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OPT Endocrine
| Term | Definition |
|---|---|
| feedback inhibition | increased activity of target tissue down regulates secreting gland |
| pituitary gland | bean-shaped gland at base of brain, connected to hypothalamus |
| adenohypophysis | anterior lobe of the pituitary; secretes FSH, LH, ACTH, TSH, PRL, GH |
| neurohypophysis | posterior lobe of the pituitary; secretes {ADH} and {oxytocin} |
| 1. visual field abnormalities 2. elevated intracranial pressure | symptoms of pituitary mass effects: |
| prolactinoma | most common type of hyper functioning pituitary adenoma; amenorrhea, lactation, infertility |
| growth hormone-producing adenomas | excess GH causes {gigantism} before epiphyses close and {acromegaly} if after closure; neoplasms of somatotrophs |
| Cushing syndrome | neoplasm of corticotroph cells that make ACTH causes hypercortisolism |
| gonadotroph adenoma | neoplasm of excess LH or FSH |
| thyrotroph adenomas | neoplasm of excess TSH |
| hypopituitarism | usually acquired diseases intrinsic to the pituitary |
| nonfunctioning pituitary adenomas | neoplasms that mostly exhibit mass effects |
| ischemic necrosis of the anterior pituitary | most commonly seen in {Sheehan syndrome} after pregnancy |
| ablation of pituitary by surgery or radiation | pituitary hypo function from inflammatory conditions |
| pituitary dwarfism | ablation of pituitary gland can cause a GH deficiency in children and they fail to grow |
| posterior pituitary syndromes | clinically important syndromes that involve ADH that is usually released when decreased water concentration in plasma |
| diabetes insipidus | ADH deficiency causes excessive urination because kidney does not resorb water; polydipsia and polyuria |
| central diabetes insipidus | type of diabetes insipidus from ADH deficiency |
| nephrogenic diabetes insipidus | type of diabetes insipidus from renal tubular unresponsiveness but normal ADH levels |
| syndrome of inappropriate ADH secretion (SIADH) | excess ADH production so resorption of excessive water; most commonly from ectopic ADH secretion from tumors and head trauma |
| thyroid | net result of hormones is to increase basal metabolic rate -disorders can be excess (hyperthyroidism), deficiency (hypothyroidism) and mass lesions |
| hyperthyroidism | most common cause of thyrotoxicosis; hyper metabolic state from elevated T3 and T4 |
| thyroid storm | abrupt onset of hyperthyroidism; medical emergency |
| primary hyperthyroidism | decreased levels of TSH but increased T3 and T4 levels |
| Graves disease | most common cause of endogenous hyperthyroidism; an autoimmune disorder |
| 1. thyrotoxicosis 2. ophthalmopathy 3. dermopathy | triad of Grave's disease |
| exophthalmos | abnormal protrusion of the eyeballs |
| pretibial myxedema | scaly thickening and orange peel texture seen in Grave's disease, especially on shins |
| hypothyroidism | deficient production of thyroid hormones |
| cretinism | hypothyroidism in childhood from lack of iodine; kids have skeletal and CNS issues |
| myxedema | hypothyroidism in older children and adults; apathy, mental sluggishness, obesity |
| primary hypothyroidism | serum TSH increased because of loss of feedback inhibition from thyroid |
| chronic lymphocytic (Hashimoto) thyroiditis | most common cause of hypothyroid disease in areas of the world where iodine is in sufficient quantities -autoimmune destruction of thyroid cells and replacement by lymphocytic cells |
| 1. cytokine-mediated cell death 2. CD8 cytotoxic T-cell mediated cell death 3. antithyroid antibodies | thyrocyte death in Hashimoto's by: |
| hashitoxicosis | hypothyroidism preceded by transient thyrotoxicosis from disruption of thyroid follicles |
| diffuse and multinodular goiter | enlargement of thyroid from impaired synthesis of thyroid hormones from lack of iodine |
| superior vena cava syndrome | goiter that compresses vessels in neck and upper thorax |
| 1. activation of proto-oncogene RET by chromosomal rearrangement 2. germline mutations | unique to thyroid cancers: |
| papillary carcinoma | most common type of thyroid neoplasm from radiation exposure; chromosomal rearrangement of {RET proto-oncogene} resulting in {RET/PTC fusion protein} -{NTRK1 and BRAF mutations activate MAP kinase pathway} |
| follicular carcinoma | thyroid neoplasm from iodine deficiency |
| medullary carcinoma | most cases are sporadic but some found in MEN 2A and B; caused by {germline RET mutations |
| anaplastic carcinoma | one of the most aggressive human cancers; in older patients with history of goiter |
| parathyroid glands | 4 glands at corners of thyroid; composed of {chief cells} and {oxyphil cells} that secrete parathyroid hormone |
| parathyroid hormone | hormone that is controlled by free calcium levels in the bloodstream, not the pituitary |
| 1. increase osteoclast activity 2. convert Vit. D to active form 3. increase Ca reabsorption in kidneys | 3 ways PTH increases calcium levels |
| hyperparathyroidism | on radiograph, bone looks like {ground (frosted) glass} and is osteoporotic |
| osteitis fibrosa cystica | replacement of resorbed bone by fibrous tissue with cysts; from hyperparathyroidism |
| brown tumors of hyperparathyroidism | aggregates of osteoclasts, giant cells and hemorrhagic debris |
| metastatic calcification | can be secondary to hypercalcemia |
| primary hyperparathyroidism | one of the most common endocrine disorders; causes {hypercalcemia} and often brought on by a parathyroid adenoma -painful bones, renal stones, abdominal groans and psychic moans |
| secondary hyperparathyroidism | chronic calcium depression, usually from {renal failure} |
| renal osteodystrophy | bone abnormalities seen in patients with renal failure and hyperparathyroidism |
| tertiary hyperparathyroidism | parathyroid activity becomes autonomous and excessive |
| hypoparathyroidism | much less common than hyperparathyroidism; hypocalcemia, muscle spasms, dental abnormalities |
| DiGeorge syndrome | congenitally missing parathyroid glands that causes symptoms of hypoparathyroidism |
| adrenal gland | paired organs with cortex and medulla; makes glucocorticoids, mineralocorticoids and sex steroids |
| adrenal medulla | contains chromaffin cells that make catecholamines, mainly epinephrine |
| 1. hypercortisolism (Cushing syndrome) 2. hyperaldosteronism 3. adrenogenital syndromes | 3 clinical syndromes of adrenocortical hyperfunction (hyperadrenalism) |
| Cushing syndrome (hypercortisolism) | any elevation of glucocorticoids; buffalo hump, moon faces, truncal obesity, hypertension and weight gain |
| primary adrenocortical hyperplasia or neoplasm | autonomous adrenal function independent of the levels of ACTH |
| primary hypothalamic-pituitary disease aka Cushing disease | over-secretion of ACTH with increased skin pigmentation |
| secretion of ectopic ACTH by non-pituitary neoplasms | small-cell lung carcinomas can have this effect |
| hyperaldosteronism | excess aldosterone causes sodium retention and potassium excretion--leads to hypertension and hypokalemia |
| secondary hyperaldosteronism | accompanied by increased levels or renin |
| primary hyperaldosteronism / Conn's syndrome | caused by an aldosterone-producing neoplasm with low renin levels |
| congenital adrenal hyperplasia (CAH) | recessive defect in an enzyme for adrenal steroid biosynthesis with an increase in ACTH; type of adrenogenital syndrome |
| 21-hydroxylase deficiency | most common enzymatic defect in CAH; required for cortisol and aldosterone |
| adrenal insufficiency | only apparent if 90% compromised; can be acute, chronic, or secondary insufficiency |
| Waterhouse-Friderichsen syndrome | massive adrenal hemorrhage secondary to sepsis that can cause acute adrenal insufficiency |
| chronic adrenocortical insufficiency (Addison Disease) | progressive destruction of adrenal cortex with increase in ACTH and pigmentation |
| 1. autoimmune adrenalitis 2. tuberculosis 3. acquired immune deficiency syndrome (AIDS) 4. metastatic cancers | causes of chronic adrenocortical insufficiency |
| secondary adrenocortical insufficiency | any disorder that reduces ACTH production; aldosterone levels and pigmentation remain normal |
| adrenal adenomas | benign adrenal tumors with little consequence |
| adrenocortical carcinoma | rare adrenal tumors that are very metastatic (most tumors in adrenal cortex are not primary tumors) |
| pheochromocytoma | neoplasms of chromaffin cells that release catecholamines, hypertension; uses rule of 10's (10% outside adrenal gland, 10% bilateral, 10% malignant) |
| multiple endocrine neoplasia syndromes | group of dominantly inherited diseases resulting in proliferative lesions of endocrine glands |
| MEN 2 | both Type 2A and 2B have gain-of-function mutations of RET proto-oncogene |
| multiple endocrine neoplasia 2A | involve the thyroid (medullary carcinoma of the thyroid), adrenal medulla (adrenal pheochromocytomas) and parathyroid gland |
| multiple endocrine neoplasia 2B | distinct germline mutation of one amino acid; like MEN 2A but no parathyroid symptoms -also get {mucosal neuromas} and {ganglioneuromas} |
Created by:
aharnold
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