Endocrine Pathology- Exam II Flashcards
Functions of the endocrine system include: (4)
- maintain metabolic equilibrium (homestasis)
- secrete chemical messengers (hormones)
- regulate activities of various organs
- process of feedback inhibition
Maintaining metabolic equilibrium:
homeostasis
Chemical messengers:
hormones
In the process of feedback inhibition, increased activity of target tissue, typically ____ the activate of the gland secreted the stimulating hormone
down regulates
Diseases of under/over production of hormones:
endocrine diseases
Endocrine diseases are associated with development of:
mass lesions
What are the 3 classifications of endocrine diseases?
- too little
- too much
- others: tumors
Tumors of endocrine glands whether benign or malignant, may secrete the hormone native to the gland. These tumors are said to be:
functional tumors
With functional tumors of endocrine glands, it may be the ___ or the _____ that calls attention to the tumor
mass effect; or metabolic effect of the excessive hormone
List the endocrine organs: (6) -
excluding testicles, ovaries, pineal gland, hypothalamus
- anterior pituitary
- posterior pituitary
- thyroid
- parathyroid
- pancreas
- adrenal gland
Where is the pituitary gland located?
base of brain- sella turcica
The pituitary gland is connected to the:
hypothalamus
The pituitary gland is connected to the hypothalamus by:
- stalk composed of axons
- venous plexus
What is the function of the pituitary gland:
central role in regulation of other endocrine glands
What are the two components of the pituitary gland?
- anterior lobe (adenohypophysis)
- posterior lobe (neurohypophysis)
What part of the pituitary gland is the adenohypophysis?
anterior lobe
What part of the pituitary gland is the neurohypophysis?
posterior lobe
How are the diseases of the pituitary gland categorized?
based on what lobe is mainly affected
Label the following image:
A: pons
B: midbrain
C: hypothalamus
D: pituitary gland
What can be seen in the following image?
pituitary gland
Label the following image:
A: hypothalamus
B: anterior pituitary (adenohypophysis)
C: posterior pituitary (neurohypophysis)
What are the different types of cells in the anterior pituitary?
- somatotrophs
- lactotrophs
- corticotrophs
- thyrotrophs
- gonadotrophs
Describe what the following cell of the adenohypophysis produces:
- somatotrophs
- lactotrophs
- corticotrophins
- thyrotrophs
- gonadotrophs
- growth hormone (GH)
- prolactin
- adrenocorticotrophic hormone (ACTH)
- thyroid stimulating hormone (TSH)
- follicle stimulating hormone (FSH) and luteinizing hormone (LH)
The following hormones are produced in the:
- growth hormone (GH)
- prolactin
- adrenocorticotrophic hormone (ACTH)
- thyroid stimulating hormone (TSH)
- follicle stimulating hormone (FSH) and luteinizing hormone (LH)
anterior pituitary (adenohypophysis)
What hormones are produced in the posterior pituitary? (2)
- Antidiuretic Hormone (ADH/Vasopressin)
- Oxytocin
The following hormones are produced in the:
- Antidiuretic Hormone (AHD/Vasopressin)
- Oxytocin
posterior pituitary (neurohypophysis)
What is the function of the following hormone?
Growth hormone (GH)
tissue growth
What is the function of the following hormone?
TSH
Stimules thyroid to produce thyroid hormones
What is the function of the following hormone?
ACTH
Acts on the adrenal gland to produce cortical hormones
What is the function of the following hormones?
FSH and LH
Act on the testes to produce testorone and sperm
Act on the ovaries to produce the ova, estrogen, and progesterone
What is the function of the following hormone?
Prolactin (PRL)
Acts on breast glandular tissue
What is the function of the following hormone?
Oxytocin
Acts on uterus for uterine contraction; functions in lactation
What is the function of the following hormone?
ADH
Acts on kidney to stimulate water reabsorption
Diseases of the anterior pituitary include:
- Hypopituitarism (decrease secretion of trophic hormones)
- Hyperpituitarism (increased secretion of trophic hormones)
Disease of the anterior pituitary in which there is a decreased secretion of trophic hormones:
hypopituitarism
Disease of the anterior pituitary in which there is an increased secretion of trophic hormones:
hyperpituitarism
What are the characteristics of hypopituitarism?
destructive lesions/processes
Give some examples of what might cause hypopituitarism:
- ischemia
- radiation
- inflammation
- neoplasms
What are the characteristics of hyperpituitarism?
functional adenoma within the anterior lobe with local mass effects
What are some of the local mass effects involved in hyperpituitarism?
- enlargement of sella turcica
- visual field abnormalites
- increased intracranial pressure
- pituitary adenomas
- radiation treatment
- neurosurgery
- Sheehan syndrome
These are all potential causes of:
hypopituitarism
Ischemic necrosis of the pituitary gland:
Sheehan syndrome (may cause hypopituitarism)
What are the clinical manifestations of hypopituitarism? (6)
- pituitary dwarfism
- amenorrhea & infertility
- low libido & impotence
- postpartum lactation failure
- hypothyroidism
- hypoadrenalism
- pituitary dwarfism
- amenorrhea & infertility
- low libido & impotence
- postpartum lactation failure
- hypothyroidism
- hypoadrenalism
These are all clinical manifestations of:
hypopituitarism
- pituitary adenomas
- pituitary hyperplasia
- pituitary carcinomas
- hypothalamic disorders
These are all potential causes of:
hyperpituitarism
What are the clinical manifestations of hyperpituitarism?
- gigantism
- acromegaly
- Cushing disease
- condition of hyperpituitarism
- excess growth hormone (GH)
gigantism
Gigantism is caused by ____ which produces excess growth hormone
primary tumor
The primary tumor in gigantism is an:
adenoma of the AP
what is the second most common anterior pituitary syndrome?
gigantism
What type of tissues are affected in gigantism?
all growing tissues
Gigantism occurs:
before growth plate closure
List the symptoms associated with gigantism: (7)
- generalized overgrowth (3 standard deviations)
- headaches
- chronic fatigue
- arthritis & osteoporosis
- muscler weakness
- hypertension
- CHF
- condition of anterior pituitary with excess growth hormone
- late diagnosis
- poor vision
- enlarged skull, hands, feet, & ribs
- soft tissue, viscera
- enlarged maxilla, mandible, nasal & frontal bones, & maxillary sinus
- intraoral manifestations
acromegaly
Describe the intraoral manifestations of acromegaly: (5)
- diastemas
- malocclusion
- macroglossia
- enlarged lips
- sleep apnea
Diabetes insipidus (central) is a condition involving the:
posterior pituitary
What are two symptoms associated with diabetes insipidus (central)?
- polyuria (dilute urine)
- polydipsia
Diabetes insipidus (central) is due to irregularities in what hormone?
Secretion of innapropriotely high levels of ADH (SIADH) from the posterior pituitary
The secretion of inappropriately high levels of ADH (SIADH) seen in diabetes insipidus (central) may cause:
- hyponatremia
- cerebral edema
- neurologic dysfunction
- increased total body water
Describe the increased total body water seen in diabetes insipidus? (2)
- blood volume normal
- no peripheral edema
Iodide from a normal diet is stored in the ____ (bound to ____) and used for production of ___ and ___
thyroid gland (bound to thyroglobulin); T3 and T4
T3 and T4 have identical chemical compositions except for:
addition of one iodide (in T4)
___ is produced exclusively by the thyroid while majority of ___ is the result of ___ conversion
T4; T3; T4
____ is the activator for synthesis of TSH
TRH (thyrotropin releasing hormone)
TRH is the activator for synthesis of:
TSH
____ is the activator for T3 and T4 production
TSH (Thyroid Stimulating hormone)
- T3/T4 levels are low
- Elevation in ____ levels
- Increase in T3/T4 production
TSH
TRH controls ___ production
TSH
TSH controls ___ production
T3/T4
The 3 glands that are responsible for thyroid function include:
- hypothalamus
- pituitary
- thyroid
A very small percentage of T3 and T4 is not bound to ____ and remains ___
thyroxine binding proteins; free in circulation
What form of T3 and T4 are metabolically active?
the small percentages of each that are free in circulation
What is the effect on basal metabolic rate with:
- decreased T3 and T4
- increased T3 and T4
- decreased BMR
- increased BMR
Low levels on T3 and T4 have what effect on gluconeogenesis and glycogenolysis?
decreased gluconeogenesis & decreased glycogenolysis
High levels of T3 and Tr have what effect on gluconeogeneis and glycogenolysis
increased gluconeogenesis & increased glycogenolysis
Low levels of T3 and T4 have what effect on protein metabolism?
decreased protein synthesis & decreased proteolysis
High levels of T3 and T4 have what effect on protein metabolism?
increased protein synthesis, increased proteolysis and muscle wasting
Low levels of T3 and T4 have what effect on lipid metabolism?
decreased lipogenesis & decreased lipolysis & increased serum cholesterol
High levels of T3 and T4 have what effect on lipid metabolism?
increased lipogenesis & increased lipolysis & decreased serum cholesterol
Low levels of T3 and T4 have what effect on thermogenesis?
Decreased thermogenesis
High levels of T3 and T4 have what effect on thermogenesis?
increased thermogenesis
Low levels of T3 and T4 have what effect on the autonomic nervous system?
normal levels of serum catecholamines
High levels of T3 and T4 have what effect on the autonomic nervous system?
Increased expression of beta adrenoreceptors (increased sensitivity to catecholamines, which remain at normal levels)
Discuss causes of primary hypothyroidism:
- intrinsic abnormality in the thyroid
- surgery
- radiotherapy
- autoimmune
Discuss the causes of secondary hypothyroidism:
pituitary failure
If hypothyroidism is caused by pituitary failure, this results in:
secondary hypothyroidism