Lecture 22 - Pathologies of the Endocrine System

Question 1

Pathologies of the Endocrine System

Answer 1

• pathologies ultimately caused by over-production or under-production of hormones

Question 2

Acromegaly

Answer 2

• pituitary gland makes too much growth-hormone produced by adenomas
• happens in adults, after epiphysis closure
• results in bone thickening

Question 3

Diabetes insipidus

Answer 3

• posterior pituitary (Neurophysis) is not making enough antiduretic hormone (ADH)

Question 4

Myxedema

Answer 4

• hypothyroidism in adulthood

Question 5

Graves Disease

Answer 5

• antibody targets against thryoid stimulating hormone (TSH) receptor
• hyperplasia of throid tissue = hyperthyroidism

Question 6

Goiter

Answer 6

• another hyperplasia of thyroid tissue only this is not an autoimmune disease
• compensatory enlargement of the thyroid
• Hyperthyroidism caused by plummer syndrome
• Can be Hypo-, Hyper-, or Euthyroidis (normal)

Question 7

Cushing Syndrome

Answer 7

• hypercortisolism of adrenal gland

- caused by excessive stimulation of adrenal cortex

Question 8

Conn Syndrome

Answer 8

• hyper aldosteronism of adrenal gland

- cause sodium retention and potassium excretion

Question 9

Features the make thyroid nodule a neoplasm

Answer 9

More likely to be neoplastic if

1. Solitary
2. In younger patients
3. In males
4. Radiation treatment - increases incidence of thyroid malignancy
5. Nodules that take up radioactive iodine - more likely to be benign (can’t take up iodine = cold nodules = probably malignant)

Question 10

Effects of Hyperparathyroidism

Answer 10

• cause increase in serum ionized calcium
• associated with parathyroid gland
• symptoms: painful bones, renal stores, abdominal groans, psychic moans (depression / seizure)
• typically primarily by adenoma and secondary to suppressed calcium levels

Question 11

Effects of Hypoparathyroidism

Answer 11

• caused by surgical removal of parathyroid gland, congenital absence (DiGeorge), or autoimmune where cell target parathyroid cells
• causes hypocalcemia
  Symptoms: increased neuromuscular irritability and cardiac arrhythmias

Question 12

Diabetes Mellitus

Answer 12

• disease of endocrine pancreas
  Pathological Changes:
• Macrovascular disease = accelerated atherosclerosis
• Hypertension = due to vascular lesions
• Diabetic microangiopathy - thickens the basement membranes of small vessels
• Diabetic nephropathy - glomerular lesions, renal vascular lesions, pyelonephritis
• Retinopathy = vascular changes and subsequent scarring
• Diabetic Neuropathy - of lower extremities - decreased sensory functions

Question 13

Effects of Islet Cell Tumors

Answer 13

• Beta cell tumor
• insulinomas = produce insulin (most common, cause significant hypoglycemia)
• Gastrinomas = hypersecretion of gastrin. Common affect = peptic ulcers. Associated with Zolliner-Ellison syndrome

Question 14

Pheochomocytoma - location and effects

Answer 14

• tumor composed of chromaffin cells in adrenal medulla
• produce excess catecholamines and give rise to hypertension and tachycardia, palpitations, headache, sweating, tremor, and sense of apprehension