Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathology 205 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

The Endocrine System

A

The endocrine system (endo-, inside, and krinein, -to secrete)

  • comprises several glands (pituitary, thyroid, parathyroid, adrenals) and
  • Scattered cells in the gonads, pancreas, intestine, and other organs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary function of endocrine cells

A

produce hormones
- the endocrine organs do not have ducts and so are called the “ductless” glands. Hormones are secreted into the blood or extra cellular spaces
Hormones that are released into the circulation act on distant organs (endocrine effect)
For example, pituitary hormones exert an endocrine effect on the thyroid, adrenals, or gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Four major endocrine glands:

A

: the pituitary, thyroid, parathyroid, and adrenals

The pituitary, thyroid, parathyroids, and adrenals are unrelated to each other and have distinct anatomic locations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

gynaecomastia

A

men gets breasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pituitary

A
  • located intracranially in an indentation of the base of the cranium called the sella turcica (a Latin term -Turkish saddle)
  • consists of two parts (anterior and posterior), which are connected to the hypothalamus via a stalk that contains extensions of neurons and the vessels of the pituitary portal system

The blood vessels transport-from the hypothalamus into the pituitary

-the neuroendocrine releasing factors that regulate the function of the pituitary cells

highly vascular- lots of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The Anterior Pituitary ( adenohypophysis )

A

consists of five distinct cell types, each of which is named according to the hormone it secretes. These hormones are:

growth hormone (GH)
prolactin (PRL )
adrenocorticotropic hormone (ACTH) 
the gonadotropins (luteinizing hormone [LH] and follicle-stimulating hormone [FSH])- teste or ovary, testosterone- ova,estro and progesterone
thyrotropic hormone (thyroid-stimulating hormone [TSH])
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q 
Growth Hormone (GH)
action and target
A

Somatomedin Synthesis º Growth Simulation

targets liver and other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

prolactin

action and target

A

lactation- targets breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thyroid Stimulating Hormone (TSH)

A

action: Thyroid Hormone Synthesis &
Release

targets thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Follicle-Stimulating Hormone (FSH)

A

action -spermatogenesis, estrogen synthesis oogenesis

organ: testi
ovary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adrenocorticotropic Hormone (ACTH)

A

action Glucocorticoid Synthesis & Release

target adrena cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Luteinizing Hormone (LH)

A

action:
Ovulation
Corpus Luteum, hence Progesterone Production
target ovary

action:
Testosterone Synthesis

target testi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Regulation!!

A

The secretion of hormones of the anterior pituitary is regulated by
positive stimulation -exerted by the cells in the hypothalamic centers and
negative feedback inhibition -created by the hormones produced by the target endocrine cells in the thyroid, adrenals, and gonads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The Posterior Pituitary (neurohypophysis)

which comes from anterior vs posterior

A
  • release oxytocin (pitressin) and the antidiuretic hormone (ADH)
    In contrast to the hormones of the anterior pituitary, which are trophic and stimulate the functions of other endocrine glands, the hormones of the posterior pituitary have no trophic functionsThese hormones act on nonendocrine cells;
  • oxytocin stimulates the contraction of the pregnant uterus and
  • ADH promotes the reabsorption of water from the renal tubules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

THE THYROID GLAND

A

weight : 15-25 g
• derived from primitive gut
• function: storage & release of thyroid hormones
• 2 “butterfly-shaped” lobes connected by narrow band of tissue called the isthmus
-ant to lower part larynx &. Above clavicle

an endocrine gland located in the neck
- consists of two types of cells: follicular cells and C cells

Follicular cells secrete thyroid hormones (thyroxine [T4] and triiodothyronine [T3])- essential for maintaining the intermediate metabolism.
The secretion of T3 and T4 is regulated by TSH

The C cells secrete calcitonin, a polypeptide - involved in the maintenance of calcium homeostasis
The secretion of calcitonin is influenced by the concentration of calcium in serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Overview of Major Diseases

A

The most important diseases involving the endocrine glands present as:

  • Hyperfunction
  • Hypofunction
  • Tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hypo

A

– low or deficient; Hyper- high or excessive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

endocrine

A
  • secretion into the circulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

exocrine

A

– secretion via duct into GI system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

syndrome

A

– group of symptoms common to several diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

disease

A

specific cause known

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

benign tumor

A

one that does not spread (metastasize)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

hypertrophy

A

– grow in size due to constant stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

autonomous

A

– with no feedback control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

primary

A

– disease caused within the gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

secondary

A

– caused by something external

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

tertiary

A

– 2ndary becomes autonomous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

hyposecreation

A

agenesis, atrophy, destruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

hypersecreation

A

tumor, hyperplaisia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

(1 of 6 comandement)
A.The Function of the endocrine gland is tightly regulated by positive and negative stimuli

dont need to know in detail

A

The function of the thyroid, adrenals, and gonads is regulated by the anterior pituitary, which secretes the trophic hormones TSH, ACTH, LH, and FSH.

The function of the pituitary is, in turn, regulated by the hypothalamic releasing factors (e.g., gonadotropin-releasing hormone [GnRH]).

The hormones of the peripheral target glands released into the blood have a negative inhibitory influence on the hypothalamus and the pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

2 of 6
B. Prolonged hyper stimulation by trophic hormones or metabolic signals leads not only to hyper function, but also to physical enlargement of the peripheral endocrine glands

A

The thyroid, when over stimulated by TSH, enlarges and becomes nodular
ACTH stimulation leads to adrenocortical hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

C. Hyper functioning endocrine glands may be hyperplastic or neoplastic

A

Hyperfunctioning endocrine glands are usually enlarged. -The enlargement may be attributable to hyperplasia (i.e., a reactive increase in cell number) or to benign or malignant tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

D. Hypo function of the endocrine glands is usually attributable to the destruction of secretory cells

A

Destruction and loss of endocrine cells or the entire gland may be caused by several mechanisms, the most important of which are inflammation, tumors, and medical interventions
Inflammation may be caused by infectious organisms or autoimmune processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

E. Neoplastic or hyperplastic enlargement of the endocrine glands results in mass lesions that compress adjacent structures

A

Local symptoms caused by endocrine gland enlargement are most evident in diseases of the pituitary and the thyroid
Enlargement of the pituitary, which is in close proximity to the optic nerve
decussation, produces defects in the visual field (so-called bitemporal hemianopsia, or bilateral loss of peripheral [temporal] sight).
Thyroid tumors may produce a bulge on the anterior side of the neck or compress the larynx, trachea, and the nerves or blood vessels of the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

F. Tumors of one endocrine gland may be associated with neoplasia and/ or hyperplasia of other glands

A

Multiple endocrine neoplasia (MEN) is a hereditary syndrome that occurs in at least three forms: MEN-l, MEN-2A, and MEN-2B
In MEN-l, the tumors originate from the pituitary , parathyroids, and pancreatic islets of langherhans
-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

In MEN-2A,

A

the tumors include medullary carcinoma originating from C cells of the thyroid, pheochromocytoma originating from the medulla of the adrenal, and parathyroid adenoma or hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

MEN-2B,

A

, which resembles MEN-2A and has the same endocrine lesions, also includes additional multiple skin and mucosal nerve tumors. The occurrence of these familial tumors has been related to defects in tumor suppressor genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pituitary Diseases

A

Diseases of the pituitary are uncommon, but may present as:
Pituitary hyperfunction
Pituitary hypofunction
A localized mass lesion causing compression of the optic chiasm or the basal portion of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Pituitary hyperfunction

A

Pituitary hyperfunction may present in several forms depending on which one of the five cells is hyperfunctioning. The pituitary is usually, enlarged
The enlargement may be attributable to macroscopic or microscopic adenomas, which are composed of a single cell type or several cell types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most common are tumors composed of

Less common are
which is the most rare
!!!

A

Most common are tumors composed of lactotropic cells (also known as prolactinomas)
Less common are somatotropic and corticotropic adenomas
Tumors composed of TSH-, LH-, or FSH-secreting cells are extremely rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Pituitary Hypofunction

A

Endocrine insufficiency of the pituitary causes hypofunction of secondary organs, which depend on trophic stimuli from the pituitary.
Pituitary hypofunction is rare, but it may be encountered in any age group.

It may involve all pituitary cells panhypopituitarism) or it may be selective-i.e., limited to one subset of anterior pituitary cells (e.g., hypogonadism secondary to the deficiency of gonadotropic cells) or posterior pituitary cells (e.g., diabetes insipidus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

The causes of pituitary hypofunction include:

A

congenital developmental defects, as in pituitary dwarfism or hypogonadism

tumors that destroy the pituitary (e.g., nonfunctioning pituitary adenoma) or the hypothalamus (e.g., craniopharyngioma or glioma)
ischemia, as in postpartum necrosis (Sheehan’s syndrome )
The diagnosis of pituitary insufficiency may be suspected clinically but must be confirmed by appropriate biochemical tests, which will show hormone deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Panhypopituitarism of adults (Simmonds’disease)

A

Panhypopituitarism of adults (Simmonds’disease) is marked by general weakness, cold intolerance, poor appetite, weight loss, and hypotension. Women affected by this disease do not menstruate and men suffer from impotence and loss of libido. Pituitary insufficiency of childhood results in dwarfism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Diabetes insipidus is marked by

diabetes mellitus is cause by sugar

A

Diabetes insipidus is marked by a lack of ADH secondary to destructive lesions of the hypothalamus, pituitary stalk, or posterior pituitary. It may be caused by tumors, infection of the brain or meninges, intracranial hemorrhage, or trauma involving the bones of the base of the skull. Patients with diabetes insipidus secrete large amounts (5 to 6 L/day) of hypotonic urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Growth Hormone

A

Deficiency Syndromes:
Children: Pituitary Dwarfism
Adults: Single deficiency – None
Multiple: Hypopit Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

growth hormose Syndromes of Excess

A

Children: Prepubertal- before closure of epiphyseal growth plate of long bones—longitudinal growth -Gigantism
Adults: enlargement of acral part of extremities - Acromegaly

47
Q

Acromegaly

A

Sign & Sym. of Tumour: Headache, Visual Field Disturbances,
GH Excess: Acral Growth, Visceromegaly, Hypertrophy, Hypertension, Osteoporosis.
Glucose intolerance
( frank Diabetes)

48
Q

Prolactin

excess

A

Excess:
♀: Galactorrhœa (30-80%), Amenorrhoea, Oligomenorrhœa, or infertility with  libido
♂: Gonadal dysfunction  impotence, galactorrhœa (14-33%), Visual field disturbances (41%), Headaches.
Children: delayed or arrested puberty

49
Q

know slide 47!!!!!!!

A

HORMONE HYPOFUNCTION HYPERFUNCTION

HGH Growth Failure Gigantism,
Acromegaly

TSH Hypothyroidism Hyperthyroidism

ACTH Adrenal Insufficiency CushingsDisease

LH & FSH		Delayed Puberty

PROLACTIN Gynaecomastia

                                                                   Impotence
                                                                 Reduced Fertility
                                                                Delayed Puberty
50
Q

Stimulation & Suppression Tests

A

slife 48
stimulation is used when Hypofunction is suspected
ex: Pituitary: Triple Bolus Test
ADH: Water Deprivation
GH: Insulin Hypoglycemia Adrenal: SynACTHen Test

suppresion: use when Hyperfunction is suspected
GH: Oral GTT
Adrenal: Dexamethasone Suppression

51
Q

Thyroid Diseases

A

Thyroid diseases are common, but fortunately, they can be diagnosed readily and treated with very good results
Thyroid diseases present as functional disturbances (hyperfunction or hypofunction) or as mass lesions (neoplasms or non-neoplastic enlargement, known as goiter)

52
Q

3 kinds of hyperthyroidism

A

Thyroid overactivity Grave’s disease, Multi-nodular goitre, Toxic adenoma, T3 toxicosis, TSH-secreting tumour (rare)

Thyroid destruction Subacute thyroiditis (acute phase), Hashimoto’s thyroiditis (acute phase)

Ectopic Thyroid Strauma Ovarii (rare), Metastatic thyroid carcinoma (rare), Exogenous Thyroxine, Thyrotoxicosis

53
Q

Clinical Symptoms

HYPERTHYROID

A 
Heat Intolerance
Flushed Skin
Incr. Perspiration
Incr. Appetite & Food Ingestion
Muscle Wasting & Weakness
Weight Loss
54
Q

Clinical Symptoms

HYPOTHYROID

A

Cold Intolerance

Dry & Pale Skin

Decr. Appetite &
Food Ingestion

Generalized
Weakness

Weight Gain

55
Q

Symptoms and Signs of Thyroid Dysfunction

HYPERTHYROID

A 
Restlessness
Hypermotility
Nervousness
Emotional lability
Fatigue
Exag. Reflexes
Hyperdefecation
56
Q

Symptoms and Signs of Thyroid Dysfunction

HYPOTHYROID

A

Apathy

Mental Sluggishness

Mental Retardation

Depressed Reflexes

Constipation

57
Q

Thyroid Testing

A

Thyroid disorders are the commonest Endocrine problems
2% of women will develop thyrotoxicosis and a further 1% primary hypothyroidism
Goiter or a thyroid nodule can be found in up to 15% of the population
This frequency demands that thyroid function tests be effective and economical

58
Q

if tsh is elevated can suspect

A

hypothyroid slide 56

59
Q

slide 57!!

A

d

60
Q

hyperthyroid

A

primary: high t4 low tsh
secondary: high t4 high tsh

61
Q

hypothyroid

A

low t4 high tsh

econdary: low t4 low tsh

62
Q

Thyroid Neoplasms

A

Thyroid tumors -benign or malignant

Benign thyroid tumors are common

found in 3 – 4 percent of all adults, they are of limited clinical significance, primarily because such tumors are small

Malignant thyroid tumors are rare. Only three to four cases of thyroid cancer are diagnosed yearly per 100,000 people and less than 1000 people die of thyroid cancer yearly in the United States

63
Q

Thyroid Carcinoma!!! 4 types

A
  • Carcinoma of the thyroid occurs in several histologic forms, including papillary, follicular, medullary, and anaplastic carcinoma.

All of these tumors except medullary carcinomas originate from follicular cells. No risk factors for developing thyroid tumors are known. Thyroid tumors are, for unknown reasons, more common in females than males

64
Q

Papillary carcinoma

best to get because good prognosis

A
  • accounts for 80 percent of all malignant thyroid tumors. -It is a low-grade malignant lesion. Papillary carcinoma is a hormonally inactive tumor and usually presents as a cold nodule on radioscans. The tumor tends to metastasize to the local lymph nodes, but distant metastases are not found until late in the disease
  • is four times more common in women than in men. It occurs relatively early in life and has a peak incidence in the third to fifth decade. This tumor has a very favorable prognosis; indeed, 80 percent of patients are alive 10 years after diagnosis
65
Q

Follicular carcinoma

A

-is much less common than papillary carcinoma, accounting for only 15 percent of thyroid malignant diseases. Most patients are older than 40 years of age and 75 percent are female. The tumor grows more aggressively than papillarycarcinoma, but it still has a good prognosis. Overall, 65 percent of patients survive 10 years

Clinically, follicular carcinoma presents as a slowly growing nodule
66
Q

Medullary carcinoma

A

-differs from other thyroid tumors in that it is derived from C cells. Like the normal C cells, medullary carcinomas produce calcitonin, a hormone involved in regulating the homeostasis of calcium

Histologically, medullary carcinoma is composed of round or oval neuroendocrine cells arranged into groups and nests
-may be inherited, and it can occur concomitantly with other endocrine tumors, such as pheochromocytoma in MEN-2

  • Familial medullary carcinomas are usually discovered early and have a good prognosis if surgically removed. Sporadic tumors, which occur at 60 years of age and older, have a less favorable prognosis

c cells!

67
Q

Anaplastic carcinoma

worst one

A

-is a rare tumor. It has an extremely unfavorable prognosis, and most patients die within 1 year of diagnosis

Histologically, such tumors are composed of undifferentiated, large or small tumor cells that bear no resemblance to normal thyroid cells

68
Q

Adrenal Gland

A

(also known as suprarenal glands)
Situated on top of the kidneys
Adrenal cortex plays role in steroid hormones like cortisol and aldosterone
Adrenal medulla synthesizes epinephrine (adrenalin)

69
Q

Diseases of Adrenal Cortex

A 
Adrenal hyperfunction 
Adrenal hypofunction
Adrenal tumors (functional or non-functional)
70
Q

Adrenal Hyperfunction

A 
Hyperaldosteronism (Conn’s syndrome)
Hypercortisolism (Cushing’s syndrome)
Adrenogenital syndrome (Enzyme deficiency – full or partial)
71
Q

Adrenal Gland

A

Adrenal Cortex – three zones, only one under control of the pituitary ie fasciculata
Adrenal Medulla – production of catecholamines like epinephrine (adrenalin)

72
Q

Adrenal Cortex!!!!

know the 3 zones and what they produce

A

Contains 3 zones
Zona glomerulosa which produces aldosterone
Zona fasciculata which produces cortisol
Zona reticularis
Diseases of each zone produce different diseases

73
Q

Zona Fasciculata

A

Produces cortisol which is required for normal glucose metabolism. Lack of cortisol produces hypoglycemica (Low blood glucose)
Excess cortisol causes hyperglycemia among other things
Hypercortisolism is known as Cushings Syndrome
Hypocortisolism is known as Addison’s Disease

74
Q

Zonal Glomerulosa

A

Produces aldosterone which is a mineralocorticoid. It regulates the amount of sodium!!!!!!!! present in the blood by renal mechanisms. Excessive amounts lead to hypertension.

Conn’s Syndrome – Disease caused by a tumor producing aldosterone. Cured by surgery but not easily diagnosed because it is rare and 2ndary aldosteronism is common due to kidney disease

75
Q

causes of hypercortis

A

acth can be produces from tumor lung and pituitary gland

76
Q

Conn’s Syndrome

A

– Disease caused by a tumor producing aldosterone. Cured by surgery but not easily diagnosed because it is rare and 2ndary aldosteronism is common due to kidney disease

77
Q

Adrenocortical Hypofunction

acute and chronic

A

Acute adrenal insufficiency
Waterhouse-Friderichsen syndrome in meningococcal sepsis
Chronic adrenal insufficiency (Addison’s disease) caused by:
Autoimmune diseases (most common!)
Tumors (bilateral metastases to adrenals)
Tuberculosis
Amyloidosis

78
Q

cushing see!!!

A

acne, moon face, buffalo hump on back, osteoporosis, obesity, easy brusing

79
Q

addison see!!!

A

personality changes, hyper pigmentation ( negative feed back to brain to stop acth) anorexia, adrenal hypertrophy, muscle weakness

80
Q

Adrenal Medulla

A

Site of production of epinephrine (adrenalin)
Stress hormone (fight or flight)
Also released due to low glucose (hypoglycemia) to increase glucose levels

81
Q

Tumors of the Adrenal Medulla!!!!!

A

Neuroblastoma—children, malignant, can cause hypertension
Pheochromocytoma—adults, mostly benign, but in 10% of cases, malignant
Vanillyl mandelic acid (VMA) (metabolic end product) found in urine—important for diagnosis
_________________________________
Note: Both neuroblastoma and pheochromocytoma may produce catecholamines and cause hypertension

82
Q

parathyroid

A

The parathyroids are located in the neck, behind the thyroid
There are usually four glands, each of which is the size of a coffee bean
Parathyroid glands secrete the polypeptide parathyroid hormone, which is involved in regulating homeostasis of serum calcium and phosphate.

83
Q

Parathyroid Glands

A

Important in regulation of calcium balance

Produces parathyroid hormone (PTH) Parathyroid hormone has a central role in calcium metabolism and hence bone metabolism

Tumors of the parathyroids commonly cause hypercalcemia which is associated with many problems eg osteoporosis, renal calculi, cardiac, neurological and psychiatric symptoms

84
Q

Parathyroid Hormone

A

Polypeptide hormone
Secreted as a large molecule of >80 amino acids
Metabolized in the circulation to the active hormone
Active hormone has a half-life of only 5 mins
Very important role in calcium metabolism
Low blood calcium levels cause release of PTH (parathyroid hormone)
PTH causes Ca retention at the kidney and Ca release from bone. Also interacts with vitamin D for calcium regulation

85
Q

Signs and Symptoms

A

stones(renal), bones, groans, moans, overtones

50% Asymptomatic
30% Bone pain
20% Renal stones
20% GI complaints, pain of the stomach and pancreas, constipation
20% CNS symptoms (fatigue, weakness)
10-20% Osteitis fibrosa cystica – decreased trabeculae. May also cause salt and pepper appearance in the skull (tiny punched out lesions)

86
Q

Diseases of the Parathyroid Glands

A

Hyperparathyroidism

Hypoparathyroidism – uncommon disorder causing low blood calcium

87
Q

Differential Diagnosis of Hypercalcemia

A

Malignancy: Parathyroid related:
Solid tumors with or
without metastases Primary hyperparathyroidism
Hematological tumors Familial hypocalciuric hypercalcemia

Renal related:	 Vitamin D:
Secondary hyperparathyroidism	 Vitamin D intoxication( increase calcium)
Milk-alkali syndrome	Sarcoidosis
Aluminum toxicity (chronic dialysis)	 Idiopathic Hypercalcemia of      infancy

High Bone Turnover:
Thyrotoxicosis (increase osteoclastic activity)
Immobilisation (reduced gravity)
Thiazide diuretics (decrease calcium)

88
Q

Prevalence of 1° HPT

A

Increased approximately 10 fold in last decade (automated lab techniques)
Varies considerably, depending on population studied
e.g. - Hospital inpatient – malignancy most common cause of hypercalcemia
- Healthy individual or hospital outpatient’s -1° HPT
- In total, usually 50% of new cases are asymptomatic

89
Q

Hypoparathyroidism

A

Rare condition!
May be caused by developmental disorder, autoimmune disease, or inadvertent surgical removal of parathyroids
Presents with hypocalcemia, tetany, irregular heartbeat, variable neurologic symptoms from hyperexcitability to depression

90
Q

Clinical Manifestations of Primary Hyperparathyroidism

A

1° HPT may present in one of three forms
Most patients have asymptomatic hypercalcemia
Insidious onset of hypercalcemia and mild non-specific symptoms such as headache, weight loss and depression
Renal colic occurs in approximately 25-35% of this group

91
Q

Causes of Hypocalcemia

A

Vitamin D Related:
Dietary deficiency, malabsorption or low exposure to sunlight
Renal failure, 1a-hydroxylase deficiency or treatment with phenytoin

Parathyroid related:
Hypoparathyroidism, pseudohypoparathyroidism
Magnesium deficiency

Iatrogenic:
Massive transfusion

Other:
Neonatal hypocalcemia
Acute pancreatitis
Hyperventilation

92
Q

Diabetes Overview

A

Diabetes mellitus - diseases of abnormal carbohydrate metabolism that are characterized by hyperglycemia.
It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin.
Every few years, the diabetes community re-evaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice.

93
Q

Overview of Major Diseases of the Pancreas

A 
Diabetes mellitus
 Pancreatitis
Acute pancreatitis
Chronic pancreatitis
Tumors of the exocrine pancreas
Tumors of the endocrine pancreas
94
Q

Diabetes

A

Hyperglycemia is the problem since glucose is a poison/ toxic in high concentration
Its poisonous effects are that it is an aldehyde which can covalently attach to proteins
This protein modification can affect blood vessels (arteries) nervous tissue etc to cause atherosclerosis and neuropathies.
Aim in diabetes is to achieve euglycemia ie normal glucose levels to prevent complications

95
Q

Diabetes Mellitus

A 
Primary
Type 1 (insulin dependent)
Type 2 (non–insulin dependent)
Secondary 
Pancreatic disease
Endocrine diseases
Genetic syndromes—hemochromatosis (disorder that results in too much iron being absorbed from the gastrointestinal tract), hyperlipidemia
96
Q

Type 1 (insulin dependent)

A

Acute onset, emergency presentation

Can present weeks to months after a viral or bacterial infection

97
Q

Type 2 (non–insulin dependent)

A

Does not present acutely
Is of epidemic proportions in some populations
Has some relationship to obesity.

98
Q

type 1 vs type 2

A

age of onset: 1: less than 30/ 2: more than 30 years old

speed of onet: 1: sudden/ 2: gradual

\body build: 1: normal/ 2: obeses

family history: 1:less than 20%/ 2: more than 60%

twin coincidence: 1: low/ 2: high

99
Q

Comparison of Type 1 and Type 2 Diabetes

A

antibodies to islet cells: 1:++/2”-

history of islet : 1:loss of beta cells/ 2: normal

srum insulin level: 1: low/ 2: normal

treatment: 1: insulin/ 2: diet, oral, hypoglycemics; insulin

100
Q

Diabetes Prevalence

A

An epidemiological model was constructed by applying age, sex, ethnic specific prevalence rates to resident populations of England at national, regional and PCT level.
The estimated prevalence of total diabetes for all people in England was 4.41% in 2001 equating to 2.168 million people.
Type 2 - 92.3%
Type 1 - 7.7%

101
Q

diabetic coma

A

ketoacidosis, hyperosmolality

102
Q

Complications of Diabetes Mellitus

A 
Cardiovascular
Atherosclerosis—gangrene of extremities
Arteriolosclerosis
Kidney
Glomerulosclerosis
Pyelonephritis
Eye
Retinopathy
Cataracts
Nervous system
Cerebrovascular disease
Peripheral neuropathy
103
Q

Pancreatitis

A

Inflammation of the pancreas
Can be acute or chronic
Acute pancreatitis is a medical emergency where the patient presents with acute abdominal pain.

104
Q

Causes of Acute Pancreatitis

A

Common Causes
Alcohol
Bile stones
Unknown

Rare Causes
Surgery
Trauma
Drugs
Metabolic diseases
Infections
 Mumps
105
Q

Features and Complications of Acute Pancreatitis

A 
Fat necrosis, calcifications, hypocalcemia 
Ascites, sterile peritonitis
Shock
Massive necrosis—pseudocyst
Abscess formation
Chronic pancreatitis
Diabetes mellitus
106
Q

Causes of Chronic Pancreatitis

A

Chronic alcoholism (70%)
Trauma
Systemic metabolic or endocrine disease
Unknown (20%)

107
Q

Chronic Pancreatitis - Clinical Features

A

Insidious onset
Pain in upper abdomen that radiates into the back
Malabsorption caused by pancreatic insufficiency
X-ray evidence of calcifications
Secondary diabetes mellitus

108
Q

Chronic Pancreatitis—Pathology

A 
Fibrosis of pancreas 
Atrophy and loss of acini
Intraductal stones
Parenchymal calcifications
Islets of Langerhans preserved, but in late stages of disease, reduced in number of replaced by fibrous tissue
109
Q

Pancreatic Neoplasms

A

In 95% of all cases, tumors are:
Exocrine rather than endocrine
Derived from ducts rather than acini or islets
Solid rather than cystic
Malignant rather than benign
Functionally silent rather than hormonally active

110
Q

Adenocarcinoma of the Pancreas

A

It is the fourth major cause of cancer death in men and fifth in women.
Each year, 25,000 new cases are reported in the United States.
Smoking increases the risk three times.
Chronic pancreatitis increases the risk two times.
It is rare before 40 years of age, but then incidence increases with age.
The prognosis is poor—most die within 2 years.

111
Q

Carcinoma of the Pancreas—Clinical Features

A

Weight loss, loss of appetite, nausea
Jaundice if located in the head
Courvoisier’s sign (gallbladder distention)
Pain if tumor located in the tail
Metastases (common)—lymph nodes, liver
Endoscopic retrograde cholangiopancreatography (ERCP) with aspiration cytology important for diagnosis

112
Q

Tumors of the Endocrine Pancreas(Islet Cell Tumors)

A

Insulinoma—hypoglycemia, syncope, profuse sweating, reversed by infusion of glucose
Gastrinoma—Zollinger-Ellison syndrome with multiple ulcers unresponsive to medical therapy; may be part of MEN1
Glucagonoma
Somatostatinoma
VIPoma (vasoactive intestinal peptide ) Verner Morrison syndrome,

113
Q

130 multiple choices, 3 hours, 20-30% from pre-mid-term material
70-80% from post midterm

A

hormoes of anterior pitiutary/ post
thyroid carcinoma primary hypothyroids, type 1,2 diabetes, pancreatitis, regulates potassium and sodium
zona fasciculata
adrenal hypofunction: addison disease may be cause by ___
atch can also be produced by

Pathology 205 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions