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31 Cards in this Set
- Front
- Back
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Hyperparathyroidism |
•Bone unfriendly •High blood Ca++ (bone resorption, incr. Intestinal absorp.) •Low blood PO4--(losses via kidney) |
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Hyperparathyroidism Bone |
•Increased PTH •Resorption of bone; calcium released into blood |
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Hyperparathyroidism Kidney |
•Increased PTH
•Increased calcium reabsorption by kidney
•Increased phosphate excretion by kidney |
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Hyperparathyroidism Intestine |
•Increased PTH
•Increased calcium uptake by intestinal mucosa |
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True |
•Patients with hypertension caused by primary hyperaldosteronism have low blood levels of renin. High blood aldosterone suppresses renal secretion of renin. |
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Hyperparathyroidism |
•Primary Hyperparathyroidism -Blood levels of calcium and parathyroid hormone are high; blood levels of phosphate are low. |
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True |
•Parathyroid Gland normally the size of a grain of rice |
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Hyperarathyroidism |
•Primary -hyperplasia or adenoma, hypercalcemia & high blood parathyroid concentration •Secondary & Tertiary -chronic renal failure, hypercalcemia caused by non-parathyroid condition. Almost always associated with high phosphate levels inducing parathyroid hyperplasia. |
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Hyperarathyroidism |
•2nd most common primary endocrine disorder behind Diabetes Mellitus •Since parathyroid gland disease (Hyperarathyroidism) was first described in 1925, the symptoms have become known as "moans, groans, stones, and bones...with psychic overtones". |
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Hyperarathyroidism |
•"Moans" (Complaints of not feeling well) •"Groans" (Abdominal pain, peptic ulcers, gastroesophageal reflux) •"Stone" (Kidney) |
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Hyperarathyroidism |
•"Bones" (Bone pain, Osteoporosis) •"Psychiatric Overtones" (Lethargy, fatigue, depression, memory problems). |
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Disease Affecting the Anterior Pituitary |
•Overactivity -Often from pituitary adenomas -Prolactinoma -(Stalk Effect) -Growth Hormone (Somatotropin) adenoma -ACTH adenoma •Underactivity -Sheehan syndrome (Mass Effect) |
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Mass Effect |
•The result of the pressure exerted by a pituitary mass on the remaining normal pituitary gland tissue and on nearby structures. -Tumor may press on optic nerves to produce visual problems. |
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Stalk Effect |
•An effect of a pituitary mass on the stalk that induces secretion of abnormal amounts of prolactin by the pituitary gland. (Prevents hypothalamic inhibition of pituitary prolactin production) |
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Stalk Effect |
•The most common type of functioning pituitary (25%) of adenoma's are Prolactinoma |
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Disease Affecting Anterior Pituitary: Adenomas |
•Prolactin 26% •None (Null cell or oncocytoma) 23% •Adrenocorticotrophic Hormone (ACTH) 15% |
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Disease Affecting Anterior Pituitary: Adenomas |
•Growth Hormone (GH) 14% •Multiple Hormones 13% •Follicle-Stimulating hormone (FSH) or luteinizing hormone (LH) 8% •Thyroid-stimulating hormone (TSH) 1% |
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Anterior Pituitary: Growth Hormone Gigantism |
•Occurs when abnormal growth hormone secretion occurs before the closure of bone epiphyseal growth plates |
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Anterior Pituitary: Growth Hormone
Acromegaly |
•Occurs when abnormal secretion of growth hormone occurs in adults after bone growth plates disappear and epiphyseal close. Normal Ht. |
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Anterior Pituitary: Growth Hormone Acromegaly |
•Treatments: -Somatostatin, dopamine agonists, GH-receptor antagonists, surgery (above), radiation following surgery |
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Anterior Pituitary: HPAC Axis |
•Hypothalamic-Anterior Pituitary-Adrenal-Cortical Axis •Anterior Pituitary Adenoma & ACTH Overproduction •Adrenal Cortex Adenoma & Overproduction of Cortisol |
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Adrenal Gland
Cortex |
•Mineralocorticoids -Aldosterone -Deoxycorticosterone -Corticosterone •Glucocorticoids -Cortisol •Androgens |
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Adrenal Gland Medulla |
•Catecholamines -Epinephrine -Norephinephrine |
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Adrenal Gland |
•Stimuli (cortex): ACTH -Secretion of Cortisol (Hydrocortisone), aldosterone, and androgenic steroids •Stimuli (medulla): autonomic nerves -Secretion of EPI, NOREPI |
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Cortisol |
•Anti-inflammatory •Inhibits insulin •Increases ketone formation |
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Acute Adrenocortical Crisis: Cortisol is Essential for Life |
Actute gland failure is invariably fatal without quick cortisol replacement:
Causes: 1. Sudden withdrawal of corticosteroid therapy
2. Bilateral acute hemorrhage Infarction of the adrenal gland (Waterhouse-Friderichsen Syndrome) This occurs during acute meningococcal meningitis, septicemia, pregnancy, disseminated intravascular coagulation. |
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Acute Adrenocortical Crisis: Cortisol is Essential for Life |
Acute adrenal gland is invariably fatal without quick cortisol replacement:
Causes: 3. Sudden worsening of chronic adrenal insufficiency |
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Major Determinants of Disease 1 |
•Many endocrine organs are controlled by the Pituitary Gland •Nonendocrine Conditions can cause excessive production of endocrine hormones •Overstimulation of target organs by pituitary hormones leads to enlargement of the target organ and overproduction of its hormones. •Overproduction of endocrine hormones accounts for most of the manifestations of endocrine disease. |
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Major Determinants of Disease 2 |
•Overproduction of hormones may be caused by hyperplasia or neoplasia of endocrine glands •Underproduction of hormones is usually caused by disease of the target organ, rather than failure of hormone stimulation •Pituitary tumors may cause symptoms by pressing on adjacent structures (mass effect), not necessarily by producing hormones. |
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Overproduction of Cortisol |
•Cushing Syndrome 1° below or 2° above •Most common cause of Cushing Syndrome: Steroid drug Therapy |
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Hypercortisol Cushings |
•Hyperglycemic •Hypertension •Truncal Obesity •Excess hair •Moon-shaped face |
