Endocrine disease Flashcards
what is endocrine system made of?
. endocrine is a signal system and is made up of discrete endocrine glands which secrete chemical messages inside of the body into the blood stream , chemical messengers go around the body to talk to other endocrine gland and induce hormonal response
. these hormones exert their effect and can regulate things like metabolism, blood sugar levels
what are the endocrine glands?
. pituitary gland -
‘ growth/lactation/thyroid’
. pineal gland - sleep wake cycle
. thyroid- metabolism
. thymus- T cell maturation
. adrenal - stress response
. pancreas - glucose metabolism
. ovaries - ovulation
. testis - spermatogenesis
what does the pineal gland do?
- pineal gland is located in the brain and it secretes melatonin that regulates circadian rhythm or sleep wake cycles
what is the most common disease that affects pineal gland?
. pineal tumours - unregulated cell proliferation within the glands which has an effect on secretion of hormones
. pineal tumours are very , very rare
. little grey area , enlarged pineal gland
<1:200,000
how common is pineal tumours within intracranial tumours?
. comprise <1% of intracranial tumours
what age is the pineal tumour peak?
. adults 35-60 years of age peak
what are the symptoms of pineal gland tumour?
. symptoms are not actually related to the hormone
. the symptoms arise due to the gland increasing in size and pushes around brain tissue around it
- headache - due to hydrocephalus - which is build up of fluid within the brain - enlargement of pineal gland can block CSF flow
- insomnia/sleep disturbances
- nausea
- blurred vision - due to increase in pressure which affects visual pathway
- upward gaze palsy ( parinaud syndrome ) - pineal gland sits near superior colliculus, which regulates up gaze movements - enlargement of pineal gland can disturb superior colliculus
- staggering gait
- hearing loss
where is pituitary gland located?
- lies close to the optic nerves
- sits below optic chaism
- sits in the hypophysial fossa of the sphenoid bone
- surrounded by sella turcica
- this means that pituitary gland is restricted in which direction it can grow when it gets a tumour because its surrounded by bones - only direction it can grow is up
what are the two regions of pituitary gland?
. anterior lobe
. posterior lobe
what does the pituitary gland link?
. pituitary gland is the main link between the nervous system and endocrine system
. lots of hormones are triggered by pituitary gland
what is the most common cause of endocrine system ?
. the most common cause of endocrine disease is tumour formation - unregulated proliferation of cells
how do pituitary tumours arise ?
- end up with more cells which are secreting more hormones - the presence of pituitary hormone hyper -secretion ( i.e. tumours )
- absence or diminution of hormone secretion caused by destruction of pituitary (i.e. caused by ischemia)
. increase in cell size causes an increase in gland size and that will have an effect on the other structures on the area , pressure is put on localised blood vessels and you can collapse down the lumen of blood vessels - this decreases blood flow
- direction and extent of local expansion and invasion of adjacent structures
non functioning adenoma (glandular tumour)- as these endocrine glands are increasing in size, the actual hormones being secreted are not changing - most dangerous - as you are getting an organ within your body increasing in size within the brain , invade adjacent structures
how common is pituitary tumour?
. represent 10-15% of intracranial neoplasms
what are different types of pituitary tumours you can have?
. when you get a pituitary tumour it can be in any one of endocrine gland cells - referred to as different tumour name
in order of prevalence
- prolactinomas - tumour of lactotroph
- growth hormone secreting adenoma - affects somatotrophs
- non secreting adenomas - most deadly - can occur in any cell type
- corticotroph adenoma (ACTH) - corticotrophs
- TSH, FSH, LH - thyrotrophs and gonadotrophs
15% of pituitary adenomas secrete >1 hormone with prolactin + growth hormone the most common combination
. tumour can affect more than one cell type
what is prolactinomas?
. prolactinomas makes up 30% of pituitary tumours
. lactotrophs become non-responsive to the prolactin inhibitory factor - loss of dopamine inhibition - over secretion of prolactin out of lactotrophs- cause secondary trauma