Endocrine Pathology Flashcards
3 main types of hyperpituitarism
= functioning adenoma
Prolactinoma
GH adenoma
ACTH adenoma
how will prolactinoma present
amenorrhoea, galactorrhoea, dec libido, infertility
how will GH adenoma present
gigantism/acromegally, DM, muscle weakness, HTN
what will ACTH adenoma cause
cushings disease
causes of hypopit
non sec pit adenoma -> compression
ischaemic necrosis (sheehan syndro, DIC, shock)
surgery/radiation
what presents similar to prolactinoma
GnRH deficiency
what are some common complication of pituitary tumours
lrg tumour -> compression of optic chiasm -> bitemporal hemianopia
raised ICP - headaches in morning/ when coughing/leaning forward, N&V
what hormones are produced by the posterior pituitary
oxytocin and ADH
changes in ADH levels and results
ADH excess = SIADH (eurovol hyponat)
ADH def = DI - absolute def (cranial) or resistance (nephrogenic)
causes of hyperthyroidism
primary = graves, multinodular goitre, thyroiditis
secondary = TSH prod adenoma
how will graves disease presnt
thyrotoxicosis, exophalmos, pretibial myxoedema
F>M
what is the antibody in graves disease
anti-TSH R ab
what AI disorders are associated with graves
SLE
pernicious anemia
T1DM
addisons
most common cause of hypothyroidism
uk = hashimotos - 45-65, painless enlargement world = iodine def
4 types of thyroid carcinoma
papillary (75-85%)
Follicular (10-20)
medullary - mainly 50-60y
anaplastic - elderly, v rare but v aggressive
what are the features of a papillary thyroid carcinoma
painless mass in neck
psammomas
what would you suspect if you saw a medullary thyroid carcinoma in a young pt
suspect MEN
blood changes in primary and secondary hyperpara
pri = inc PTH, inc Ca sec = inc PTH, low Ca
causes of pri hyperpara
adenoma, gland hyperplasia, carcinoma
causes of secondary hyperpara
renal F
symptoms of hypoparathy
CATS go numb
chvostek - tap facial nerve -> twitch
trousseau - inflate Bp cuff -> carpopedal spasm
hormone production in the adrenals
ZG -> mineralo (aldos)
ZF -> glucoc (cortisol)
ZR -> androgens
Medulla -> stress hormones
how will cushings syndro present
HTN, trunchal obesity, moon face, buffalo hump, cutaneous striae
causes of cushings syndro
exogenous steroids = most common
ectopic ACTH = sml cell carcinoma of lung
cushings d = ACTH prod adenoma
how will hyperaldosteronism present
HTN and hypokalaemia
causes of hyperaldosteronism
Conn’s syndro (aldos sec adenoma), bilat adrenal hyperplasia
causes of adrenal insuff
acute = sudden withdrawal of long term steroids, sepsis with DIC, haemorrhage chronic = AI/TB
