MedComplex-Endocrine2 Flashcards
_________ of the thyroid or goiter is the MOST COMMON manifestation and reflects impaired synthesis of thyroid hormone, mostly from a deficiency of dietary_______
Enlargement….. iodine
Low concentrations of T3 and T4 in the serum results in inadequate feedback inhibition of the pituitary, which responds to the low levels of thyroid hormones by OVERPRODUCING _____.
TSH
Most patients are euthyroid, and it is far more common in females than males (about ___ to ___)
8 to 1
________ Goiter? Enlargement of the thyroid without functional, inflammatory, or neoplastic alterations.
NON-Toxic
2 types of NON-toxic goiters: The types are _______ nontoxic, seen mostly in adolescence and pregnancy, and _________ nontoxic goiters, usually seen in persons over the age of fifty.
diffuse…. multinodular
What does the diffuse type of goiter represent?
It represents the early stages of the disease where the gland is diffusely enlarged with mildly enlarged follicles with minimal ______
colloid
What does the ________ type represent? Reflects more of a chronic disease, with nodular enlargement and cyst formation with microscopically, larger follicles with increased colloid separated by dense fibrosis, focal calcifications and chronic inflammation.
multinodular
Hyperfunctioning of the thyroid gland in the vast majority is caused by ________ (85%)
Graves Disease
*TEST Q?? WOAH! What is the most PREVALENT AUTOIMMUNE DISEASE in the US?
Graves Disease
Graves Disease is an autoimmune disease caused by antibodies to the _____ receptors on the surface of the thyroid follicular cells.
TSH
The pathogenesis of Graves Disease relates to increased circulating antibodies (___) that bind to the surface of the thyroid cells, exerting a stimulus similar to the effects of TSH itself.
IgG
Graves Disease: Elaboration of these thyroid-stimulating antibodies requires thyroid-specific helper (CD-4) positive T-Cells that recognizes the TSH receptors and activates the ___- cells.
B cells
Which thyroid disorder? The colloid tends to be depleted and appears scalloped or “moth-eaten” where it abuts the epithelium.
Graves Disease
The protrusion of the eyeballs is a common complication of _______, caused by enlargement of the orbital extraocular muscles.
graves disease
What condition? Patients exhibit a gradual onset of nervousness, tremor, weakness and weight loss, although they have an increased appetite.
Graves
If GRAVES IS left untreated, it progressively leads to thyroid failure with resultant _______thyroidism!!!
hypothyroidism
Graves disease is a hyper or hypo thyroid condition?
hyper (until late stages when it becomes hypo c/o thyroid burnout)
Primary Hypothyroidism is associated with which tissue?
the thyroid gland
Secondary Hypothyroidism is associated with which tissue?
pituitary gland
Tertiary Hypothyroidism is associated with which tissue?
hypothalamic tissue
Myxedema Madness may develop from hyper or hypo thyroidism?
hypo
What is Cretinism?
Congenital _____thyroidism that can either be endemic, sporadic, or genetic.
HYPOthyroidism
Inflammation of the thyroid that is most often immune-mediated, characterized by gradual failure because of an immune destruction of the gland is describing WHAT?
hashimoto thyroiditis
H.T. is more common in ______ (6:1) and most prevalent between 45 and 65 years of age.
women
** I WILL PROBABLY ASK THIS* HASHIMOTO THYROIDITIS patients are at an increased risk for the development of WHICH TYPE OF CANCER?
B-cell Lymphomas
Is Hashimoto’s Thyroiditis hypo or hyper thyroid?
HYPO
_______ Syndrome: Hypercortisolism due to either adrenal tumors or hyperplasias.
Cushing
Cushing Syndrome: ______cortisolism due to either adrenal tumors or hyperplasias.
HYPER
What is the difference between Cushing’s Disease and Cushing’s Syndrome?
Disease=pituitary causes….Syndrome = Adrenal Causes
Which one can cause which between Cushing’s Disease and Cushing’s Syndrome?
Disease (pituitary) can cause syndrome (adrenal)
________ Disease: Hyposecretion of adrenal cortical hormones due to autoimmune destruction of the gland
Addison
Addison Disease: ______secretion of adrenal cortical hormones due to autoimmune destruction of the gland
HYPO
Cushing Syndrome: A result of hypersecretion of __________ from adrenal cortical tumors or hyperplasias
glucocorticoids
WHAT IS THE MOST COMMON CAUSE OF CUSHING SYNDROME?
Chronic Corticosteroid Rx
Cushing _______ is five times more frequent than Cushing ________, associated with primary adrenal tumors or hyperplasias.
disease….syndrome
Cushing disease is mostly seen in middle-aged ______ (25-45)
WOMEN
Adrenal cortical tumors (benign adenomas or malignant carcinomas) are _____ because of their high _____ content.
yellow, lipid
Which condition presents with MOON FACE?
Cushing Syndrome
Which test can differentiate if a person has Cushing Disease vs Syndrome?
DexaMethaSone Suppression Test
What is the Tx for exogenously induced Cushing Syndrome?
TAPER patient off of steroid tx
Adrenal insufficiency is usually a consequence of adrenal destruction, ACUTELY (_______-______ Syndrome)
Waterhouse-Friderichsen
Adrenal insufficiency is usually a consequence of adrenal destruction slowly by an autoimmune disease (_______ Disease)
Addison
What is ACUTE adrenal insufficiency? What is chronic?
Waterhouse-Friderichsen is acute….Addison is chronic
What is also known as Acute Meningococcemia: characterized by an overwhelming Neisseria meningitides septicemia?
Waterhouse-Friderichsen Syndrome
________: Accounts for the vast majority (70-80%) of adrenal insufficiency today. Seen mostly in white women
Addison Disease
What is the most unique physical manifestation of the gram negative epticemia aka waterhouse-friderichsen syndrome?
purpura
Which gram negative bacterium is responsible for Waterhouse-Friderichsen Syndrome again?
Nisseria Meningitidis
What is Primary chronic adrenal insufficiency due to autoimmune destruction of the adrenal gland?
Addison Disease
In Addison Disease After 90% of the gland has been destroyed, clinical manifestations due to failure to produce ___________, ____________, and ________ appear.
glucocorticoids, mineralcorticoids, and androgens
Clinically, Addison’s Disease presents with extreme weakness and ________, sometimes leading to bed rest, with weight loss, anorexia, nausea, and personality changes.
fatigue
Affected Addison’s patients are _________ (glucocorticoid deficiency) with electrolyte imbalances, (mineralcorticoid deficiency causing hyponatremia, hyperkalemia, with volume depletion leading to hypotension)
hypoglycemic
Addison’s = diffuse tan pigmentation usually develops on the skin related to increased pituitary _____ precursor hormone stimulation of melanocytes
ACTH
__________: A rare neoplasm of _______ cells of the adrenal medulla that synthesizes and releases the Catecholamines (Epinephrine and Norepinephrine).
Pheochromocytoma….chromaffin
Although uncommon, Pheochromocytoma give rise to a surgically correctable form of _________.
hypertension
Addisons and Cushings are the adrenal ________, whereas Pheochromocytoma affect the adrenal _______
cortex…medulla
Clinical Pheochromocytoma: Clinically, the dominant manifestation is _______, which classically is abrupt, with tachycardia, palpitations, H/A, sweating, and tremor, often associated with N/V, abdominal and chest pain
Hypertension
exercise, lifting or bending can perpetuate the HTN affects of which condition?
Pheochromocytoma
Pheochromocytoma: This sudden release may acutely precipitate pulmonary _______. Myocardial infarction, ventricular fibrillation, cerebrovascular accidents, and congestive heart failure.
edema
What are the two markers in the urine to diagnose a Pheochromocytoma?
VMAs and MetaNephrines
