Adrenal & Thyroid Disorders

Question 1

The adrenal cortex is the outer part of the adrenal gland. It secretes more than 50 steroid hormones, which are classified as ______, ______, and ______.

Answer 1

Glucocorticoids

Question 2

Catacholamines are ______ that are released as a response to stress that include epinephrine (75%), norepinephrine (25%), and dopamine (?)

Answer 2

Mineralocorticoids

Question 3

The term ______ refers to any of the hormones synthesized by the adrenal cortex.

Answer 3

Neurotransmitters

Question 4

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.

Answer 4

Anti-inflammatory

Question 5

______ is a mineralocorticoid that maintains extracellular fluid volume by promoting reabsorption of sodium, excretion of potassium and hydrogen.

Answer 5

Aldosterone

Question 6

Androgens like dehydroepiandosterone (DHEA) play a role in ______ growth and development.

Answer 6

Pubertal

Question 7

Cushing syndrome is a spectrum of clinical abnormalities caused by an excess of ______.

Answer 7

Corticosteroids

Question 8

The ______ form is created by excessive production of ACTH (Cushings disease).

Answer 8

Pituitary

Question 9

The ______ form is caused by excessive cortisol secretion from benign or malignant adrenal tumors.

Answer 9

Adrenal

Question 10

The ______ form is caused by an ACTH secreting tumor from carcinoma of the long, G.I. tract, or pancreas.

Answer 10

Non-Pituitary

Question 11

Cushing syndrome can result from high doses of ______.

Answer 11

Corticosteroids

Question 12

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.

Answer 12

Normalize
Adrenalectomy
Transsphenoidal
ACTH
Corticosteroid

Question 13

Adrenocortical insufficiency (in which all three classes of adrenal corticosteroids is reduced) from a primary cause is known as ______ disease.

Answer 13

Addison’s

Question 14

The most common cause of this disease is an ______ response. Other causes include TB, infarction, fungal infections (histoplasmosis), AIDS, and metastatic cancer.

Answer 14

Autoimmune

Question 15

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)

Answer 15

Hypothalamus-Pituitary-Adrenal (HPA)

Question 16

Clinical manifestations of Addison’s include…

Answer 16

weakness, fatigue, weight loss, anorexia, skin hyperpigmentation, hypotension, hyponatremia, hyperkalemia, nausea, vomiting, and diarrhea

Question 17

Normal actions of steroids include ______ properties, hepatic ______, stimulate lipolysis, mobilize glycerol and free fatty acids, protein ______, androgenic effects, mineralocorticoid effects.

Answer 17

Antiinflammatory

Gluconeogenesis

Catabolism

Question 18

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.

Answer 18

Cortisol

ACTH

Dexamethasone

Question 19

Clinical manifestations of cushing syndrome include…

Answer 19

Emotional disturbance, moon face, osteoporosis, cardiac hypertrophy, buffalo hump, obesity, adrenal tumor, wrinkled skin, abdominal striae, amenorrhea, muscle weakness, purpura, skin ulcers

Question 20

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

Answer 20

Stress

Question 21

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.

Answer 21

Glucocorticoid

Mineralocorticoid

Salt

Question 22

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.

Answer 22

Pheochromocytoma

Catecholamines

Question 23

Clinical manifestations of a pheochromocytoma include (the classic triad) severe pounding ______, ______, profuse ______. Attacks maybe provoked by medications (antihypertension, opioids, contrasts, tricyclic antidepressants)

Answer 23

Headache

Tachycardia

Sweating

Question 24

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.

Answer 24

Catecholamines

Question 25

HYPERTHYROIDISM VERSUS HYPOTHYROIDISM

1. Thyroid size
2. Neuromuscular
3. Opthalmologic
4. Gastrointestinal
5. Dermatologic
6. Cardiovascular
7. Menstrual

Answer 25

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

Question 26

______ disease is a multisystem autoimmune disease of unknown etiology that includes thyroid enlargement, increased production of thyroid hormone, and exophthalmos (eyeball protrusion)

Answer 26

Graves

Question 27

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)

Answer 27

Thioamides
Iodine
B-Blockers
Iodine
Storm

Question 28

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.

Answer 28

Primary
Secondary
Tertiary

Question 29

Hashimoto’s disease is autoimmune ______.

Answer 29

Thyroiditis

Question 30

______ sign is a facial muscle spasm when the face is tapped below the temple.

Answer 30

Chvostek’s

Question 31

______ 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.

Answer 31

Trousseau’s