Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GERR > Lecture 28: Endocrine Pathology and Diabetes > Flashcards

Lecture 28: Endocrine Pathology and Diabetes Flashcards

1
Q

what is diabetes mellitus

A

abnormal metabolic state characterised by glucose intolerance due to inadequate insulin action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

difference between T1D and T2D

A

T1D:

  • juvenile onset
  • destruction of B cells
  • result of viral infection/ autoimmune
  • insulin dependent

T2D:

  • maturity onset
  • due to defective insulin action
  • insulin resistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe the pathogenesis of T1D

A
  • viral infection (coxsackie B?) in genetically susceptible children
  • infection perturbs immune regulation resulting in loss of tolerance
  • auto reactive T cells infiltrate islets –> insulinitis and destroy B cells
  • autoantibodies detectable against variety of B cell antigens
  • abrupt clinical onset when B cell loss becomes critical –> hyperglycaemia / ketoacidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

describe pathogenesis of T2D

A
  • complex multifactorial and polygenic
  • insulin resistance –> reduced ability of peripheral tissues to respond to insulin
  • B cell dysfunction –> inadequate insulin secretion in face of hyperglycaemia and insulin resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

give examples of complications of diabetes

A
  • retinopathy
  • nephropathy
  • peripheral vascular disease
  • infections
  • peripheral neuropathy
  • autonomic neuropathy
  • atherosclerosis
  • MI
  • Hypertension
    etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

outline renal complications of diabetes

A
  • diabetic nephropathy
  • glomerular lesions –> diffuse mesangial sclerosis and nodular glomerulosclerosis (damage to basement membrane accompanied by proteinuria
  • vascular lesions –> atherosclerosis of large vessels and arteriosclerosis of small vessels; hyaline arteriosclerosis of efferent arteriole
  • pyelonephritis w/ papillary necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the most common cause of hyperpituitarism

A
  • adenoma of ant. pit.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe the adenomas the types of adenomas that can cause hyperpituitarism

A
  • can be macro or micro and functional or non functional
  • functional assc. w/ distinctive endocrine syndromes
  • -> prolactinomas most common and assc. w/ loss of libido and infertility
  • macro adenomas assc. w/ mass effects e.g. visual disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is acromegaly

A

clinical syndrome assc. w/ excess growth hormone prod. by pituitary adenoma in adulthood

  • gigantism similar pathogenesis but exposure occurring prior to epiphyseal fusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

list some causes of pituitary hypofunction

A
  • adenoma
  • metastatic carcinoma
  • post-partum ischaemic necrosis (Sheehan’s syndrome)
  • infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

give examples of how ant. pit. hypofunction can be characterised

A
  • hypothyroidism

- hypoadrenalism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

list some types of thyroid disease

A
  • hypothyroidism
  • hyperthyroidism
  • colloid goitre
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

give some causes of hypothyroidism

A
  • iodine deficiency
  • congenital biosynthetic defect/ dyshormonogenetic goitre
  • post-ablative e.g. surgery, radiotherapy
  • Hashimoto’s (auto immune thyroiditis) –> most common
  • drugs e.g. lithium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

describe Hashimoto’s thyroiditis

A
  • lymphocytic infiltrate w/ formation of reactive lymphoid follicles w/ germinal centres
  • degenerative changes in thyroid follicular epi cells –> Hurthle cell change
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe the pathogenesis of Hashimoto’s

A
  • thyroid epi –> breakdown in self tolerance and induction of thyroid autoimmunity
  • T-cell mediated cytotoxicity
  • Thyrocyte injury from activated macrophages (assc. w/ chronic inflammation and fibrosis)
  • plasma cells w/ anti-thyroid Ab –> Ab-dependent cell mediated cytotoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

give some causes of hyperthyroidism

A
  • diffuse toxic hyperplasia
  • -> Grave’s disease
  • hyper functioning toxic multi nodular goitre
  • hyper functioning toxic adenoma
  • thyroiditis
  • -> lymphocytic
  • -> granulomatous
  • struma ovarii
  • exogenous thyroid hormone
  • thyroid gland tumours –> follicular adenoma
17
Q

describe Grave’s disease

A
  • breakdown in tolerance to thyroid autoantigens producing autoantibodies incl. thyroid stimulation immunoglobulin
  • thyroid stimulating immunoglobulin binds to TSH receptor mimicking impact of TSH
18
Q

outline types of multinodular goitre

A
  • endemic –> areas of iodine deficiency e.g. mountainous areas
  • sporadic –> seen in females, young adulthood, ingestion of foods, substances that interfere w/ synthesis of thyroxine biosynthesis
  • rarely dyshomonogenetic goitre due to congenital enzyme defects affecting thyroxine biosynthesis
  • usually eythyroid, rarely hyperthyroid –> toxic multinodular goitre
19
Q

name some clinical effects of multinodular goitre

A
  • difficulty swallowing
  • difficulty breathing
  • hoarse voice
20
Q

give examples of differentiated thyroid tumours

A
  • papillary carcinoma –> affects young
  • follicular carcinoma –> affects young to middle age
  • medullary carcinoma –> affects elderly
21
Q

describe Cushing’s syndrome

A
  • hypercortisolism due to ACTH producing pituitary microadenoma (Cushing’s disease)
  • may also result from adrenal cortical neoplasms, adrenal cortical hyperplasia, or ectopic ACTCH
22
Q

describe Conn’s syndrome

A
  • primary hyperaldosteronism
  • assc. w/ bilateral nodular hyperplasia of adrenal glands
  • hypertension and hypokalaemia
23
Q

list types of Cushing’s syndrome

A
  • pituitary (Cushing’s disease)
  • Adrenal
  • paraneoplastic
  • iatrogenic (from steroids)
24
Q

describe phaeochromocytoma

A
  • tumour of adrenal medulla
  • 10% tumour
  • -> 10% extra adrenal
  • -> 10% bilateral
  • -> 10% malignant
  • -> 10% familial
  • can cause hypertensive crises during anaesthesia for surgery
  • screened w/ urinary catecholamines
25
Q

describe acute hypoadrenalism

A
  • Waterhouse Friedrickson Syndrome
  • assc. w/ neisseria menigitidis, disseminated intravascular coagulation
  • haemorrhage into adrenal gland, assc. acute adrenal dysfunction
26
Q

describe Addison’s disease

A
  • chronic adrenocortical insufficiency
  • caused by chronic autoimmune adrenalitis, TB, AIDS and metastatic carcinoma

Symptoms

  • fatigue
  • weakness
  • GI disturbance
  • hyperpigmentation (primary –> assc. w/ ^ ACTH levels)
27
Q

describe hyperparathyroidism

A
  • cause of hypercalcaemia
  • 90% assc. w/ adenoma (seen in assc. w/ multiple endocrine neoplasia syndrome)
  • 10% assc. w/ parathyroid hyperplasia (seen secondary to chronic renal failure)

GERR (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions