantism

FALSE

acromegaly can cause congestive heart failure
acromegaly = guarded prognosis

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name the causes and features of dwarfism:

Causes:

Failure of pituitary gland to produce growth hormone
Lack of response to growth hormone by the patient’s tissues

Treatment:

Short stature
Small jaws and teeth

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how can dwarfism be treated?

if lack of production of growth hormone is the problem, then hormone replacement therapy works

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what is the normal histology of the thyroid glad?

Follicles filled with colloid

the thyroid gland Produces hormones that regulate what?

the RATE at which the body carries out its necessary functions - "the bodies thermostat"

where is the thyroid gland located?

Located in the middle of the LOWER NECK, below the larynx and above the clavicles - has bow-tie shape

T/F: You can’t always palpate a normal thyroid gland

True

how is PRIMARY hyperthyroidism diagnosed? | which hormones are reduced/increased

- Elevated TH | - decreased TSH

what causes Synthroid ?

Ingestion of exogenous thyroid hormone

what is graves disease? | AKA what is its etiologic characteristic

Diffuse toxic hyperplasia of the thyroid tissue

clinical features of hyperthyroidism are the result of what?

due to hypermetabolic state and overactivity of the sympathetic nervous system

clinical features of hyperthyroidism:

``` A) Hypermobility B) G-I hypermotility, malabsorption C) Tachycardia D) Nervousness, tremor, irritability E) Heat intolerance and excessive sweating F) Soft, warm, flushed skin ```

what clinical sign is indicative of Graves Disease?

Exophthalmos | bulging of the eyes

What is a "thyroid storm"? why can it be deadly?

- sudden onset of severe hyperthyroidism, usually triggered by stress. - A medical emergency—patients often die of cardiac arrhythmias if untreated

______________ can be used to destroy overactive thyroid tissue

reactive iodine

_____________ is also known as diffuse toxic hyperplasia of the thyroid gland

Graves Disease

what groups are at risk for Graves disease?

** females = 7X more likely

manifestations of graves disease:

A) Hyperthyroidism B) **Exophthalmos (40%)** C) Skin lesions ** pretibial myxedema ** (rash below knee)

what 3 things can cause a decrease in thyroid hormone production?

1) Iodine deficiency 2) Autoimmune destruction of thyroid 3) Ablation by surgery or radiation therapy

Autoimmune destruction of the thyroid leads to what disease?

Hashimoto’s thyroiditis

clinical features of hypothyroidism:

1) creatinism - if infant or early childhood | 2) Mydxema - older children and adults

features of Myxedema: | late childhood & adult hypothyroidism

``` Generalized apathy Mental sluggishness—can mimic depression Obesity Cold intolerance Enlarged tongue ```

In HYPOthyroidism, when are serum TSH levels increased? when are they not increased?

A) Increased in primary cases B) Not increased in cases caused by hypothalamic or pituitary disease

why must hypothyroidism be treated quickly in younger patients?

The damage to skeletal and nervous systems could become permanent (creatinism)

characteristics of Hashimoto Thyroiditis :

- Female predominance (older women, genetic risk) - Autoimmune; progressive destruction of gland - Patients usually at risk for other autoimmune diseases and B-cell Non-Hodgkin lymphomas

characteristics of Hashimoto Thyroiditis :

- Female predominance (older women, genetic risk) - Autoimmune; progressive destruction of gland - Patients usually at risk for other autoimmune diseases and B-cell Non-Hodgkin lymphomas

T/F: patients with Hashimoto Thryoiditis have no established risk of development of thyroid neoplasm

True

__________ are the most common manifestation of thyroid disease

Goiters | enlargements of the thyroid gland

what causes goiters?

impaired synthesis of thyroid hormone - Most often due to dietary deficiency of iodine

what are the most common clinical features of goiters?

*** due to mass effects *** (growth of tissue masses) Cosmetic problem Airway obstruction Dysphagia Compression of vessels

what causes a "toxic goiter"?

occur when a hyper-functioning nodule develops within a longstanding goiter - results in HYPERthyroidism

Characteristics of Thyroid neoplasms:

- Thyroid nodules are common - Most nodules are non-neoplastic disease - 1% of nodules are carcinomas

T/F: Thyroid Nodules in females and young patients are more likely to be neoplastic

FALSE - males and young patients more likely to be neoplastic

what is the only known environmental link for thyroid neoplasms?

exposure to radiation in first 2 decades

what groups are at the highest risk for PAPILLARY Thyroid Carcinoma's?

* ** Most common type of thyroid cancer - FEMALES - peaks in 30s-50s

which onconogene is mutated in patients with Papillary Thyroid Carcinomas?

RET proto-oncogene mutation

PATHOLOGY of Papillary Thyroid Carcinomas:

A) microscopically characterized by papillary projections B) nuclear clearing - ORPHAN ANNIE nuclei C) nuclear grooves

Follicular Thyroid Carcinoma s make up ___% of all thyroid neoplasms

10-20%

characteristics of Follicular Thyroid carcinomas:

- Older age than papillary; areas with dietary iodine deficiency - May resemble a Follicular Adenoma

what type of thyroid neoplasm is Derived from the parafollicular (C) cells?

Medullary Thyroid Carcinoma

the course of Medullary thyroid carcinomas may be _____ or familial

sporadic

Both _________ and ___________ thyroid carcinoma types will show a mutation of the RET proto-onconogene

1) Papillary thyroid carcinoma | 2) Medullary Thyroid Carcinoma

Patients with Medullary Thyroid Carcinomas will show an elevation of what hormone?

Increased serum calcitonin | makes sense- medullary carcinomas derived from PARAFOLLICULAR cells..... they secrete calcitonin

to diagnose FOLLICULAR thyroid carcinoma, you must see invasion through ____________, or into the _____________

- through the capsule | - into the blood vessels