Endocrine System Pathology 1 Flashcards
What hormones are secreted by the most common adenomas, causing hyperpituitarism?
(1) Prolactinomas - secrete prolactin
(2) Somatotrope adenomas - secrete growth hormone
(3) Corticotrope adenomas - secrete acth
(4) Gonadotrope adenomas - secrete fsh and lh
(5) Thyrotrope adenomas - secrete tsh
What are some of the causes of hypopituitarism?
(1) Adenoma impinging on pituitary
(2) Loss of blood supply
(3) Congenital agenesis
(4) Metastatic cancer
The following symptoms of amenorrhea postpartum, loss of hair, weakness, hypopigmentation would point to what diagnosis?
Postpartum pituitary necrosis (Sheehan necrosis)
In Sheehan necrosis what would happen when thyrotropin releasing hormone is administered?
There would be a lack of prolactin produced in response
What occurs with diabetes insipidus?
Decreased ADH causes polydipsia and polyuria
An open embryonic thyroglossal duct can cause what?
Thyroglossal duct cysts and fistulas with the potential for infection or in papillary cancer
What are the symptoms of Graves’ disease?
(1) Diffuse toxic goiter
(2) Nervousness
(3) Palpitations
(4) Rapid pulse
(5) Fatigability
(6) Weight loss
(7) Sweating
(8) Emotional lability
(9) Menstrual changes
(10) Exophthalmos
How does cretinism present in newborns?
Apathy
Sluggishness
Severe mental retardation
Stunted growth
Low body temperature
Cretinism is a congenital condition of iodine deficiency. This leads to insufficient thyroid hormone.
Hashimoto’s thyroiditis is associated with what autoimmune conditions?
(1) Systemic lupus erythematosus (SLE)
(2) Rheumatoid arthritis
(3) Graves’ disease
(4) Pernicious anemia
(5) Sjogren’s syndrome
Many autoimmune conditions are comorbid with other autoimmune conditions.
What are the phases of subacute thyroiditis?
Phase one: thyrotoxicosis
Phase two: hypothyroidism
Phase three: recovery to euthyroid state
Granulomatous and silent subacute thyroiditis are most often seen after what type of infection?
Viral infection
What are some causes of goiters?
(1) Physiologic enlargement
(2) Iodine deficiency
(3) Hashimoto’s thyroiditis
(4) Goitrogens
(5) Failure of thyroid hormone synthesis
Goiters are enlarged thyroid glands that can be caused by hyperthyroidism or hypothyroidism
What are hot nodules?
Thyroid adenomas are benign nodules that are highly active and take up radioactive iodine
What are the characteristics of thyroid cancer?
They are slow growing nodules that have lost function and do not take up radioactive iodine
Medullary carcinoma of the thyroid (mtc) is genetically associate with what conditions?
Multiple endocrine neoplasia types 2A and 2B
When is parathyroid hormone normally secreted?
It is secreted in response to low blood calcium levels. It increases reabsorption of calcium
What causes primary hyperparathyroidism?
Parathyroid adenoma. Primary endocrine conditions affect the gland at the gland level itself (vs. the hypothalamus or pituitary).
What causes secondary hyperparathyroidism?
Decreased serum calcium as a result of chronic renal disease. Secondary endocrine conditions are because of disorders of the pituitary. Tertiary conditions are due to hypothalamus dysfunction.
What three types of hormones are produced by the adrenal cortex?
(1) Mineralocorticoids - aldosterone
(2) Glucocorticoids - cortisol
(3) Androgens - DHEA
What is aldosterone’s effect in the body?
It increases sodium and water reabsorption by the kidneys
What are the symptoms of Cushing’s syndrome?
(1) Redistribution of body fat
(2) Skin atrophy with easy bruising and striae
(3) Hirsutism
(4) Muscle weakness
(5) Osteoporosis
(6) Amenorrhea
(7) Hypertension
(8) Hyperglycemia
(9) Psychiatric dysfunction
What is Conn’s syndrome?
Primary aldosteronism usually due to adrenocortical adenoma or hyperplasia that causes hyperproduction of adrenal mineralocorticoids.
What is Addison’s disease?
Adrenal gland fails to produce cortisol, aldosterone, and androgens, causing hypotension, increased pigmentation of the skin, increased serum potassium, decreased serum sodium, chloride, glucose and bicarbonate. Patients may present with increased thirst.
A mutation in the 21-hydroxylase gene (CYP21A2) causes what condition?
Congenital adrenal hyperplasia. 21-hydroxylase catalyzes the formation of cortisol and aldosterone (from progesterone).
Is this condition autosomal recessive or dominate?
Autosomal recessive
What is produced in the adrenal medulla?
Epinephrine and norepinephrine
What is the primary symptom of pheochromocytoma?
Paroxysmal or persistent hypertension. Pheochromocytoma is an adrenal gland tumor that hypersecretes hormones.
Where is insulin produced?
Pancreatic islet beta cells
Where is glucagon produced?
Alpha cells of the pancreas
What causes type I diabetes mellitus?
Failure of the beta cells of the pancreas to produce insulin from either autoimmune or genetic causes
What causes type II diabetes mellitus?
Increased insulin resistance of cells associated with central obesity and sedentary lifestyle
How do insulinomas clinically present?
Increased insulin secretion, confusion, anxiety, stupor, convulsions and coma (Whipple’s triad)
What is the Zollinger-Ellison syndrome?
A gastroduodenal hyperacidity syndrome caused by a gastrin-secreting tumor (gastrinoma) in the pancreas or intestinal wall
