endocrine dysfunction

Question 1

panhypopituitarism

Answer 1

loss of all anterior pituitary hormones, leaving only posterior function intact

Question 2

hormones of the anterior pituitary

Answer 2

prolactin
melanocyte stimulating hormone
gonadotropic hormone
thyroid stimulating hormone
adrenocorticotropic hormone
growth hormone

Question 3

hormones of the posterior pituitary

Answer 3

antidiuretic hormone

oxytocin

Question 4

hypopituitarism

Answer 4

diminished or deficient secretion of pituitary hormones. gonadotropin deficiency leads to regression of secondary sex characteristics (breasts, etc). most common cause tumours in the pituitary or hypothalamic region. dx: absent or deficit reserve of pituitary GH.

Question 5

pituitary hyperfunction

Answer 5

excess GH before closure of the epiphyseal shafts results in proportional overgrowth of the long bones. rapid vertical growth accompanied by increased and rapid development of muscle and viscera. If excess GH occurs after epiphyseal closure, growth occurs in transverse direction, producing condition known as acromegaly.

Question 6

precocious puberty

Answer 6

manifestations of sexual development before age 9 in boys and 8 in girls. in boys, interstitial cell stimulating hormone stimulates Leydig’s cell of the testes to secrete hormones; in girl follicle stimulating hormone and luteinizing hormone stimulate ovarian follicle to secrete estrogen.

Question 7

types of precocious puberty

Answer 7

central precocious puberty: puberty development is activated by the hypothalamic gonadotropin releasing hormone. this produces early maturation and development of the gonad with secretion of sex hormones, development of secondary sex characteristics, and sometimes production of mature semen and ova
peripheral precocious puberty: early puberty resulting from hormone stimulation other than the gonadotropin hormone. isolated manifestations associated with puberty with variations in normal sexual development.
incomplete precocious puberty: included are premature thelarche (development of breasts), premature pubarche (development of sexual hair), and premature menarche (isolated menses)

Question 8

diabetes insipidus

Answer 8

under secretion of antidiuretic hormone (vasopressin), producing a state of uncontrolled diuresis. polyuria and polydipsia cardinal signs of DI. dx: restrict fluid intake and see urine response; normally urine is concentrates and reduced in volume, in DI there is no change but there is weight loss from dehydration. tx: hormone replacement IM or subQ (vasopressin)

Question 9

syndrome of inappropriate antidiuretic hormone (SIADH)

Answer 9

hypersecretion of ADH from the posterior pituitary. causes fluid retention and hypotonicity.

Question 10

juvenile hypothyroidism

Answer 10

deficiency in secretion of thyroid hormone.

Question 11

goitre

Answer 11

enlargement or hypertrophy of the thyroid gland. may occur with deficient, excessive, or normal thyroid hormone secretion.

Question 12

lymphocytic thyroiditis

Answer 12

enlarged thyroid gland due to autoimmune disorder (cells attack the body organs, tissues, and cells). self limiting disease. gland enlarged symmetrically, is firm, freely movable, and nontender

Question 13

hyperthyroidism

Answer 13

most common cause of hyperthyroidism is Grave’s Disease - caused by autoimmune response to TSH receptors. Clinical sign of GD is enlarged thyroid gland, excessive motion and exophthalmos (protruding eyeballs). 3 tx to reduce hormone secretion: anti thyroid medication to interfere with biosynthesis of TH; subtotal thyroidectomy; or ablation with radioiodine

Question 14

hypoparathyroidism

Answer 14

disorders that result in deficit PTH. two transient forms of hypoparathyroidism in infants - both result of PTH deficiency: maternal hyperparathyroidism or maternal DM OR infants fed milk formula with high phosphate to calcium ratio.

Question 15

pseudohypoparathyroidism

Answer 15

genetic defect in the cellular receptors to PTH. result is normal parathyroid gland and elevated PTH

Question 16

chvostek and trousseau sign to indicate hypoparathyroidism

Answer 16

chvostek - facial muscle spasm elicited by tapping the facial nerve in the region of the parotid gland
trousseau - carpal spasm elicited by pressure applied to nerves in upper arm

Question 17

acute adrenocortical insufficiency

Answer 17

insufficient secretion of adrenal corticosteroids - glucocorticoids, mineralocorticoids, and sex steroids

Question 18

cushing syndrome

Answer 18

group of manifestations caused by excessive circulating free cortisol. 5 categories of cushing syndrome: pituitary - attributed to excess of ACTH; adrenal - hypersecretion of glucocorticoids; ectopic - autonomous secretion of ACTH; latrogenic - large amounts of exogenous corticosteroids; food dependent - inappropriate sensitivity of adrenal gland to normal postprandial increase in secretion of gastric inhibitory polypeptide

Question 19

Congenital adrenal hyperplasia (CAH)

Answer 19

family of disorders caused by decreased enzyme activity required for cortisol production in the adrenal cortex, The adrenal glands produce
excessive amounts of cortisol precursors and androgens to compensate. Excessive androgens cause masculinization of the urogenital system.