[M] Week 7: Endocrine System - Part 2 Flashcards
- derived developmentally from pharyngeal pouches that also give rise to the thymus.
- Located at the back of the thyroid
Parathyroid Gland
There are 4 parathyroid glands what are those
2 superior and 2 inferior
Function of parathyroid gland
regulate calcium homeostasis
The activity of the parathyroid is in the?
bloodstream
The four parathyroid glands are composed of two cell types are?
chief and oxyphil cells
Chief cells predominate
Normally, decreased levels of free calcium stimulate the synthesis and secretion of?
Parathyroid Hormone (PTH)
HYPERPARATHYROIDISM
Primary, Secondary, and Tertiary
- compensatory hypersecretion of PTH in response to prolonged hypocalcemia, most commonly from chronic renal failure
- an autonomous overproduction of parathyroid hormone (PTH), usually resulting from an adenoma or hyperplasia of parathyroid tissue
- persistent hypersecretion of PTH even after the cause of prolonged hypocalcemia is corrected, for example after renal transplant
- Secondary
- Primary
- Tertiary
what are their main causes
Thyroid ::
Parathyroid ::
Thyroid - Hyperplasia
Parathyroid - Adenoma
Parathryoid
- one of the most common endocrine disorders, and it is an important cause of hypercalcemia
- CAUSES:
1. Adenoma - 85 to 95%
2. Primary hyperplasia - 5-10%
3. Parathyroid carcinoma - 1%
Primary Hyperparathyroidism
Parathryoid
What is the most common cause of primary hyperparathyroidism
a solitary parathyroid adenoma arising sporadically
Parathryoid
- caused by any condition that gives rise to chronic hypocalcemia, which, in turn, leads to compensatory overactivity of the parathyroid glands.
- Renal failure is by far the most common cause
Secondary Hyperparathyroidism
Parathyroid
- far less common than is
hyperparathyroidism. - Due to deficient PTH
- Causes:
1. Surgically Induced
2. Congenital absence of all glands
3. Familial isolated hypoparathyroidism
4. Autosomal dominant hypoparathyroidism
Hypoparathyroidism
- In this condition, hypoparathyroidism occurs because of end-organ resistance to the actions of PTH
- Serum PTH: normal or elevated - sometimes, the serum PTH is normal but the organ itself is not responsive
- PTH resistance is the most obvious clinical manifestation
- TSH resistance is generally mild, while LH/FSH resistance manifests as hypergonadotropic hypogonadism in females.
- ORGAN ITSELF REJECTS THE HORMONES
Pseudohypoparathyroidism
Pancrease have how much islets of langerhans?
1 million
What are the fourmajor cell types found in the pancrease?
- Beta (68%)
- Alpha (20%)
- Delta (10%)
- PP Cells (2%)
Beta and Alpha are most important
Pancrease
MATCH
- Insulin - Induce hypoglycemia
- Pancreatic polypeptide - Stimulate secretion of gastric and intestinal enzymes and inhibit intestinal motility
- Glucagon - Induce hyperglycemia
- Somatostatin - Suppresses both insulin and glucagon secretion
A. Alpha
B. Delta
C. PP Cells
D. Beta
- D
- C
- A
- B
Pancreas
Match
- Elaborate vasoactive intestinal polypeptide (VIP), which is a hormone that induces glycogenolysis and hyperglycemia
- Synthesize serotonin and are the
source of pancreatic tumors that
cause the carcinoid syndrome.
A. DI Cells
B. Eneterochromaffin Cells
- A
- B
DISORDERS OF ISLET CELLS
- a systemic disease or group of metabolic disorders characterized by hyperglycemia– the increase in blood sugar
- Arises from defects due to insulin secretion, insulin action or both
Diabetes Mellitus
Diagnosis - Diabete Mellitus
According to the ADA and WHO diagnostic criteria for diabetes include the following:
1. A random glucose ____, with classical signs and symptoms
2. A fasting glucose ____ on more than one occasion
3. An abnormal OGTT in which the glucose is 2 hours after a standard carbohydrate load
- > 200 mg/dL
- > 126 mg/dL
- > 200 mg/dL
DISORDERS OF ISLET CELLS
- Results from severe lack of insulin caused by an immunologically mediated destruction of B-cell
- Commonly develops in childhood, manifest at puberty, and progresses with age
- An autoimmune disease where genetic susceptibility and environmental factors play important role
Type 1 Diabetes Mellitus
DISORDERS OF ISLET CELLS
Infections, e.g., viruses, coxsackievirus B, mumps, CMV, rubella, & IM → Tissue damage & inflammation or produce proteins that mimic self-antigen (molecular mimicry) or viral “de ja vu” with predisposing and precipitating virus
Environmental Factors of TYPE 1 DM
DISORDERS OF ISLET CELLS
Genetic factors even more important role than in type 1 diabetes
Type 2 Diabetes Mellitus
MORPHOLOGY OF DIABETES
Pancreas:
1. Type 1: reduced number & size of islets, ____, beta-cell degranulation
2. Type 2: subtle reduction of islet cell mass, ____ ____
- insulitis
- amyloid replacement
TREATMENT OF DIABETES MELLITUS
what type of Diabetes can be prevented?
Type 2 by lifestyle and dietary alterations
TREATMENT OF DIABETES MELLITUS
Type 1 cannot be prevented because it is autoimmune however it can be cured, how?
Islet cell transplantation
- are paired endocrine organs consisting of a cortex and a medulla, which differ in their development, structure, and function.
- Glands located on top of the kidney.
- Also called as Suprarenal Glands
ADRENAL GLAND
Cortex of the ADRENAL GLANDS
Match
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
A. secretes glucocorticoids in the
form of cortisol
B. secretes sex steroids in the form
of androgen and estrogen
C. secretes mineralocorticoid in
the form of aldosterone
- C
- A
- S
Medulla of adrenal secretes?
catecholamines; epinephrine
Adrenal Glands
What disorder can be acquired by conditions that produce
elevated glucocorticoid levels
CUSHING SYNDROME (HYPERCORTICOLISM)
pabasa nalang ng shits dito
Adrenal Glands
the generic term for a group of closely related conditions characterized by chronic excess
aldosterone secretion
HYPERALDOSTERONISM
HYPERALDOSTERONISM
Chronic excess of aldosterone→ Na+ retention and K+ excretion→?
- High sodium = hypertension
- Low potassium = hypokalemia
Type of HYPERALDOSTERONISM
Match
- autonomous overproduction of aldosterone, with resultant hypertension, suppression of the renin-angiotensin system, and decreased plasma renin activity
- RAAS activation, which occurs when there is a drop in blood pressure, a decrease in blood pressure, reduced renal perfusion, hypovolemia, or sometimes even during pregnancy.
A. Primary Hyperaldosteronism
B. Secondary Hyerperaldosteronism
- A
- B
Adrenal Glands
Disorders of sexual differentiation, such as virilization or feminization, can be caused by primary gonadal disorder
and several primary adrenal disorders
ADRENOGENITAL SYNDROME
ADRENOCORTICAL INSUFFICIENCY
This uncommon but catastrophic syndrome is characterized by the following:
- Overwhelming bacterial infection, classically Neisseria meningitidis septicemia but occasionally caused by other highly virulent organisms, such as Pseudomonas species, pneumococci, Haemophilus influenzae, or even staphylococc
PRIMARY ACUTE ADRENOCORTICAL
INSUFFCIENCY
WATERHOUSE-FRIDERICHSEN SYNDROME
ADRENOCORTICAL INSUFFICIENCY
- Decreased stimulation of the adrenals due to a deficiency of ACTH
- An uncommon disorder resulting from the progressive destruction of the adrenal cortex. In the Philippines, the primary cause of chronic adrenocortical insufficiency is tuberculosis.
- Clinical manifestations appear when 90% of adrenal cortex is destroyed
PRIMARY CHRONIC ADRENOCORTICAL
INSUFFCIENCY (ADDISON DISEASE)
MULTIPLE ENDOCRINE TUMOR
- a rare heritable disorder with a
prevalence of about 2 per 100,000. - characterized by abnormalities involving the parathyroid, pancreas, and pituitary gland; thus the mnemonic device, the three P’s.
MEN-1, or Wermer syndrome,
MULTIPLE ENDOCRINE TUMOR
is characterized by pheochromocytoma, medullary carcinoma of the thyroid, and
parathyroid hyperplasia.
MEN-2A, or Sipple syndrome
MULTIPLE ENDOCRINE TUMOR
- has significant clinical overlap with MEN-2A
- accompanied by neuromas or ganglioneuromas involving the skin, oral mucosa, eyes, respiratory tract, and gastrointestinal tract, and a marfanoid habitus, with long axial
skeletal features and hyperextensible joints
MEN, TYPE 2B
MULTIPLE ENDOCRINE TUMOR
- Variant of MEN-2A, no other clinical manifestations; genetic testing done among kindred; RET mutation → prophylactic thyroidectomy
- It arises in the family, so we need to counsel the family to undergo screening because they will eventually develop medullary thyroid cance
FAMILIAL MEDULLARY THYROID CANCER
It is a minute, pinecone-shaped organ (hence its name), weighing 100 to 180 mg and lying between the superior colliculi at the base of the brain
PINEAL GLAND
- It is composed of a loose, neuroglial stroma enclosing nests of epithelial-appearing pineocytes, cells with photosensory and neuroendocrine functions
- “Third Eye”
PINEAL GLAND
