C11 Endocrine System Flashcards
The endocrine system?
Regulates and integrates the body’s metabolic activities
What does the hypothalamus control?
The function of endocrine glands through its neural and hormonal paths connected to the anterior pituitary gland
Hormones are secreted from?
Glands that are discharged to the blood or lymph and circulated to target organs upon where they act
Hormone functions?
-Body energy and metabolism
-Sexual function and reproduction
-Growth and development
-Homeostasis
-Response to surroundings, stress and injury
Pituitary Gland
Located at the base of the brain. Function is the relation between the hypothalamus and the number of important hormones they control
What hormones does the pituitary gland control?
-Follicle-stimulating hormone (FSH): follicle and
sperm
-Luteinizing hormone (LH): follicle. Testosterone
and estrogen
-Prolactin (or luteotropic hormone) (LHT) and
oxytocin: lactation and sex hormones
-Antidiuretic hormone (ADH): water from kidneys
-Human growth hormone (hGH): growth and
bone mass
-Thyroid-stimulating hormone (TSH): body
metabolism, growth, energy
-Adrenocorticotrophic hormone (ACTH): cortisol
& glucose metabolism
Diabetes Insipidus-Description
Kidneys are unable to prevent the
excretion of water. Also known as Pituitary Diabetes.
-Idiopathic, tumors, infections, inherited (only
nephrogenic-originating in the kidneys)
-Central (pituitary gland)
-Nephrogenic (kidneys)
-Gestational (placenta)
-Dipsogenic (excess fluids.
No problem with ADH)
Diabetes Insipidus-Symptoms
-Polyuria-abnormal high amt of urine
-Polydipsia-excessive thirst
-Dehydration
-Dry skin
-Fatigue and weakness
Diabetes Insipidus-Dx
-Low osmolality in urinalysis
-Dehydration test
-MRI
Diabetes Insipidus-Treatment
-Increase in fluid intake
-Hormone replacement therapy
Thyroid Gland
Butterfly shaped endocrine gland in the front part of the neck
Thyroid Hormones
Thyroxine (T4)(90%):
-4 molecules of iodine
-Precursor (90% of synthesis)
-Digestion
-Heart and muscle function
-Brain development
Triiodothyronine (T3)(10%):
-3 molecules of iodine
-Active form (converted from T4)
-Metabolism
-Body temperature
-Growth
-Heart and digestive function
Simple Goiter-Description
Hyperplasia of the thyroid gland (not related to infection or neoplasm)
-Colloid: insufficient iodine in the diet
-Sporadic or non-toxic: from the ingestion of goitrogens
-Simple: Normal T4 and T3 with thyroid enlargement
Simple Goiter-Symptoms
-Small nodule
-Compress esophagus or trachea leading to
dysphagia (swallow), dyspnea, dizziness and syncope (fainting)
Simple Goiter-Dx
-Physical exam
-T3 and T4 radioimmunoassay test
-Biopsy if suspect of thyroid cancer
Simple Goiter-Treatment
-Dietary supplementation of iodine (shrimp and
selfish)
-T3 and T4 replacement therapy
-Avoidance of goitrogenic foods and drugs
-Surgery in unresponsive therapies
Graves Disease-Description
Over secretion of thyroid hormones. The most common of
hyperthyroidism.
-Genetic or immune origin
-More frequent in women
Graves Disease-Symptoms
-Nervousness / Anxiety
-Loss of sleep
-Excessive perspiration
-Heat intolerance
-Weight loss
-Fatigue
-Muscle and decalcification
-Graves ophthalmopathy/ Exophthalmos (abn protrusion of eyeball sockets)*
-Graves dermopathy
-Thyrotoxicosis (tachycardia, heart murmurs)*
Graves Disease-Dx
-Physical exam
-T3 and T4 radioimmunoassay test
-TSH levels
-Antithyroid immunoglobulin levels
Graves Disease-Treatment
-Antithyroid agents
-Surgery or radioactive iodine therapy
-Dietary supplementation of iodine
-Beta-blockers
-Thyroxine supplementation
Hashimoto Thyroiditis- Description
Swelling and inflammation of the thyroid.
-The most common of hypothyroidism
-Lymphocytes infiltrating the thyroid. Genetics?
-More frequent in women
Hashimoto Thyroiditis-Symptoms
-Moderate enlargement of the thyroid
-Pain and tenderness in the neck area
-Dysphagia
-Fatigue
-Sleepiness
-Difficulty concentrating
-Depression
-Cold intolerance
-Dry skin and hair
Hashimoto Thyroiditis-Dx
-Antithyroid immunoglobulin levels
-Present of antibodies that react with
thyroid
-MRI
-Biopsy
Hypothyroidism-Description
Cretinism (congenital) or Myxedema (acquired).
-Insufficient thyroid hormones or loss of functionality thyroid
-Congenital, iatrogenic, inflammation or autoimmune.
-Secondary from pituitary dysfunctions
Hypothyroidism-Symptoms (*age/individual)
-Fatigue
-Intolerance to cold*
-Muscle cramps
-Excessive sleepiness
-Diminishes appetite
-Weight gain
-Dry skin and hair
-Weak nails
Hypothyroidism-Treatment
Hormone replacement therapy
Hypothyroidism-Dx
-Radioimmunoassay for levels of T3 and T4
-Normally elevated TSH (*except from
pituitary dysfunction)
-High cholesterol and alkaline phosphates
Hypothyroidism-Prognosis
Myxedema (severe form of hypothyroidism) coma/crisis (emergency)
Adrenal Gland
Located top of each kidney contains cortex and medulla
Adrenal Cortex contains
Mineralocorticoids:
-Aldosterone: sodium and potassium in
the blood.
Glucocorticoids:
-Cortisol: glucose metabolism.
Adrenal androgens:
-Testosterone
Adrenal Medulla contains
Epinephrine/Adrenaline
-Heart rate, muscle strength, blood pressure, and sugar metabolism
Norepinephrine
-Heart rate and blood pressure, glucose from energy stores, increases blood flow to skeletal muscle, etc.
Dopamine (small amounts):
-Movement, memory, reward, sleep, mood, etc.
Cushing Syndrome-Description
Hypersecretion of cortisol* from the adrenal cortex
-Most common in females
-Bilateral hyperplasia (elevated ACTH)
-Iatrogenic
Cushing Syndrome-Symptoms
-“moon-shaped” face
-Hump on the upper back
-Purple striae (stretch marks)
-Impaired glucose tolerance
-Fragile skin
-Emotional changes
-Hypertension
-Amenorrhea (no period)
-Erectile dysfunction
Cushing Syndrome-Treatment
-Restore concentrations of cortisol
-Drug therapy
-Radiation therapy
-Adrenalectomy
Cushing Syndrome-Dx
-Blood and urine cortisol steroid levels
-Dexamethasone suppression test
-Brain MRI and abdominal CF scans
Addison Disease-Description
Insufficient cortisol from the adrenal cortex
-More common between 30-50 yrs.
-Auto-immune
-Infections, TB, cancer, dysfunction pituitary gland
Addison Disease-Symptoms
-Muscle Weakness and pain
-Weight loss
-Hypoglycemia
-Craving for salt
-Hypotension
-Nausea and vomiting
-Addisonian crisis (renal failure)*
Addison Disease-Treatment
HRT
Addison Disease-Dx
-Blood test for K, Na, cortisol and ACTH
-ACTH stimulation test
-Insulin-induced hypoglycemia
-CT scan of the adrenal glands or the pituitary.
Glucose has high ___
OSMOTIC PRESSURE
Hormones in Glucose Metabolism
Insulin, Glucagon, Epinephrine
Insulin
-Secreted by the pancreas when BGL is elevated
-Increases movement of glucose out of the blood
-Insulin attaches to a cell receptor
-Brain does not need insulin to move glucose
Glucagon
-Secreted by the pancreas when BGL is low
-Promotes the conversion of glycogen in the liver
-Secreted when BGL< 70 mg/dL aprox.
Epinephrine
-Secreted by the adrenal glands when BGL is really
low
-Stops the secretion of insulin and promotes the
release of glucose from the liver
Glucose Regulation
Fasting AE 2-3h AE
Normal 80-100 170-200 120-140
Impaired Glucose 101-125 190-230 140-160
Diabetic 126+ 220-300 200+
-in Mg/DL
Diabetes Mellitus
-Chronic disorder of carbohydrate metabolism resulting from insufficient production of insulin or from inadequate utilization of this hormone
-Hyperglycemia vs hypoglycemia
Diabetes Mellitus-Description
Glucose metabolism impaired
Diabetes Mellitus-Symptoms
-Polyuria
-Polydipsia
-Polyphagia
-DKA* (ketoacidosis severe)
-Fruity breath*
-Hard to heal infections
-Fatigue and weakness
-*Epinephrine
-Diaphoresis (high sweat)
-Tremors
-stroke like symptoms
-Confusion
Diabetes Mellitus-Dx
-HbA1c>6.5%
-BGL>200 mg/dL
-Fasting BGL>126 mg/dL
-Oral glucose tolerance test
Diabetes Mellitus-Treatment
-Insulin*
-Exercise
-Diet*
-Hydration
Diabetes Mellitus-Complications
-Metabolic crises
-Vascular diseases, necrosis and gangrene
-Atherosclerosis
-Retinopathy
-Kidney disease and renal failure
-Numbness, paresthesia and bouts of pain.
-Difficulties swallowing,
constipation/diarrhea, bladder problems
-Wound healing problems
-Diabetic coma
-Insulin shock
T1 Diabetes- Description
characterized by the complete absence of insulin secretion
T1-Characteristics
-< 30 yrs.
-Genetic dysfunction + trigger event
-Typically lean patients
-They need INSULIN
-Prone to diabetic ketoacidosis (DKA):
buildup of acids in blood from fat into
ketones
T1-Symptoms
-Polyuria
-Polydipsia
-Polyphagia
-DKA=diabetic ketoacidosis
-Fruity odor
-Hard to heal infections
-Fatigue and weakness
-*EPI= diaphoresis, tremors, stroke like symptoms
T2 Diabetes-Description
Some production of insulin
T2-Characteristics
-> 40 yrs.
-Obesity and inactivity
-Typically overweight patients
-No need of insulin (exceptions)
-Prone to hyperosmolar hyperglycemic
state (HHNS): dehydration with significant
ketoacidosis
T2-Symptoms
-Polyuria
-Polydipsia
-Polyphagia
-Hard to heal infections
-Fatigue and weakness
-*EPI= diaphoresis, tremors, stroke like symptoms
Testes Hormones
-Testosterone
-Inhibin
Ovaries Hormones
-Estrogen
-Progesterone
-Inhibin
Polycystic Ovary Syndrome-Description
Cysts in the ovaries. Genetic and life style
PCOS-Symptoms
-Amenorrhea/ irregular menses/ anovulation)
-Obesity
-Infertility
-Prediabetes or type 2 diabetes
-Hirsutism (hair growth in places common in men)
-Acne
-Alopecia
-Hypertension
-Elevated blood cholesterol
-Sleep apnea
PCOS-Dx
-Physical examination
-Hormones levels (LH to FSH ratio)
-HbA1c and fasting glucose
-Ultrasound for ovaries
PCOS-Treatment
-Low-dose oral contraceptives
-Medication for type 2 diabetes
-Exercise
-Diet
