Pathology Exam 2 Pg 28-34

Front 1

Primary function of the neuroendocrine system

Back 1

to maintain body homeostasis through the manufacture and secretion of a variety of chemical mediators (hormones)

Front 2

A) what is it called when hormones exert their effects on distant sites?

B) when they diffuse through interstitial tissue and exert effects on adjacent sites?

C) when they exert their effects on their own cell of origin?

Back 2

A) endocrine effects

B) paracrine effects

C) autocrine effects

Front 3

A) hydrophobic hormones

B) hydrophilic hormones

Back 3

A) steroids and thyroid hormones (cholesterol derivatives)-->diffuse through plasma membrane to help w/transcription of genes

B) all other hormones (amino acid derivatives)

Front 4

Abnormalities of endocrine organs

Back 4

hyperfunction (abnormal stimulation, autonomous function, ectopic production)

hypofunction (congenital defect, acquired defect, end organ unresponsiveness)

the local effects of an enlarging mass

Front 5

Anterior pituitary hormones

Back 5

Growth hormone (GH)
Adrenal corticotropic hormone (ACTH)
Follicle stimulating hormone (FSH)
Lutenizing hormone (LH)
Thyroid stimulating hormone (TSH)
Prolactin (PL)

Front 6

Posterior pituitary hormones

Back 6

Antidiuretic hormone (ADH, vasopressin)
Oxytocin

These are found in the hypothalamus, then stored in the posterior pituitary

Front 7

What is the most common basis of hyperpituitarism, and is usually due to a functional, benign, monoclonal neoplasm (pituitary adenoma) which secretes one of the polypeptide hormones?

Back 7

Autonomous pituitary hypersecretion

Front 8

What is the most common secretory product of pituitary adenomas?

Back 8

Prolactin excess

Front 9

Which hormone is responsible for exaggerated skeletal growth (giantism) before puberty and acromegaly (enlargement of face, hands, & feet) after puberty?

Back 9

Growth hormone excess

Front 10

What is the 2nd most common functional disorder of the pituitary?

Back 10

Acromegaly

Front 11

An increase in which hormone results in Cushing disease?

Back 11

ACTH

Front 12

Hypopituitarism most commonly results from what? What does this lead to?

Back 12

Extensive destruction of anterior lobe tissue

Leads to panhypopituitarism (Simmond disease)

Front 13

Clinical features of Growth hormone (GH) deficiency (before and after puberty)

Back 13

before puberty-pituitary dwarfism (short stature with normal proportions) and delayed sexual maturity

after puberty-asymptomatic

Front 14

Clinical features of Gonadotropin deficiency (in children, adult females, and adult males)

Back 14

children-delayed puberty

adult females-amenorrhea, loss of secondary sex characteristics, atrophy of ovaries and external genitalia

adult males-aspermia, loss of secondary sex characteristics, testicular atrophy

Front 15

Clinical features of TSH deficiency

Back 15

hypothyroidism

Front 16

Clinical features of ACTH deficiency

Back 16

Hypoadrenalism

Front 17

What is the most frequent cause of hypopituitarism?

Back 17

Non-functioning adenoma

Front 18

What does Sheehan Syndrome result from?

Back 18

Results from infarct of anterior lobe secondary to hypotension or shock.

Usually due to obstetric hemorrhage and hypotension

Front 19

What is it called when, during pregnancy, the pituitary doubles in size, compromising the circulation, resulting in sudden hypotension and infarct? The first sign of this is failure to lactate or resume mences.

Back 19

Sheehan Syndrome

Front 20

An increase or decrease of which hormone does NOT have any associated clinical effects?

Back 20

Oxytocin

Front 21

A) What happens when you secrete excess ADH?

B) What happens when you don't make enough ADH?

Back 21

A) Syndrome of inappropriate ADH (SLADH)-renal retention of water and inability to dilute urine

B) Diabetes insipidus-symptoms similar to diabetes mellitus, and can be due to an end-organ unresponsiveness to the hormone

Front 22

What is it called when expanding pituitary masses produce visual impairment by impinging the optic chiasm or compressing the oculomotornerves?

Back 22

Bitemporal hemianopsia

Front 23

What is the function of parafollicular or "C" cells?

Back 23

secrete the hormone calcitonin to oppose the effects of parathyroid hormone

Front 24

Thyroid hormones and functions

Back 24

T3 & T4 are released from the pituitary and have a negative feedback on the hypothalamus and pituitary

Front 25

Hyperthyroidism (thryotoxicosis)

Back 25

Hypermetabolic state produced by lots of T3 and/or T4. This is caused by Graves' disease, toxic multinodular goiter, and toxic adenoma,

Front 26

Hypothyroidism

Back 26

Deficiency of T3 and/or T4 and results from intrinsic thyroid disease (primary hypothyroidism) or TSH deficiency (secondary hypothyroidism)

Front 27

Late childhood or adult hypothyroidism (myxedema)

Back 27

Hypometabolic state characterized by tiredness, apathy, lethargy, slow speech, rough skin, and dilated heart.

Major causes: surgical, chemical, radiation, idiopathic myxedema, and Hashimoto thyroiditis

Front 28

Gestational or early infancy hypothyroidism (cretinism)

Back 28

Arises from lack of iodine or defects in thyroid hormone synthesis. This may cause retardation, spasticity, and deaf-mutism (neurologic cretinism)

Front 29

Hashimoto thyroiditis

Back 29

Autoimmune disease in middle-aged women associated with hypothyroidism. The thyroid gland is enlarged, firm, and rubbery.

Front 30

Graves Disease (diffuse toxis gioter)

Back 30

Autoimmune disease in young, adult women associated with hyperthyroidism. Symptoms include enlarged thyroid, ocular changes(proptosis, diplopia, lid lag), and thickening of the skin over the feet and legs (pretibial myxedema)

The ocular changes are present in 70% of cases, but the skin changes are only present in 15%.

Front 31

Goiter

Back 31

Enlargement of the thyroid gland

Front 32

Diffuse nontoxic goiter (simple/colloid goiter)

Back 32

Gradual, painless enlargement of the thyroid due to compensatory hyperplasia because of inability to secrete thyroid hormones.

Front 33

Multinodular gioter (adenomatous gioter)

Back 33

The end result of a long-standing diffuse nontoxic goiter, causing thryomegaly. They are more frequently seen in older females. Most of the time, the thyroid works fine (euthyroid). These are easily confused with cancer.

Front 34

What is the method for distinguishing a non-neoplastic nodule from a neoplastic nodule or a malignant nodule from a benign nodule?

Back 34

There is no method

Front 35

Benign neoplasms

Back 35

Adenomas arising from follicular epithelial cells. They become more frequent with age and are rarely functional. These have little malignant potential.

Front 36

Malignant neoplasms

Back 36

Relatively infrequent, but radiation exposure increases the risk. One nodule in a male is more likely malignant, but malignancy is higher in females.

Front 37

What is the most common thyroid malignancy?

Back 37

Papillary adenocarcinoma.

This is most present in young adult females. Surgery is needed to remove the entire thyroid, since it spreads by lymph nodes. This has a good prognosis.

Front 38

Follicular carcinoma

Back 38

Most present in middle-aged females and grows slowly. The tumor spreads hematogenously to organs. There is a poor prognosis because it can differentiate.

Front 39

Parathyroid gland functions

Back 39

Regulate calcium metabolism

*This is opposed by the hormone calcitonin*

Front 40

How is hyperparathyroidism relfected?

Back 40

By elevated PTH levels even in the face of hypercalcemia and increased urine calcium secretion.

Front 41

What is most frequent cause of primary hyperparathyroidism?

Back 41

A parathyroid adenoma, although parathyroid hyperplasia and ectopic production of PTH also occur.

Front 42

Hypoparathyroidism

Back 42

Characterized by low PTH and hypocalcemia. This is the result of parathyroidectomy.

Front 43

What is the function of mineralocorticoids (aldosterone)?

Back 43

Regulate extracellular fluid volume and potassium metabolism in the kidney

Front 44

Where are glucocorticoids (cortisol) produced and what is their function?

Back 44

Produced in the inner zone of the kidney and increase appetite, fat deposition in the face, protein breakdown, and impair inflammation and immunity.

Front 45

Excess mineralocorticoids

Back 45

Primary hyperaldosteronism (Conn Syndrome) is most often seen in middle-aged women and presents as moderate hypertension. This is caused by aldosterone-secreting cortical adenomas.

Front 46

Excess glucocorticoids (Cushing Syndrome)

Back 46

Relatively uncommon, but presents in middle-aged females.

Front 47

A) Primary hypercortisolism is associated with what?

B) Secondary hypercortisolism is associated with what?

Back 47

A) low serum ACTH

B) high serum ACTH

Front 48

Excess androgens (adrenogenital syndromes)

Back 48

Uncommon, but may be inherited disorders that affect enzymatic activity in the steriodogenesis pathway, resulting in congenital adrenal hyperplasia.

Leads to precocious puberty in boys or masculinization of females

Front 49

Primary chronic adrenocortical insufficiency (Addison disease)

Back 49

Results from a chronic destructive process that destroys 90% of the kidney's cortex.

Front 50

Secondary adrenocortical insufficiency

Back 50

Results from decreased ACTH secretion from the pituitary, causing lack of hyperpigmentation

Front 51

Acute adrenal insufficiency

Back 51

Life-threatening situation, resulting from sudden stress in patients with Addison disease or the abrupt withdrawal of exogenous steroidsa

Front 52

What makes up the Islets of Langerhans? What are their functions?

Back 52

Alpha cells (20%)-secrete glucagon (inhibits utilization of glucose)

Beta cells (70%)-secrete insulin (promotes utilization of glucose)

Delta cells (5%)-secrete somatostatin (inhibits insulin and glucagon release)

Front 53

What is the most common disease of the general population in the US, affecting 2% of people?

Back 53

Diabetes mellitus

Front 54

What is insulin and what is its function?

Back 54

An anabolic hormone involved in carb, protein, and lipid metabolism. It increases glucose rate of transport, promotes glycogen formation, converts glucose to triglycerides, and promotes nucleic acid and protein synthesis.

Front 55

Type I Diabetes (Juvenile onset, Insulin-dependent)

Back 55

15% of cases, results from inadequate insulin production and reduced number of beta cells in the pancreas.

Patients develop cytotoxic T cells and autoantibodies to beta cells, which are triggered by environmental factors.

Health problems include ketoacidosis, retinal damage, kidney damage, vascular disease, and infection

Front 56

Type II Diabetes (Adult onset, non-insulin dependent)

Back 56

Most common form of diabetes. Patients have deficient insulin secretion and end-organ resistance to insulin, are often obese, and have CV and kidney disease, nerve damage, and cataracts.

Front 57

Insulinoma (beta-cell tumors)

Back 57

Most common islet cell tumors. 10% are malignant.

Symptoms-hypoglycemia, stupor, loss of consciousness. These can be aborted by administering glucose.

Front 58

Gastrinoma

Back 58

Tumors associated with gastric acid hypersecretion. Slightly over 50% are malignant.

Result in ulcers (Zollinger-Ellison syndrome) and fluid/electrolyte disturbance secondary to diarrhea and malabsorption.