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Pathology - Year 2 AC > Week 7 - The Endocrine System > Flashcards

Week 7 - The Endocrine System Flashcards

1
Q

What types of endocrine diseases can occur?

A
  • underproduction
  • overproduction
  • mass lesions
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2
Q

What makes up the endocrine system?

A 
Hypothalamus 
Pituitary gland
Thyroid gland 
Parathyroid glands
Adrenal glands
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3
Q

How does the hypothalamus contribute to the endocrine system?

A
  • located in the brain - above brain stem
  • links the CNS to the endocrine system
  • produces releasing and inhibiting hormones - stop and start the production of other hormones throughout the body
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4
Q

What hormones does the anterior pituitary gland produce?

A
  • growth hormone
  • thyroid stimulating hormone
  • adrenocorticotrophic hormone
  • follicle stimulating hormone
  • lutenising hormone
  • prolactin
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5
Q

What hormones does the posterior pituitary gland produce?

A
  • ADH

- oxytocin

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6
Q

What pituitary diseases can occur?

A

Hyperpituitarism-related effects
-adenomas (benign tumours - functionally active)

Hypopituitarism-related effects
-injury, surgery, radiation, inflammation

Local mass effect
-compressing the optic chiasm

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7
Q

What is hyperpituitarism?

A

Condition due to the primary hypersecretion of pituitary hormones

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8
Q

What causes hyperpituitarism?

A

Most common:
-adenoma in anterior lobe

Other:

  • cancer
  • hyperplasia
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9
Q

What are the types of pituitary adenoma?

A
  • functional - prolactinoma
  • non-functional
  • macroadenomas (>1cm in diameter)
  • microadenomas (
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10
Q

What is the effect of having too much ACTH?

A

Cushing’s disease

-buffalo hump, moon face, poor wound healing, thin skin etc

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11
Q

What is the effect of having too much growth hormone?

A
  • gigantism (children)

- acromegaly (adults)

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12
Q

What is the effect of having too much prolactin?

A
  • galactorrhea/amenorrhea
  • sexual dysfunction
  • infertility
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13
Q

What is the effect of having too much TSH?

A

Hyperthyroidism

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14
Q

What is the effect of having too much FSH/LH?

A
  • hypogonadism
  • mass effects
  • hypopituitarism (occurs with loss of 75% or more of the anterior pituitary parenchyma)
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15
Q

What are the causes of hypopituitarism?

A
  • ischaemic necrosis of the pituitary: Sheehan’s syndrome (post-partum)
  • non-functioning adenomas - grow to potentially cause hypopituitarism
  • surgery or irradiation - take out too much
  • inflammatory lesions - rare
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16
Q

What can be the causes of hyperthyroidism?

A
  • Grave’s disease (autoimmune) - proptosis (bulging eyes, shouldn’t be able to see white at the bottom of the eye, muscle at the back of the eye cause them to bulge)
  • over treatment by thyroxine (for hypothyroidism)
  • infective - De Quervain’s thyroiditis - related to viral infection
  • toxic multinodular goitre
  • toxic adenoma - single nodule in the thyroid gland producing thyroxin
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17
Q

What are the symptoms of hypothyroidism?

A
  • intolerance to heat
  • fine, straight hair
  • bulging eyes
  • facial flushing
  • enlarged thyroid
  • tachycardia
  • high systolic BP
  • breast enlargement
  • weight loss
  • muscle wasting
  • localised oedema
  • menstrual changes (amenorrhea)
  • diarrhoea
  • tremors
  • finger clubbing
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18
Q

Explain why Grave’s disease occurs

A
  • auto-immune condition, stimulates auto-antibodies
  • the auto-antibodies attach to TSH receptors, meaning the receptors are constantly stimulated
  • however because the antibodies are blocking the TSH receptors, this means that TSH decreases but thyroxine increases (unregulated overproduction)
  • negative feedback can’t occur so thyroid hormone production can’t be regulated
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19
Q

How is hyperthyroidism managed?

A
  • testing: clinical and thyroid function tests (blood test)
  • treat the cause
  • carbimazole/propylthiouracil
  • radioiodine therapy (ingest radioactive iodine, kills off thyroid gland - decreases production)
  • thyroidectomy
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20
Q

What can cause a goitre and what precautions need to be made?

A
  • iodine deficiency
  • could be hyper/hypothyroidism

-ensure trachea is not compressed by it

21
Q

What are the causes of hypothyroidism?

A
  • iodine deficiency
  • autoimmune - Hashimoto’s thyroiditis
  • iatrogenic - surgery, radioiodine
  • pituitary defects
  • congenital
22
Q

What are the symptoms of hypothyroidism?

A

-intolerance to cold
-receding hairline
-facial and eyelid oedema
-extreme fatigue
-thick tongue - slows speech
-anorexia
-brittle nails and hair
-hair loss
-apathy
-lethargy
-dry skin
-muscle aches/weakness
-constipation
Late clinical manifestations:
-weight gain
-Bradycardia
-subnormal temp
-thickened skin
-cardiac complications
-decreased LOC

23
Q

What is Hashimoto’s thyroiditis and who does it effect?

A

Autoimmune destruction of the thyroid gland

  • women > men
  • 45-60 years old
24
Q

How is hypothyroidism managed?

A

Thyroxine

25
Q

How common is thyroid cancer and what is the most common type to get?

A

-relatively uncommon

  • most common type is papillary carcinoma
  • papillary thyroid carcinoma is a non-functional tumour
26
Q

How many parathyroid glands are there what do they do and what are they regulated by?

A

4 in total (2 pairs - upper and lower)

  • regulate calcium
  • regulated by parathyroid hormone
27
Q

What are the causes of hypoparathyroidism?

A

-removal by surgery (thyroidectomy)

  • congenital
  • hereditary (autoimmune)
28
Q

What are the symptoms of hypoparathyroidism?

A

Due to low calcium:

  • irritability
  • tetany (condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands)
  • seizures
29
Q

What can cause hyperparathyroidism?

A

Primary
-adenoma

Secondary
-chronic renal failure

Tertiary
-after renal transplant

30
Q

What are the symptoms of hyperparathyroidism?

A

Due to hypercalcaemia:

  • constipation
  • depression
  • seizures
  • muscle wasting
  • polyuria
  • bone fractures
  • kidney stones
31
Q

What are the names parts of the adrenal glands?

A

Cortex

Medulla

32
Q

How are hormones and what hormones are released from the adrenal glands?

A
  • Trigger –> hypothalamus
  • hypothalamus released corticotropin releasing hormone (CRH)
  • pituitary gland then releases ACTH which acts on the adrenal glands which release:

Zona glomerulosa:
-mineralocorticoids (aldosterone -secreted by cortex)

Zona fasciculata:
-glucocorticoids (cortisol)

Zona reticularis
-sex hormones (testosterone, oestrogen)

33
Q

What causes hyperaldosteronism?

A

Primary:
-Conn’s disease in >50% (excess production of the hormone aldosterone by the adrenal glands, resulting in low renin levels)

Secondary:
-due to high renin levels (renin - increases BP)

34
Q

What are the symptoms of Conn’s disease?

A
  • oedema
  • hypertension
  • high sodium
  • low potassium
35
Q

What is cortisol and what does it do?

A

Glucocorticoid

  • essential to life
  • regulates blood sugar
  • inhibits inflammation
  • stress response
  • release by circadian rhythm (normal)
  • stress
36
Q

What can excess release of cortisol (glucocorticoid) cause?

A

Cushing’s syndrome

37
Q

What causes Cushing’s syndrome?

A
  • excess release of cortisol (glucocorticoid)
  • ACTH releasing tumour (pituitary/lung)
  • steroids
38
Q

What are the symptoms of Cushing’s syndrome?

A
  • emotional disturbance
  • moon face
  • osteoporosis
  • cardiac hypertrophy - hypertension
  • buffalo hump
  • obesity
  • thin, wrinkled skin
  • abdominal striae
  • amenorrhea
  • muscle weakness
  • purpura
  • skin ulcers (poor wound healing)
39
Q

What is Addison’s disease?

A

Adrenal insufficiency

40
Q

What can cause Addison’s disease?

A

Autoimmune
Infection
Neoplasms

41
Q

What are the symptoms of Addison’s disease?

A
  • GI symptoms (anorexia, N&V, diarrhoea)
  • weight loss
  • hyperpigmentation
  • low sodium, high potassium
42
Q

What causes addisonian crisis?

A

Addisonian crisis = acute adrenal insufficiency

Caused by stopping steroids abruptly

43
Q

Name the gonadocorticoids and where they are secreted from

A

Testosterone
Oestrogen

Both are secreted from the gonads

44
Q

What are adrenaline and noradrenaline and where are they secreted from?

A

Adrenal medulla

Catecholamines

45
Q

What is a phaeochromocytoma?

A

A rare, catecholamine-secreting tumour that may precipitate life-threatening hypertension

Malignant in 10% cases but may be cured by surgical removal

46
Q

What are the symptoms/signs of phaeochromocytoma?

A
  • hypertension
  • sweating
  • palpitations
  • nervousness
  • increased metabolic ratio
  • rapid heart rate
47
Q

What are multiple endocrine neoplasia (MEN)?

A

Group of inherited diseases resulting in proliferative lesions of multiple endocrine organs

Different types

48
Q

What does the endocrine system secrete to cause an effect?

A

Hormones

Pathology - Year 2 AC (19 decks)

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