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90 Cards in this Set
- Front
- Back
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Where are the receptors for polypeptides and amines?
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on cell surface
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Where are the receptors for steriods? On what do that act?
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in cytoplasm, act on nucleus--bind to DNA
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What is another name for the post. pituitary? What does the post. pit. contain?
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neurohypophysis it contains granules of stored hormones
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The ant. pit. is derived from the ___ ____.
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oral canal
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The post. pit is derived from the ______?
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floor of the 3rd ventricle
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What is the pit. stalk? where is it?
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between the hypothalamus and the post. pit. It contains neural connections
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What arethe 7 hormones produced by the ant. pit.?
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1- TSH
2- FSH 3-LH 4- GH 5-Prolactin 6- ACTH 7-MSH |
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Describe the vision defect with a pit. tumor?
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loss of bilateral upper temporal quadrants of the visual field
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What is the most likely cause of excess hormone production by the ant. pit?
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adenoma
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Name 5 characteristics involved somatotroph tumors? What hormone is in excess?
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GH
1- acromegaly 2-gigantism 3-osteoporosis 4- HTN 5- glucose intolerance |
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Do gonadotrophs present with any clinical symptoms?
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no, just elvated FSH and LH
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What is the most common hyperfunctioning tumor of the pit?
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prolactinomas
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An excess of adrenal cortical steriods is ____?
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Cushings DIsease
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A loss of 75% of the pit. parenchyma is _____?
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hypopituitarism
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Name 3 causes of hypopituitarism.
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1- ablation
2- non-secretory adenoma 3- sheehans's syndrome |
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What is Sheehan's syndrome?
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post-partum necrosis of the pit. ( it grew due to pregnancy--the blood supply could not keep up)
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What is empty sella syndrome an example of?
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hypopituitarism
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What is diabetes insipidus?
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Lack of ADH, you pee alot, have high serum osmolality and Na
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What type of cells comprise the post. pit?
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glial cells and axonal processes
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What 2 nuclei extend down into the post. pit.?
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1-paraventricular
2- supraoptic nucleus |
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The paraventricular nucleus secretes _____ and is resonsible for ___ and ____.
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oxytocin,
uterine contraction and milk ejection |
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The suproptic nucleus secretes _____ and acts of ____.
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ADH, renal tubules
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Describe SIADH. What is the most common cause?
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continued release of ADH without regard to serum osmolality., ectopic production from tumors
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Which hormones are secreted by the thyroid?
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T3, T4 and calcitonin
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The hypermetabolic state caused by elevated T3 and T4 is ___?
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Hyperthyroidism
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What are 4 causes of hyperthyroidism.
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1- graves disease
2- exogenous thyroid hormone 3- hyperfunction goiter 4- hyperfunction adenoma |
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What are 8 clinical manifestations of Graves?
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1- weight loss
2- tachycardia 3- arrhythmias 4- diarrhea 5- weakness 6- tremor 7- nervousmess 8- heat intolerance |
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Is thyroid storm a medical emergency? why?
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yes, acute.....tachycardia
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What are the lab findings for hyperthyroidism?
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decreased TSH, elevated T4
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What is the mechanism of Graves?
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autoAb that stimulates the TSH receptor
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What are 5 causes of hypopituitarism?
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1- autoimmune
2- surgery 3-iodine/enzyme deficiency 4- idiopatic 5- hypopituitarism (secondary) |
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What are 2 outcomes associ. with hypothyroidism? Which one goes with what age?
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Adults- myxedema
Infants- cretinism |
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What are the lab results of hypothyroidism?
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increased TSH but decreased T4
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What is a dominant characteristic of hypothyroidism?
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big, puffy tongue
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Inflammation of the thyroid is ___.
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thyroiditis
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Name 5 types of thyroiditis.
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1- suppurative (infectious)
2- nonspecific lymphocytic 3- subacute granulomatous 4- Hashimotos 5- Riedels (fibrosis) |
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Hashimotos is an _____ disease, and is characterized by an ____ that ____ and _____ the TSH receptor.
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autoimmune disease, Ab, binds and inhibits
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What is the most common form of thyroiditis in the US?
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Hashimotos
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In Hashimoto's, the the goiter painful?
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No
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Histologically, what would you see in Hashimotos?
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increased lmyphocytes and plasma cell infiltrates,
Germinal centers, and Hurthle Cells (eosinophillic epithelial cells) |
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Decribe a benign thyroid follicular adenoma.
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1- encapsulated, normal looking
2-painless cold nodule 3- solitary 4- difficulty swallowing |
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Name the 4 types of malignant thyroid tumors.
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1- papillary
2- follicular 3- medullary 4-anaplastic |
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What is the most common malignant thyroid tumor? what is the survival rate?
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papillary, 10 yr = 80%
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What are 3 histo characteristics of papillary carcinomas?
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1- papillary folds
2- orphan annie eyes 3- psammoma bodies (calcified) |
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Do papillary tumors go to the nodes? do follicular carcinomas?
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yes, no (b/c they are more aggressive)
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Are follicular tumors solitary and cold?
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yes
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What is a medullary carcinoma?
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neuroendocrine tumor of the C-cells
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What are 3 signs of a medullary tumor?
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neck mass, dysphagia, hoarseness
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What are 4 pathological manifestatons of a medullary carcinoma?
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1- polygonal to spindle-shaped cell
2- nests, trabeculae 3- amyloid 4- C-cell hyperplasia |
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Describe anaplastic tumors?
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Rapidly fatal neck mass
metastatic occurs with goiter sometimes |
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What are the 3 morphological patterns of anaplastic carcinomas?
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1-pleiomorphic giant cells
2- sarcomatous spindle cells 3- squamoid cells |
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What do the parathyroid glands secrete, what governs their secretion?
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PTH, serum Ca levels
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What are 3 places of action of PTH?
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1- bone
2- kidney 3- intestines |
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What are the clinical features of hyperparathyroidism?
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painful bones, kidney stones, abdominal groans, and pychic moans
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What is the skeletal disorder in hyperparathyroidism?
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osteitis fibrosa cystica
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What are the 2 kidney disorders of hyperparathyroidism?
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1-nephrolithiasis
2-nephrocalcinosis |
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WHat GI problems do you have in hyperparathyroidism?
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1-constipation
2- ulcers 3- nausea 4- pancreatitis |
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What CNS and neuromuscular problems will you see in hyperparathyroidism?
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1-depression and weakness
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What is the leading cause of secondary hyperparathyroidism?
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renal failure followed by Ca and Vit. D deficiencies
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Describe the meachanism of how renal failure leads to hyperparathyroidism.
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1- decreased PO4 excretion
2- decreased serum Ca---> hyperplasia of parathyroid and PTH secretion |
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Can secondary hyperparathyroidism lead to calciphylaxis? What is this?
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yes, Ca in the blood vessels leading to ischemia of other organs
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What are 3 causes of hypothyroidism?
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1- surgical removal
2- congenital absence (DeGeorges) 3- autoimmune |
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What are 6 clincial signs of hypothyroidism?
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1- decreased Ca
2- Increased PO4 3- tetany 4- convulsions 5- Chvostek sign 6- Trousseau's sign |
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Can hypoparathyroidism lead to cataracts and dental root hypoplasia?
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yep
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Describe pseudohypoparathyroidism.
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End organ resistance to PTH, PTH levels are elevated but Ca levels are low
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What are the hormones released from the adrenal gland?
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1-cortisol
2- aldosterone 3- androgens |
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What stimulates the release of cortisol?
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ACTH from the ant. pit.
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What are 3 functions of cortisol?
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1- inhibits glucose uptake into the cells
2- promotes fat deposition 3- increasees hepatic gluconeogensis |
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Cushings syndrome is an _____.
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excess of cortisol
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What are 5 causes of cushings?
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1- long term steroid use
2- ACTH-producting neoplasm of the pit. 3-Excessive hypothalamic stimulation of ACTH release 4- functional adrenal neoplasm or hyperplasia 5- ectopic ACTH produced by malignacy |
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What are some clinical manifestations of cushings?
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1- central obesity
2- buffalo hump 3- moon face 4- hirsutism 5- excess androgens 6- hyperglycemia 7-Acne |
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What can you use to determine the etiology of cushings?
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the dexamethasone suppression test.
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Using the DEX test you see plasma ACTH go down you can say the cause is due to______?
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adrenal cushings
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Using the DEX test (high dose) if you see that urine steriods go down you can say the cause is due to ____?
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pituitary tumor
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What are 5 clinical features of Hyperaldosteronism?
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1- HTN
2- fatigue 3- increased Na 4- decreased K 5- metabolic acidoisis |
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A cause of primary hyperaldosterone is _____.
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Conns syndrome (adrenal adenoma)
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What are lab results of primary hyperaldosterone?
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increased aldosterone and DECREASED renin
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What are 2 causes of secondary hyperaldosterone?
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1- CHF----> deminished renal perfusion
2- renal artery stenosis |
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What are the lab results of Secondary hyperaldosterone?
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Increased aldosterone and INCREASED renin (the kidney can not help)
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What is the most common cause of congenital adrenal hyperplasia? What will you see here?
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21-hydroxylase deficiency
Androgen excess and Na wasting due to the aldosterone deficiency. |
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17-hydroxylase deficiency leads to ______.
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androgen deficiency and accumulations of mineralcorticoid activity (Na retention and HTN)
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What are the 2 forms of primary hypoadrenalism?
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1- waterhouse-friedericksen
2- addisons disease |
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What are some clinical features of hypoadrenalism?
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1- weakness
2- decreased glucose 3- wt loss 4- decreased Na 5- increased ACTH 6- can not withstand stress |
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What are some possible etiologys of Addisons?
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1- autoimmune
2- viral (herpes, CMV, AIDS) 3- chronic infection(fungal, TB) 4- metastatic cancer 5- systemic disease (amyloidosis, saroid, hemochromatosis) |
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What is the pathology of addisons?
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1- shrunken atrophic glands
2- lymphoid infiltrates 3- etc.... |
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What is a pheochromocytoma?
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a tumor of neural crest cells in the adrenal medulla that secretes catecholamines
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Is a neuroblastoma malignant? At what age is it most common? Is it limited to the adrenal medulla?
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yes!!, kids under 5 yrs, it can occur anywhere along the sympathetic NS
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What is MEN syndrome?
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multiple Endrocrine Neoplasia
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What are the 3 prototypes of MEN?
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MEN-I = 3 Ps (defect in tumor suppressor gene 11q13
MEN-II = (Sipples), mutation of RET MEN-III = (william ), defect in RET different from MEN II |
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What are 3 characteristics of MEN-II?
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1-medullary carcinoma of thyroid
2-pheochromocytoma 3- parathyroid hyperplasia |
