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understanding human disease > chap 25 > Flashcards

chap 25 Flashcards

1
Q

endocrine glands

A

major endocrine glands
- pituitary, thyroid, parathyroid, adrenal cortex, medulla, pancreatic islets, ovaries and testes

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2
Q

endocrine gland disorders due to..

A

hypersecretion of hormone, hyposecretion of hormone, inadequate response of target tissue, disorder of signaling

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3
Q

most frequent and serious problems

A

Diabetes mellitus
Thyroid hyperfunction
Thyroid hypofunction
Hyperparathyroidism
Cushing syndrome - too much cortisol
Most common neoplasm is thyroid cancer

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4
Q

signs, symptoms and tests

A

Most symptoms relate to underproduction or overproduction of a hormone
Diagnosis depends on matching symptoms and signs with
- Hormone dysfunction
- Laboratory confirmation of abnormal hormone levels
Physical examination
- Thyroid is the only accessible endocrine gland
Enlargement can be nodular or diffuse
Can palpate:
- Localized nodules, cysts, and masses
- Diffuse hypertrophy (goiter)
Neoplasms of other endocrine organs are detected by:
- Effects of the mass - could be pushing on something
- Effects of hormones produced by the neoplasm if it is functional
- Hypofunction if the neoplasm replaces normal glandular tissue
Laboratory analysis of blood or urine for hormones or breakdown products, such as:
- Thyroid hormone
- Parathyroid hormone
- Steroid hormone
- Catecholamines (epinephrine and norepinephrine) and breakdown products
- Stimulatory hormones released by pituitary

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5
Q

pituitary gland

A

Suspended by stalk from hypothalamus at base of brain - the separate lobes have nothing to do with each other
Anterior lobe
Posterior lobe - extension of the hypothalamus, nervous tissue, store the hormones that are made in the hypothalamus, release is due to action potential in the neuron
Hypothalamus controls both glands

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6
Q

anterior pituitary lobe hormones

A

tropic hormones - causes a downstream release of another hormone
Growth hormone: stimulates growth of tissues
Prolactin: stimulates milk production
Thyroid-stimulating hormones (TSH)
Adrenocorticotropic hormone (ACTH)
Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH) - affect ovaries and testes

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7
Q

posterior pituitary hormones

A

Antidiuretic hormone (ADH): causes more concentrated urine
Oxytocin: stimulates uterine contractions and milk secretion

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8
Q

pituitary diseases: neoplasms

A

Mass such as a neoplasm (uncontrolled growth of cells) is most common disease
Most common tumors affecting pituitary gland are adenomas of the anterior pituitary
Most are functioning tumors = producing hormone
Usually produce only a single hormone
Many grow slowly have other side affects
Mass effect
Pressure on nearby structures - optic chiasm
Intracranial pressure
Stalk effect
Interference with hypothalamic inhibition of prolactin secretion

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9
Q

mass effect

A

Pressure on nearby structures - optic chiasm
Intracranial pressure

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10
Q

Pituitary adenoma: stalk effect

A

Interference with hypothalamic inhibition of prolactin secretion
- Tumor blocks delivery of dopamine (blocks the making of prolactin in non-pregnant individuals) to anterior pituitary
Leads to galactorrhea

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11
Q

growth hormone adenoma

A

Functioning adenoma
GH overproduction - hypersecretion
- Gigantism - before puberty
- Acromegaly - after puberty, after the growth plates have already fused, the bones can’t get longer, but they can become thicker

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12
Q

clinical manifestation of acromegaly

A

Connective tissue proliferation
- Enlarged tongue, interstitial edema, increase in the size and function of sebaceous and sweat glands, coarse skin and body hair
Metabolic
- Abnormal glucose tolerance: cardiac hypertrophy, hypertension (heart enlarges)e, atherosclerosis, type 2 diabetes mellitus
- GH increases levels of blood glucose which can lead to type II diabetes
Bony proliferation
- Large joints
- Enlargement of facial bones, cranium, and hands and feet
- Protrusion of the lower jaw and forehead

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13
Q

panhypopituarism

A

Results from destruction of anterior pituitary
Causes atrophy of thyroid, adrenal cortex, and gonads → all the hormones of the anterior pituitary will be reduced
Lethal if not treated - because you need these hormones
Most common causes:
Large neoplasms of pituitary
Postpartum pituitary necrosis
Surgical removal of pituitary

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14
Q

diabetes insipidus

A

Insufficiency of ADH
Caused by destruction of posterior pituitary and/or hypothalamus
- Tumors
- Surgery
- Hemorrhage - stroke or aneurysm
Symptoms
- Polyuria and polydipsia (thirsty)
- partial/total inability to concentrate the urine

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15
Q

thyroid hormones

A

T3 and T4
T4 is inactive until converted into T3 in the tissues
T3 needs 3 iodines, t4 needs 4 iodines
T3 is the most active but more T4 is secreted
Function? Increase basal metabolic rate, the basic amount of energy that you need to do basic homeostasis, increased growth and development in utero, permissive to catecholamines
Thyroid hormone control
Dependent on iodine

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16
Q

hypothyroidism

A

Causes
- Destruction or atrophy or thyroid gland
- If you didn’t have enough TSH
- Deficient production of thyroid stimulating hormone by pituitary
- Iodine deficiency
- Autoimmune = Hashimoto Thyroiditis
- The immune system infiltrates the thyroid gland and destroys it
Symptoms?
- Weight gain because BMR goes down but you eat the same amount
- Intolerant to cold
- Sluggish reflexes
- Hair loss, constipation, not moving around a lot
Diagnosis?
- Measure blood levels of thyroid hormones as well as TSH (a more reliable indicator of thyroid hormone issues)
- TSH will go up and this can be used as the determining diagnosis
- Thyroid gland would be enlarged - goiter, enlarged because more TSH

17
Q

acquired hypothyroidism

A

Lack of iodine in diet
T3 and T4 are not made
Lack negative feedback to the hypothalamus
TRH and TSH continue to be made
Thyroid will enlarge in response to the TSH
Results in nontoxic goiter

18
Q

hyperthyroidsim

A

Most common cause is Grave’s Disease
- 80-90% of all hyperthyroidism
Common autoimmune diseases in US
- Mostly women
- Antibody mimics TSH
Manifestations:
- Increased heart rate and palpitations
- Weight loss despite increased appetite
- Flushed skin and intolerance to heat
- Tremor
- Hyperactivity
- Diarrhea
- Insomnia
- Exophthalmos

19
Q

diabetes mellitus

A

Worldwide epidemic
Group of Disorders characterized by hyperglycemia
Types
Type 1: pancreatic beta cell destruction predominantly by an autoimmune process
Type 2: a combination of beta cell dysfunction and insulin resistance
Prediabetes
Gestational diabetes mellitus

20
Q

diagnosis of diabetes

A

One of the following three criteria:
Classic Symptoms and random blood glucose>200 mg/dl
Fasting blood glucose>126 mg/dl
Blood glucose>200 mg/dl after OGTT

21
Q

type 1 diabetes

A

Autoimmune
Clinical symptoms following destruction of 80-90% of Beta cells
Genetic Susceptibility
HLA Genes

22
Q

prediabetes

A

Number of insulin-producing beta cells is beginning to decline
Diagnosis=
Indication that weight loss, exercise, healthy eating habits are needed to improve or diabetes will occur
Pharmacologic treatment
improve glucose tolerance

23
Q

gestational diabetes

A

High level of placental hormones cause the pregnant woman to be less responsive to insulin
Most women secrete more insulin
Those who cannot secrete more insulin develop pregnancy related diabetes
Gestational Diabetes
Manage with diet
Diet with supplementary insulin if necessary
Typically returns to normal after delivery
If unmanaged can lead to Type 2 diabetes in mom

24
Q

acute effects of diabetes

A

Polyuria
Polydipsia
Polyphagia
Urinary water loss = wasting electrolytes
Deficits of Na
Ketoacidosis

25
Q

diabetic ketoacidosis

A

Characterized by:
Hyperventilation
Glycosuria
Acidosis
Vomiting
Nausea
Ketonuria
Osmotic diuresis
Volume depletion
Life threatening
More common in Type I

26
Q

acute complications of diabetes

A

Diabetic ketoacidosis
Hypoglycemia
Blood glucose below 50 mg/dl blood
Hypoglycemic unawareness

27
Q

complications of diabetes

A

Mainly caused by hyperglycemia
Glycosylation=Glucose binds to proteins
Effects
Inflammation
Promote thrombosis
Damage endothelial cells
Promote vascular disease

28
Q

long term effects of diabetes

A

Proportional to severity and duration of hyperglycemia
Tissues Affected
Blood vessels
Atherosclerotic Vascular Disease
Kidney Disease
Retina
Peripheral Nerve Disease
Infections

29
Q

diabetes treatment

A

Blood glucose control
Diet and Exercise
Type I=insulin replacement
Type II=
Oral drugs to increase insulin secretion or decrease hyperglycemia
Limit CHO
Exercise
Insulin

30
Q

pheochromocytoma

A

a rare, usually non cancerous tumor that develops in an adrenal gland
- classic adrenergic symptoms including: episodic headache, sweating, and tachycardia

31
Q

addison’s disease

A

also called adrenal insufficiency, is an uncommon disorder that occurs when your body doesn’t produce enough of certain hormones. In Addison’s disease, your adrenal glands, located just above your kidneys, produce too little cortisol and, often, too little aldosterone.

32
Q

cushing’s syndrome

A

is a disorder that occurs when your body makes too much of the hormone cortisol over a long period of time. Cortisol is sometimes called the “stress hormone” because it helps your body respond to stress. Cortisol also helps. maintain blood pressure. regulate blood glucose, also called blood sugar

understanding human disease (25 decks)

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