Endocrine Pathology

Gen Path Exam 2

What is the role of the pituitary gland?

secretion of hormones

anterior pituitary is controlled by what?

hypothalamus

most hormone problems occur in the anterior or posterior pituitary?

anterior

what are the 5 hormones of the anterior pituitary?

growth hormone, prolactin, TSH, FSH, LH, ACTH

Posterior pituitary includes

ADH and oxytocin

target of growth hormone

liver and adipose tissue

effect of growth hormone

stimulation of growth, metabolism of carb and lipids

prolactin target

mammary glands

prolactin function

production of milk

TSH target

thyroid

TSH function

secretion of thyroid hormones

FSH target

ovaries and testicles

FSH function

reproductive functioning

LH target

testies and ovaries

LH function

production of sex hormones

ACTH target

adrenal gland

ACTH function

secretion of glucocorticoids

most common cause of hyperpituitarism

functional pituitary adenoma

pituitary adenoma category

neoplasia

what type of tumor is pituitary adenoma

benign

most common hormone overproduced from pituitary adenoma

growth hormone

demographics of pituitary adenoma

increases with age

common symptoms for all pituitary adenoma regardless of hormone effected

headaches and vision problems

functional vs nonfunctional vs silent pituitary adenoma

function is too much hormone produced, nonfunctional is no hormone produced and silent is normal hormone produced

pituitary adenoma diagnosis

hormone level testing and imaging

treatment of pituitary adenoma

surgery, radiation, medication

Two types of growth hormone adenoma

gigantism and acromegaly

gigantism main features

pre-puberty, increase in body size

acromegaly main features

post-puberty, enlarged face, hands, and feet

A as in adult

Which of the following hormones is secreted by the anterior pituitary gland?

A. Oxytocin

B. Antidiuretic hormone (ADH)

C. Growth Hormone (GH)

D. Epinephrine 

C. Growth Hormone (GH)

Euthyroid meaning?

Thyroid is normal

Primary hyperthyroidism T3 and T4 vs TSH levels

elevated T3 and T4, decreased TSH

Secondary hyperthyroidism T3 and T4 vs TSH

increased TSH, increased T3 and T4

Primary hypothyroidism hormone levels

decreased T3 and T4, increase TSH

secondary hypothyroidism hormone levels

decreased TSH, decreased T3 and T4

Two most common cause of hyperthyroidism

graves disease and multinodular goiter

clinical presentation of hyperthyroidism

weight loss, tachycardia, tremor, anxiety, thyroid storm

medical emergency that can result from hyperthyroidism?

cardiac arrythmias

diagnosis of hyperthyroidism

elevated T3 and T4

graves disease category

immune mediated

graves disease is due to ____________ against ____ receptor

autoantibodies, TSH

What is the most common cause of hyperthyroidism

Graves disease

demographics of graves disease

more common in women

graves disease clinical presentation

hyperthyroidism, exophthalmos, enlarged thyroid gland, dermopathy, and thyroid storm

diagnosis of graves disease

elevated T3 and T4 and decreased TSH

treatment for graves disease

anti-thyroid medication, radioactive iodine, surgery

multi nodular goiter category

metabolic

two main causes of multinodular goiter

decreased thyroid hormone and increased serum TSH

most common cause of decreased thyroid hormone in multinodular goiter

iodine deficiency

multinodular goiter demographics

mostly women

clinical presentation of multinodular goiter

enlarged thyroid gland, can cause symptoms of hyperthyroidism over time

diagnosis of multinodular goiter

ultrasound, biopsy, thyroid function tests

treatment of multinodular goiter

radioactive iodine and surgery

most common cause of hypothyroidism in the US

Hashimoto's thyroiditis

cause of hypothyroidism in underdeveloped countries

iodine deficiency

clinical presentation of hypothyroidism

fatigue, weight gain, col intolerance, dry skin, constapation

Diagnosis of hypothyroidism

low T3 and T4

Hashimoto thyroiditis category

immune mediated

Hashimoto thyroiditis is autoantibodies against what?

thyroid antigens

autoimmune response in Hashimoto thyroiditis results in what?

destruction of thyroid epithelium so can't make thyroid hormone

demographics of hashimotos disease

middle aged women

Hashimoto thyroiditis clinical presentation

painless thyroid enlargement

diagnosis of Hashimoto thyroiditis

biopsy, thyroid function tests, detection of autoantibodies

two autoantibodies detected in Hashimoto thyroiditis

anti-thyroglobulin antibody and anti-thyroid peroxidase antibody

treatment for Hashimoto thyroiditis

thyroid hormone replacement therapy

thyroid adenoma category

neoplastic

thyroid adenoma tumor type

benign, from follicular cells

thyroid adenoma demographics

mostly women

thyroid adenoma clinical presentation

painless thyroid nodule, may have symptoms of hyperthyroidism

treatment for thyroid adenoma

monitor, surgery

thyroid adenoma diagnosis

ultrasound, blood test, biopsy

papillary thyroid carcinoma category

neoplastic

papillary thyroid carcinoma etiology

thyroid malignancy

papillary thyroid carcinoma demographics

women

papillary thyroid carcinoma clinical presentation

painless thyroid mass, lymphadenopathy

papillary thyroid carcinoma diagnosis

ultrasound, biopsy

papillary thyroid carcinoma treatment

surgery

thyroglossal duct cyst category

developmental

thyroglossal duct cyst etiology

cyst from remnants of thyroglossal duct

thyroglossal duct cyst clinical presentation

midline neck mass, MOVES WITH SWALLOWING

thyroglossal duct cyst diagnosis and treatment

imagine, excision

parathyroid hormone does what?

regulates calcium and phosphate levels

Primary hyperparathyroidism category

metabolic

Primary hyperparathyroidism etiology

overproduction of PTH

Primary hyperparathyroidism is most commonly due to what?

parathyroid adenoma

Primary hyperparathyroidism clinical presentation

hypercalcemia, bone pain, constapation, frequent urination, depression and confusion

Primary hyperparathyroidism diagnosis

high serum calcium, high PTH

Primary hyperparathyroidism treatment

surgical removal adenoma

Secondary hyperparathyroidism category

metabolic

Secondary hyperparathyroidism is most often due to

kidney disease

Secondary hyperparathyroidism results in

overproduction of PTH by parathyroid

clinical presentation of secondary hyperparathyroidism

decreased bone mineralization and calciphylaxis

diagnosis of secondary hyperparathyroidism

low serum calcium, high PTH and phosphate

treatment for secondary hyperparathyroidism

treat underlying cause, like kidney disease

What is in the adrenal cortex?

glucocorticoids, mineralocorticoids, androgens

what id in the adrenal medulla?

catecholamines (epinephrine and norepinephrine)

Hypercortisolism (Cushing syndrome) category

metabolic

Hypercortisolism (Cushing syndrome) etiology

elevated glucocorticoids level

exogenous cause of Cushing syndrome

corticosteroid use

most common cause of Cushing syndrome

corticosteroid use