Dictionary for patients of terms in endocrinology and diabetes
 

Dr Asjid Qureshi
MB ChB (Edin), MD (Lon), MRCP (Edin)
London Diabetes and Endocrinology
Consultant
Wellington Hospital and Clementine Churchill Hospital

 
 

London, UK

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D E F I N I T I O N   OF   M E D I C A L    T E R M S

T h y r o i d

Ablative dose of radioiodine
  • In the context of hyperthyroidism, this indicates a dose of radioiodine that aims to render the thyroid under active. The term is also used in thyroid cancer after thryoid surgery to indicate a dose of radioiodine that aims to ablate any remaining thyroid tissue and eliminate any residual cancer.

     

Autoimmune
  • This is a failure of the body to recognise particular cells as its own resulting in the malfunctioning of these cells, e.g. Addison`s disease due to adrenal anti-bodies.

     

Block and Replace
  • A regime of medical treatment used by some centres in patients with an over active thyroid. Anti-thyroid medication is given in higher doses to block thyroid hormone production and levothyroxine is used to replace and normalise thyroid function.

     

Free T3
  • This is a more active form of thyroid hormone. 20% of free T3 is secreted by the thyroid. The remainder is generated by conversion of free T4 to T3 elsewhere in the body.

Free T4
  • Free T4 is only released from the thyroid. T4, like T3 is bound proteins and it is only the free forms (free T3 and T4) that have a biological effect.

     

Goitre
  • An enlarged thyroid gland. This can occur normally during puberty and pregnancy.

     

Hyperthyroidism
  • An over active thyroid

     

Hypothyroidism
  • An under active thyroid

     

Grave`s disease
  • An autoimmune disease that is associated with the clinical features of an over active thyroid, enlarged thyroid (goitre) and thyroid eye disease. Not all these features are present in all patients. In contrast to some other causes of an over active thyroid, Graves disease not infrequently responds permanently to anti-thyroid medication.

     

Radioiodine
  • Radioiodine is iodine that is radioactive. It is used in the treatment of hyperthyroidism and can be administered as a tablet or liquid. Please see the article on radioiodine for further details.

     

Thyroglobulin
  • This is a protein produced solely by the thyroid. Its measurement is often used to detect any residual thyroid tissue in patients treated for thyroid cancer.

     

Thyroidectomy
  • Removal of part or all of the thyroid by surgery. These are referred to a partial and total thyroidectomy respectively.

     

Thyroid stimulating hormone

  • A hormone that is release from the pituitary gland and stimulates the thyroid gland to produce thyroxine. Levels are typically low with an over active thyroid and raised with an under active thyroid.

     

Toxic multi-nodular goitre
  • An over active thyroid caused by multiple nodules in the thyroid that over produce thyroid hormone. This condition is not likely to respond permanently to anti-thyroid medication and usually requires thyroid surgery or radioiodine therapy.

     

 

P i t u i t a r y

 ACTH
  • Adrenocorticotrophic hormone (ACTH) is a hormone released from the pituitary gland in response to CRH from hypothalamus. ACTH acts on the adrenal glands which in turn produces hormones such as cortisol.

     

FSH
  • Follicle stimulating hormone is released by the pituitary and acts on the gonads. In men it stimulates the production of spermatozoa and in woman it plays a role in the development of ovarian follicles.

     

Gamma-knife
  • Gamma-knife radiosurgery is a technique for delivering focused radiotherapy. Gamma-knife radiosurgery to the pituitary is usually indicated when surgery is not possible or preferred.

     

Growth hormone
  • GH is released from the pituitary gland in response to GHRH from the hypothalamus. Growth hormone excess in children results in gigantism and in adults, acromegaly.

     

Hormone replacement
  • The replacement of hormones that are deficient. This is commonly association with HRT and women, but the term is not infrequently used to indicate replacement of other hormones in for example hypopituitarism.

     

Hyperprolactinaemia
  • Raised blood prolactin level. This may be caused by a variety of conditions including a benign pituitary tumour, certain medication and fibroids. 

     

Hypopituitarism
  • A state in which the pituitary gland is producing inadequate amounts of hormones. The causes for this may be pituitary surgery, radiation or a pituitary tumour.

     

Hypophysectomy
  • The surgical removal of the pituitary gland. The indication for this is usually a large pituitary tumour.

     

Hypothalamus
  • This is a part of the brain that lies above the pituitary and communicates with the pituitary through hormones such as Corticotrophin releasing hormone (CRH), gonadotrophin releasing hormone (GnRH) and growth hormone releasing hormone (GHRH) to regulate release of hormones from the pituitary gland.

     

LH
  • Luteinising hormone is released by the pituitary and acts on the gonads. In males, it results in testosterone production by the testis. In women it plays a role in ovarian follicle development and ovulation. 

     

Optic chiasm
  • The optic chiasm is a structure that lies above the pituitary gland and is formed of the two nerves as they cross towards each eye. The optic chiasm can be compressed and therefore vision effected in large pituitary tumours.

     

Pituitary

  • A gland that is situated just below the brain that releases various hormones including ACTH, LH, FSH, prolactin and vassopressin. 

     

Pituitary macroadenoma
  • A pituitary tumour that is larger than 1cm in diameter. Pituitary tumours are virtually all benign.

     

Pituitary microadenoma
  • A pituitary tumour that is smaller than 1cm in diameter. Pituitary tumours are virtually all benign.

     

Vassopressin
  • Vassopressin is a hormone released from the posterior (back) portion of the pituitary gland. It acts on the kidneys to help retain water in the body. A deficiency of this hormone results in diabetes insipidus.

     

 

A d r e n a l

Adrenalectomy
  • Removal of the adrenal gland by surgery. This is increasingly being performed laproscopically where possible.

     

Aldosterone

  • A hormone produced by the adrenal gland in response numerous factors, including. Aldosterone acts on the kidneys to conserve sodium and water. In Addison`s disease aldosterone levels are reduced, whilst in Conn`s syndrome, levels are increased.

     

Autoimmune
  • This is a failure of the body to recognise particular cells as its own resulting in the malfunctioning of these cells, e.g. Addison`s disease due to adrenal anti-bodies.

     

Conn`s syndrome
  • A disorder in which there is excess aldosterone. This may be because of an adrenal lesion (adenoma) releasing excess aldosterone or a condition know as hyperplasia in which both adrenal glands over produce this hormone. In contrast to the former, there is no distinct lesion in the latter that is amenable to surgery.

     

Laproscopic surgery
  • A technique for operating through small incisions using telescopes and instruments. This avoids larger incisions that may be associated with an increased risk of certain complications of surgery. Laprocopic is not always possible and depends on local skills, the size of the lesion being removed and whether it is benign or malignant.

     

Phaeochromocytoma
  • A disorder in which there is an excess of catecholamine, usually the hormones adrenaline or noradrenaline. In 90% of cases this is caused by a discrete benign tumour in an adrenal gland that is surgically treatable.

     

Renin
  • Is produced by specialised cells in the kidney in response to decreased pressures. By acting through the angiotensin system, it enhances the secretion of aldosterone.

     

 

R e p r o d u c t i v e

Amenorrhoea
  • Absent menstruation. If menstruation has never occurred this is referred to as primary amenorrhoea whereas secondary amenorrhoea refers to menstruation that has stopped since first beginning.

     

FSH
  • Follicle stimulating hormone is released by the pituitary and acts on the gonads. In men it stimulates the production of spermatozoa and in woman it plays a role in the development of ovarian follicles.

     

Galactorrhoea
  • Milk production from the breast. This is most commonly associated with hyperprolactinaemia.

     

Gynaecomastia
  • Breast development in men.

     

Hormone replacement
  • The replacement of hormones that are deficient. This is commonly association with HRT and women, but the term is not infrequently used to indicate replacement of other hormones in for example hypopituitarism.

     

LH
  • Luteinising hormone is released by the pituitary and acts on the gonads. In males, it results in testosterone production by the testis. In women it plays a role in ovarian follicle development and ovulation. 

     

Oligomenorrhoea
  • Infrequent menstruation

     

Oopherectomy

  • Removal of an ovary.

     

Premature ovarian failure
  • Spontaneous menstruation that ceased permanently before the age of 40yrs

     

 

O b e s i t y

Bariatric surgery
  • An umbrella term for different types of surgery used in the treatment of obesity. Procedures can be divided into restrictive, mal-absorptive and combination procedures (restrictive and mal-absorptive)

     

BMI

  • A calculation of weight (in Kg) divided by height squared (in meters). BMI is used by healthcare professionals to subdivide obesity into various categories that help them organise treatment.

     

Bypass surgery
  • Surgical techniques used to bypass a structure. In obestiy, this entails bypassing a variable portion of bowel. This results in a degree of malabsorption that is intended to aid weight loss.

     

Central adiposity
  • Fat tissue around the abdominal organs. This type of fat tissue is believed to be more harmful to patients than subcutaneous adiposity.

     

Co-morbidities
  • Medical conditions such as diabetes and high blood pressure that are associated with the main condition; in this case with obesity.

     

Eating disorder
  • In the context of obesity this refers to an abnormal pattern of eating that contributes to weight gain

     

Gastric balloon
  • The positioning of a balloon, filled with saline, into the stomach. This is a restrictive procedure used in the treatment of obesity.

     

Gastric banding
  • The positioning of a adjustable band around the stomach, such that the stomach cavity is reduced in volume. This is a restrictive procedure used in the treatment of obesity.

     

Obesity
  • A patient with a BMI greater than 25kg/m2

     

Obstructive sleep apnoea
  • A condition in which there is repeated collapse of the airways during sleep that results in disturbed sleep. Obesity increases the risk of this condition.

     

Subcutaneous adiposity
  • Fat tissue under the skin.

     

Waist-hip ratio
  • The ratio of the circumference of the waist to the circumference at the hips. Waste to hip ratios differ between men and women. An increased waist to hip ratio may indicate more central adiposity. 

     

 

D i a b e t e s

Cataracts
  • A condition in which deposits develop in the lens of an eye. Surgical replacement of the lens may be required if the deposits are marked.

     

Charcot foot
  • Deformation of joints within the foot. This condition can occur in diabetes and is thought to result from a combination of nerve damage and abnormal pressure on joints.

     

Diabetes mellitus

  • A group of medical conditions characterised by higher than normal levels of blood glucose.

     

Dialysis
  • An artificial process that replaces the function of the kidneys.

     

Haemodialysis
  • A process by which blood is withdrawn from the body, cleaned of harmful products by exposure to semi-permeable members and then returned to the body.

     

HbA1c
  • Glycosylated haemoglobin (HbA1c) results from a reaction between glucose and haemoglobin. HbA1c is used by healthcare workers to estimate diabetes control over the past 2-3 months.

     

HDL
  • High-density lipoprotein. The "good cholesterol."

     

Hyperglycaemia
  • An elevated blood glucose. Patients target glucose should be 4-7mmol/l before meals. Targets for glucose control are stricter in pregnancy and frequently relaxed in the elderly.

     

Hypoglycaemia
  • A low blood glucose. Although this is defined by some as a glucose <2.2mmol/l, patients may begin to experience symptoms of hypoglycaemia at a higher or lower level.

     

LDL
  • Low density lipoprotein. "Harmful cholesterol."

     

Microalbuminuria
  • A state in which small amounts of protein are lost through the kidneys into the urine. This can occur as a result of diabetes related damage.

     

Monofilament (10gm)
  • A tool used to assess pressure sensation on the soles of the feet. An abnormal test may indicate nerve damage due to diabetes and be associated with an increased risk of foot ulcer formation

     

Monogenic diabetes
  • A small group of disorders in which single genetic defects result in forms of diabetes mellitus, e.g. maturity onset diabetes of the young (MODY).

     

Nephropathy
  • Kidney damage that results from diabetes mellitus. This terms covers a spectrum of disease from microalbuminuria to renal failure requiring dialysis.

     

Peritoneal dialysis
  • A process of introducing sterile fluid into the peritoneum (space around the bowels and abdominal organs). Harmful chemicals and products enter this fluid which is then removed from the body.

     

Total cholesterol
  • The sum of various cholesterol types in the blood (LDL, IDL, VDL, HDL, etc.)

     

Type 1 diabetes
  • Insulin dependent diabetes. This occurs in young patients and requires insulin treatment in all cases. Omitting insulin will result in diabetic ketoacidosis (DKA).

     

Type 2 diabetes
  • The commonest type of diabetes. This occurs in older patients and can be treated with life-style changes and oral medication. Insulin is also frequently used in this condition when glucose control is not ideal using other measures.

     

 
 

DISCLAIMER: The information contained in the Endocrinology Specialist website is general information and not specific endocrine or diabetes advice. Patients should always consultant their physician or an endocrinology specialist. For further details please read the full disclaimer.

 
 

 
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