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Mechanisms of Disease > Endocrine System Pathology > Flashcards

Endocrine System Pathology Flashcards

1
Q

______ is caused by deficient ADH production by the neurohypophysis

A

Diabetes Insidpidus

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2
Q

What is the consequence of decreased ADH?

A
  • Excess water excretion
  • Serum Na+ and osmolarity increase
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3
Q

What are some potential causes of diabetes insipidus? (3)

A
  1. Head trauma
  2. Tumors
  3. Inflammation of the hypothalamus/pituitary
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4
Q

What are the two types of diabetes insipidus?

A
  1. Insufficient ADH → Central DI (CDI)
  2. ADH insensitivity → Nephrogenic DI (NDI)
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5
Q

What are the symptoms of CDI? (3)

A
  1. Frequent urination
  2. Extreme thirst
  3. Life-threatening dehydration
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6
Q

What are the treatments for mild and severe CDI?

A
  • Mild - drink more water
  • Severe - vasopressin
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7
Q

What is SIADH?

A

Syndrome of Inappropriate ADH secretion

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8
Q

What is the most common cause of SIADH?

A

ADH-secreting tumors (ex: small-cell lung carcinoma)

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9
Q

What is the consequence of excess ADH secretion?

A
  • Excessive water resorption
  • Dilutes blood → hyponatremia
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10
Q

How does SIADH present clinically?

A
  1. Hyponatremia
  2. Cerebral edema
  3. Neurologic dysfunction (like water intoxication)
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11
Q

Urine excretion can be increased to ___ mL/min when large quantities of hypotonic fluids are ingested.

A

16 mL/min

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12
Q

What are the symptoms of water intoxication? (3)

A
  1. Swelling of CNS neurons
  2. Convulsions
  3. Coma (deadly)
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13
Q

What is Sheehan syndrome? Cause?

A
  • Ischemic necrosis to the pituitary during/after pregnancy
  • Anterior pituitary undergoes hypertrophy during pregnancy without new vasculature
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14
Q

What are the symptoms of Sheehan syndrome? (5)

A
  1. Amenorrhea
  2. Infertility
  3. Lactation failure
  4. Hypothyroidism
  5. Pallor due to loss of melanocyte stimulation
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15
Q

Where are steroid and peptide hormones produced?

A
  • Steroid - adrenal cortex
  • Peptide (catecholamines) - adrenal medulla
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16
Q

Release of catecholamines are induced by _____

A

nerve signals

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17
Q

What disease is known as the progressive destruction of the adrenal cortex?

A

Addison disease

18
Q

What are the different causes of Addison disease and how do they affect the gross appearance of the adrenal glands? (4)

A
  1. Autoimmune - shrunken
  2. Infection - inflammatory
  3. AIDS - inflammatory
  4. Cancer - enlarged with tumor
19
Q

What are the symptoms of Addison’s disease? (5)

A
  1. Progressive weakness and easy fatigue
  2. GI disturbances
  3. Skin hyperpigmentation due to increase in POMC
  4. Volume depletion/hypotension
  5. Hypoglycemia and lack of gluconeogenesis
20
Q

Cushing syndrome results from _____

A
  • chronic exposure to high blood glucocorticoid levels
  • Most commonly due to excess ACTH secretion by the adenohypophysis
21
Q

Iatrogenic Cushing syndrome results from ____

A
  • Medical administration of glucocorticoids to treat non-endocrine disorders
  • Immune suppression for autoimmune/transplant patients
22
Q

Endogenous Cushings can be _____ or _____.

A
  • ACTH dependent
  • ACTH independent
23
Q

Is an adrenocortical tumor ACTH dependent or independent?

A
  • ACTH independent
  • Produces ACTH or ACTH-like peptide
24
Q

What is the cause of Cushing’s disease?

A
  • ACTH-secreting pituitary adenoma
  • Leads to high cortisol levels
25
Q

How do high cortisol levels affect other hormones?

A
  1. Suppress CRH secretion (hypothalamus)
  2. Suppress ACTH secretion (pituitary)
  3. Inhibits GH, TSH, and gonadotropin
  4. Decreases insulin production and gluconeogenesis
26
Q

What are the symptoms of Cushing’s?

A
  1. Hypertension
  2. Centralized weight gain
  3. Atrophy of fast-twitch muscle fibers → proximal limb weakness
27
Q

Cushing’s promotes catabolism of collagen and bone production which leads to?

A
  • Fragile skin with poor wound healing
  • Striae on the skin
  • Osteoporosis
28
Q

What is a pheochromocytoma?

A
  • Benign tumor of chromaffin cells in the adrenal medulla
  • Results in norepinephrine secretion
29
Q

What are the symptoms of a pheochromocytoma? (6)

A
  1. Tachycardia
  2. Cold hands/feet
  3. Feeling hot (cannot dissipate)
  4. Throbbing headache (secondary to severe HTN)
  5. Nausea and vomiting
  6. Visual disturbances
30
Q

Goiters result from ____

A
  • Impaired synthesis of thyroid hormones
  • Usually due to iodine insufficiency
31
Q

Size of a goiter is directly related to _____

A

amount of hormone deficiency

32
Q

What foods can impair thyroid hormone synthesis and lead to development of a goiter?

A
  • Cabbage
  • Cauliflower
  • Cassava root (tapioca)
    • Thiocyanate inhibits iodine transport
33
Q

Thyroiditis refers to any inflammation of the thyroid. What are the 3 most common types?

A
  1. Hashimoto
  2. Granulomatous
  3. Subacute lymphocytic
34
Q

______ is an autoimmune disorder that results in autoantibodies against thyroglobulin and thyroid peroxidase.

A

Hashimoto thyroiditis

35
Q

What are the general symptoms of hypothyroidism? (7)

A
  1. Depression-like symptoms (fatigue, apathy, mental sluggishness, etc.)
  2. Slower metabolism (weight gain)
  3. Cold intolerance
  4. Decreased sympathetic nerve activity → constipation, decreased sweating
  5. Decreased blood flow → skin becomes cool and pale
  6. Reduced cardiac output → SOB, decreased exercised capacity
  7. Accumulation of ECM substances into the skin → nonpitting edema, enlargement of the tongue, deepening of voice
36
Q

_______ is an autoimmune disorder of the thyroid, where autoantibodies cause stimulation of the thyroid.

A

Graves disease

37
Q

How does Graves disease present clinically? (5)

A
  1. Hyperthyroidism (diffuse hypertrophy); may result in goiter
  2. Heart hypertrophy/ischemia
  3. Exophthalmos
  4. Localized infiltrative dermopathy on the shins (less common)
  5. Generalized lymphoid hyperplasia
38
Q

What is osteomalacia?

A
  • Failure to mineralize calcium from bone
  • Results from vitamin D deficiency
  • Hypocalcemia
39
Q

How does osteomalacia present clinically?

A
  1. Soft bones prone to breaks (similar to osteoporosis)
  2. In children, rickets
40
Q

How is osteomalacia treated?

A

Vitamin D supplementation; mostly with milk

41
Q

What is the difference between primary and secondary hyperparathyroidism? Which is most common (***)

A
  • Primary - increased PTH production, typically by a solitary parathyroid adenoma
  • ***Secondary - result of chronic renal failure

Mechanisms of Disease (13 decks)

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