Endocrine Disease

Question 1

List some of the major endocrine glands:

Answer 1

1. Pineal
   
   2. Pituitary
   3. Thyroid
   4. Pancreas
   5. Adrenal

Question 2

What is the function of the pineal gland?

Answer 2

It secrets Melatonin that regulates the Circadian rhythm or sleep/wake cycle.

Question 3

What are the symptoms a patient with a Pineal tumour may experience?

Answer 3

Pineal tumours are very very rare
	• Headaches 
	• Nausea 
	• Blurred vision 
	• Upwards Graze palsy 
	• Gait
	• Insomnia/ sleep disturbance 
	• Hearing loss

Question 4

List the common adult pituitary tumours:

Answer 4

1. Prolactinomas
   
   2. Growth Hormone secreting adenoms
   3. Non secreting adenomas
   4. Corticotroph adenoma (ACTH)
   5. TSH, FSH, LH are all rare

Question 5

What are the signs and symptoms of Prolactinomas?

Answer 5

They make up 30% of pituitary tumours 
In women: 
	• Amenorrhea - usually noticed 
	• Galactorrhea - 'witches milk' 
In men: 
	• Testicular atrophy 
	• Gynecomastia -' man boobs'
	• Diminshed body hair 
	• Impotence

Question 6

What are the signs and symptoms of growth hormone secreting tumours?

Answer 6

Patients report gradual enlargement of facial features, hands and feet. Rumour may be large at time of diagnosis as signs and symptoms are slow.

Question 7

What are the signs and symptoms of Cortictrophin secreting adenoma (ACTH)?

Answer 7

Ratio in females to makes = 4:1 
	•  Truncal obesity 
	• Abdominal striae
	• Moon faces 
	• Thin skin 
	• Hight blood pressure 
	• Glucose intolerance 
	• Fatigue

Question 8

What are the signs and symptoms of FSH, LH and TSH?

Answer 8

• Least common
  
  • Usually in middle aged mend and women
  • Usual presentation visual field loss, headache and Diplopia
  • In men decreased libido/energy

Question 9

What are the signs and symptoms of non secreting adenomas?

Answer 9

• Severe frontal headaches

* Visual field defect (monocular or bitemporal hemianopia sup>inf) typical

Question 10

What are the symptoms of a patient with Hyperthyroid?

Answer 10

• Weight loss despite good appetite
  
  • Heat or cold intolerance
  • Tachycardia

Question 11

What type of disease is Graves disease?

Answer 11

It is an autoimmune disease caused by the breakdown in self tolerance.

Autoantibodies bind to or in the regions of TSH receptors and results in an increase of T4 + T3.

Question 12

Why doe the EOM’s increase in size?

Answer 12

• Infiltration of T-cells to retro-bulbar space
  
  • Inflammation/oedema
  • Accumulation of ECM matrix components i.e. GAGS hyaluronic acid and chondroitin sulphate
  • Increase number of adipocytes

Question 13

What is Hyperthyroidism Goitres associated with?

Answer 13

Lack of iodine

Question 14

What are the 2 types of Diabetes Mellitus?

Answer 14

1. Type 1 - B-cell destruction in Islet of Langerhans = No insulin production - No glucose uptake into cells
   
   2. Type 2 - Insulin resistance and B-cell dysfunction