endocrine system Flashcards
hormone deficiency
caused by the glandular destruction
endocrine cells cannot synthesize hormone
ex) type 1 diabetes
hormone excess
caused by tumor growth, autoimmunity or genetic mutations
excessive function of endocrine cells
ex) graves disease
hormone resistance
caused by the genetically inherited diseases
produce dysfunctional membrane receptors
defective hormone action elevated levels of hormone
ex) type 2 diabetes
hypopituitarism
pituitary tumor adenoma - interferes with hypothalamic delivery to pituitary gland
tropic hormone production is reduced and target gland hormone production is reduced
pituitary gland is dysfunctional and doesn’t respond to feedback system
diagnosis ; low tropic and endocrine hormone levels
tx: hormone replacement
hyperpituitarism
pituitary adenoma
protactinomas:
Women: menstrual abnormalities, vaginal dryness, osteopenia
Men: decreased libido, erectile dysfunction, infertility
Amenorrhea (W)
Galactorrhea (W)
Gynecomastia (M)
Hypogonadism (M)
diabetes insipidus
Hypopituitarism that originates in the posterior pituitary gland
causes: tumors, infection, inflammatory disorders
ADH is inhibited - water is not retained
presentation “dry”
polyuria
do a urinalysis - low osmolarity
meds: vasopressin ADH
SIADH
Syndrome of Inappropriate Antidiuretic Hormone
Hyperpituitarism
causes: nervous system disorders, pulmonary
SIADH causes excess water reabsorption into the bloodstream
Causes hypervolemia, hyponatremia and highly concentrated urine
presentation “soaked inside”
fatigue, confusion, edema, HTN
severe/rapid onset: seizures, slowed reflexes
urinalysis: elevated osmolarity, sodium
tx: fluid restriction fouesmide - excrete more water
hyperthyroidism
excessive secretion of T3 and T4
graves disease
subacute thyroiditis inflammation
Toxic adenoma: single hyperfunctioning tumor
primary reason: thyroid gland is hyper secreting
think “fast” symptoms
symptoms: nervousness, insomnia, sensitive to heat, weight loss, inc appetite
graves disease: exothalamus - wide eye stare
periorbital edema
TSH low, T3 and T4 high
tx: methimazole
hypothyroidism
insufficient T3 and T4 (thyroxine)
risk factors: age, caucasians, females, medications/drugs
primary: thyroid doesn’t produce enough hormone
Hashimoto’s thyroiditis: high number of lymphocytes and TSH receptor antibodies in the thyroid gland
presentation “low and slow”
weight gain, puffy face, peripheral edema, lethargy, slow pulse, cold intolerance
diagnosis: TSH high, T3 and T4 low
secondary: TSH low, T3 and T4 low
tx: levothyroxine
addison’s disease - hypo
autoimmune destruction of adrenal gland
secondary: pituitary tumor or prolonged corticosteroid drug usage Autoimmune destruction leads to decreased cortisol response to stress
Less cortisol available→ adrenal crisis
Prolonged glucocorticoid usage: CRF and ACTH feedback suppression
presentation “skinny and weak”
fatigue, muscle weakness, adrenal atrophy, urinary losses: sodium and water
hyponatremia: low serum levels
hyperkalemia: high serum potassium
rapid ACTH test
tx: daily glucortiocsteroid and mineralcortcocoid replacement
cushing’s syndrome - hyper
pituitary adenomas; Excessive secretion of ACTH from anterior pituitary
nelson’s syndrome: Pituitary secretes excessive ACTH, but there is no adrenal gland to receive the stimulus
No cortisol, no feedback to pituitary to stop releasing ACTH
carney complex: genetic disorder that causes adrenal hyperplasia
cushing disease: diffuse hyperplasia of anterior pituitary cells,→ increase ACTH secretion → adrenal hyperplasia
Circadian rhythm of adrenal secretion is disrupted
presentation “big and brittle” - moon face, buffalo hump, cardiac hypertrophy, osteoporosis
diagnosis: Dexamethasone suppression test
tx: Ketoconazole: inhibit steroidogenesis
pheochromomcytoma
Rare tumor of adrenal medulla that secretes epinephrine and norepinephrine
severe hypertension, altered mental status, seizures, tremors, tachycardia
pineal gland dysfunction
Pineal gland: contains sympathetic neurons that travel to the retina
Releases melatonin
Pineal gland tumor puts pressure on other parts of the brain
Hydrocephalus: treated with a shunt
Symptoms:
Headache
Nausea and vomiting
Seizures
Memory disturbances
Visual changes
