Term
| What is seen when there is problems with the Pituitary-Thryoid axis? |
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Definition
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Term
| What is seen with problems in the Pituitary-Adrenal axis? |
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Definition
| Cushing's and Addison's disease? |
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Term
| What is seen with problems in the Pituitary-Gonadal axis |
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Definition
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Term
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Definition
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Term
| Hypothalamic - Pituitary - Adrenal axis |
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Definition
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Term
| Hypothalamic - Pituitary - Gonadal axis |
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Definition
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Term
| List the anterior pituitary hormones, their regulatory hormones |
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Definition
• Thyroid stimulating hormone (TSH; TRH)
• Adrenocorticotrophin (ACTH; CRH)
• Luteinizing hormone (LH; GnRH)
• Follicle stimulating hormone (FSH; GnRH)
• Growth hormone (GH; GHRH & GHRIH)
• Prolactin (PRL; Dopamine) |
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Term
| Which two ant pit hormones are under negative feedback? |
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Definition
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Term
| What is different about PRL regulation, compared to regulation of the other ant pit hormones? |
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Definition
| PRL is primarily under inhibitory control by dopamine, rather than being released upon stimulation |
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Term
| List 5 symptoms of pituitary tumours (adenomas)? |
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Definition
| • Headache (intracranial pressure) • Drowsiness • Seizure • Visual defects (pressure on optic chiasm) • Abnormal hormone secretion |
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Term
| Why are adenomas considered benign, when they are associated with malignancies? |
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Definition
| Because they are not metastatic (don;t cause cancer) |
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Term
| What are the most common hormonal problems related to an adenoma? |
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Definition
1. Hyperprolactinemia
2. ACTH hypersecretion
3. GH hypersecretion |
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Term
| (T/F) Hyperprolactinemia is the most common type of pituitary tumour |
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Definition
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Term
| What is seen in galactorrhea, and what sexes can have it? |
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Definition
- Men and women
- Spontaneous flow of milk from the tumour |
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Term
| What is seen in amenorrhea, and what sexes can have it? |
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Definition
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Term
| What is caused by oversecretion of ACTH? |
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Definition
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Term
| What is the cause of gigantism? |
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Definition
| Pre-pubertal GH oversecretion |
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Term
| What is the cause of acromegaly? |
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Definition
| Post-pubertal GH oversecretion |
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Term
| How can a pituitary tumour destroy the gland? |
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Definition
- Compression compromises vascular suppl
- Disruption of the pituitary-hypothalamic axis |
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Term
| What is the end result of this? |
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Definition
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Term
| (T/F) Hypopituitaryism is always caused by a pituitary tumour |
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Definition
|
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Term
| What are two other causes? |
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Definition
1. Sheehan's syndrome
2. Pit stalk transection |
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Term
| What is the cause of Sheehan's syndrome, and which sex does it occur in? |
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Definition
| Vascular collapse following an obstetrical hemmorrhage, causing death of the pituitary; women only |
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Term
| What can cause a pit stalk transection? |
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Definition
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Term
| What is a unique characteristic of a pituitary stalk transection, and why does it occur? |
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Definition
| Panhypopituitaryism, except PRL is elevated. PRL is elevated because dopamine can no longer reach the pituitary gland, and thus, PRL secretion is constant |
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Term
| If the adenoma causes a hormone deficiency, how is it treated? |
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Definition
| Hormone replacement of downstream hormones (no point replacing the pituitary hormones) |
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Term
| If the adenoma causes a hormone excess, how is it treated? |
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Definition
1. Inhibitory drug therapy
2. Ablation therapy |
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Term
| What is bromocryptine used for? |
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Definition
| Treatment of hyperprolactinemia |
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|
Term
| (T/F) Hypothyroidism is very rare |
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Definition
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Term
| Which sex is it more common in? |
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Definition
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Term
| What is the cause of primary hypothyroidism? Secondary? Which is more common |
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Definition
Primary (90% of cases): Thyroid gland malfunction
Secondary: Pituitary deficiency of TSH |
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Term
| What are the 4 causes of hypothyroidism? |
|
Definition
1. Autoimmune
2. Thyroiditis
3. Congenital
4. Surgical |
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Term
| What is hashimotos disease? |
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Definition
| Hypothyroidism caused by autoimmune attack on thyroid gland |
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|
Term
| What are the clinical symptoms of hypothyroidism? |
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Definition
- Goiter
- Reduced metabolism |
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Term
| What symptoms are seen because of the reduced metabolism? |
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Definition
– Pale, cool, edematous
– Cold intolerant
– Slow heart rate (bradycardia)
– Lethargic
– Decreased appetite/weight gain |
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Term
| (T/F) Goiter is seen in both primary and secondary hypothyroidism |
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Definition
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|
Term
| Why does goiter only occur in primary hypothyroidism? |
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Definition
| Only in primary because it is caused by overstimulation by TSH, and in secondary hypothyroidism there is reduced TSH |
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Term
| If someone has a goiter, does this confirm that they have hypothyroidism? |
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Definition
| No, because hyperthyroidism is also characterized by a goiter |
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Term
| Why does lack of iodine in the diet lead to formation of a goiter? |
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Definition
| Because no TH can be made due to the iodine deficiency, so overstimulation by TSH occurs |
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Term
| What is the cause of cretinism? |
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Definition
| Congenital hypothyroidism |
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Term
|
Definition
| Mental retardation and growth restriction caused by untreated congenital hypothyroidism |
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|
Term
| What two congenital defects can give rise to cretinism? |
|
Definition
- Iodine deficiency
- Thryoid gland malformation |
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Term
| What are two therapies, and do any of them have any stipulations? |
|
Definition
- Thyroxine supplement
- Iodine replacement (only if cretinism is caused by iodine deficiency) |
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Term
| (T/F) Neonatal screening can test for congenital hypothyroidism |
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Definition
|
|
Term
| What precautions can the mother take? |
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Definition
| Ensure adequate iodine in diet |
|
|
Term
| What is the most common form of hyperthyroidism? |
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Definition
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|
Term
| What is the cause of graves disease? |
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Definition
| Autoimmune - Ab's generated that chronically stimulate TSH receptors |
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|
Term
| What other 3 ways can hyperthyroidism occur? |
|
Definition
- Thyroid nodules
- Latrogenic
- TSH secreting adenoma |
|
|
Term
| What is a thyroid nodule? |
|
Definition
| An adenoma that secretes TH |
|
|
Term
| What is the latrogenic cause of hyperthyroidism? |
|
Definition
| Overmedication of hypothyroidism |
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|
Term
| What are the symptoms of hyperthyroidism? |
|
Definition
- Goiter
- Increased metabolism
- Exophthalmus |
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|
Term
| What are the signs of hyperthyroidism related to increased metabolism |
|
Definition
- Weight loss without appetite loss
- Fatigue/muscle weakness
- Tachycardia
- Nervousness
- Heat intolerance
- Osteoperosis |
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|
Term
|
Definition
| Tissue behind the eye grows and pushes the eye forward |
|
|
Term
| Describe what occurs in graves disease? |
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Definition
| Constant TH production, even in the presence of a proper regulatory pathway and no TSH secretion |
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Term
| (T/F) Graves is easily classed as primary or secondary |
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Definition
| False, it behaves secondary (constant stimulation from an outside source), but is similar to primary because there is no problem in the feedback mechanism. However, there is no pathology of the thyroid. |
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Term
| What 3 things are used for the treatment of hyperthyroidism? |
|
Definition
1. Radioactive iodine
2. Medication
3. Surgery |
|
|
Term
| (T/F) Radioactive iodine treatment usually produces hypothyroidism, which requires thyroxine therapy |
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Definition
|
|
Term
| What two medications are used in treatment of hyperthyroidism? What does each do? |
|
Definition
1. Beta blocker - alleviates symptoms
2. Anti-thyroid drugs (propylthiouracil and methimazole) |
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Term
| How do anti thyroid drugs work? |
|
Definition
| They interfere with thyroperoxidase, and thus prevents activation of iodine and iodination of tyrosine |
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|
Term
| What is surgery used to treat? |
|
Definition
- Cancerous thyroid nodules
- Goitre |
|
|
Term
| What is pheochromocytoma? |
|
Definition
| A tumour of the adrenal medulla that secretes catecholamines |
|
|
Term
| What are two diseases related to pathologies with the adrenal cortex? |
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Definition
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|
Term
| What is the cause of Chushings? |
|
Definition
|
|
Term
| What causes the excess glucocorticoids? |
|
Definition
- ACTH secreting tumour
- Glucocorticoid secreting adrenal tumour
- Glucocorticoid therapy of chronic inflammatory conditions |
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|
Term
| What are the two types of ACTH secreting tumours? |
|
Definition
1. Pituitary
2. Paraneoplastic (in the lung) |
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|
Term
| Which of these causes is related to primary cushings? Secondary cushings? |
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Definition
| Adrenal tumour is related to primary; all other causes are related to secondary |
|
|
Term
| List the clinical features of Chushings |
|
Definition
- Obesity
- Moon face
- Buffalo hump
- Reduced muscle mass in limbs
- Stria
- Increased hair growth |
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|
Term
| (T/F) The obesity cause by cushings is limited to abdominal areas |
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Definition
|
|
Term
| List 4 other features of chushings |
|
Definition
1. Osteoperosis
2. Insulin resistance
3. Delayed healing/increased infection
4. Reduced stress response |
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|
Term
| Why does insulin resistance develop? |
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Definition
| Because cortisol triggers gluconeogenic effects |
|
|
Term
| What is addisons disease? |
|
Definition
| A deficiency of adrenocortical hormones |
|
|
Term
| Which 3 hormones are missing in primary addisons? Secondary? |
|
Definition
– Glucocorticoids (primary & secondary)
– Mineralocorticoids (primary only)
– Androgens (primary only) |
|
|
Term
| What are the 3 causes addisons? |
|
Definition
- Autoimmune reaction
- Destructive tumours
- Adrenal gland infection |
|
|
Term
| List 6 clinical features of addisons? |
|
Definition
• Wgt loss/Anorexia
• Weakness/fatigue
• Hypotension (salt loss)
• Hyperpigmentation
• Body hair loss
• Hypoglycemia |
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