ES Diseases

Excess pituitary hormones secretion

Inflammation or tumor of pituitary gland

• Leads to chronic disease resulting from excessive production and secretion of pituitary hormones 

Gigantism

Abnormal pattern of growth

• Hypersecretion of growth hormone occurs before puberty 

• Accelerated growth of long bones

• Caused by anterior pituitary adenoma 

Acromegaly

Chronic metabolic condition in adults caused by hypersecretion of GH by pituitary gland 

• Hypersecretion of GH after puberty 

• Excessive overgrowth of soft tissue 

• Excessive jaw growth

  • May experience osteoarthritis

• Caused by pituitary tumor or adenoma 

Hypopitutarism

Caused by deficiency or absence of any pituitary hormones produced by anterior pituitary lobe 

• When thyrotrophin secretion is reduced, functioning of thyroid gland is affected 

• When corticotropin secretion is reduced, salt balance and nutrient metabolism is affected 

• Caused by pituitary tumor or tumor in hypothalamus 

Dwarfism

Deficiency of pituitary GH in children results in short stature

• Underdevelopment of body in children 

  • Adult height of 4 foot 10 inches or less

• Hyposecretion of pituitary gland hormones (GH), results in delayed growth

• Can be congenital, caused by cranial tumor or hemorrhage after birth 

Diabetes insipidus

Disturbance of water metabolism, resulting in extreme thirst and excessive secretion of dilute urine

• Deficiency in release of vasopressin by the posterior pituitary gland

  • Results in excretion of copious amounts of dilute urine (polyuria)

• Excessive thirst (polydipsia), fatigue, dehydration

• Caused when posterior pituitary gland released reduced amounts of vasopressin 

• May be hereditary or insult to the hypothalamus or pituitary gland from head trauma 

Simple goiter

Any enlargement of the thyroid gland usually by swelling in the neck

• May be asymptomatic in early stages

• Usually female 

• As hyperplasia (enlargement through increase in cells) increases, it presses on the esophagus 

  • Produces difficulty swallowing 

• Simple goiter results from deficiency of iodine in the diet

  • Needed for synthesis of T3 and T4

    • Together known as thyroid hormone 

  • Inadequate blood level of thyroid hormone causes anterior pituitary gland to increase secretion of thyrotropin 

    • Keeps trying to stimulate thyroid gland to produce hormone

    • Continued stimulation causes thyroid gland to increase

Hashimoto thyroiditis

Chronic disease of the immune system that attacks the thyroid gland

• Mostly in women

• Gradual and painless lumpy enlargement of the thyroid gland

  • Pressure in neck and difficulty swallowing

• Caused by heredity 

  • Antibodies destroy thyroid tissue instead of stimulating it

  • Gland enlarges in inflammatory response  

  • Gland tissue becomes replaced by fibrous tissue

Graves Disease

Condition of primary hyperthyroidism, occurs when entire thyroid gland hypertrophies (increase in the size of cells or tissues), results in diffuse goiter (entire thyroid gland, located at the base of your neck, swells up uniformly and smoothly) 

• Overproduction of thyroid hormones

  • Causes increased metabolism and changes

• Rapid heartbeats and palpitations, nervousness, excitability, and insomnia

• Weight loss 

• Tremor, loss of hair

• Exophthalmos: outward protrusion of eyes

• Thyrotoxicosis: exaggerated thyroid hormone levels

  • Life threatening 

• Caused by autoimmune response 

  • Antibodies to thyroid antigens stimulate hyperactivity of thyroid gland 

  • Genetics

Cretinism

Congenital hypothyroidism developing in infancy or early childhood

• Thyroid gland is absent or hormone is not synthesized by thyroid gland 

  • Causes intellectual developmental disorder and delayed growth

•  Child develops as a dwarf, is stocky in stature, and has a protruding abdomen

• Caused by an error in fetal development

  • Causes thyroid gland to fail to develop

Myxedema and myxedema coma

• Severe hyperthyroidism with reduced levels of T3 and T4 leads to slowing of organ function 

• Fatigue, muscular weakness, hair loss, weight gain 

• Skin is dry and scaly

  • Pugginess 

• Caused by thyroid gland inability to synthesize T4

  • Result of reduced amounts of thyrotrophin, radiation of thyroid gland, removal of gland 

Myxedema: disease characterized by clinical manifestations associated with low metabolic rate caused by thyroid hormone deficiency 

Myxedema Coma: result of severe untreated hypothyroidism exacerbated by events like MI or infection

Hyperparathyroidism

Condition caused by overactivity of one or more of the four parathyroid glands 

• Results in overproduction of PTH 

• Increase the breakdown of bone 

  • Results in excessive calcium in blood (hypercalcemia)

  • Irritability of nerve and muscle tissues 

  • Conduction defects 

• Caused by increased activity of parathyroid gland

  • Results of excessive growth (adenoma) or hyperplasia

Hypoparathyroidism

Condition in which secretion of PTH by the parathyroid glands is reduced

• PTH Increases blood calcium level by stimulating bone demineralization and increasing calcium absorption in digestive tract/kidneys  

• When level of PTH is insufficient, calcium levels are reduced

  • Results in hypocalcemia

    • Overstimulation of skeletal muscles 

• Caused by surgical destruction of parathyroid gland 

  • Accidental removal 

Cushing syndrome

Condition of chronic hypersecretion of adrenal cortex, excessive cortisol levels

• Fatigue, muscular weakness, weight gain, changes in appearance

• Fat deposits from scapular area (buffalo humps) and in trunk

  • Causes protruding abdomen

• Salt and water retention 

• Changes in mood and decreased memory 

• Skin becomes thin, easily bruised

• Caused by hyperplasia (the increase in the number of normal-looking cells) of adrenal gland, excessive secretion of corticotrophin from pituitary gland, or tumor of cortex 

Addison disease

Partial or complete failure of adrenocortical function

• Manifests as fatigue, weakness, anorexia, agitation, confusion

• Bronze color skin 

• Progressive destruction of adrenal gland and reduction in its hormones

• Caused by autoimmune process, tuberculosis, hemorrhage, fungal infections, neoplasms, surgery 

Diabetes mellitus

Chronic disorder of carbohydrate, fat, and protein metabolism caused by inadequate production of insulin by the pancreas or faulty use of insulin by the cells

• Functional pancreas secretes insulin and maintains glucose levels within precise range

  • Insulin reduces blood glucose levels by transporting glucose into cells for use as energy and storage as glycogen

• A reduction in insulin → hyperglycemia 

  • Deprives cell of fuel 

  • Cells begin to metabolize fats and proteins

    • Allows wastes called ketone bodies to accumulate in blood (ketosis)

• Ketonuria develops as excess ketone bodies are excreted in urine

  • Leads to acidosis

• Polyuria (abnormally large volume of urine), polyphagia (excessive hunger), polydipsia (excessive thirst), weight loss, fatigue 

• Caused by heredity 

Type 1 Diabetes

• Early onset before 30 yrs old

• Little or no insulin being secreted

• Difficult to control

Type 2 Diabetes

• Most common

• Gradual onset, older than 55 yrs

• Some pancreatic function remains

• Can control symptoms 

Gestational diabetes

Condition of damaged ability to process carbohydrate that has onset during pregnancy

• May be asymptomatic

  • Exhibits symptoms of diabetes mellitus  

• Caused by destruction of insulin by the placenta 

  • Reduced effectiveness of maternal insulin 

• Fetus takes glucose from mother

  • Stresses balance of glucose production and usage 

• Elevated levels of estrogen and progesterone block insulin 

Hypoglycemia

Abnormally low glucose level in the blood

• occurs when excessive insulin enters the bloodstream or when the glucose release rate falls below tissue demand

• sweating, nervousness, weakness, hunger, dizziness, trembling, headache, and palpitations

• Extremely low blood glucose levels can cause central nervous system manifestations

  • Confusion, visual disturbances, behavior that may be mistaken for drunkenness, stupor, coma, and seizures

• Major cause of drug-induced hypoglycemia is insulin overdose 

• Failure to eat a meal or excessive exercise also can trigger hypoglycemia in the insulin-dependent patient with diabetes