Endocrine Flashcards
What do acidophils secrete?
GH and Prolactin
What do basophils secrete?
Trophic Hormones
What does the posterior lobe of the pituitary do?
Stores hormones made by the Hypothalamus
What is the function of TSH?
- Stimulates Thyroid
- Produces Thyroxine
What is the function of FSH and LH?
Regulates menstrual cycle
What is the function of ICTH?
Stimulates Leydig cells of Testes to produce Testosterone
What is the function of ACTH?
- Stimulates Adrenal Cortex to produce:
- Cortisol
- Steroid Sex Hormones
- Melanocytes to produce Melanin
What hormones does the Posterior Pituitary Store?
- ADH
- Oxytocin
What are the 4 Types of Pituitary Tumors?
- Craniopharyngioma
- Chromophobe Adenoma
- Acidophil Adenoma
- Basophil Adenoma
Which Pituitary Tumor is most common in Children?
Craniopharyngioma
What is the most common Adult Pituitary Tumor?
Chromophobe Adenoma
What is the Embryologic orgin of the Pituitary?
- Anterior - Rathke’s Pouch
- Posterior - Diencephalon
What is the Embryologic orgin of the Thyroid Gland?
- Tubular invagination from Middle Posterior Tongue = Foramen cecum
- Down to Thyroglossal Duct –> Neck (Anterior to the Larynx)
What is the Embryologic orgin of the Adrenal Cortex?
Neural Mesoderm
What is the Embryologic orgin of the Adrenal Medulla?
Neural Ectoderm
What is the Embryologic orgin of the Parathyroid Glands?
3rd and 4th branchial pouch, along with thymus
Thyroid Adenomas, do NOT produce the hormone Thyroxin, which is the exception?
Follicular Adenoma
Which Thyroid Carcinoma is the most common?
Papillary
What is Thyroid Papillary CA, linked to?
Previous exposure to Radiation
Papillary Thyroid CA, grows slowly, and spreads to where?
Regional Lymph Nodes
What is Follicular Thyroid CA’s etiology related to?
Longstanding Nodular Goiter
Which Thyroid CA has the tendency for Blood Borne Mets going to the bone (may show up 20 yrs later)?
Follicular
Which Thyroid CA is of C Cell origin, so the tumor produces Calcitonin?
Medullary
Which Thyroid CA is seen in MENS Type III?
Medullary
Which Thyroid CA, is rare, and one of the fastest growing malignancies in mankind, with a 100% fatality rate?
Anaplastic
Which Thyroid CA, is histologically characterized by Orphan Annie Nuclei?
Papillary
What is the histology of Medullary Thyroid CA?
- Undifferentiated, Spindly cells (doesn’t really look like thyroid tissue)
- Adjacent pools of amyloid representing Calcitonin being produced
What are the manifestations of Hypopituitarism (Pituitary Failure)?
- Dwarfism
- Simmond’s Ds
- Diabetes Insipidis
What are the manifestations of Hyperpituitarism?
- Giantism
- Acromegaly
What are the manifestations of Hypothyroidism?
-
Cretenism
- Aplasia
- Familial Goiter
- Childhood Iodine Def
-
Myxedema
- Hashimoto’s Ds
- Nodular Goiter
- Ablation to cure Grave’s or Cancer
- Hemochromatosis
What are the causes of Hyperthyroidism?
-
Grave’s Ds
- # 1 cause
-
Functioning Thyroid Adenoma
- Producing its own endogenous thyroxin
-
Nodular Goiter
- That recieves to much compensated iodine
What are Complications of Hyperthyroidism?
- High Output Cardiac Failure
-
Malignant Exopthalamus (Grave’s)
- Corneal Blindness
-
Thyroid Storm
- HTN, Arrhythmia, Malignant Hyperthermia, Delirium, Death
What are the causes of Hypoadrenalism?
- Waterhouse-Friderichsen Sx (Acute Adrenal Failure)
- Addison’s Ds (Chronic Adrenal Failure)
- Hypopituitarism
What are the causes of Hyperadrenalism?
- Hypercortisolism - Cushing’s Sx
- Hyperaldosteronism - Conn’s Sx
- Excess Sex Steroids have Virilizing Effect - Adrenogenital Sx
- Not enough GH in Childhood
- Child is proportionate in stature
- Everything is small
Dwarfism
- Total Anterior Pituitary Failure
- Pituitary dysfunctions in adults who have already achieved full stature
-
Decrease in Trophic Hormones
- No ICTH = Males - no spermatozoa
- No FSH/LH = Females - sterile
- No MSH = Pallor
- No TSH = Hypothyroidism
- No ACTH = Hypoadrenalism
Simmond’s Disease
What disease is most likely associated with Simmond’s Ds in Males?
Chromophobe Adenoma
What disease is most likely associated with Simmond’s Ds in Females?
Post Partum Necrosis
- Failure of the Posterior Pituitary
- No secretion of ADH (stored in PP)
- Pt urinates up to 5L/day causing:
- Polydypsia
- Na and K plummet
Diabetes Insipidis
- Acidophil Adenoma producing excess GH in Childhood
- Enormous growth in stature
- Adenoma destroyes the rest of the pituitary, so the other pituitary hormones are non-functional
-
High Output Cardiac Failure
- Heart can’t keep up with volume of the body
Giantism
- Acidophil Adenoma producing excess GH in an adult
- Pt grows Appositionally
- Acral portions (hands, feet) become thicker not longer
- Organs and facial features are enlarged
- Latern Jaw
- Hypofunction of other Endocrine Organs
- Secondary DM (GH acts opposite of Insulin)
Acromegaly
What is the function of the Thyroxin hormone?
Determines Rate of Basal Metabolism
What is the function of the hormone, Thyrocalcitonin?
- Promotes Ca uptake by bones
- Inhibits bone resorption
- Thyroid gland forms but there is bad thyroxin or it can’t make thyroxin due to enzyme deficiency
- Feedback causes increased TSH stimulation causing enlargement
Congenital Goiter / Familial Goiter
In Hashimoto’s Ds the thyroid gland becomes symmetrically enlarged due to what?
Lymphocyte Infiltration
(Destruction of the thyroid gland parenchyma)
In Grave’s Ds the thyroid gland becomes symmetrically enlarged due to what?
Hyperplasia
(the Auto-Ab act like TSH)
- Lack of Dietary Iodine
- Low Thyroxine (T4) because there is no iodine needed for the conversion of thyroglobulin -> T4
- Signal Pituitary to secrete TSH, causing a massive nodular (irregular) enlargement of the thyroid
Nodular (Adenomatous) Goiter
- Systemic Ds of excessive Fe storage that collects in all endocrine organs
- Males
Hemochromatosis
- No thyroid hormone as a kid
- Permanent mental retardation, short stature, puffy skin, coarse facial features, wide spaced eyes
- Macroglossia
- Slowed dental eruption
Cretenism
- No thyroid hormone as an adult
- Reversible mental sluggishness
- Yellow skin due to hypercarotemia
- Hyaluronic acid accumulates in tongue and skin
- Macroglossia
- Slow Basal Metabolism
Myxedema
What are the causes of Bilateral Hemorrhagic Necrosis?
- Septicemia (Meningococcus)
- DIC especially in post-surgical individuals
- Pts on Anti-Coagulation Therapy
What does Bilateral Hemorrahgic Necrosis cause?
- Plunges pts into Acute Adrenal Crisis
- All Adrenal Hormones go bad
- Adrenal gland -> hemorrhagic, non-functional, infarcted
- What causes 70% of Chronic Adrenal Failure?
- 50% of pts also have another Autoimmune Ds
- Chronic Atrophic Gastritis
- Autoimmune Hypoparathyroidism
- Type I DM
- Hashimoto’s
Autoimmune Adrenalitis
What infections cause Chronic Adrenal Failure?
- TB
- Histoplasmosis
- Caused by Bilateral Adrenal Hemorrhage
-
Hypotension, Collapse, Coma and Death within hours to 2 days
- due to failure of adrenal hormones (mineralcorticoids)
- Can mimic Child Abuse
Waterhouse-Friderichesen Sx
What are the causes of Addison’s Ds?
MATTH
- Metastic Cancer
- Adrenal Cortex Atrophy due to Autoimmune Ds
- TB
- Trauma
- Histoplasmosis
What are the causes of Cushing’s Sx (Hypercortisolism)?
-
Low ACTH Levels
- Iatrogenic
- Corticol Adenoma or Carcinoma of Adrenal Gland
-
High ACTH Levels
- Basophil Adenoma of Pituitary
- ACTH Producing CArcinoma
What are the causes of Conn’s Sx (Hyperaldosteronism)?
- Small Aldosterone Producing Adenoma (70%)
- Bilateral Hyperplasia (rare)
-
2o Hyperaldosteronism from conditions that increase Renin production:
- Heart Failure
- Decreased Renal Perfusion
- Hypoalbuminemia
- Liver Failure
- Kidney Ds
What are the signs and symptoms of Conn’s Sx?
- Hypernatremia –> Fluid retention –> severe HTN
- Hypokalemia
- Peroidic Flaccid Paralysis
Congenital Adrenal Hyperplasia is a group of Autosomal recessive diseases which all involve what?
- Missing enzyme that prevents Cortisone production
- 21-Hydroxylase Deficiency (90%)
What is the functioning tumor of the Adrenal Medulla, that produces Catecholamines causing severe HTN?
Pheochromocytoma
