Endocrine System Patholog1.pdf

LAST MINUTE REVISION OF ENDOCRINE PATHOLOGY Introduction to Endocrine System Pathology The endocrine system includes autocrine, paracrine, and endocrine hormones that target distant cells. Hormones interact through surface receptors and intracellular receptors, which are crucial...

LAST MINUTE REVISION OF ENDOCRINE PATHOLOGY Introduction to Endocrine System Pathology The endocrine system includes autocrine, paracrine, and endocrine hormones that target distant cells. Hormones interact through surface receptors and intracellular receptors, which are crucial in signal translation. Major Disorders of Endocrine Glands The endocrine disorders can manifest as hyperfunction, hypofunction, or tumors (both benign and malignant) that impair glandular functions. Pathology of the pituitary gland lecture name Anatomy and Function of the Pituitary Gland Central endocrine regulation mainly through the anterior lobe (adenohypophysis) and posterior lobe (neurohypophysis). Local mass effects in pituitary gland can include optic chiasm compression resulting in visual abnormalities and elevated intracranial pressure with possible cranial nerve palsy. Hyperpituitarism and Pituitary Adenomas Caused by adenomas, hyperplasia, or carcinomas in the anterior pituitary, and extrapituitary tumors secreting hormones. Symptoms depend on the specific hormone Effect example Growth hormone-producing (somatotroph cell ) adenomas can lead to gigantism or acromegaly depending on the age and hormonal levels impacted by these adenomas. Symptoms and Effects of Acromegaly Prognathism (enlarged jaw), enlarged hands and feet, and systemic effects such as abnormal glucose tolerance, muscle weakness, hypertension, arthritis, osteoporosis, and heart failure. Often results from oversecretion of growth hormone by a pituitary adenoma. Hypopituitarism and Posterior Pituitary Syndromes Symptoms depend on the specific hormone deficiency and include growth failure (due to growth hormone deficiency) in children and deficiencies affecting thyroid-stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), and prolactin. Disorders such as diabetes insipidus due to issues in ADH production. Adrenal Gland Pathology: Cushing's Syndrome Characterized by excess glucocorticoids, potentially from external glucocorticoid administration or diseases increasing ACTH. Manifestations may include growth retardation in children and virilization in women. Hyperaldosteronism Primary hyperaldosteronism (Conn's syndrome) due to excessive aldosterone secretion, often from an adrenal adenoma, leading to hypertension and potassium loss, muscular weakness and cardiac arrhythmias Secondary hyperaldosteronism results from reduced renal perfusion encouraging increased aldosterone secretion. Endocrinopathy(DM) lecture name Diabetes Mellitus Overview ✓ Diabetes Mellitus is marked by persistent high blood sugar levels primarily due to insulin secretion defects and/or action. The disease significantly impacts various body organs, including kidneys, eyes (vision), nerves, and the vascular system (both macro and micro). Classification and Pathogenesis of Diabetes Diabetes is categorized into Type 1 (autoimmune beta cell destruction) and Type 2 (characterized by insulin resistance and inadequate secretion). Pathogenesis varies with Type 1 involving autoimmune mechanisms leading to islet cell destruction and Type 2 involving insulin resistance and gradual beta cell function loss. Diabetes and Its Systemic Complications Diabetes contributes to systemic complications such as vascular diseases (both large and small scale), renal impairment (nephropathy), eye conditions (retinopathy), and nervous system disorders (neuropathy). It accelerates atherosclerosis and thickening of the basement membranes impacting various organ functions. Ocular Complications and Neuropathy in Diabetes Patients with diabetes are at an increased risk of developing visual impairments, cataracts, glaucoma, diabetic retinopathy, and neovascularization. Diabetic neuropathy leads to motor and sensory disturbances affecting both central and peripheral nervous systems. Clinical Features of Diabetes Common initial symptoms include excessive urine output (polyuria), increased thirst (polydipsia), excessive hunger (polyphagia), and possible ketoacidosis. Insulin deficiency primarily causes a significant catabolic state altering metabolism of glucose, fats, and proteins. Classic Triad of Diabetes Symptoms Polyuria, polydipsia, and polyphagia form the classic symptom triad of diabetes, accompanied by weight loss and muscle weakness due to negative energy balance. Hyperosmolar Nonketotic Coma This severe complication predominantly appears in decompensated Type 2 diabetic patients, characterized by extreme dehydration and coma due to a lack of adequate fluid intake, often in elderly patients. Hyper and hypothyroidism lecture name Hyperthyroidism Thyrotoxicosis: Characterized by elevated levels of free T3 and T4, leading to a hypermetabolic state and increased activity of the sympathetic nervous system. Symptoms: Include heat intolerance, weight loss despite increased appetite, palpitations, tremors, muscle weakness, and thyroid ophthalmopathy. Hypothyroidism Causes: Typically due to iodine deficiency or autoimmune thyroiditis, which can lead to conditions like cretinism in children and myxedema in adults. Symptoms: Features mental sluggishness, cold intolerance, weight gain, and pericardial effusions. Thyroiditis Hashimoto Thyroiditis: Autoimmune destruction that often progresses to hypothyroidism. Epidemiology: Most commonly found in middle-aged women, associated with an increased risk of B cell non-Hodgkin lymphomas. Graves' Disease Commonality: It is the most frequent cause of hyperthyroidism, especially prevalent in women. Clinical Presentation: Includes thyrotoxicosis, ophthalmopathy, exophthalmos, dermopathy, with a diffuse enlarged thyroid. Goiter (Diffuse and Multinodular) Causes: Arises from impaired thyroid hormone synthesis, often due to iodine deficiency. Types: Endemic goiter is common in low iodine areas, whereas sporadic goiter arises from dietary or hereditary factors. Carcinomas and Related Complications Types of Thyroid Carcinomas: Include papillary, follicular, and anaplastic carcinoma. Complications: Can lead to critical conditions like airway obstruction, dysphagia, and complications from compression of nearby structures. Parathyroid Pathology Function: Parathyroid glands regulate calcium levels through PTH, which affects bone resorption, calcium reabsorption, and phosphate excretion. Disorders: Include hyperparathyroidism, characterized by high calcium levels and symptoms due to excessive bone resorption Hyperparathyroidism Specifics Primary Hyperparathyroidism: Presents with symptoms of high calcium levels such as painful bones and renal stones. Secondary Hyperparathyroidism: Often results from chronic renal failure with symptoms that include renal osteodystrophy and potentially severe calcifications. Hypoparathyroidism Causes: Typically due to the surgical removal of parathyroids or congenital issues like Di George syndrome. Symptoms: Manifests as neuromuscular irritability, cardiac arrhythmias, and seizures related to low calcium levels, requiring management with calcium and vitamin D.