Pathologies of Endocrine

Question 1

Hypo-pituitarism causes:

Answer 1

tumour, radiotherapy or infarction. example: pituitary apoplex - haemorrhage

Question 2

order of cell loss in hypo-pituritarism

Answer 2

GHRH
GH
TRH
CRH

Question 3

Causes of Hyper-pituitarism

Answer 3

tumours

Question 4

Hyper prolactinaemia

Answer 4

symptoms: galactorrhea, hypogonadism, headache and pituitary insufficiency
treatment: dopamine agonist or surgery

Question 5

Cushings

Answer 5

symptoms: truncal obesity, moon face, thin skin, easily bruised, depression, psychosis, insomnia and hirsuitism

cause - increased ACTH leading to increased cortisol

treatment - surgery

Question 6

Acromegaly

Answer 6

symptoms: skin/connective tissue growth, skeletal growth, visceral growth, neuro-muscular changes and insulin resistance

causes - increased in GHRH leading to increase in GH

treatment - surgery, hydrocortisone pre-operatively, somatostatin and dopamine agonist

Question 7

SI-ADH

Answer 7

increased ADH, leads to increased H2O resorption, a decrease in plasma osmolarity

causes - tumors, thoracic disease, drugs

treatment - fluid restriction, diuretics long term to restrict the function of ADH at the nephron

Question 8

Diabetes Insipidus

Answer 8

either:
central - lack of ADH due to damage to pituitary
nephrogenic - organ resistance due to receptor defects or drugs

symptoms- large volume of urine, dilute, increased thirst/drinking, dehydration in volume is not maintained

treatment - thiazides (if nephrogenic)

Question 9

Cretism

Answer 9

severe iron deficiency in mother and child leading to growth arrest, mental retardation

Question 10

neonatal hypothyroidism

Answer 10

failure of the thyroid to develop, less severe neurological phenotype

Question 11

transient neonatal hypothyroidism

Answer 11

caused by maternal TSH receptor blocking antibody

Question 12

Hashimotos

Answer 12

hypothyroidism caused by auto immune thyroid destruction

Question 13

Causes of hypothyroidism in adults

Answer 13

Hashimotos, Goitre/thyroid cancer, lithium/amiodarone, subacute thryoiditis, excess iodine intake

Question 14

Causes of hyperthryoidism

Answer 14

Graves, De Quervains thyroiditis, solitary toxic adenoma, plummer’s disease (tonic MNG), gestation thyroxicosis (GTT)

Question 15

Grave’s Disease

Answer 15

hyperthryoidism caused by TSH receptor antibodies, leading to global increase in iodine uptake, which leads to stimulation of thryoid growth and hormone secretion

expothalmos (bulging eyes) and pre-tibial mix oedema

Question 16

De Quervain’s Thyroiditis

Answer 16

acute viral inflammation leading to hyperthryoidism, no uptake in thyroid scans

Question 17

Hypo thryoidism symptoms

Answer 17

decreased BMR
decreased appetite
decreased HR and CO
increased weight
constipation
lethargy
impaired mental function
sensitive to cold

Question 18

Hyperthryoidism symptoms

Answer 18

increased BMR
increased appetite
increased HR and CO
decreased weight
increased bowel movements
tremors
intolerant of heat

Question 19

Addissons

Answer 19

destruction of the adrenal gland
diagnosis: 9am cortisol is low, and ACTH is high
treatment - replace glucocorticoids and mineral deficiency but not sex steroids

Question 20

Cushing’s Syndrome

Answer 20

excess cortisol
symptoms: centripetal obesity, moon face, proximal myothpathy, hypertension, hypokalaemia, thin skin, bruising, osteoporosis, diabetes

disease is it is pituitary dependent

treated by unilateral adrenalectomy

Question 21

Conn’s syndrome

Answer 21

excess of aldosterone due to tumor of adrenal cortex

have Na and K retention caused hyperkalaemia and hypertension
elevated aldosterone but supressed renin