Endocrine Disorders 1 Flashcards
How are hormones inhibited?
They are inhibited by their own release.
What are the hormones found in the anterior lobe of the pituitary gland? (6)
Growth hormone (GH)
Adrenocorticotropic hormone (ACTH)
Thyroid stimulating hormone (TSH)
Follicle stimulating hormone (FSH)
Leutinizing hormone (LH)
Prolactin (PRL)
What are the hormones found in the posterior lobe of the pituitary gland?
Oxytocin
Vasopressin/Anti-diuretic Hormone (ADH)
What is the most common cause of adult pituitary dysfunction?
Pituitary adenoma (tumor of pituitary gland)
Are micro or macro adenomas more prevalent?
Micro adenoma
What percent of people is thought to have a micro adenoma?
About 20%
How big is a micro pituitary adenoma?
under 1 cm
Under 10 mm
How big is a macro pituitary adenoma?
1 cm or more
10 mm or more
What is the most common type of pituitary adenoma?
Prolactinoma (36%-57%)
What is the second most common type of pituitary adenoma?
Nonfunctioning adenoma (28-37%)
What is the most rare type of pituitary adenoma?
Thyrotropinoma (1%)
You have a male patient that has breast enlargement and increased female characteristics, what type of pituitary adenoma might they have?
Prolactinoma
You have a patient that has gigantism and acromegaly. What type of pituitary adenoma might they have?
Somatotropinoma (GH)
What type of pituitary adenoma does not respond to medication very well?
Corticotropinoma
What visual effects can be caused by a macro pituitary adenoma? Where do the effects begin?
Bi-temporal visual field loss from pressure on the optic chiasm. Effects begin more superior and continue inferiorly.
Term for sudden vascular damage to the pituitary
Pituitary apoplexy
What can pituitary apoplexy result in?
Loss of hormone release due to ischemia or hemorrhages, resulting in other systems to shut down.
Are males or females more likely to experience pituitary apoplexy?
Males 3:1
Are males or females more likely to experience pituitary apoplexy?
Males 3:1
What are some signs and symptoms of pituitary apoplexy?
Headache
nausea/vomiting, syncope
Visual field defects
diplopia
blurred vision
A patient is experiencing hypotension, hypoglycemia, and subarachnoid hemorrhage, what could this patient have?
Adrenal insufficiency
What is the most common cause of pituitary apoplexy?
pituitary adenoma
What is it called when the pituitary has insufficient blood supply due to loss of blood during pregnancy?
Sheehan’s syndrome. Patient goes into shock.
What are some complications from gigantism (somatotropinoma- GH)?
Type 2 diabetes
Cardiomegaly
Heart failure
Sleep apnea
What is the disease when excess Gh is present after the growth plates close?
Acromegaly
A patient notices his shoe size/ ring size increasing, facial features enlarging, and a deepening of the voice, what disease might this be?
Acromegaly
(Corticotropinoma- GH)
What two diseases are in response to corticotropinomas?
Gigantism (before growth plates close)
Acromegaly (after growth plates close)
Disease that results in high cortisol levels
Cushing’s Disease
Disease that has excessive production and release of catecholamines
Pheochromocytoma
Disease that has low cortisol or low aldosterone
Addison’s disease
Explain Cushing’s disease vs Cushing’s syndrome
Cushing’s disease: Pituitary adenoma that results in excessive anterior pituitary secretion of ACTH.
Cushing’s syndrome: Causes increase in cortisol from other parts of the body.
What is the most common exogenous source of increased cortisol levels that may cause Cushing’s syndrome?
Prednisone medication
What things can cause Cushing’s syndrome?
Adrenal adenoma
Adrenal carcinoma
Ectopic ACTH (cancer)
Exogenous steroid use (Prednisone)
A patient is experiencing hyperglycemia, hypertension, and osteoporosis, what disease may this person have?
Cushing’s syndrome
What ocular complications could you see from Cushing’s syndrome?
1)Central serous choroidopathy
2) Posterior Subscapular Cataracts
3) Steroid-Response glaucoma
4) Visual field defects (adenoma)
5) Microvascular retinopathy
What percent of patients experience ocular complications from Cushing’s syndrome?
5%
Tumor of the adrenal medulla
Pheochromocytoma
What are some signs and symptoms of Pheochromocytoma?
Increased sympathetic nervous system so:
Hypertension
Headache
Flushing
Diaphoresis
Tachycardia
Heat intolerance
Weight loss
What can pheochromocytoma lead to if it is bad enough?
Hypertensive crisis
If you take a serum and urine test to look at catecholamines, what disease are you looking for?
Pheochromocytoma
What is Von Hippel-Lindau Syndrome? What can it be associated with?
VHL is a tumor supressor gene that is absent in this syndrome. It can be associated with Pheochromocytoma.
What kind of genetic inheritance is Von Hippel-Lindau syndrome?
Autosomal dominant
What is unregulated in Von Hippel-Lindau syndrome?
VEGF
You see a retinal capillary hemangioma, what disease causes this?
Von Hippel-Lindau syndrome. Look for a pheochromocytoma
You see a retinal capillary hemangioma, what disease causes this?
Von Hippel-Lindau syndrome. Look for a pheochromocytoma
Lack of ADH produced in pituitary that causes inability to concentrate urine.
Diabetes Insipidus
What is the most common type of dwarfism? What is a lack of?
Disproportionate (80%)
Lack of growth hormone in 70% of cases.
When does Addisons disease occur?
at 90% destruction
Is Addisons disease a primary or secondary insufficiency?
Primary
What is the most common cause of Addison’s disease?
Autoimmune Disease
How do you check for Addison’s disease?
Give ACTH to patient and observe ATCh levels. If ATCH levels don’t rise, they have Addison’s disease.
Life threatening condition caused by low cortisol levels
Addison’s Crisis
What can cause Addison’s crisis?
Corticosteroid withdrawal
Stress
Trauma
