Endocrine- the rest Flashcards
The hypothalamus is split in to the anterior pituitary and the posterior pituitary. What hormones are secreted from these?
ANTERIOR - multiple hormone - growth hormone - thyroid stimulating hormone (TSH) - adreno-corticotrophic hormone (ACTH) - FSH LH - prolactin
POSTERIOR - oxytocin (uterus contractions)
ADH( reabsorption of water from urine)
Hyperpituitarism related effects normally happen due to adenomas, cancer or hyperplasia . What are hypopituitarism related causes?
- ischaemic necrosis of the pituitary: Sheehans syndrome
- non functioning adenomas
- surgery or irradiation
- inflammatory lesions
What are the symptoms of hyper-pituitarisms and hypo-pituitary problems?
- compressing the optic chiasm
- visual problems
- treated by scapping away adenoma
When a pituitary adenoma occurs what does each of these hormone increases lead to:
- ACTH
- Growth hormone
- Prolactin
- TSH
- FSH/LH
ACTH - crushings disease
growth hormone - gigantism (children)
- acromegaly (adults) (facial features)
Prolactin - galactorrhea/ amenorrhea
- sexual dysfunction
- infertility
TSH - hyperthyroidism
FSH/LH - hypogonadism
- mass effects
- hypopituitarism
What causes hyperthyroidism?
- Graves disease (auto immune )
- over treatment by thyroxine
- infective - De Quervains thyroiditis (viral infection)
- toxic multinodular goitre
- toxic adenoma
What are the symptoms of hyperthyroidism?
- heat intolerance
- muscle wasting
- localised oedema
- tremors
- weight loss
- enlarged thyroid
- finger clubbing
- menstrual changes
- bulging eyes
What causes graves disease?
- unregulation overproduction of thyroid hormones
- antibody sits on receptor
- so switches off THS production - thyroxine increases
*Hyperthyroidism must be managed and treat the cause. What drugs will do this?
- carbimazole/ propylthioracil (down regulate thyroid gland)
- Radioiodine therapy (kills thyroid gland) (must be isolated from children)
- thyroidectomy
What causes hypothyroidism?
- iodine deficiency
- Autoimmune - Hashimoto’s thyroiditis
- lacrogenic: surgery, radioiodine
- pituitary defects
- congenital
What are the symptoms of hypothyroidism?
- intolerance to cold
- receding hairline
- facial and eyelid oedema
- weight gain
- lethargy
- muscle aches and weakness
- constipation
What is Hashimotos thyroiditis?
- autoimmune destruction of the thyroid gland
How do you manage hypothyroidism?
- thyroxine
What is the most common type of thyroid cancer?
- papillary carcinoma
- however normally non-functional tumour
What causes hypo-parathyroidism?
- removal by surgery (thyroidectomy)
- congenital
- hereditary (autoimmune)
What are the functions of the parathyroid glands?
- 4 in total
- to help calcium and phosphate regulation
What are the symptoms of hypo-parathyroidism?
- symptoms normally due to low calcium
- irritability
- tetany (muscle spasms)
- seizures
Hyper-parathyroidism are caused by ?
- adenoma
- chronic renal failure
- after renal transplant
What are the symptoms of hyper- parathyroidism
- due to hypercalcemia
- constipation
- depression
- seizures
- muscle wasting
- polyuria
- bone fractures
- kidney stones
(bones, stones, abdominal groans & psychic moans )
What are the symptoms of conns disease which is caused by hyperaldosteronism ?
- oedema
- hypertension
- high sodium
- low potassium
Glucocorticoids: corticol may increase due to stress, using steroids. What is caused when there is excess release?
- cushings syndrome
- due to ACTH releasing tumours
- or steroid use
What are the symptoms of cushings syndrome/ long term steroid use ?
- moon face
- buffalo hump
- thin, wrinkled skin
- adrenal tumour or hyperplasia
- muscle weakness
- poor wound healing
What is cushings disease?
- increase in corticol levels
Addisons disease is an adrenal insufficiency. What are the causes of it?
- autoimmune
- infection
- secondary to neoplasms
What are the symptoms of Addison’s disease?
- GI symptoms (anorexia, nausea, vomiting, diarrhoea)
- weight loss
- hyperpigmentation ((black in the gums ect. ) due to low circulating adrenal levels, ACTH increases)
- low sodium , high potassium
- Addison’s crisis (acute adrenal insufficiency ) - can be due to coming off steroids quickly
What is a phaeochromocytoma ?
tumour of the adrenal medulla which secrets adrenaline and noradrenaline
- increases heart rate, BP and metabolic rate
What are the presentations of phaeochromocytoma ?
Hypertension Sweating Palpitations Nervousness Increased metabolic ratio Rapid heart rate
What is multiple endocrine neoplasia? (MEN)
- Group of inherited diseases resulting in proliferative lesions of multiple endocrine organs
- there are different type
