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31 Cards in this Set
- Front
- Back
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Hypercortisol Cushings |
•Hyperglycemic •Hypertesnsion •Truncal Obesity •Excess hair •Moon-Shaped-Face |
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Under activity of the Adrenal Cortex (Adrenocortical Insufficiency) Addisons Disease (Hypocortisol) |
Causes: 1. Dysgenesis •Genetic, ACTH receptor gene
2. Impaired Steroidogenesis •Congenital Adrenal Hyperplasia -Enzyme deficiencies |
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Under activity of the Adrenal Cortex (Adrenocortical Insufficiency)
Addisons Disease (Hypocortisol) |
3. Adrenal Destruction •Autoimmune Adrenalitis - 21-hydroxylase •Metastasis •Infection •Amyloidosis
Low Cortisol = High ACTH |
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Addison's Disease (Hypocortisol) |
•Personality changes, Confusion, Coma
•Anorexia, nausea, vomiting
•Thyroid and parathyroid disease
•Diarrhea, abdominal pain |
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Addison's Disease (Hypocortisol) |
•Low blood levels of cortisol causes the pituitary gland to secrete large amounts of ACTH. One of the metabolic breakdown products of ACTH is melanocyte stimulating hormone (MSH), which stimulates melanin production in skin.
•Low Cortisol = High ACTH |
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Diseases of the Adrenal Medulla |
•Underactivity -Of little consequence (Unlike loss of cortical fx!) •Overactivity - Hypertension -Pheochromocytoma - (most common neoplasm of adrenal medulla) |
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Diseases of the Adrenal Medulla |
Overactivity - Hypertension •Rule of 10 -10% arise outside the adrenal (paraganglioma's, chromaffin cells in major blood vessels, carotid bodies). -10% are bilateral in adrenal -10% are malignant |
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Diseases of the Adrenal Medulla |
Overactivity •Rule of 10 -10% are in children -10% are associated with other endocrine neoplasms such as multiple endocrine neoplasia (MEN) |
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Under activity of the Anterior Pituitary (Hypopituitarism) |
•Sheehan Syndrome is also known as Pituitary Necrosis.
OR
•Simmonds Syndrome if it is Not pregnancy related. |
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Under activity of the Anterior Pituitary (Hypopituitarism) |
•Pale Skin (Decrease MSH) •Hypothyroidism (Decrease MSH) •Failure of Lactation (Decrease Prolactin) |
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Under activity of the Anterior Pituitary (Hypopituitarism) |
•Adrenal Insufficiency (Decrease ACTH) •Ovarian failure with amenorrhea (Failure to menstruate) (Decrease FSH, LH) |
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Under activity of the Anterior Pituitary (Hypopituitarism) |
•MSH: Melanocyte stimulating hormone. MSH is a breakdown product of ACTH. Excess of MSH produces dark skin. Deficiency produces pale skin. |
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Disease of the Thyroid Gland |
•Metabolic rate
•Thyroglobulin: Globulin (a protein) in the thyroid gland that binds to thyroid hormones while they are stored in the gland
•Triiodothyronine T3 •Thyroxine T4 |
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Disease of the Thyroid Gland |
•Hyperthyroid, euthyroid, hypothyroid •Goiter: Enlarged thyroid gland -Toxic or Non-Toxic •Thyroxine Binding Globulin: Blood binding protein for thyroid hormones |
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Disease of the Thyroid Gland |
•Thyrotoxicosis - metabolic effect •Hyperthyroidism - condition of the gland -Hence, a patient could be thyrotoxic due to medication, but the gland is normal |
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Disease of the Thyroid Gland |
•Failure of gland to respond to feedback loops •Autoimmune disease |
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Disease of the Thyroid Gland |
Cause: Blood Thyroid hormones (T3 and T4) •Step 1 -Increase TSH-releasing hormone from hypothalamus •Step 2 -Increase TSH from anterior pituitary •Step 3 -Increase output of thyroid hormones (T3 and T4) |
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Thyroid Gland |
•Triiodothyronine (T3) & thyroxine (T4) -Release caused by TSH which is controlled by: •Cold (+) •Thyroxine (-) •Catecholamines (+) -Increase Metabolic Rate -Allowing full effect of other hormones (amplifies cAMP), a permissive effect -Increase glycolysis, lipolysis, gluconeogenesis |
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Hyperthyroidism Causes |
•Overmedication
•Primary hyperthyroidism - increased thyroid gland output due to disease of the thyroid gland itself
•Secondary hyperthyroidism - increased thyroid gland output due to increased TSH via the anterior pituitary |
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Hyperthyroidism Causes |
•Graves Disease accounts for 80-90% of all hyperthyroidism -Autoimmune disease - thyroid stimulating globulin -Toxic goiter -Exopthalmus -Skin disease over shins (brownish thick scaly plagues) |
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Disease of the Thyroid Gland |
•1 Hypothyroidism: Gland itself is diseased. -Too little thyroid -TSH is high (trying to stimulate gland) |
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Disease of the Thyroid Gland |
• 1. Hyperthyroidism: Gland itself is diseased. -Too much thyroid -TSH is low |
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Goiter |
•Enlarged Thyroid Gland |
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Hyperthyroidism Graves Disease |
•Thyroid Stimulating Immunoglobulin •Exopthalmus (bug-eyes) •Lid-Lag -T3&T4 = high -TSH = Low |
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Hypothyroidism |
•Hashimoto Thyroiditis (Autoimmune) •Accumulation of lymphocytes as part of the autoimmune reaction •Antibodies block TSH, hinder T3 and T4 production Thyroid Follicles |
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Hypothyroidism |
1. Typical cause is Thyroiditis in primary Hypothyroidism 2. Developing nations due to a lack of iodine in diet |
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Hypothyroidism |
•Symptoms -Myxedema - accumulation of thick fluid in skin, organs -Puffy eyes, bags under eyes, swollen tongue, edema of vocal cords (hoarseness), swelled hands & feet, weight gain, mental dullness, weak, slow reflexes, intolerant to cold, constipated, bradycardia |
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Hypothyroidism |
•T3, T4 are low, TSH is elevated •Children - Cretinism |
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Hypothyroidism in infant (Cretin) |
•Permissive effect on many other Hormones •Essential for normal development |
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Neoplasms of the Thyroid Gland |
•Benign -Adenoma
•Malignant -Papillary carcinoma (80%) most common; 5 year survival 90%
-Follicular carcinoma (15%); 5 year survival rate |
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Neoplasms of the Thyroid Gland |
•Malignant -Medullary carcinoma (5%); 5 yr survival rate -Anaplastic carcinoma (rare); not favorable outcomes here. Older pts. Fatal within one yr. |
