Adrenal & Thyroid Disorders Flashcards
The adrenal cortex is the outer part of the adrenal gland. It secretes more than 50 steroid hormones, which are classified as ______, ______, and ______.
Glucocorticoids
Catacholamines are ______ that are released as a response to stress that include epinephrine (75%), norepinephrine (25%), and dopamine (?)
Mineralocorticoids
The term ______ refers to any of the hormones synthesized by the adrenal cortex.
Neurotransmitters
The glucocorticoid cortisol (Hydrocortisone) helps maintain vascular integrity and fluid volume. It also helps regulate blood glucose concentration but is mainly given to patients for its ______ properties.
Anti-inflammatory
______ is a mineralocorticoid that maintains extracellular fluid volume by promoting reabsorption of sodium, excretion of potassium and hydrogen.
Aldosterone
Androgens like dehydroepiandosterone (DHEA) play a role in ______ growth and development.
Pubertal
Cushing syndrome is a spectrum of clinical abnormalities caused by an excess of ______.
Corticosteroids
The ______ form is created by excessive production of ACTH (Cushings disease).
Pituitary
The ______ form is caused by excessive cortisol secretion from benign or malignant adrenal tumors.
Adrenal
The ______ form is caused by an ACTH secreting tumor from carcinoma of the long, G.I. tract, or pancreas.
Non-Pituitary
Cushing syndrome can result from high doses of ______.
Corticosteroids
The primary goal for treatment of Cushing’s is to ______ hormone secretion. This can be done by drug treatment, ______ if the cause is by adrenal type, ______ resection or radiation therapy if it is caused by a pituitary adenoma, removal of tumor if it is caused by an ectopic ____ secreting tumor, or a change or discontinuation in exogenous ______ therapy.
Normalize Adrenalectomy Transsphenoidal ACTH Corticosteroid
Adrenocortical insufficiency (in which all three classes of adrenal corticosteroids is reduced) from a primary cause is known as ______ disease.
Addison’s
The most common cause of this disease is an ______ response. Other causes include TB, infarction, fungal infections (histoplasmosis), AIDS, and metastatic cancer.
Autoimmune
A disorder of the ______ system results and secondary adrenocortical insufficiency. This disorder causes a lack of pituitary ACTH secretion (glucocorticoids and androgens low and mineralocorticoids normal)
Hypothalamus-Pituitary-Adrenal (HPA)
Clinical manifestations of Addison’s include…
weakness, fatigue, weight loss, anorexia, skin hyperpigmentation, hypotension, hyponatremia, hyperkalemia, nausea, vomiting, and diarrhea
Normal actions of steroids include ______ properties, hepatic ______, stimulate lipolysis, mobilize glycerol and free fatty acids, protein ______, androgenic effects, mineralocorticoid effects.
Antiinflammatory
Gluconeogenesis
Catabolism
Diagnostic tests for Cushing’s include ______ status, plasma ______ and ______ levels (loss of diurnal variation), 24 hour urine for free cortisol, ______ suppression test, and CT/MRI if tumor is suspected.
Cortisol
ACTH
Dexamethasone
Clinical manifestations of cushing syndrome include…
Emotional disturbance, moon face, osteoporosis, cardiac hypertrophy, buffalo hump, obesity, adrenal tumor, wrinkled skin, abdominal striae, amenorrhea, muscle weakness, purpura, skin ulcers
Addisonian crisis is triggered by ______. Causes may include infection, surgery, trauma, hemorrhage, psychiatric, sudden withdrawal of corticosteroid hormones, post adrenal surgery, sudden pituitary gland destruction
Stress
Hormone replacement for Addison’s include ______ replacement(⅔ in morning and ⅓ in the afternoon), a ______ in the morning, and ______ additives may be needed for excess heat or humidity.
Glucocorticoid
Mineralocorticoid
Salt
A ______ is a tumor of the adrenal medulla that causes excessive secretion of ______. This tumor is rare, happens at any age, is not gender specific, and usually benign.
Pheochromocytoma
Catecholamines
Clinical manifestations of a pheochromocytoma include (the classic triad) severe pounding ______, ______, profuse ______. Attacks maybe provoked by medications (antihypertension, opioids, contrasts, tricyclic antidepressants)
Headache
Tachycardia
Sweating
Diagnostic studies included a 24 hour urine for ______ and CT/MRI for tumor localization.Treatment with adrenalectomy, meds to decrease catecholamine production, HTN sympathetic blocking agents or calcium channel blockers, monitoring BP and glucose.
Catecholamines
HYPERTHYROIDISM VERSUS HYPOTHYROIDISM
- Thyroid size
- Neuromuscular
- Opthalmologic
- Gastrointestinal
- Dermatologic
- Cardiovascular
- Menstrual
Hyperthyroidism: enlarged thyroid, muscle weakness, tremors, sleep disturbances, irritability, nervousness, heat intolerance, lid lag, stare, eyeball protrusion, weight-loss, frequent bowel movements, warm moist smooth skin, tachycardia, scant menses
Hypothyroidism: enlarged thyroid, muscle cramps, fatigue, depression, memory impairment, cold intolerance, periorbital edema, weight gain, constipation, dry skin, brittle nails, dry coarse hair, bradycardia, heavy menses
______ disease is a multisystem autoimmune disease of unknown etiology that includes thyroid enlargement, increased production of thyroid hormone, and exophthalmos (eyeball protrusion)
Graves
Treatment of hyperthyroidism includes anti-thyroid medication ______ (Propylthiouracil PTU, Methimazole TAPAZOLE), ______ (SSKI), and ______, radioactive ______, and surgery which is indicated for a thyroid _____ (complications of surgery include laryngeal nerve damage, parathyroid gland damage)
Thioamides Iodine B-Blockers Iodine Storm
Hypothyroidism can be classified as ______ which includes abnormality of the thyroid gland itself, ______ which is damage to the thyroid gland or malfunction of the pituitary gland, and ______ which is the malfunction of the hypothalamus.
Primary
Secondary
Tertiary
Hashimoto’s disease is autoimmune ______.
Thyroiditis
______ sign is a facial muscle spasm when the face is tapped below the temple.
Chvostek’s
______ sign is a carpal spasm when arterial circulation is interrupted by applying a blood pressure cuff and pumping it above the systolic pressure for three minutes.
Trousseau’s
