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MED YEAR 2 :GI,Endocrine ,Renal and reproductive > Endocrine system pathology , physiology > Flashcards

Endocrine system pathology , physiology Flashcards

1
Q

describe the vascular and neuronal connections between hypothalamus and pituitary

A

1) Anterior Pituitary = vascular pathway

2) Posterior lobe = neuronal pathways

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2
Q

List main pituitary hormones

posterior Gland

A

Posterior pituitary (neurohypophysis) :

  • Oxytocin ( milk ejection , uterine contraction , love hormone ) = neural lobe
  • ADH ( supra optic nucleus )= vasoconstriction and Increases H2O permeability, increases thirst and keeps water in the kidney
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3
Q

List hormones from Anterior pituitary

A

Mainly trophic hormones

1) Growth hormone (Insulin in the liver)
2) TSH
3) Prolactin (milk)
4) LH
5) Melanocyte stimulating hormone (stimulates melanocytes to produce melanin)
6) ACTH (adrenal gland to secrete corticosteroids)
7) FSH (gonads )

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4
Q

what are trophic hormones?

A

1-Regulates hormone secretion by another endocrine gland ie: TSH –>TH via the thyroid gland

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5
Q

which hormones are secreted by the neurohypophysis?

A

ADH, Oxytocin

another name for posterior pituitary

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6
Q

How are the levels of the trophic hormones modulated by feedback?

A

Vetral Hypothalamus ( releases releasing hormones)
1-TRH –>TSH
2-GnRH–>FSH,LH

There are releasing and inhibiting hormones too ( ie : Prolactin Releasing Hormone is inhibited most of our life , and only positive when breast milk is needed .

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7
Q

Decreased secretion of which hormone results from damage of the The hypothalamic–hypophysial portal system

A

Hypothalamic hypothesis portal system – connects to the anterior pituitary = blood connection so It causes decrease in trophic hormones .
The hypothalamic–hypophysial portal system is the conduit that connects the brain to the anterior pituitary. The portal system is made up of two capillary beds, one in the median eminence and the other in the anterior pituitary.

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8
Q

1) What connects the anterior pituitary to the hypothalamus ?
2) what connects the posterior pituitary to the hypothalamus ?

A

1- The hypothalamic–hypophysial portal system

2-Neuro tissue –>neuronal connection

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9
Q

what is circadian rhythm ?

A

1- Body clock (normal rhythm of secretion of hormones )

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10
Q

primary hypo secretion

A

1-Too little hormone in secreting gland

dietary no I2, genetic , chemical , toxic ,autoimmune disease , cancer

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11
Q

Secondary, tertiary Hyposecretion?

A

1) Too little tropic hormone ( ie too little TSH )= pituitary hypo function =trauma , carcinoma , ischaemic necrosis =Sheehan’s disease

2) Tertiary = deficiency of the hypothalamic releasing hormone
ie: not enough TRH

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12
Q

what is panhypopituitarism

A

1- Not enough of any hormone ( anterior and posterior pituitary )

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13
Q

Hypersecretion

primary, secondary , tertiary

A

1-primary = Abnormality in the gland

2) Secondary = excessive tropic hormone from the pituitary
3) Tertiary = too much of the hypothalamus releasing hormones

( often due to cancer )

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14
Q

consequence of

a) increases ACTH
b) increases in Prolactin
c) Increase in TSH
d) Increase in hGh in children

A

a) ACTH = corticosteroids in excess= Cushings disease
b) Increase prolactin =Imparied reproductive function
c) Increased TSH = Graves Disease
d) Hgh Increase = gigantism in children

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15
Q

Thyroid hormones:
1-where are they made
2-what is needed

A

-20-40 follicles in a lobule, filled with a substance called colloid in THYROID GLAND
-cuboidal epithelial cells
iodine is required to FORM
1)Iodide + tyrosine –>Monoiodotyrosine(MIT)
2) DIT
3)MIT+DIT=T3 Triiodothyronine
4)DIT+DIT=Thyroxine

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16
Q

Manufacturing of T3, T4
(cell transporter channels x2
enzyme for the Iodine x1
receptors in the gland)

(10)

A

1)RER in cell synthesizes thyroglobulin, packaged via Golgi apparatus –>coloid to make thyroglobulin with I-
2)Na+ /I transported allows Na+ into a cell with I- but I- needs to be moved to colloid via CL/I transporter= cl moves into the cell and I- goes into the colloid
3)Iodide –>IoDINE via peroxidase enzyme
4)Iodine binds to tyrosine
(MIT, DIT, T3, T4 made)
5) Lipid soluble so they are packaged into the follicular cells and T3, T4 separated from thyroglobulin via lysosome
6)lipid hormones bind to thyroid binding proteins
7)T3 is more reactive but more T4 is released, so sometimes T4 is converted to T3– they bind to receptors on DNA=Thyroid hormone receptor and Retinoid X receptor
8) Metabolic effect is brought around

17
Q

Metabolic Actions of T3 /T4

A

1) Metabolic :
- O2 consumption increases
- Increased BMR
- Carbohydrate metabolism increases( glycogenolysis, and gluconeogenesis )
- Lipid metabolism ( increases free fatty acid levels, increases FFA oxidation, increases LDL receptor number = less cholesterol in blood )
- Protein metabolism (synthesis and break down )

18
Q

Systemic effects of thyroid hormones

6

A

1) Heart = increased HR, CO, blood flow to the skin
2) Lungs = increases BR
3) GIT=Increases appetite, secretes digestive juices, motility
4) Promotes normal reproduction and lactation
5) MSK =normal growth
6) NS=Normal neuronal development

Thyroid hormones affect every cell and all the organs of the body. They:
Regulate the rate at which calories are burned, affecting weight loss or weight gain. Can slow down or speed up the heartbeat.

19
Q

HPA AXIS

A

Stress -ve on hypothalamus
Cold +ve effect
TRH–>TSH–>T3,4
( BMR increases, protein synthesis, sympathetic tone )

20
Q

TSH action of the thyroid gland?

A

1) Increases Iodide trapping and binding ( more Na+/I- symporter)
2) Promotion o thyroglobulin into the colloid
3) Stimulates T3, T4
4) Promotion of colloid endocytosis into follicular cells
5) Increased size and number of follicular cells
6) Increases T3, T4 in blood

21
Q

Hypothyroidism

-causes

A

Problems with the thyroid gland due to thyroiditis =Hashimoto’s disease or Chronic lymphocytic Thyroiditis

  • I2 deficiency
  • enzyme deficiency
  • removal of the thyroid gland
  • Goitre( enlargement of the gland )
  • Lithium
22
Q

Congenital hypothyroidism

diagnosis in children and effect on development

A

1) early diagnosis of the child

2) brain, bone, development seriously impaired!

23
Q

causes of hyperthyroidsm

A

1) Autoimmune disease ( TSH receptor on the thyroid gland, and trick the receptor into secreting too much thyroid hormone )= GRAVE’S DISEASE
2) Thyroid Adenoma
3) TSH-secreting adenoma (rare)
4) thyrotoxicosis
5) Follicular Adenoma = small proportion produce thyroxine

24
Q

signs and symptoms of hyperthyroidism

name 4

A
  • Hyperactivity
  • Irritability
  • Palpitations
  • Diarrhoea
  • Weight loss
  • Fatigue and weakness from hyperactivity
  • Tremor and tachycardia
25
Q

Signs and symptoms of hypothyroidism

name 4

A
  • sluggishness
  • Cold intolerance
  • Breathlessness
  • Weigh gain whilst not eating much
  • bradycardia
  • dry skin
  • constipation
26
Q

Cushings syndrome

A

-ACTH producing tumour in anterior pituitary gland
-Adrenal Hyperplasia + hypercortisolaemia
Too much cortisol = glucocorticoid

27
Q

Addisons disease

A 
-chronic adrenocortical insufficiency 
Caused by : TB, AIDS, metastatic carcinoma 
-Too little cortisol , aldosterone 
-They look bronzed
-lack of energy or motivation (fatigue)
- muscle weakness.
- low mood.
- loss of appetite 
- unintentional weight loss.
- increased thirst
28
Q

Hyper parathyroidism causes and effects

A

In primary hyperparathyroidism, one or more of the parathyroid glands is overactive.

  • Too much parathyroid hormone (PTH).
  • Too much PTH causes calcium levels in your blood to rise too high,
  • bone thinning and kidney stones.
29
Q

causes of Hyperpituitarism

A
  • adenoma of the anterior lobe of pituitary gland
  • Prolactinomas = v common (loss of fertility )
  • Excess GH from adenoma in Pituitary gland =ACROMEGALY= giantism
30
Q

Goitre

A

Enlarged thyroid gland
1- iodine deficiency ie : Himalayas
2-Females
3-Congenital enzyme effects affecting thyroxine biosynthesis

31
Q

Different types of cancer in thyroid gland

A

1) Papillary Carcinoma (lymph nodes–>Spread to blood, diagnosed in children )
2) Follicular Carcinoma = spread through blood to lungs and bones , young and Middle Aged people
3) Medullary Carcinoma= neuroendocrine hormone = secretes calcitonin, contain amyloid pink staining, found in elderly spread to local areas, lymphatic and blood stream

32
Q

What is it called when :

a) Too many glucocorticoids
b) You have an overactive thyroid= too much T3, T4
c) Too much aldosterone

A

A)Cushings
B)Graves
c)Conn’s

33
Q

what is Crohns disease ?

A

It is a type of inflammatory bowel disease

MED YEAR 2 :GI,Endocrine ,Renal and reproductive (32 decks)

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