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N 2440 > 11.2 - Alterations of Hormone Regulation > Flashcards

11.2 - Alterations of Hormone Regulation Flashcards

1
Q

Mechanisms of Hormonal Alterations

A

1) Failure of feedback systems
- signals to increase hormone production fail

2) Dysfunction of endocrine gland
- secretory cells are unable to produce hormones or produce excessive amounts

3) Increased hormone degradation or activation

4) Ectopic hormone release
- hormones are produced by tissues other than endocrine glands

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2
Q

Target Cell failure

A
  • target cells fails to respond to the hormone that is binding due to:

1) decrease in # of receptors
2) impaired receptor function
3) presence of antibodies
- interfere with hormone binding to receptor
4) antibodies can mimic hormones and activate receptor (w/out the hormone)

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3
Q

Diseases of Posterior Pituitary

A

1) SIADH
2) Diabetes Insipidus

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4
Q

SIADH

A
  • hypersecretion of ADH
  • causes excessive water retention
    • too much water = not enough Na: hyponatremia
  • symptoms of fluid overload: edema, neurological issues (confusion, seizures)
  • Serum hypoosmolality: low concentration of solutes in the blood (blood is more dilute)
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5
Q

Diabetes Insipidus

A
  • insufficient ADH
  • kidneys do not retain enough water (= dehydration)
  • Polyuria: excessive urine output (body is not retaining fluid)
  • Polydipsia: extreme thirst (body is getting rid of fluid)
  • hypernatremia: not enough water means too much Na
  • hyper- osmolality: high concentration of solutes (blood is less dilute/more concentrated)
  • bc blood is more concentrated, urine is not concentrated
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6
Q

3 Types of Diabetes Insipidus

A

1) Neurogenic
- brain does not produce enough ADH due to damage to hypothalmaus

2) Nephrogenic
- kidneys fail to respond to ADH

3) Psychogenic
- excessive water intake can suppress ADH
- causes dilute urine output = mimics DI

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7
Q

Diseases of Anterior Pituitary

A

1)Hypopituitarism

2) Panhypopituitarism

3) Hyperpituitarism

4) Hyper secretion of growth Hormone

5) Hypersecretion of Prolactin

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8
Q

Hypopituitarism

A
  • anterior pituitary fails to produce ONE of its hormones

Causes
1) Pituitary Infraction - compromised blood supply (ie. hemmorhage, stroke)

2) Head trauma - can disrupt pituitary

  • 1 of hormones like: TSH, FSH, ACTH, are not secreted
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9
Q

Panhypopituitarism

A
  • anterior pituitary fails to produce ALL of its hormones

ACTCH deficiency

TSH deficiency - hypothyroidism (thyroid is not being stimulated)

LH and FSH deficiency - hypogonadism: not enough sex hormones being produced

GH deficiency - stunted growth, decreased muscle mass

Symptoms
- wrinkles
- puffy face
- no armpit hair
- pale/yellow skin

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10
Q

Hyperpituitarism

A
  • overproduction of hormones produced by anterior pituitary
  • caused by benign tumour (pituitary adenoma)

Symptoms
- hypo secretion of neighbouring hormones (suppresses production of other hormones)
- headache and fatigue - from pressure of tumour

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11
Q

Hyper secretion of Growth Hormone

A

Causes
1) Acromegaly
- hyper secretion of GH in ADULTHOOD

  • since epiphseal plates of bones are closed in adulthood excessive GH does not cause increased height, it abnormal growth of tissue/bones
  • symptoms: enlarged nose, lips, and protruding jaw

2) Gigantism
- hyper secretion of GH in childhood
- causes abnormal growth of long bones = increased height

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12
Q

Hypersecretion of Prolactin

A
  • caused by prolactinomas (benign tumour)

Females
↑ prolactin =
- amenorrhea (no period)
- galactorrhea (produces breast milk when not pregnant
- hirsutism - excess hair growth
- osteopenia - decreased bone density

Males
- hypergonadism - decreased testosterone production
- gynecomastia - enlarged breasts
- erectile dysfunction

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13
Q

Alterations of Thyroid function

A

1) Hyperthyroidism
2) Hypothyroidism
3) Thyroid Carcinoma

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14
Q

Hyperthyroidism

A
  • overactive thyroid gland
  • ↑ TH levels
  • ↓ TSH levels
  • speeds up body’s metabolism
  • causes: weight loss, tachycardia, heat intolerance (skinny)

Common Cause:
1) Graves Disease - immune system attacks thyroid
- antibodies stimulate thyroid

Symptom:
- pretibial myxedema (shin swelling)
- large and protruding eyeballs

2) Goitre - enlarged thyroid gland
- caused by nodular thyroid disease

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15
Q

Hypothyroidism

A
  • thyroid does not produce enough thyroid hormone
  • slows metabolism

Caused by:
Primary
1) Hashimoto - immune system attacks thyroid
- enlarged thyroid

2) Post-partum - fatigue, hair loss, depression

Congenital (in newborns)
- Results in: thick neck, stunted growth, dry skin, eyes wide apart, PROTRUDING TONGUE

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16
Q

Thyroid Carcinoma

A
  • carcinoma = malignant
  • caused by exposure to radiation
  • present as lump or nodule
17
Q

Alterations of Parathyroid Function

A

1) Hyperparathyroidism
2) Hypoparathyroidism

18
Q

Hyperparathyroidism

A

Primary: excess secretion of PTH

Secondary: occurs in response to hypocalcemia

Manifestations
1) Hypercalcemia
- breaks down a lot of bone and releases a lot of Ca in blood

2) Hypercalciuria
- excessive Ca in urine = can cause kidney stones

3) Pathological fractures
- lot of PTH breaks down a lot of the bone

19
Q

Hypoparathyroidism

A
  • low parathyroid hormone
  • caused by damage to parathyroid in surgery

Manifestations
1) Hypo calcemia
- bc PTH breaks down bone to increase Ca on blood

2) Chvostek
- facial twitching caused by tapping the facial nerve

3) Trousseau
- occurs when hand bends inward and hand when the BP cuff is inflated

20
Q

Alterations of Pancreas

A

1) Type I Diabetes Mellitus
2) Type II Diabetes Mellitus
3) Other types of diabetes Mellitus

21
Q

Type I Diabetes Mellitus

A
  • immune system destroys bodys beta cells (which secrete insulin and amylin)
  • causes an insulin deficiency
  • glucagon levels are high = glucose levels are high (hyperglycemia)

Manifestations
- Polydipsia - extreme thirst
- Polyuria - frequent peeing
- Polyphagia - excessive hunger; cells can not take up glucose (too much glucose in blood)

22
Q

Type II Diabetes Mellitus

A
  • pancreas produces insulin, but body does not respond properly due to decreased insulin sensitivity
  • overtime, beta cells lose ability to produce insulin = deficiency

Symptoms:
- overweight
- neuropathy

23
Q

Other Types of Diabetes

A

Gestational Diabetes
- glucose intolerance developed during pregnancy (lot of glucose in blood ad not being used for energy in cells)

Maturity Onset Diabetes of Youth
- mutations affects beta cell function

24
Q

Complications of Diabetes Mellitus

A

1) Hypoglycemia - low blood sugar

2) Diabetic Ketoacidosis
- not enough insulin, means the body can not take up glucose in cells
- body breaks down fat for energy
- causes ketone accumulations (fruity breathe)

3) Hyperglycemic Syndrome

25
Q

Chronic Complications of Diabetes Mellitus

A

Macro
- CV
- Stroke

Micro
- Retinopathy - blindness
- Nephropathy - kidney damage
- Neuropathy - affects nerves

Infection
- due to poor circulation and
- elevated glucose also makes it difficult to heal

26
Q

Symptoms of Diabetic Ketoacidosis

A
  • nausea and vomiting
  • extreme thirst
  • FRUITY BREATH
  • feeling weak and tired
  • frequently peeing
27
Q

Alterations of Adrenal Function

A

1) Disorders of the Adrenal Cortex

2) Hypersecretion of adrenal androgens and estrogens

3) Disorders of the Adrenal Medulla

28
Q

Disorders of the Adrenal Cortex

A
  • excessive cortisol function

1) Cushings Syndrome
- excessive production of ACTCH (anterior pituitary) = chonic excess cortisol

Symptoms
- fat pad on back
- bruising
- thin arms and legs
- large abdomen (pendulous)
- mood face: weight gain in face and neck

2) Hyperaldosteronism
- excessive production of aldosterone
1. Primary - Conns Syndrome
- ↑ aldosterone =↑ BP

  2. Secondary - due to RAAS

3) Adrenocortical Hyperfunction
- not enough cortisol

  1. Addisons Disease
    • damage to adrenal glands that causes insufficient cortisol
    • addisons crisis: sudden drop in cortisol = hypotension and hypoglycemia
2. Secondary Hypercortisolism 
   - pituitary glands fail to produce enough ACTH which stimulate adrenal gland to produce cortisol
29
Q

Hypersecretion of adrenal androgens and estrogens

A

Feminization
- caused by excess estrogen function
- occurs in males

Symptoms
- short stature
- gynecomastia - breast tissue growth

Virilization
- caused by excess androgen function
- occurs in females

Symptoms
- enlarged clit
- male-patterned growth
- deepened of voice

30
Q

Disorders of the Adrenal Medulla

A
  • excess catecholamines

1) Adrenal Medulla Hyperfunction
- caused by tumour (pheochromocytoma)
- secretes catecholamines on a continuous basis

Symptoms:
- tachycardia
- hypertension
- anxiety
- panic attacks

N 2440 (26 decks)

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