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79 Cards in this Set
- Front
- Back
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The most common type of pituitary adenoma?
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Prolactinoma
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Which pituitary tumor causes amennorrhea, or oligomenorrhea, impotence, galactorrhea, gynecomastia, and visual complaints?
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Prolactinoma
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What does a pituitary tumor causing Cushings disease overproduce?
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ACTH
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In Cushings disease, the ACTH overstimulates the adrenal gland to overproduce CORTISOL, resulting in what?
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Cushing's syndrome
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Buffalo hum, moon facies, violaceous striae, truncal obesity, hypertension, hyperglycemia, osteoporosis, and poor wound healing are all characteristics of what?
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Cushing's disease/
Cushing's syndrome |
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Anterior pituitary adenoma that overproduces GH AFTER adolescence causes what?
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Acromegaly
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Anterior pituitary adenoma that overproduces GH PRIOR to puberty causes what?
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Gigantism
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Overproduction of LH, NOT associated with a pituitary adenoma resulting in acnre, hirsutism, and infertility is what?
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Polycystic Ovarian Syndrome
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What is the LH:FSH ratio in PCOS?
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> 2:1
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High levels of FSH and LH because of ovarian failure, NOT associated with a pituitary adenoma is what?
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Menopause
no estrogen or progesterone for negative feedback inhibition on the anterior pituitary |
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What is the FSH:LH ratio in menopause?
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>2:1
but they are both elevated |
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Excess ADH secretion from the posterior pituitary resultin gin hyponatremia and cerebral edema +/-hypertension is what?
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Syndrome of inappropriate ADH (SIADH)
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What are the causes of SIADH?
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small cell lung CA - can paraneoplastically produce ADH
head trauma resulting in damage to the hypothalamus or posterior pituitary |
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What are the two most common causes of Panhypopituitarism?
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pituitary tumor
postpartum pituitary necrosis |
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Pituitary Cachexia or Simmond's Disesase are alternative names for what pituitary hypofunction?
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panhypopituitarism
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Congenital deficiency of growth hormone resulting in a short and proportionately small individual is what?
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pituitary dwarfism
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ADH deficiency secondary to decreased secretion by the posterior pituitary causing polyuria and polydipsia is what?
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Diabetes Insipidus (central)
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What is the cause of nephrogenic diabetes insipidus?
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d/t lack of kidney response to ADH
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Overproduction of aldosterone d/t an adrenal adenoma resulting in severe hypertension, hypokalemia ---> muscle weakness is what?
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Conn syndrome
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ANY cause for increased glucocorticoids results in what?
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Cushing's syndrome
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What are some of the causes of Cushing's syndrome?
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adrenal adenoma/cardinoma = over production of cortisol
Cushing's disease Small cell lung carcinoma prolonged "steroid" use |
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What is the appropriate way to screen and diagnose Cushing's syndrome?
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start with a 24 hour urinary cortisol screen then confirm the diagnosis with a low dose overnight dexamethasone suppression test
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A tumor of the adrenal medulla resulting in excress secretion of norepinephrine +/- epinephrine is known as what?
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Pheochromocytoma
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What is the only site in the body that manufactures norepinephrine?
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adrenal medulla
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What is the result of a pheochromocytoma?
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sporadic hypertension +/- palpitations, paroxysmal hyperhidrosis and episodic aggressive behavioral changes
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What is the best test to screen for a Pheochromocytoma?
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24 hour urinary vanillyl mandelic acid (VMA); the final metabolite of both NE and Epi
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What other ways can you screen for Pheochromocytoma, other than VMA?
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next best is the 24 hour metanephrines and normetanephrines then the next best is 24 hour urinary catecholamines
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Malignant tumor or the adrenal medulla or the sympathetic ganglia or borth producing excess norepinephrine is what?
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Neuroblastoma
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This disease features decreased aldosterone production resulting in hypotension, hyperkalemia, muscle weakness and cardiac arrhythmias along with hyperpigmentation?
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Addison's disease
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What is the cause of hyperpigmentation in Addison's disease?
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There is decreased negative feedback from aldosterone on the pituitary gland and you get an increase in POMC and the products it breaks up into; which are ACTH and MSH
MSH = melanocyte stimulating hormone |
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What is Addison's disease usually due to? what is another cause?
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usually autoimmune but can also be d/t invasion by Mycobacterium tuberculosis or Histoplasma capsulatum
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What is the most common type of hyperthyroidism in the US?
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Grave's Disease
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What type of goiter is Grave's disease?
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diffuse toxic goiter
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What is the antibody found in grave's disease?
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anti-TSH antibody
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How do you pharmacologically manage Grave's disease?
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propylthiouracil
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What is the risk group for Grave's disease?
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young females typically in their 20s
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This disease is d/t reactivation and subsequent hyperactivity of isolated nest of cells with in the thyroid gland?
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Plummer's Disease
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What type of goiter is Plummers Disease?
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nodular toxic goiter
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What women are at risk for Plummer's Disease?
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post-menopausal, multiparous females
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Iodine Deficiency results in what?
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diffuse simple goiter
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Constipation, fatigue, dry skin and coarse hair, swollen legs, cold intolerance, and weight gain are signs of hyper or hypothyroid?
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HYPO
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What is the #1 form of hypothyroidism in the US?
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hashimoto's Thyroiditis
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What is the antibody in Hashimotos Thyroiditis?
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anti-microsomal AB (anti-thyroid AB) and/or anti-thyroglobulin ABs
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How do you treat Hashimoto's Thyroiditis?
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levothyroxine
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Hashimoto's Thyroiditis is a disorder of what cell?
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T cell
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The thyroid gland eventually fibroses and becomes non-functional and this can be d/t a history of chronic use of migraine meds; what is this called?
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Riedel's Thyroiditis (Fibrous Thyroiditis)
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Patient complains of malaise, fever, and upper respiratory complaints x2 weeks, then thyroid becomes enlarged and tender with pain radiation to jaws, face, and ears what is the likely cause? and what is the name for this?
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etiology is probably viral
DeQuervain's thyroiditis (sub-acute thyroiditis; granulomatous thyroiditis) |
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There are many variants of Sick Euthyroid Syndrome but they ALL have what in common when it comes to TFT's?
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NORMAL TSH
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What is the benign tumor of the thyroid?
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follicular adenoma
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A 45 female with a single,palpable thyroid nodule with signs of hyperthyroidism probably has what?
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follicular adenoma
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"cold nodules" are associated with benign or malignant thyroid tumors?
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malignant; because they are usually non-functional
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"hot nodules" are associated with benign or malignant thyroid tumors?
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benign; because they are usually functional
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What are the 4 major types of thyroid carcinomas?
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papillary
follicular anaplastic medullary |
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What is the most common type of thyroid carcinoma?
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papillary CA
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What is the prognosis for papillary thyroid carcinoma?
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best prognosis
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psammoma bodies and Orphan Annie nuclei are associated with what type of thyroid carcinoma?
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Papillary CA
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What type of thyroid carcinoma is very aggressive with a very poor prognosis?
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anaplastic CA
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This thyroid carcinoma is a tumor of parafollicular C cells that manufacture caclitonin which encourages Ca deposition into bone; what is the tumor?
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medullary carcinoma
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What is the overall effect of PTH on serum Ca and P?
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increased Ca
decreased P |
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What is the effect of PTH on...
osteoclast? GI absorption of Ca? renal phosphate excretion? |
activates osteoclasts
increases GI absorption of Ca increases renal phosphate excretion |
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How do we get Vit D?
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from the conversion of 7-dehydrocholesterol in our skin when it's exposed to UV irradiation and we also ingest it via diet
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Primary hyperparathyroidism results in hi or lo levels of PTH, Ca, and PO4?
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high PTH
hi Ca lo PO4 |
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Secondary hyperparathyroidism is d/t what?
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low calcium
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What may a cause of secondary hyperparathyroidism be?
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chronic renal failure; kidney won't respond to PTH and will not reabsorp Ca so it is lost in the urine and in response the parathyroids make more PTH
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what are the PTH, Ca and PO4 levels in secondary hyperparathyroidism?
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HIGH PTH
lo Ca high PO4 |
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What is the #1 cause of hypoparathyroidism?
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accidental parathyroid removal with thyroidectomy
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What is the cause of Pseudohypoparathyroidism?
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PTH receptors are non-functional
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What are the PTH, Ca, and PO4 levels in pseudohypoparathyroidism?
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hi PTH
lo Ca hi PO4 |
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What is the cause of pseudopseudohypoparathyroidism?
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PTH receptora re fine but 2nd messenger systems in targe tissues are defective
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What is the effect of pseudopseudohypoparathyroidism on rissue response to PTH and how doe sit affect Ca and PO4?
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tissue resonse slow to PTH (but it is possible); therefore Ca and PO4 equilibrate back to normal levels SLOWLY
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What is the inheritance pattern of multiple endocrine neoplasias (MENs)?
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Autosomal Dominant
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What is their risk of developing certain neoplasias?
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LIFE-LONG
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How many types of MEN are there?
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Three;
Men Type 1 Men Type 2a Men Type 2b |
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Which type of MEN is Wermer's syndrome?
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Type 1
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What type of MEN is Sipple's syndrome?
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Type 2a
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What type of MEN is MEN type 3?
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Type 2b
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What organs are associated with MEN Type1?
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pituitary
parathyroids pancreas adrenal cortex |
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what organs are associated with MEN Type 2a?
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parathyroid
thyroid adrenal medulla |
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what organs are associated with MEN Type 2b?
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adrenal medulla
thyroid |
