Term
| What is a common clinical finding in a person who has any sort of large pituitary macroadenoma? |
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Definition
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Term
| What is the most common functional adenoma? |
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Definition
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Term
How much of the adenohypophysis must be lost before clinical problems occur?
What is the most common cause of this loss? |
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Definition
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Term
What is the most common cause of hypopituitarism in children?
What can be the manifestations of this?
What are the characteristics of this cause? |
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Definition
Craniopharyngiomas (Rathke pouch tumors)
Can cause pituitary dwarfism and hypothyroidism (low-no TSH)
Seen above th sella turcica and has cysts and calcifications because of its origion from odontogenic (tooth-forming) epithelium. |
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Term
| What are two causes (one primary and one secondary) of "empty sella syndrome"? |
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Definition
Primary-defect in the diaphragma sellica that allows arachinoid and CSF to herniate into the sella and compress the pituitary.
Secondary-A mass (an adenoma for instance) enlarges the sella, then is either removed or undergoes spontaneous necrosis. |
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Term
| Explain the pathology then say the name of an associated disorder that can cause the formation of tumors in the pituitary and other endocrine organs such as the parathyroid glands? |
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Definition
| One copy of the MEN1 gene is inherited as defective and the other is lost through mutation while living. This allows cancers to grow in endocrine organs more easily. This is known as Multiple Endocrine Neoplasia type 1, or Werner's syndrome. |
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Term
A mother presents with agalactorrhea after the birth of her first child which was complicated with an excessive hemorrage causing hypovolemic shock. She also experiences tiredness, cold intolerance and infrequent bowel movements. What is a probable diagnosis given the nature of the child's birth?
What is the pathology of this disorder? |
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Definition
Sheehan's syndrome
Necrosis of the pituitary due to blood loss and necrosis. This is a result of the hypovolemic shock during her childbirth. |
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Term
| What are the principal causes of macrovascular disease as seen in type II diabetes? |
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Definition
| Lead to accelerated atherosclerosis, causing MI, stroke and lower extremity gangrene. |
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Term
What are the principal causes of microvascular disease as seen in type II diabetes?
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Definition
| affects the retina, kidneys and peripheral nerves with retinopathy, nepropathy and neuropathy. |
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Term
| What are 3 pathogenic mechanisms are the foundation of the pathology seen in hyperglycemia? |
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Definition
Formation of advanced glycation end products (promote inflammation and cross link matrix proteins reducing vessel elasticity)
Activation of Protein Kinase C (Pro-VEGF causing neovascularization seen in retinopathy; obstructs the eye! Also, profibrogenic factors increase leading to increased BM. Pro-inflammatory cytokines)
Intracellular hyperglycemia and disturbances in polyol pathways (sorbitol accumulates; cannot convert to fructose! Depletetion of NADPH reduces glutathione causing ROS to be more damaging [Polyol pathway]). |
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Term
| What is the pathogenesis of the vascular lesions seen in diabetes? |
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Definition
Increased in advanced glycation end products which bind to macrophages and T cells. Increase inflammation.
Protein Kinase C activation
Reduction in glutathione levels. |
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Term
| What is an independent risk factor for the many complications of obesity? |
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Definition
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Term
| What is the most common cause of an acute adrenal crisis? |
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Definition
| Sudden sessation of adrenocorticoids |
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Term
| What is the most common cause of chronic hypofunction of the adrenals? |
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Definition
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Term
What is a common enzyme deficency seen with hypoadrenal function?
What is this syndrome called?
What clinical findings can be seen? |
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Definition
21 Hydroxylase deficiency
Adrenogenital syndrome
Increased ACTH
Hyperplastic adrenals
Ambiguous genetalia in females
Hypogonadism |
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Term
| Sepsis leading to shock caused by N. mengitidis is known as what? |
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Definition
| Waterhouse-Friderischsen syndrome |
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Term
| What is the most common cause of chronic adrenal insufficiency? What is this syndrome called? |
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Definition
Autoimmune disease
Addison's Disease |
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Term
| What is the most common finding in Addison's disease? |
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Definition
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Term
| What is the most common cause of adrenal hyperfunction? |
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Definition
| Cushing's disease (usually an adenoma, rarely hyperplasia) |
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Term
| What is the most common cause of cushing's syndrome? |
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Definition
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Term
| What age and gender is at the highest risk for adrenal tumors? |
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Definition
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Term
| What is the most common cause of hyperaldosteronism |
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Definition
| aldosterone producng adrenocortical adenoma [Conn syndrome] |
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Term
| True or false: Neuroblastomas have a worse prognosis if they occur in infants less than a year old. |
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Definition
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Term
| What endocrine tumors are commonly found in Werner's syndrome (MEN I) |
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Definition
parathyroid abnormalities, pituitary adenoma, pancreatic islet cell adenoma
Think PPP |
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Term
| What endocrine problems can occur in MEN IIa (Sipple syndrome)? |
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Definition
Parathyroid hyperplasia, medullary carcinoma, pheochromocytoma
Think PPM |
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Term
What are some common endocrine abnormalities with MEN IIb?
What is NOT present? |
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Definition
Parathyroid hyperplasia, medullary carcinoma, pheochromocytoma (same as IIa)
Also, marfanoid habitus and mucosal ganglioneuromas.
Primary hyperparathyroidism is not present |
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