Endocrine- Pituitary & thyroid Flashcards
What does the pituitary gland do?
It receives signals from the brain (hypothalamus) and triggers hormones to be released.
What hormones are produced by the anterior pituitary gland?
ACTH- adrenocorticotrophic hormone.
TSH- thyroid stimulating hormone
GH- growth hormone
What hormones are produced by the posterior pituitary gland?
ADH =Anti-diuretic hormone
Oxytocin.
What are the two types of pituitary tumours you can get?
Functional- produce a hormone (ATCH/GH/TSH)
Non-functional-they just get bigger and squash things
What are the symptoms of a pituitary tumour?
Vision loss:
a pituitary tumour could affect the optic chiasma- (where the nerves cross) this would cause the loss of the nasal field.
Causing- Tunnel vision.
Discuss the effect of insufficient growth hormone on adults and children.
children- Growth failure- Right proportions but not enough of it.
Adults- metabolic change- Increased fat but loss of vitality (causing weakness)
Discuss the effect of excess growth hormone on adults and children.
Children- gigantism
Adults- acromegaly.
Describe what you would see intra-orally in an acromegally patient?
- Large tongue
- Interdental spacing
- reverse overbite
- “Denture shrinking”
How is growth hormone assessed?
Using levels of IGF- Insulin like Growth factor. (levels are proportional)
What is graves disease?
Autoimmune disease-
immune system produces antibodies that fit the TSH receptor.
This activates the thyroid gland and produces more thyroid hormone.
What is shown in this image?
Goitre- excercise of the thyroid gland producing a larger gland.
List symptoms of Hyperthyroidism?
- Diahorrea.
- Hot & excess sweating
- palpitations
- muscle weakness
- weight loss.
List signs of hyperthroidism
- High blood pressure & heart failure
- tachycardic
- atrial fibrillation
- Eye lid lag
- eyelid retraction.
- tremor
- hyperreflexia
Everything speeds up: metabolism. Heart rate.
What is this?
Ophthalmopathy
What causes opthalmopathy?
The antibody attaching to fat cells causing them to be red and swollen.
Discuss T3 and TSH levels in hyperthyroidism caused by the pituitary gland.
Raised TSH
Raised T3
Discuss T3 and TSH levels in hyperthyroidism caused by graves or adenomas
Low TSH
Raised T3
What drugs do we use to treat hyperthyroidism?
Beta blockers
Carbimazole.
Compare primary and secondary disease.
Primary- caused by a gland failure
Secondary- caused by control failure.
SeCondary = control
What is autoimmune thyroiditis?
When antibody binding to the gland causes gland inflammation and reduced metabolism.
WHat is idopathic atrophy?
Breakdown where the cause is unknown.
Compare the effect of hyperthyroidism and hypothyroidism
Hyperthyroidism increases metabolism.
Hypothyroidism decreases metabolism.
What are the T4 and TSH levels in hypothyroidism caused by the pituitary gland?
Reduced T4 and Reduced TSH
What are the T4 and TSH levels in hypothyroidism caused by the thyroid gland failure?
Raised TSH
Reduced T4
How do you treat hypothyroidism?
Give the patient Thyroid hormone (thyroxine)
slowly increase the dose.
What has to be given to patients post thyroid cancer surgery?
T4 as they no longer have their thyroid gland so are unable to produce thyroid hormone.
How would you treat an uncontrolled hyperthyroid patient?
Wait until they have their hyperthyrodism under control.
How would you treat an uncontrolled hypothyroid patient?
Avoid sedatives .
What are the signs and symptoms of a hypothyroid disorder?
Everything slows down:
Signs: bradycardia (slowed heart rate)
Symptoms :Weight gain (metabolism slows down)
cold intolerance.
