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endocrine - Coggle Diagram
endocrine
Diabetes
Prediabetes
: Impaired glucose tolerance (elevated values after OGTT), Elevated fasting glycaemia
T1 "Juvenile"
Absolute deficiency due to AI (CD8+) beta cell destruction / multifac: (HLA DR3, HLA DR4) + (viral) + (microbiome)
-- -- -- -- -- -- -- Reduction of beta cells to 10-20% + increased load → reduced insulin → hyperglycaemia → osmotic diuresis → polyuria,
-- -- -- -- -- -- -- polydipsia → increased lipolysis → ketone bodies → ketoacidosis, foetor acetonaemicus, Kussmaul's ketoacidosis, coma
-- -- -- -- -- -- ---Therapy: insulin
Type 2
: Impaired insulin secretion due to peripheral insulin R / multifac (polygenic + enviroment)
-- - -- - -- -- peripheral ins R (prolonged high sugar intake) → compensatory hyperinsulinemia →
-- - -- - -- -- "beta cell depletion" → reduced insulin production (also due to "lipotoxicity")
-- - -- - -- -- Therapy: regimen measures, treatment of dyslipidemia, obesity, Antidiabetic : metformin (increases insulin sensitivity)
LADA
(Latent Autoimmune Diabetes in Adults),
MODY
(Maturity-Onset Diabetes of the Young),
Monogenic diabetes
,
Gestational
diabetes
2ndary
: pancreatitis, CF, hemochromatosis, Cushing's sy, infections (Coxsackie, congenital rubella), steroid use
CH: nephropathy, retino, neuro - acceleration of artherosclerosis - RF for infec
AC: KA, Hyperos sy, HypoGlycemia, LA
parathyr
Hyper
: :arrow_up: Ca / preg / bone pain,
demineral ,fibrous osteodystrophy,
urolithiasis, cholelithiasis
Primary
: parathyroid adenoma, paraneoplastic PTH production, part of MEN
Secondary
: compensation for hypocalcemia (renal failure, malabsorption)
Tertiary
: adenoma arising during long-term compensation of hypocalcemia → hyperthyroidism independent of the triggering stimulus
Hypo
: :arrow_down: Caemia, low PTH / ectomy, polyendocrine AI sy (+addison), DeGeorge / paresthesia, increase neurom. tetany, arrhythmia, psycho instable
Tu
Adenom
: Solitary, of principal cells
Carcinoma
: Difficult to distinguish from adenoma, max. infiltration into blood vessels, Locally aggressive, mostly non-mts
Adrenocortical sy
CORTEX
Adrenogenital Sy
: CAH (21-hydroxylase deficiency), tumors / ↑ Androgens / Virilization, pubertas praecox
Hyper
Cushing’s Sy
: ↑ ACTH (pituitary, ectopic), tu, iatro / Central obesity, moon face, buffalo hump, striae, osteoporosis, HTN, steroid DM
Conn’s Sy
: Adenoma, zona glomerulosa hyperplasia, ↑RAAS Aldosterone ↑ / HTN, edema, hypoK, MALK
Hypo
Aldost
Primary (peripheral
): AI (21-hydroxylase Ab), tu, Waterhouse-Friderichsen / ↓ Cortisol, ↓ Aldosterone / Hyperpig, HTN, electrolyte imbalance (↓Na, ↑K)
2ndary (central)
: ↓ ACTH (e.g., pituitary dysfunction) / ↓ Cortisol only (RAAS → Aldosterone normal) / No hyperpig, no aldosterone defi
:!!:
Crisis
: Ac hormone deficiency → Shock, fever, weakness, ↓Na, ↑K, ↓Glu Life-threatening / May result from abrupt corticosteroid withdrawal
Pituitary
Adenohypophys
Hypo > 80%
Sheehan's sy
: Postpartum infarction due to hemorrhagic shock / ACTH (→ adrenal insufficiency) Common after childbirth; life-threatening
Tumor Damage
: Compression or destruction by pituitary adenoma or other tumor / Varies (dep on location)
Empty Sella Syndrome:
Herniation or inflamm > flattening / Partial or complete loss / Oft idio or post-inflamm
Infiltrative or Inflam Diseases:
Sarcoid, TB, LCH
White Addison’s
: Secondary adrenal insufficiency due to pituitary failure (↓ACTH) ACTH / No hyperp, normal K⁺/Na⁺
Hyper
Adenomas
: adult, ass w/ hypersec, grey-pibk ty, destroying sella / prolactine (30%), STH (gigantism vs acromegaly) + IGF1 sec ,
-- -- -- -- -- -- ACTH (central cushing disease) , TSH (rare), Gonadotrophic (asymp) , plurihurmonal
Carcinomas: Extremely rare, same as adenoma + mts
Neuro
SY
Diabetes Insipidus (DI)
: Polyuria, polydipsia, dehydration, dilute urine Due to ↓ ADH (central or nephrogenic cause)
SIADH (Schwartz-Bartter Syndrome)
: HypoNa, nausea, vomiting, weakness, seizures, coma, brain edema / Oft paraneoplastic (e.g. small cell lung cancer)
TU
Pituicytoma
: Rare, B glioma-like tumor from pituicytes / Loc in post pituitary
Spindle cell oncocytoma
: B posterior pituitary / Eosinophilic cells with spindle shape
Sella
Craniopharyngioma
: Visual defects, endocrine symp (hypopituitarism), in children / Arises from Rathke's pouch, locally aggr, non-mts
Metastases (lung, breast, prostate)
Thyroid sy
sy
Hyperthyroidism and thyrotoxicosis
inflam
Subacute granulomatous thyroiditis
Ch sclerosing thyroiditis (Riedel's goiter)
thyroiditis Hypothyroidism
.
Hyperplasia
Nodular colloidal goiter
Graves-Basedow disease
Tu
Follicular adenoma
Carcinoma
Follicular
Anaplastic
Papillary
Medullary
Primary lymphoma
(MALT, in AI thyroiditis)
Secondary tu - lung, breast, lymphoma, melanoma
Adrenal
Cortex Tu
Carcinoma
: Rare, large (>5 cm), invasive, dystrophic calcification, familial sy
Myelolipoma
: B, yellow, circumscribed, fat + hematopoietic elements**
Adenoma
: Common, B, often secrete cortisol or aldosterone
Secondary tumors
: Mts from kidneys, lungs
Medulla
Pheochromocytoma
: ↑ Catecholamines → HTN, 10% rule (bilateral, extraadrenal, M), familial (VHL, NF1) /
-- -- -- -- -- -- -- -- --- --- --Chromaffin cells + sustentacular cells, vascular, soft, ~5 cm
Neuroblastoma
: M childhood (<5 yrs), poorly differ, Homer-Wright rosettes / Oft extraadrenal (abdomen, nasal cavity), dystrophic calcification