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Test 3
Endocrine system
57
Pathology
Undergraduate 3
11/14/2011

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Term
Pituitary
Definition
located in base of skull in "sella". Divided into two parts, the anterior and posterior portions. 
Term
Anterior Pituitary 
Definition
has five cell types, each of which secretes a hormone
Term
five hormones of anterior pituitary 
Definition

1. Growth Hormone (GH)

2. Prolactin (PRL)

3. Adrenocorticotropic hormone (ACTC)

4. Gonadotropins hormones

5. Thyrotrophic hormone (TSH)

Term
Gonadotropins hormones
Definition
lutinizing (LH) and follicle stimulating hormone (FSH)
Term
Posterior pituitary 
Definition
closely affiliated with the hypothalamus and produces 1. Oxytocin and 2. Antidiuretic hormone (ADH)
Term
Oxytocin
Definition
stimulates contraction of pregnant uterus
Term
Antidiuretic hormone (ADH)
Definition
promotes the reabsorption of water in the kidney
Term
Thyroid gland
Definition
two lobes connected with an isthmus consists of two types of cells 1. Follicular cells and 2. C cells
Term
Follicular cells
Definition
secrete thyroxine (T4) and T3 (metabolism)
Term
C cells
Definition
secrete calcitonin (involved in calcium homeostasis)
Term
Parathyroid glands
Definition

located within the thyroid tissue (small bean shaped)

secrete parathormone and involved in regulating calcium and phosphate

Term
Adrenal glands
Definition
composed of a cortex (outer) and inner medulla
Term
Cortex
Definition

divided into three zones

1. Zona glomerulosa

2. Zona fasciculata

3. Zona reticularis

Term
Zona glomerulosa 
Definition
secretes mineral corticoids- aldosterone
Term
Zona fasciculata
Definition
secretes glucocorticoids- cortisone
Term
Zona reticularis
Definition
secretes sex streriods, estrogens and androgens
Term
Medulla
Definition
consists of cells that produce epinephrine and norepinephrine 
Term
Endocrine function
Definition

PG releases tropic hormones, TSH, ACTH, LH, and FSH. these hormones stimulate the target gland and then the target gland releases substances that cause the hypothalamus to release factors that have a negative stimulus upon the PG. This keeps the process in balance. 

production of these hormones are carefully regulated by both positive and negative feed back

Term
Target organ is destroyed
Definition
the pituitary keeps sending out an increased signal. ex: Addision's disease, the levels of ACTH are markedly increased. 
Term
Pituitary diseases
Definition
associated with an enlarged gland
Term
Pituitary hyper function
Definition
symptoms depend on which cells are involved in hyper secretion 
Term
Pituitary adenomas
Definition

may compress the posterior pituitary leading to diabetes insipitus (DI)

(Prolactinomas, Somatotrophic adenomas, corticotropic adenomas)

Term
Prolactinomas
Definition
small benign tumor secreting cells. stimulate milk production not related to pregnancy.
Term
Somatotrophic adenomas
Definition
larger GH producing tumors. produce in young children before symphyseal plate completion gigantism. in post pubertal patients causes acromegaley 
Term
acromegaley
Definition
in post pubertal patients. causes enlarged acral portions including hands, tongue, haws and nose. 
Term
Corticotropic adenomas
Definition
produce cells with excess ACTH leading to Cushing syndrome
Term
Pituitary hypofunction
Definition
include: 1. congenital defects 2. pituitaries destroyed by tumors 3. destruction of gland by ischemia 4. destructions of posterior pituitary produces DI with large loss of water and hypernatremia (elevated sodium)
Term
Congenital defects
Definition

Pituitary dwarfism and Jacob-Cretzfied

often transferred diseases dealing with GH's

Term
Hypernatremia
Definition
elevated sodium
Term
hyperthyroidism
Definition

patient presents with thin hair, weight loss, diarrhea, warm skin, hyperreflexia and pretibial edema. Ecophtalmus (eye bulges out) common and eye-catching observation

 

Term
Thyrotoxicosis
Definition
also known as hyperthyroidism 
Term
hyperthyroidism examples
Definition

1. grave's disease

2. idiopathic nodular hyperplasia (gland is enlarged)

3. tumors that produce thyroxine (adenomas)

4. exogenous thyroid medication

5. diagnosis made by determination of TSH and T4 and T3

Term
Grave's disease
Definition

caused by ABy to TSH receptors on surface of thyroid cells. These ABy bind to receptors and act like TSH to stimulate thyroxine production.

autoimmune disease

Term
Hypothyroidism
Definition
patient presents with loss of hair, cold intolerance, muscle weakness, heart failure (slow heart), periorital edema, puffy face constipation 
Term
hypothyroidism examples
Definition

1. developmental defects (Thyroid aplasia)

2. Thyroiditis (hashimoto's Thyroiditis)

3. surgical removal of thyroid

4. Iodine deficiency

5. generally associated with elevated TSH as there is decreased T4 and T3 and negative feedback

Term
Thyroiditis (Hashimoto's thyroiditis)
Definition
best defined autoimmune disease. can result in destruction of gland
Term
Nodular goiter
Definition

enlarged gland made up of nodules. vary in size and morphology but most are euthyoid (normal).

symptoms often related to space occupying benign glands that put pressure on surrounding tissues. 

Term
thyroid neoplasms
Definition

may be benign or malignant

adenomas very common. usually a nodule with a defined capsule. some take up iodine and other do not. not diagnostic for malignancy 

divided into histological types of papillary follicular, medullary and anaplastic carcinomas

Term
Thyroid neoplasm carcinomas
Definition

risk factors include radiation, well documented in the Japanese exposed to the atomic bomb and children who had their thymus irradiated 

all derived from follicular cells, except the medullary carcinomas which are derived from the C-cells

Term
hyperparathyroidism
Definition

results in increased PTH (parathyroid hormone) and increased calcium in the blood. patient may present with increase in kidney stones, bone density diseases. 

most commonly caused by parathyroid adenomas

parathyroid carcinomas also occur

Term
Excess calcium
Definition
produces 1 lethargy, muscle weakness, and conduction defects in the heart. 
Term
Excess PTH
Definition
causes bone resorption of calcium from the tubular lumen. Also promotes the active form of VIT A which increases uptake of calcium from the small intestine. 
Term
Active form of Vit A
Definition
increases uptake of calcium from the small intestine
Term
Hypoparathyroidism
Definition
can be caused by surgical removal of thyroid. may be congenital. leads to hypocalcemia.
Term
hypocalcemia
Definition
leads to changes in neuromuscular activity often called tetany
Term
Tetany
Definition
be induced by hyperventilation and removing ionized calcium
Term
hyperaldosteronism (conn's syndrome)
Definition
hypersecretion of aldosterone, retention of NA, hypertension
Term
adrenogenital syndrome
Definition
hypersecretion of adrenal sex hormones, androgens, may be congenital or develop later in life
Term
Cushing's Syndrome
Definition

hypersecretion of cortisones

either caused by 1. increased ACTH from the pituitary or 1. increased secretion from the adrenal (either hyperplasia or tumor)

 

Term
Cushing's syndrome
Definition
characterized by central obesity, buffalo hump, moon facies, glucose intolerance, hypertension and thinning of the skin
Term
Addison's disease 
Definition

adrenocortical hypofunction 

most commonly caused by autoimmune adrenalitis (president Kennedy has this form)

adrenals can be destroyed by infections such as TB and histoplasmosis

 

Term
addison's disease
Definition
characterized clinically by fatigue, weight loss, and nausea. with lack of mineral corticoids get NA loss and K retention
Term
Neuroblastoma
Definition

a tumor derived from precursors of the adrenal medulla cells

malignant tumors that occur in neonates and young children

Term
Pheochromocytoma 
Definition

most common tumor of the adrenal medulla in adults

 

Term
pheochromocytoma
Definition

produces hypertension and thus the removal of tumor cures this disorder

most are benign, some malignant (removed laproscopically)

secrete epinephrine and norepinephrine

diagnosed clinically, radiologically and by measuring epinephrine, norepinephrine and breakdown products vanillymandelic acid (VMA)

Term
euthyoid
Definition
normal
Term
lack of mineral coricoids
Definition
NA loss and K retention 
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