Ch 22 Alterations of Hormonal Regulation

Question 1

SIADH is characterized by (high,low) levels of ADH

Answer 1

high

Question 2

An anterior pituitary adenoma usually causes (hyposecretion, hypersecretion) of hormones from the adenoma itself and (hyposecretion, hypersecretion) of hormones from the surrounding pituitary cells

Answer 2

hypersecretion;hyposecretion

Question 3

An individual with type 1 diabetes who has the dawn phenomenon has a (lower, higher) blood glucose in the early morning than in the middle of the night

Answer 3

higher

Question 4

Cretinism is caused by untreated congenital (hypothyroidism, growth hormone deficiency)

Answer 4

hypothyroidism

Question 5

In autoimmune diabetes, also called type (1A, 1B, 2) diabetes pancreatic beta cells are destroyed by autoreactive (cytotoxic T lymphocytes, natural killer cells)

Answer 5

1A; cytotoxic T lymphocytes

Question 6

Persons who have type I diabetes have a deficit of insulin and (glucagon, amylin) and a relative excess of (glucagon, amylin)

Answer 6

amylin; glucagon

Question 7

In diabetes, microvascular disease refers to (accelerated artherosclerosis, destruction of capillaries), whereas macrovascular disease refers to (accelerated artherosclerosis, destruction of capillaries)

Answer 7

destruction of capillaries; accelerated artherosclerosis

Question 8

What causes round face and truncal obesity in Cushings?

Answer 8

Cortisol excess causes lipolysis and altered fat distribution

Question 9

Why is there bruising even with little bumps in Cushings?

Answer 9

Bruising easily is part of Cushing disease because having too much cortisol causes proteins to break down and makes the small blood vessels very fragile

Question 10

An excess of what hormone causes hyperpigmentation in Cushings? How?

Answer 10

ACTH (AdrenoCorticoTropic Hormone). ACTH excess causes hyperpigmentation because excessive MSH (melanocyte-stimulating hormone) is formed as an alternate cleavage product of the same hormone precursor. MSH stimulates production of melanin, a skin pigment.

Question 11

What is the difference between a primary and secondary endocrine disorder?

Answer 11

A primary endocrine disorder is caused by a problem in the gland that secretes a hormone whose action is directed toward other tissues rather than to another gland, but secondary endocrine disorder is caused by a problem with a gland that secretes a hormone whose target tissues are another gland that it stimulates or suppresses

Question 12

What is the difference between thyrotoxicosis and thyrotoxic crisis?

Answer 12

Thyrotoxicosis is the effects of having too much thyroid hormone, as seen with hyperthyroidism, but thyrotoxic crisis is the effects of dangerously high levels of thyroid hormone, with high fever, extreme tachycardia, and potential death from heart failure or cardiac dysrhythmias

Question 13

What is the difference between neurogenic and nephrogenic diabetes insipidus?

Answer 13

Neurogenic diabetes insipidus is caused by a problem in the hypothalamus of posterior pituitary that decreases ADH (antidiuretic hormone) release, but nephrogenic diabetes insipidus is caused by a problem in the kidney itself that causes insensitivity to ADH

Question 14

What is the difference between acromegaly and gigantism?

Answer 14

Acromegaly occurs with hypersecretion of growth hormone in adults, but gigantism occurs with hypersecretion of growth hormone in children and adolescents whose epiphyseal plates have not yet closed, so their long bones are able to grow

Question 15

SIADH (Syndrome of Inappropriate antidiuretic hormone secretion) clinical manifestations

Answer 15

lethargy, hyponatremia, perhaps seizure, decreased plasma osmolality, concentrated urine

Question 16

Hypothyroidism clinical manifestations

Answer 16

lethargy, cold intolerance, hoarseness, nonpitting boggy edema around eyes, coarse hair, decreased body temperature (Lazy, cute horses eat exotic hairy testicles=lethargy, cold, hoarseness, eye edema, hair, temperature )

Question 17

Adrenal adenoma causing hypersecretion of androgens in a woman: clinical manifestations

Answer 17

virilization (development of male characteristics), lack of breast development, hirsutism, increased muscle bulk

Question 18

Diabetic ketoacidosis clinical manifestations

Answer 18

polyuria, decreased level of consciousness, Kussmaul breathing, acetone smell to breath, hyperglycemia, decreased blood pH, glycosuria (Polly decreed consciously: Kissing fruity, hyper gorillas decreases boredom=polyuria, decreased LOC, Kussmal, fruity breath, hyperglycemia, glycosuria, blood)

Question 19

Hypoglycemia clinical manifestations

Answer 19

tachycardia, diaphoresis, tremor, pallor, confusion, decreased level of consciousness, perhaps seizure

Question 20

Primary hyperaldosteronism clinical manifestations

Answer 20

hypertension, hypokalemia, increased blood pH, increased urine potassium

Question 21

Type 1 diabetes mellitus clinical manifestations

Answer 21

polydipsia, polyuria, nocturia, increased appetite, weight loss, hyperglycemia, glycosuria Remember: hungry, thirsty, skinny, poly, nightie, sugary.

Question 22

Diabetes insipidus clinical manifestations

Answer 22

polydipsia, polyuria, nocturia, hypernatremia, increased plasma osmolality, large volume of dilute urine Remember: thirsty, salty, poly, nightie, watery

Question 23

Addison disease clinical manifestations

Answer 23

weakness, fatigue, hypotension, hyperkalemia, hypoglycemia, elevated ACTH

Question 24

Cushings clinical manifestations

Answer 24

facial flush, moon face, purple striae, pendulous abdomen, easy bruising, supraclavicular fat pad, hyperpigmentation (in ACTH-dependent causes of cortisol excess), trunk obesity, thin extremities

Question 25

Failure of the hypothalamus to secrete its usual hormones presents clinically as what disease?

Answer 25

Pituitary disease

Question 26

Tumors of chromaffin cells of the adrenal medulla are called what?

Answer 26

Pheochromocytomas

Question 27

Excessive water intake that decreases plasma osmolality by overwhelming the ADH mechanisms is called what?

Answer 27

Dipsogenic diabetes insipidus

Question 28

When necrosis or another problem in the anterior pituitary causes deficiency of all its hormones, the individual has what?

Answer 28

Panhypopituitary

Question 29

Prolactin-secreting tumors in the anterior pituitary are called prolactinomas in women, they cause what?

Answer 29

Galactorrhea (milk production not associated with childbirth)

Question 30

Persons who have longstanding diabetes may develop hypoglycemia without the usual sympathetic nervous system manifestations, a condition called what?

Answer 30

Hypoglycemia unawareness

Question 31

A person who has hypothyroidism can develop a nonpitting boggy edema called what? This same term when used with the word coma indicates decreased level of consciousness associated with hypothyroidism

Answer 31

Myxedema

Question 32

Enlargement of the thyroid gland is called a what, and is a response to increased stimulation by what?

Answer 32

Goiter; TSH

Question 33

Type I diabetes often is diagnosed when the acute complication what occurs?

Answer 33

Diabetic Ketoacidosis

Question 34

Persons who have primary hyperparathyroidism are predisposed to form kidney what?

Answer 34

Stones

Question 35

Cushing __ is caused by hypersecretion of ACTH from the anterior pituitary, but the term Cushing __ is used for any condition involving chronic exposure to excessive cortisol

Answer 35

Disease; syndrome

Question 36

Why do type 2 diabetes patients not get diabetic ketoacidosis as often as type 1 diabetes patients?

Answer 36

Persons who have type 2 diabetes make a little insulin, which goes to the liver and reduces the formation of the ketoacids. Persons who have type 1 diabetes have severe insulin deficiency, and they have excessive fat breakdown and make ketoacids faster then the body can remove them

Question 37

In acromegaly, why does the excess growth hormone increase the size of extremities, but not height.

Answer 37

A child who has too much growth hormone grows tall like a giant, but if an individual already is an adult before developing too much growth hormone, then the effects are different because the long bones have already stopped growing. Adults with growth hormone excess develop enlarged jaw, forehead, tongue, hands and feet

Question 38

Why does hyperparathyroidism cause bone weakness?

Answer 38

Parathyroid glands make parathyroid hormone and send it out into the blood. Parathyroid hormone circulates in the blood to bones and changes them. The action of the parathyroid hormone takes a little calcium out of the bones. Because the body is making too much parathyroid hormone, too much calcium came out of the bones and makes them weak

Question 39

Post op thyroid surgery why do you inflate BP cuff and look at hands?

Answer 39

Monitor for complication of thyroid surgery that can be detected this way and get treatment quickly if this occurs. During thyroid surgery, sometimes the parathyroid glands are injured, because they are located right behind the thyroid. With parathyroid gland injury, the blood calcium decreases and makes nerves and muscles jumpy and crampy. We can detect low calcium in the early stages this way

Question 40

Dibetes insipidus

Answer 40

A problem with antidiuretic hormone, ADH. ADH tells kidneys to concentrate urine. Kidneys are not receiving enough ADH signals. Kidneys make a lot of dilute urine

Question 41

Why will losing weight help in type II diabetes?

Answer 41

Fat cells make signaling chemicals and release them into the blood. Some of these signaling chemicals cause the body to be resistant to the action of insulin, causing high blood sugar. Insulin resistance is part of the problem in type II diabetes

Question 42

Why do patients with Addison disease get lightheaded when standing up?

Answer 42

Adrenal gland does not make enough cortisol and aldosterone, these two help maintain circulating blood volume. Without them, blood volume gets too low. Standing causes gravity to bring blood down and not enough blood brings oxygen to the brain causing this

Question 43

Why do patients get type 1 diabetes?

Answer 43

Their immune system killed the cells in the pancreas that normally make the hormone insulin