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SP16- Gen Path Exam 3 > Pituitary and Thyroid Glands (Endocrine System) > Flashcards

Pituitary and Thyroid Glands (Endocrine System) Flashcards

1
Q

The endocrine system is a control system made up of _____ major glands.

A

eight

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2
Q

What do the endocrine glands secrete? Where do they secrete them?

A

hormones
into the bloodstream
(versus exocrine glands which secrete into ducts)

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3
Q

What are three possible results of HYPOsecretion of hormones by the endocrine glands?

A

Agenesis
Atrophy
Destruction

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4
Q

What are the possible results of HYPERsecretion of hormones by the endocrine glands?

A

Tumor

Hyperplasia

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5
Q

Which gland is the “master gland” that controls most other endocrine organs?

A

Pituitary Gland

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6
Q

Where is the pituitary gland located?

A

at the base of the brain

in the sella turcica

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7
Q

How large is the pituitary gland?

A

approximately the size of a pea

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8
Q

The pituitary gland is made up of _____ lobes and is connected to the ______ via a stalk.

A

two

hypothalamus

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9
Q

The anterior lobe of the pituitary gland produces and secretes _____ hormones. What are they?

A

6

```
Flat Pig
FSH
LH
ACTH
TSH
Prolactin
i (ignore)
Growth Hormone
~~~

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10
Q

True or False: The posterior lobe of the pituitary gland produces two hormones.

A

False, the posterior lobe is axonal, not glandular. It is made up of projections from the hypothalamus and RELEASES (two) hormones made by the hypothalamus

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11
Q

Other than axonal process from the hypothalamus, what is the posterior lobe composed of?

A

modified glial cells

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12
Q

The posterior lobe of the pituitary gland releases ______ and ______.

A

oxytocin

ADH (vasopressin)

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13
Q

What does ADH (vasopressin) do?

A

acts on the kidneys to stimulate water retention;

raises blood pressure by contracting arterioles

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14
Q

HYPERfunction of the anterior lobe of the pituitary is almost always associated with ________. Are they benign or malignant?

A

Adenoma

benign

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15
Q

What are the common symptoms associated with a pituitary adenoma (anterior)?

A 
Hormone Hyperproduction
Mass Effect (bone resorption, intracranial pressure, disturbances of vision, etc)
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16
Q

HYPOfunction of the anterior lobe of the pituitary will lead to deficiency of one or multiple hormones. What are the three common causes for hypofunction?

A
  1. Nonfunctional Pituitary Adenoma
  2. Postpartum Ischemic Necrosis
  3. Ablation/ Destruction by surgery, radiation, or tumor
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17
Q

Postpartum Ischemic Necrosis is most commonly from _______ syndrome and requires over ____ % of the anterior lobe to be destroyed for clinical side effects to appear.

A

Sheehan’s

75%

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18
Q

Anterior hypo-production of GH results in ______.

A

pituitary dwarfism

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19
Q

Hypoproduction of Gonadotropin (aka FSH) will manifest as _____ in women or ______ in men.

A

Women: amenorrhea and infertility
Men: decreased libido, impotence, lack of pubic/axillary hair

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20
Q

True or False: Decreased production of prolactin would result in increased post-partum lactation.

A

False, NO prolactin = NO lactation

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21
Q

Decreased production of TSH would manifest as ______.

A

hypothyroidism

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22
Q

Which hormone is lacking in a patient who displays hypoadrenalism?

A

ACTH

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23
Q

If the posterior lobe is hypofunctioning, which hormone is going to be primarily influenced? Clinical symptoms?

A

ADH (vasopressin) will be decreased
= less retention of water (drop in BP)
= increased urination (diabetes insipidus)

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24
Q

Gigantism is caused by a(n) ______ in the anterior lobe that secretes ______.

A

adenoma

growth hormone

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25
Q

Growth hormone diseases are termed based on when the adenoma occurs relative to _________.

A

when the epiphyseal plates in the long bones close

before closure = gigantism, after closure = acromegaly

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26
Q

What are the clinical features of Gigantism?

A

generalized increase in the size of the body

arms and legs are disproportionately long

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27
Q

An increase in the secretion of growth hormone after closure of the epiphyseal plates would possibly result in _____.

A

acromegaly

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28
Q

What are the clinical features of acromegaly?

A

enlarged bones of the hands, feet, and face
prognathism (development of diastema)
hypertension and congestive heart failure

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29
Q

How are gigantism and acromegaly treated? What is the prognosis in each situation?

A

Both = surgical removal of adenoma

Gigantism (early) = fair to good prognosis
Acromegaly (late) = guarded prognosis (heart involved)

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30
Q

What are the two potential causes of pituitary dwarfism?

A
  1. Failure of the pituitary gland to produce GH

2. Lack of response to GH by tissues

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31
Q

How is the lack of GH production (pituitary dwarfism) treated?

A

hormone replacement therapy = good prognosis

32
Q

Where does the thyroid gland arise from?

A

the base of the tongue

33
Q

After arising from the base of the tongue, the thyroid gland migrates down the neck to its location ______ and _____ to thyroid cartilage.

A

anterior

inferior

34
Q

The thyroid gland is made up of follicles filled with _____

A

colloid

35
Q

What is a “lingual thyroid?”

A

if the thyroid tissue arises from the tongue and remains there
(careful with lumps on the tongue, you want to confirm the presence of thyroid in the neck, and test the tissue before removing)

36
Q

The thyroid gland produces hormones that regulate the _____ at which the body carries out its necessary functions.

A

rate

37
Q

Where is the thyroid gland located?

A

the middle of the lower neck
below the larynx
above the clavicles

38
Q

What is the shape of the thyroid gland?

A

“Bow Tie”

39
Q

True or False: You are always able to palpate a normal thyroid gland during a head and neck exam.

A

False

40
Q

What are five common causes of HYPERthyroidism??

A
  1. diffuse toxic hyperplasia (Grave’s Disease)
  2. Hyperfunctional multinodular goiter
  3. Hyperfunctional thyroid adenoma
  4. TSH-secreting pituitary adenoma (rare)
  5. Ingestion of exogenous thyroid (synthroid)
41
Q

Primary hyperthyroidism is categorized via an elevated level of _____ and a decreased level of ______.

A

elevated TH

decreased TSH

42
Q

The clinical features of hyperthyroidism are due to the _________ state and overactivity of the _________ nervous system.

A

hypermetabolic

sympathetic

43
Q

What are the common features associated with hyperthyroidism?

A 
HEAT intolerance and excessive sweating/flushed skin
WEIGHT LOSS despite increased appetite
WIDE EYES/staring gaze
tachycardia/palpitations
hypermobility/jittery
malabsorption/diarrhea/hyper GI
Nervousness/tremor/irritability
44
Q

A _______ is the sudden onset of sever hyperthyroidism, usually triggered by stress.

A

thyroid storm

45
Q

True or False: A thyroid storm is not a medical emergency.

A

False: patients often die of cardiac arrhythmias if untreated

46
Q

Graves Disease is also known as _____ _____ _____.

A

diffuse toxic hyperplasia

47
Q

Is Graves Disease more common in men or women?

A

women (7:1)
it is an autoimmune disease
significant genetic component

48
Q

How does Graves Disease manifest clinically?

A

hyperthyroidism
exophthalmos (40% show protruding eyeballs)
skin lesions (pretibial myxedema)

49
Q

Hypothyroidism is due to decreased thyroid hormone production. What causes hypOthyroidism?

A
  1. iodine deficiency
  2. autoimmune destruction of the thyroid (Hashimoto’s)
  3. Ablation by surgery or radiation
50
Q

What are the two types of hypothyroidism (differences are due mostly to age at which it develops)?
Which is more severe?

A
  1. Cretinism (infancy or early childhood)
  2. Myxedema (older children and adults)

Cretinism is more severe

51
Q

_______ causes an impaired development of the skeleton and central nervous system.

A

Cretinism

remember….its a type of hypothyroidism

52
Q

True or False: Cretinism can cause severe mental retardation.

A

True: also a short stature and protruding tongue

53
Q

______ is a type of hypothyroidism that causes generalized apathy, mental sluggishness, obesity, cold intolerance, and an enlarged tongue.

A

Myxedema

54
Q

With Primary Hypothyroidism there is a(n) _____ in serum TSH. With Primary Hyperthyroidism there is a(n) _____ in serum TSH

A

Hypo = INCREASE in TSH (lack of TH is acknowledged, so TSH continues to be pumped out to the thyroid)

Hyper = DECREASE in TSH (too much TH is sensed, so the brain stops sending TSH out to the thyroid)

55
Q

What is the treatment for hyper and hypothyroidism?

A 
Hyper = reactive iodine = destroys overactive thyroid
Hypo = Sythroid = hormone replacement

If identified and treated properly, the prognosis is good for both conditions. However, any damage to nervous system or skeleton could be permanent

56
Q

What is Hashimoto’s Thyroiditis?

A

a common cause of HYPOthyroidism
= an autoimmune, progressive destruction of the gland
=female predominance with significant genetics

57
Q

Hashimoto’s Thyroiditis begins initially as _____ and progresses to ______.

A

euthyroid (aka: normal)

hypothyroid

58
Q

True or False: Patients with Hashimoto’s Thyroiditis have an increased risk for other autoimmune diseases and Non-Hodgkin Lymphomas (B Cell).

A

True

59
Q

True or False: Patients with Hashimoto’s Thyroiditis have an established risk of developing a thyroid neoplasm.

A

False

60
Q

What is the most common manifestation of thyroid disease?

A

Goiters

61
Q

What is the most common cause of goiters?

A

dietary deficiencies (some cases are idiopathic)

62
Q

What are the most common clinical features of a goiter (due to effect of large mass)?

A

cosmetic problem
airway obstruction
dysphagia
compression of vessels

63
Q

True or False: Although thyroid nodules are common, most nodules are non-neoplastic.

A

True

64
Q

____% of thyroid nodules are carcinomas.

A

1%

65
Q

Nodules in ____ and ____ patients are more likely to be neoplastic.

A

males

young

66
Q

What is an example of an environmental factor that could predispose a patient to developing a goiter?

A

radiation exposure in the first two decades

67
Q

More than 85% of thyroid cancers are of what type?

A

Papillary Carcinoma

68
Q

True or False: Females are less likely to develop papillary thyroid carcinomas.

A

False: females more likely (even though thyroid nodules are more likely in males)

69
Q

Papillary Thyroid Carcinomas are sometimes related to a ______ proto-oncogene mutation.

A

RET

70
Q

True or False: Papillary Thyroid Carcinomas have a low 10 year survival rate.

A

False: more than 95% survival rate

71
Q

Pathologically, a papillary thyroid carcinoma appears with _____ projections, ________nuclei, and _______ grooves.

A

papillary projections
orphan-annie nuclei (nuclear clearing)
nuclear grooves

72
Q

True or False: Follicular Thyroid Carcinoma is more common than Papillary Thyroid Carcinoma.

A

False
Papillary = >85%
Follicular = 5-15%
Medulary = ~5%

73
Q

Papillary Thyroid Carcinomas typically occur in the 3rd-5th decades. When do Follicular Thyroid Carcinomas occur?

A

later/older age (usually associated with dietary deficiency. the two could go hand-in-hand)

74
Q

A Follicular Thyroid Carcinoma may resemble a Follicular Adenoma. What does that mean?

A

could see invasion through the capsule

75
Q

Medullary Thyroid Carcinoma is derived from _____ cells. Because of this, these carcinomas will show an increase in serum _______.

A

parafollicular (C)

calcitonin

76
Q

Medullary Thyroid Carcinoma is a component of _____ syndromes and all will have a mutation in the _____ proto-oncogene.

A

MEN (Multiple endocrine neoplasia)

RET

77
Q

What is “MEN”?

A

a group of medical disorders associated with tumors of the endocrine system (pheochromocytoma, thyroid, adrenal, parathyroid )

SP16- Gen Path Exam 3 (12 decks)

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