Chapter 20: Alteration of Hormonal Regulation

Question 1

What are the two primary mechanisms that cause increase or decrease in hormone levels?

Answer 1

Inappropriate amount of hormone delivered by target cells and inappropriate response by target cell

Question 2

What is the most common cause for hypothalamic dysfunction and what are some examples in what causes it?

Answer 2

Damage to the pituitary stalk caused by lesion, head injury, surgical procedure, and tumor

Question 3

What happens as a result of inadequate hypothalamic hormone?

Answer 3

The body produces inadequate pituitary hormones: FSH, LH, ACTH, TSH, and GH

Question 4

What is syndrome of inappropriate antidiuretic hormone secretion (SIADH) and what is the common cause?

Answer 4

A hypersecretion of ADH commonly caused by ectopic production of ADH by tumors, pulmonary or CNS disorders, surgery and medications

Question 5

What is diabetes insipidus (DI)?

Answer 5

A hyposecretion of ADH leading to a high loss of free water into the urine

Question 6

What is the difference between Neurogenic (central) DI and Nephrogenic DI?

Answer 6

Neurogenic is an inadequate secretion of ADH while Nephrogenic is an inadequate response to ADH

Question 7

What is Hypopituitarism and what is the most common cause?

Answer 7

The absence of one or more anterior pituitary hormones or the complete failure of all anterior pituitary hormones. Most common cause is pituitary infarction or lesions

Question 8

What is Hyperpituitarism and what is the most common cause?

Answer 8

The hypersecretion of hormones of the anterior pituitary usually caused by a slow growing pituitary adenoma or tumor

Question 9

There are two forms of hypersecretion of growth hormone (GH): acromegaly and giantism. What is the difference?

Answer 9

Acromegaly is hypersecretion of GH during adulthood while Giantism is hypersecretion in children and adolescents whole epiphysial plates have not closed

Question 10

What is prolactinoma?

Answer 10

Hypersecretion of prolactin from tumors or prolactinomas that secrete prolactin

Question 11

What is Primary thyroid disorders?

Answer 11

Dysfunction or disease of the thyroid resulting in either an increase or decrease in TH

Question 12

What is Central (secondary) thyroid disorders?

Answer 12

Disorders of the pituitary glands TSH production

Question 13

What is Thyrotoxicosis and how is it caused?

Answer 13

A condition that results from any cause of increased TH levels, can be caused by dysfunction of pituitary, thyroid gland, ectopic thyroid tissue or ingestion of TH medication

Question 14

What is hyperthyroidism and what is primary and secondary hyperthyroidism?

Answer 14

Hyperthyroidism is an excess amount of TH, primary is thyroid gland dysfunction caused by graves disease, secondary is caused by TSH secreting pituitary adenomas (tumors)

Question 15

Describe Graves disease

Answer 15

Autoimmune disease caused by stimulation of thyroid by autoantibodies against TSH receptors. Might experience pretibial myxedema

Question 16

What is pretibial myxedema?

Answer 16

Subcutaneous swelling on the anterior portion of the legs and erythematous skin

Question 17

What is Thyrotoxic crisis?

Answer 17

Life threatening worsening of the thyrotoxic state which TH levels rise dramatically

Question 18

What is Hypothyroidism?

Answer 18

Deficient production of TH by the thyroid gland and is the most common disorder of thyroid

Question 19

Describe primary and central (secondary) hypothyroidism?

Answer 19

Primary is loss of thyroid function most common cause is Hashimoto disease, secondary is pituitary failure to synthesize TSH most common cause is pituitary adenomas (tumor)

Question 20

What is myxedema coma?

Answer 20

Medical emergency characterized by diminished consciousness due to severe hypothyroidism

Question 21

What is Hashimoto disease and is it related to primary or secondary hypothyroidism?

Answer 21

Autoimmune disease causing destruction of thyroid tissue, is the most common cause of primary hypothyroidism

Question 22

What is congenital hypothyroidism?

Answer 22

Thyroid tissue absence or hereditary defects in TH synthesis

Question 23

What is Thyroid carcinoma?

Answer 23

Most common endocrine malignancy, ionizing radiation is the most common cause

Question 24

What is Hyperparathyroidism?

Answer 24

Increased secretion of parathyroid hormone (PTH) and is classified with primary, secondary, and tertiary

Question 25

What is Primary Hyperparathyroidism?

Answer 25

Inappropriate excess secretion of PTH by one or more of the parathyroid glands

Question 26

What is Secondary Hyperparathyroidism?

Answer 26

A compensatory response of the parathyroid glands to hypocalcemia

Question 27

What is Tertiary Hyperparathyroidism?

Answer 27

Develops overtime due to long-standing periods of hypocalcemia

Question 28

Describe Hypoparathyroidism and the most common cause

Answer 28

Abnormally low PTH levels most commonly caused by damage to parathyroid glands during thyroid surgery

Question 29

What is Diabetes mellitus?

Answer 29

A group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both

Question 30

What is the difference between Type 1 and Type 2 diabetes mellitus?

Answer 30

Type 1 diabetes is caused by an autoimmune destruction of beta cells causing absolute insulin deficiency, Type 2 is caused by the loss of beta cell’s insulin secretion along with body’s insulin resistance

Question 31

What is Gestational diabetes mellitus (GDM) ?

Answer 31

Diabetes diagnosed in the second or third trimester of pregnancy

Question 32

What is Maturity-onset diabetes of youth (MODY) ?

Answer 32

Present before 25 years of age and have at least 13 genetic mutations that affect beta cell function but with little impact on insulin action

Question 33

What is hypoglycemia and which type is more at risk?

Answer 33

Called insulin shock or insulin reaction and type 1 diabetes is at more risk

Question 34

What is diabetic ketoacidosis (DKA)?

Answer 34

A serious complication related to deficiency of insulin and an increase of insulin counterregulatory hormones

Question 35

Disorders of the adrenal cortex are related to hyperfunction and hypofunction. Hyperfunction of increased cortisol causes what disease?

Answer 35

Cushing disease

Question 36

What is Cushing syndrome?

Answer 36

Clinical manifestations resulting from chronic exposure to excess cortisol regardless of cause

Question 37

What is Cushing disease?

Answer 37

Excess endogenous secretion of ACTH

Question 38

What is Addison disease?

Answer 38

Also termed Primary adrenal insufficiency, it is characterized by inadequate corticosteroid and mineralocorticoid synthesis and elevated levels of serum ACTH