Pathophysiology final exam review/ summary notes

Pathophysiology Final Exam
Review
Endocrine disorders
 Affects many aspects of body functions
o Growth and development
o Energy metabolism
o Muscle and adipose tissue distribution
o Sexual development
o Fluid and electrolyte balance
o Inflammation and immune responses
 diseases involving the endocrine system present with hypofunction or hyperfunction
o primary or secondary disorder
 primary: target gland producing hormone
 secondary: target gland is functioning but something is wrong with the
pituitary system that affects the signal
 tertiary: from the hypothalamus
o hypo-congenital, decreased function, neoplastic growth, aging, disease
o hyper- usually as a result of excessive hormone production
 increased hyperplasia of tumor
 paraneoplastic syndrome – tumors can start producing hormones
 metaplastic lung cancer
When a hormone is released in circulation in the blood to produce a biological effect on distant
target cells
hypo means low function
hyper means high function

Primary disorders
 originate in the target gland responsible for producing the hormone
Secondary disorder
 the target gland is essentially normal, but its function is altered by defective levels of
stimulating hormones or releasing factors from the pituitary system

General aspects of altered endocrine function
 processes that disturb the normal function of the endocrine system ->
o impaired or uncontrolled synthesis or release of hormones

, o altered interaction between hormones and their target tissues
 something is wrong with the signal
o abnormal responses of the target tissues to their hormones

Process in which there is normal function of the endocrine function that gets impaired

General Dysfunction
 hypofunction – under function
o congenital defects
o gland destroyed by
 disruption of blood flow
 example: overinflation of trache cuff
 inflammation
 autoimmune response
 neoplastic growth
 cancer or tumor
 hyperfunction
o associated with excess hormone production
 excessive stimulation
 hyperplasia of gland
 grows in size, shape and number
 hormone producing tumor
 administration of exogenous hormones
 Artificial hormones or not coming from where they are supposed
to come

Hormone Disorders
 tertiary
o Abnormality in stimulation from the hypothalamus
 Secondary
o Abnormality in stimulation from the pituitary
 Primary
o Abnormality in the gland

Negative feedback: normal when they have enough they say stop

,Disorders of the pituitary
Anterior pituitary function
 Produces
o Adrenocorticotropic hormone (ACTH)
 Anterior lobe of the pituitary
 Controls the release of cortisol from the adrenal
o Thyroid- stimulating hormone (TSH)
 Thyroid gland
o Growth hormone (GH)
o Follicle-stimulating hormone (FSH)
 Fertility
o Luteinizing hormone (LH)
 Sex hormone
o Prolactin
 Milk production




Hypothalamus-pituitary axis
 Releasing hormones from hypothalamus tell the pituitary what to release into
the blood

,  Trophic hormones from the pituitary tell specific peripheral glands to grow and
produce their hormones

General: Clinical manifestations and diagnosis of pituitary
disease
 Clinical manifestations
o Variety of manifestations
 Pituitary hormone hypersecretion
 Hyposecretion
 Localize mass effect
o Most common
 Pituitary adenoma (adult)
 Hypothalamic tumors (children)
 Diagnosis
o Laboratory
o MRI
o CT
o Hormone stimulation tests
o Serum cortisol
o Serum TSH
o Plasma osmolality
o ASSAY test
 Looks at hormone levels
 Pituitary tumors can be classified as primary or secondary

Hyperpituitarism/pituitary adenomas (tumor)
 Etiology
o Hyperfunction associated with excessive hormone production
o Adenoma arising from anterior pituitary
o Hyperplasia
o Carcinoma of anterior pituitary
o Hypothalamic lesions

Clinical manifestations: pituitary adenoma
 Mass effect of expanding tumor
 Female: amenorrhea (absence of menstrual cycle), glactorrhea (milk secretion in women
who are not lactating) , infertility (lactotrophic adenoma)
 Male: decreased libido, impotence
o Lack of sex drive, can’t get it up
 Visual field abnormalities