Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
68 Cards in this Set
- Front
- Back
|
Corticotrophs |
ACTH MSH- melaning stimulating hormone |
|
|
Pituitary apoplexy |
Bleeding into pituitary tumour causing hemarrege Hypopituratory |
|
|
Hypopituitarism |
Children lack of GH- dwarfism Lack of gonadotrophic hormones- failure of development of gonads Adults- hypothyroidism hypoadrenalism diabetes insipidus |
|
|
Hyperpituitarism |
Caused by adenoma Males Distant- due to increase trophic hormones Local- due to expansion of the lesion |
|
|
Prolactinoma |
Commonest Females- infertility galatorrhea amenorrhea Male- gynacomastia galactrrhea Treatment- bromocriptine blocks the production of prolactin |
|
|
Somatotroph adenoma |
Increase growth hormones Children- before closure of epiphysis- gigantism Adults- acromegaly |
|
|
Acromegaly in adults |
Enlargement of hands and feet Increase size of skull protrusion of jaws and frontal bone Diabetes mellitus |
|
|
Corticotroph adenoma |
Basophils adenoma Increase adrenocorticotrophic hormones Increase cortisol Cushing disease- increase in cortisol |
|
|
Local effects of the pituitary |
Compression of optic nerves and optic chiasm- bitemporal hemianopia Expansion of sell a Tricia and erosion of clinic process- x-ray changes Extension into cavernous sinuses Raised intracranial pressure |
|
|
Posterior pituitary syndrom |
Lack of ADH- diabetes insipidus Too much- reabsorption of pure water- hyponatremia |
|
|
Hypoparathyroidism |
Hypocalcaemia Caused surgical removal Developmental abnormality Autoimmune destruction |
|
|
Hyperparathyroidism |
Primary Secondary Teritary |
|
|
Primary hyperparathyroidism |
Adenoma Hypercalcemia Ectopic production of PTH Asymptomatic |
|
|
Parathyroid hyperplasia vs adenoma |
Affect all 4 glands Affect only 1 gland |
|
|
Multiple endocrine neoplasia |
MEN 1- parathyroid adenoma pancreas adrenal pituitary MEN 2- parathyroid adenoma phaeochromocytoma maxillary carcinoma of thyroid hormone |
|
|
Secondary hyperparathyroidism |
Due to chronic hypocalcemia- secondary increase in PTH common cause chronic renal disease |
|
|
Teritary hyperparthyroism |
Due to long standing secondary hyperparathyroid |
|
|
Parathyroid gland |
Increase Ca and Mg Decrease Phosphorus and bicarbonate |
|
|
Plasma calcium |
Ionized Bound to albumin Complex |
|
|
Calcium regulating hormones |
Parathyroid hormones Vitamin D/ calcitriol Calcitonin |
|
|
Parathyroid hormone formation |
PTH is a polypeptide of 84 aa It is synthesized to a large precursor as pre-pro-PTH 115 aa The removal of 25 aa (90aa) produce pro-PTH a further 6aa(84aa) removal form PTH PTH yield N and C terminal fragments on 34 aa N terminal have and half life simular to PTH C terminal have a longer half life life |
|
|
Information on parathyroid hormones |
Its is the main regulator of calcium Highest in the morning lowered at night |
|
|
Parathyroid hormones function |
Binds to receptors on rtf he kidney increase reabsorption of Ca and Mg increase excretion of phosphorus and bicarbonate Lower GFR Stimulate the conversion of 25-HCC to 1:25DHCC inactivated vitD to active vitD |
|
|
Formation of calcitriol |
Vitamin D3 is synthesized by sunlight Chilolecalciferol is transported by vitamin D binding protein to the liver Enzyme catalyst by 25 hydroxylase to form 25HCC 25HCC in the kidney converted to 1:25 DHCC by 1 alpha hydroxylation in the PCT |
|
|
Too much vitD |
25HCC is converted to 25:25DHCC by 24-hydroxylase |
|
|
Action of calcitriol |
1:25 DHCC stimulates the intestinal mucosal syntgsis of calbindin-D a calcium binding protein that stimulate the intestine mucosal to absorb calcium and phosphorus Promotes osteclastic bone resotption |
|
|
Calcitonin |
Release from patafolicullar C cells when there is a raised plasma Ca Reduced osteclastic bone reabsorption Increase cAMP |
|
|
Adrenal cortex |
Glomerulosa- aldosterone regulated by Ag11 Fasiculata- largest Reticularis- androgens and oestrogen |
|
|
Adrenal hypofunction |
Primary Acute- adrenal crises Chronic- addison disease Problems with the gland itself Secondary Problems with the pituitary Problems with higher center |
|
|
Primary acute adrenal hypofunction |
Massive adrenal hemorrhagic Bacteria infection Anticoagulant treatment in patients Intra-partum hypoxia in new born Disseminated intravascular coagulation |
|
|
Primary chronic adrenal hypofunction |
Addison's disease Due to progress destruction of the adrenal cortex Deficiency in cortisol |
|
|
Cause of adrenal hypofunction |
Autoimmunity - fibrosis and lymphocytes infiltrate Infection tuberculosis, fungal infection - granulation Metastatic carcinoma - replaced by tumor Sarcoidosis |
|
|
Secondary adrenal hypofunction symptoms |
Lack pigmentation abd aldosterone |
|
|
Primary chronic adrenal hypofunction symptoms |
Hyperpigmentation due to increase MSH Hyperkalaemia |
|
|
Cushing syndrome cause |
Exogenous Corticosteroids therapy Endogenous ACTH producing pituitary adenoma |
|
|
Cushing syndrome signs |
Tuncal Obesity Moon face Buffalo hump Purple striae blood vessles can be seen Thinning of skin Hypertension Diabetes mellitus Hirutism Male incompetence Hypokalemia Hpyercalcemia |
|
|
Conn's disease |
Increase aldosterone from zona glomerulosa Adenoma Hypertension Hypokalemia |
|
|
Adrenal adenoma |
Uncommon Solitary Encapsulated yellow Surrounded by compressed adrenal |
|
|
Adrenal medulla neoplasms |
Phaeochromocytoma- adults Neuroblastoma- children |
|
|
Phaeochromocytoma |
Uncommon Neoplasm of chromaffin cell Secretes cathecolamines- hypertension palpitations tachycardia Diagnosis VMA vanillmandelic acid |
|
|
Pheochromocytoma morphology |
Reddish brown neurotic and hemorrhagic Large cells glandular and pink |
|
|
Neuroblastoma |
Increase epinephrine and nor epinephrine Tumor spread Generic alteration of N-myc genes Bulging eyes Calcification hemorrhagic necrosis Homer-wright rosettes |
|
|
Vitamin D deficiency |
Rickets |
|
|
Pseudohypoparathyroidism |
Low serum calcium and high phosphate but the parathyroid hormone level is high Defect in adenaly cyclase Typet1- no cAMP type 2-cAMP |
|
|
Diabetes insipidus |
Polyuria- increase urine Polydipsia- increase intake of water Polyphagia- hungry |
|
|
Control of cortisol secreation |
External stimulus Hypothalamic Anterior pituitary Adrenal cortex Tissues |
|
|
Pho: signs and symptoms |
Pressure Pain Perspiration Palpitations Pallor |
|
|
Congenital adrenal hyperplasia |
Enlarge clitoris, labia fusion |
|
|
Graves disease |
Hyperthyroidism Autoimmune diseases Associated with goitre |
|
|
Addison disease |
Primary- disease of adrenal cortex Seconday- reduce ACTH tertiary- reduced CTH |
|
|
Signs of addison's disease |
Hyperpigmentation Anaemia Hyperkalaemia Hypoglycemic Hypotension |
|
|
Diffenciency in adrenaline and nor adrenaline |
Hypoglycemia Postural hypotension |
|
|
Diagnosis of Cushing if its hormonal active or tumor active |
If you suspect cushing- monitor cortisol free urine output Salvia cortisol at nights Dexamethasone suppression - dexamethasone suppression Is the cushing caused by autoimmune secretion - dexamethasone suppression If suppression psuedocushing syndrome not suppression cushing syndrome If suppression psuedocushing syndrome not suppression cushing syndrome Is it Cushing- give ACTH high ACTH ACTH dependent low ACTH ACTH independent |
|
|
Hypokalemia |
Cause muscle weakness, Polydespia, Polyuria, polyphagia |
|
|
Test for primary hyperaldosteronism |
Low Renin High aldosterone Stop spironalactone six weeks before |
|
|
Deficiency in thyroid |
Cretinism - children Dwarfism- children Myxedema- adult |
|
|
Formation of calcitriol |
7-hydrocholesterol-(sunlight) cholecalicerferal(liver)- calcidiol(kidney)- calcitriol |
|
|
Increase P in the cell |
Inhibit 1 alpha hydroxilase which causes a decrease in calcitriol hence decrease calcium Increases glomerular filtration rate increases P |
|
|
Symptoms of hypoparathyroidism |
Laryngospasm Seizures Spasm tetany |
|
|
Generalize and localize symptoms of primary hyperparathyroidism |
Osteitis fibrosis cystic Brown tumour |
|
|
Common cause for hyperparathyroidism |
Chronic renal failure |
|
|
Somatotrophs amino acids |
191 |
|
|
Insulin like growth factor 2 |
S ecreated by brain kidney pancreas and muscle |
|
|
Insulin like growth factor 1 |
Release from the liver stimulated by somatotropin Stimulates the effects on osteoblast and chondrocytes activity to promote growth Inhibit apoptosis Regulate cellular DNA synthesis |
|
|
IGF-binding protein |
Regulate IGF-1 IGF-2 |
|
|
Instrument to measure growth |
Staediometer |
|
|
Color of the adrenal |
Cortex- yellow Medulla - brown |
|
|
Congenital adrenal hyperplasia |
Decrease cortisol Increase ACTH adrenal hyperplasia 21 hydroxylase genes |
