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Syst Path 600 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Pituitary hormones: anterior

A

Somatotrophs –> HGH

Thyrotrophs –> TSH

Gonadotrophs –> FSH/LH

Lactotrophs –> prolactin

Corticotrophs –> ACTH and MSH

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2
Q

Pituitary hormones: posterior

A

NOT produced in posterior pituitary; merely stored and secreted there

Oxytocin
ADH

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3
Q

Pituitary gigantism

A

GH hypersecretion before epiphyseal plates close

Increased stature but little bony deformity.

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4
Q

Hypersomatotropism

A

Excessive GH secretion

Gigantism
Acromegaly

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5
Q

Acromegaly

A

Excessive GH in adulthood

Distinctive coarsening features, joint degeneration, peripheral neuropathies

Increased risk of cardiac disease, GI cancer, hypertension

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6
Q

Prolactinoma

A

Benign tumour of the pituitary gland causing excess prolactin secretion

Symptoms caused by excess circulating prolactin or by pressure of tumour on surrounding tissues

Idiopathic. May be stress related

40% pituitary tumours produce prolactin

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7
Q

Prolactinoma: Sx

A

Hyperprolactaemia

Pain, visual disturbances from macroprolactinoma

Amenorrhea (hyperprolactinaemia disrupts gonadotropin secretion –> hypogonadism)

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8
Q

ACTH Secreting Pituitary Adenoma

A

Tumour of pituitary gland

Causes Cushing’s disease (hyperadrenalism)

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9
Q

Generalized Hypopituitarism

A

Endocrine deficiency syndromes resulting from partial or complete loss of anterior pituitary lobe function.

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10
Q

Generalized Hypopituitarism: Sx

A

Usually insidious. Depends on hormones affected.

Most commonly GH lost first, then gonadotropins, then TSH and ACTH.

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11
Q

Hyperpituitarism

A

Overproduction of any of the pituitary hormones

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12
Q

Low gonadotropins: Sx

A

In kids: delayed puberty

In premenopausal women/ amenorrhea, reduced libido, regression of secondary sexual characteristics, infertility.

In men: erectile dysfunction, testicular atrophy, regression of secondary sexual characteristics, infertility. Decreased muscle mass.

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13
Q

Low GH: Sx

A

Decreased energy, muscle mass, central obesity, impaired attention and memory.
Usually asymptomatic and clinically undetectable

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14
Q

Low TSH: Sx

A

Hypothyroidism: facial puffiness, hoarse voice, bradycardia, cold intolerance. Weight gain. Hair loss. Slowed thinking.

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15
Q

Low ACTH: Sx

A

Hypoadrenalism: fatigue, hypotension, stress and infection intolerance

–> does not result in hyperpigmentation characteristic of primary adrenal failure.

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16
Q

Hypopituitarism: appetite

A

Can affect appetite (resemble anorexia nervosa or conversely hyperphagia–> obesity)

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17
Q

Low ADH: Sx

A

Diabetes insipidus.

Extreme thirst, dehydration, hyperatremia.

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18
Q

Low oxytocin

A

Generally few symptoms if not birthin’ or nursin’

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19
Q

Cushing’s Syndrome

A

Chronic high cortisol

Excess pituitary production of ACTH, usually secondary to pituitary adenoma.

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20
Q

Cushing’s syndrome: Sx

A 
Moon facies 
Truncal obesity with thin limbs
Buffalo hump
Muscle wasting
Thin skin
Poor wound healing 
Purple straie
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21
Q

Cushings disease

A

Cushings syndrome caused by excessive pituitary production of ACTH

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22
Q

ACTH-dependent hyper function of the adrenal cortex can result from:

A

1 hypersecretion of ACTH by pituitary gland

  1. Secretion of ACTH by nonputuitary tumour
  2. Administration of exogenous ACTH
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23
Q

Test to differentiate between pituitary and adrenal hypercortisol disorders.

A

Dexamethasone suppression test

(Suppresses ACTH release by pituitary; if cortisol levels still high then problem is adrenal).

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24
Q

Central Diabetes insipidus

A

Neurogenic diabetes insipidus

Low levels of ADH (vasopressin) produced by hypothalamus, or failure or pituitary gland to release it.

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25
Q

Diabetes insipidus: Sx

A

Polydypsia

Polyuria

26
Q

Diabetes insipidus: Dx

A

Urine test for glucose (to rule out diabetes mellitus)

Water deprivation test
(Water deprivation followed by injection of ADH –> positive for insipidus if symptoms relieved.

27
Q

Glucocorticoids

A

Cortisol, cortisone, corticosterone

Make energy available for immediate use.

Low glucocorticoid levels/high demand –> pituitary gland releases CRH

Released by adrenal cortex (zona fasicularis)

28
Q

ADH

A

Antidiuretuc hormone

Made by hypothalamus, released posterior pituitary in response to high blood osmotic pressure (dehydration)

Kidneys retain more water
Decreased sweat production
Vasoconstriction –> increase BP

29
Q

hGH

A

Human growth hormone

Released by anterior pituitary gland continually (especially during sleep); increases in response to hypoglycemia

Promotes synthesis and secretion of IGFs throughout body –> cell growth, lipolysis, glucose sparing

30
Q

Aldosterone

A

Mineralocorticoid
Produced by the adrenal cortex (zona glomerulosa) in response to angiotensin II, and increased circulating K+

Angiotensin II (RAA Pathway) is a response to dehydration/trauma/decreased Na+ levels

Acts on kidneys to increase reabsorption of H2O

31
Q

PTH

A

Parathyroid hormone

Released by parathyroid gland in response to decreased levels of Ca+.

Increase osteoclast activity, plus acts on kidneys to release calcitriol

32
Q

T3/T4

A

Thyroid hormones

Released by follicular thyroid cells in response to TSH, which js released by the anterior pituitary in response to low levels of circulating T3/T4, or low BMR

Increases BMR, increases number of Na+/k+ pumps, up regulate beta receptors.

33
Q

Insulin

A

Produced by beta cells in the pancreatic islet

Response to hyperglycemia

Pushes glucose into cells (increase GluT transporters)

34
Q

Hyperthyroidism

A

Overactivity of the thyroid gland –> high thyroid hormones

Most common in women during menopause and after childbirth

35
Q

Graves’ disease

A

Most common form of hyperthyroidism

Autoimmune stimulation of thyroid follicles

Affects entire gland

36
Q

Hyperthyroidism: Sx

A 
Increased heart rate, BP
Abnormal heart rhythms
Increased sweat
Anxiety
Insomnia 
Weight loss
Goitre
37
Q

Hyperthyroidism: causes

A

Graves’ disease
Thyroiditis
Toxic adenoma (secretes hormone without TSH)
Plummers disease (toxic multinodular goitre)
Overactive pituitary (rare)
Excess iodine

38
Q

Symptom unique to Graves

A 
Eye symptoms
Puffiness
Increased tear formation
Irritation 
Light sensitivity 
Diplopia
Exophthalmos

Also orange-peel skin, especially over shin.

39
Q

Hashimoto’s disease

A

Aka Hashimoto’s thyroiditis

Chronic autoimmune inflammation of the thyroid

Usually results in hypothyroidism (most common cause)

40
Q

Most common form of thyroiditis

A

Hashimoto’s

41
Q

Most common cause of hypothyroidism

A

Hashimoto’s

42
Q

Hashimoto’s: in the beginning

A

50% underactive thyroid

In some people, initial hyperthyroidism or normal function, followed by hypothyroidism.

43
Q

Hashimoto’s: comorbidities

A

Other endocrine and/or autoimmune disorders, or certain chromosomal conditions. (downs, turners, klinefelters)

44
Q

Hashimoto’s: Sx

A

Painless enlargement of thyroid

Cold intolerant
Fatigue

45
Q

Type 1 vs Type 2 diabetes: Sx

A

Type 1: fatigue, malaise, fruity ketone breath
Weight loss.
Atherosclerosis
Vision problems

Type 2: polydypsia polyuria

46
Q

Type 1 vs Type 2 diabetes:

Underlying path

A

Type 1: destruction of pancreatic beta cells –> not enough insulin produces

Type 2: down-regulation of insulin receptors –> body can’t deal with the glucose.

47
Q

Hormones produced by adrenal cortex

A

Zona glomerulosa: Mineralocorticoids (aldosterone)

Zona fasculata: glucocorticoids (cortisone, cortisol, corticosterone)

Zona reticularis: androgens
(DHEA)

48
Q

Adrenal medulla

A

Centre of adrenal gland. Nervous tissue (not endocrine)

Release catecholamines (NE, epinephrine, DA)

49
Q

Epinephrine (hormone)

A

Increases heart rate and force of contractions

Smooth muscle relaxation

Glycogen To glucose conversion in liver

50
Q

Norepinephrine (hormone)

A

Vasoconstrictive (increase BP)

51
Q

Addison’s disease

A

Chronic adrenal insufficiency, hypocortisolism

Adrenal gland doesn’t produce enough steroid hormones. (Mineralocorticoids and glucocorticoids)

Usually (70%) autoimmune. Also cancer, infection (TB), genetics
Rare

52
Q

Addison’s disease: Sx

A

Weak
Tired
DizZy
Dark skin patches.

Dehydration
Excess K+, not enough Na+

Insulin sensitivity –> hypoglycemia

53
Q

Secondary adrenal insufficiency

A

Symptoms similar to addisons but the problem is that the pituitary isn’t releasing ACTH

54
Q

Conn’s syndrome

A

Primary (hyper)aldosteronism

Overproduction of aldosterone by adrenal gland

55
Q

Conn’s syndrome: Sx

A 
Increased BP
Weakness (hypo mm)
Periods of paralysis
Muscle cramps (hyper neuron)
Metabolic alkalosis 
Hypocalcemia
56
Q

Conn’s syndrome: causes

A

50-60% Adrenal adenoma (benign)

40-50% adrenal hyperplasia

RAA disorders (rare)

57
Q

Hypothyroidism

A

Underactivity of thyroid gland

Common

58
Q

Myxedema

A

Very severe hypothyroidism

Can lead to coma

59
Q

Secondary hypothyroidism

A

Pituitary gland fails to produce enough TSH

60
Q

Cretinism

A

Congenital hypothyroidism

Stunted mental and physical growth.

Syst Path 600 (5 decks)

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