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Pathophysiology > Chapter 22 > Flashcards

Chapter 22 Flashcards

1
Q

Acromegaly

A
  • is a rare condition characterized by an overproduction of growth hormone (GH)
  • most often occurs because of a benign growth hormone-secreting pituitary adenoma
  • results in an overgrowth of soft tissues and bones in the hands, feet, and face
  • prognosis depends of age at onset, age when treatment started, and tumor size
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2
Q

ACTH deficiency

A
  • with associated loss of cortisol, is a potentially life-threatening disorder
  • generalized pituitary hypofunction
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3
Q

Advanced glycation end product (AGE)

A
  • with recurrent or persistent hyperglycemia, glucose becomes irreversibly bound to collagen and other proteins in RBCs, blood vessel walls, interstitial tissue, and within cells. The products of this binding are known as AGE
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4
Q

Autoimmune thyroiditis (Hashimoto disease, chronic lymphocytic thyroiditis)

A
  • is caused by the destruction of thyroid tissue by antibodies
  • it is the most common cause of hypothyroid goiters in the US
  • As thyroid tissue is destroyed by antibodies, there may be a transient phase of hyperthyroidism due to leaking thyroid hormone from the damaged tissues
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5
Q

Central (secondary) hyperthyroidism

A
  • is less common than primary and is caused by TSH-secreting pituitary adenomas
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6
Q

Congenital hypothyroidism

A
  • is caused by thyroid hormone deficiencies during fetal or early neonatal life
  • AKA cretinism
    -All infants are screened for decreased thyroid function at birth
  • Treatment is synthroid
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7
Q

Cushing disease

A
  • refers to excess endogenous secretion of ACTH
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8
Q

Cushing-like syndrome

A
  • may develop as a side effect of long-term pharmacologic administration of glucocorticoids
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9
Q

Cushing syndrome

A
  • refers to the clinical manifestations resulting from chronic exposure to excess endogenous cortisol
  • more common in women
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10
Q

Dawn phenomenon

A
  • is an early morning rise in blood glucose concentration caused by nocturnal elevations of GH, which decreases metabolism of glucose by muscle and fat
  • increasing the dose of evening insulin manages the problem
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11
Q

Diabetes insipidus

A
  • is an insufficiency of ADH, leadign to polyuria and polydipsia
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12
Q

Exopthalmos

A
  • protrusion of the eyeball
  • present in hypothyroid diseases such as Graves disease
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13
Q

Familial hypocalciuric hypercalcemia (FHH)

A
  • is a benign autosomal dominant condition that can mimic hyperparathyroidism and is characterized by a high serum calcium level, low serum phosphate level, and low urine calcium excretion
  • caused by the mutation in the calcium-sensing receptor in the parathyroid gland
  • differentiated from primary hyperparathyroidism gland by measurement of 24-hr urine calcium excretion, which is very low in FHH
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14
Q

Feminization

A
  • caused by hypersecretion of estrogens
  • the development of female sex characteristics
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15
Q

FSH deficiency

A
  • the onset of FSH and LH deficiencies in women of reproductive age is associated with amenorrhea and with atrophy in the vagina, uterus, and breasts
  • in postpubertal males, the testicles atrophy and facial hair growth is diminished
  • both men and women experience a decrease in body hair and libido
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16
Q

GH deficiency

A
  • occurs in children and adults
  • may result from any of the causes of hypopituitarism
  • in children, it is manifested as hypopituitary dwarfism
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17
Q

Ghrelin

A
  • DM
  • is a peptide produced in the stomach and pancreatic islets that regulates food intake, energy balance, and hormonal secretion
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18
Q

Giantism

A
  • in children or adolescents whose epiphyseal plates have not yet closed, the effect of increased GH levels causes excessive skeletal growth, with some individuals becoming 8- or 9-feet tall
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19
Q

Glucagon

A
  • Glucagon is one of several counterregulatory hormones released in response to cellular deficiency of glucose.
  • Glucagon suppresses insulin and stimulates hepatic glucose production (from glycogen), resulting in elevated glucose levels.
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20
Q

Glycation

A
  • is a normal nonenzymic process that involves the reversible attachment of glucose to proteins, lipids, and nucleic acids
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21
Q

Graves disease

A
  • hyperthyroid condition
  • characterized by diffuse thyroid enlargement and excess thyroid hormone secretion
  • the patient develops antibodies to the TSH receptor. These antibodies attach to the receptors and stimulate the thyroid gland to release T3, T4, or both
  • the excess release of thyroid hormones leads to the clinical manifestations associated with thyrotoxicosis
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22
Q

Hyperaldosteronism

A
  • is characterized by excess aldosterone secretion by the adrenal cortex
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23
Q

Hypercortisolism

A
  • hyperfunction that causes increased secretion of cortisol
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24
Q

Hyperparathyroidism

A
  • is a condition involving an increased secretion of parathyroid hormone (PTH)
  • associated with increased serum calcium levels
25
Q

Hypocortisolism

A
  • low levels of cortisol secretion
26
Q

Hypoparathyroidism

A
  • is an uncommon condition associated with inadequate circulating PTH
  • characterized by hypocalcemia
27
Q

Hypopituitarism

A

is a rare disorder that involves a decrease in one or more of the pituitary hormones
- most common hormone deficiencies associated with hypopituitarism involve GH and gonadotropins

28
Q

Hypothyroidism

A
  • a deficiency of thyroid hormone that causes a general slowing of the metabolic rate
  • patients with overt hypothyroidism have elevated TSH and decreased thyroxine levels
29
Q

Iatrogenic hypothyroidism

A
  • results from radioiodine thyroid ablation, thyroidectomy, and medications (lithium and amiodarone)
30
Q

Incretin

A
  • DM
  • are a class of peptides that are released from the GI tract in response to food intake and function to increase synthesis and secretion of insulin and beta-cell proliferation and regeneration, and protection against beta-cell damage
31
Q

Iodine deficiency (endemic goiter)

A
  • is the most common cause of primary hypothyroidism
  • rare in US due to use of iodized salt and fortified foods
32
Q

LH deficiency

A
  • the onset of FSH and LH deficiencies in women of reproductive age is associated with amenorrhea and with atrophy in the vagina, uterus, and breasts
  • in postpubertal males, the testicles atrophy and facial hair growth is diminished
  • both men and women experience a decrease in body hair and libido
33
Q

Macular edema

A
  • DM
  • fluid accumulation and retinal thickening near the center of the macula
34
Q

Metabolic syndrome

A

-Metabolic syndrome has five components: elevated glucose levels, abdominal obesity,
elevated BP, high levels of triglycerides, and decreased levels of high-density lipoproteins (HDLs).
- An individual with three of the five components is considered to have metabolic syndrome.
- Individuals with metabolic syndrome are at an increased risk for the development of type 2 diabetes.

35
Q

Myxedema

A
  • a characteristic sign of severe or long-standing hypothyroidism
  • nonpitting, boggy edema around the eyes, hands, and feet
  • the tongue and laryngeal and pharyngeal mucous membranes thicken, producing thick, slurred speech and hoarseness
36
Q

Myxedema coma

A
  • medical emergency
  • is a diminished level of consciousness associated with severe hypothyroidism
  • s/sx: hypothermia, hypoventilation, hypotension, hypoglycemia, lactic acidosis, and coma
37
Q

Nephrogenic diabetes insipidus

A
  • is caused by the inadequate response of the renal tubules to ADH and is usually acquired or may be genetic
38
Q

Neurogenic (central) diabetes insipidus

A
  • is caused by the insufficient secretion of ADH
  • it occurs when any organic lesion of the hypothalamus, pituitary stalk, or posterior pituitary interferes with ADH synthesis, transport, or release
39
Q

Nontoxic nodular goiter

A
  • hyperthyroidism
  • is more common in iodine-deficient regions and may require decompression with associated with airway, esophageal, or venous obstruction
40
Q

Painless (silent) thyroiditis (silent or subacute lymphocytic thyroiditis)

A
  • hypothyroid
  • is pathologically identical to Hashimoto disease
41
Q

Panhypopituitarism

A

A total failure of the pituitary gland results in a deficiency of ALL pituitary hormones

42
Q

Pheochromocytoma

A
  • cause the hyperfunction of the adrenal medulla (produces epi and nor-epi)
43
Q

Pituitary adenoma

A
  • hyperpituitarism
  • are usually benign slow-growing tumors that arise from cells of the anterior pituitary
44
Q

Polyol pathway

A
  • DM
  • with hyperglycemia, intracellular glucose is shunted into an alternate metabolic pathway for glucose metabolism
  • overactivation of this pathway results in the accumulation of sorbitol and reduces glutathione (antioxidant)
45
Q

Postpartum thyroiditis

A
  • hypothyroid
  • pathologically related to Hashimoto disease and generally occurs within 6 to 12 months of delivery with a course similar to that of painless thyroiditis
46
Q

Pretibial myxedema (Graves dermapathy)

A
  • hyperthyroid
  • characterized by subcutaneous swelling on the anterior portions of the legs and by indurated and erythematous skin
47
Q

Primary adrenal insufficiency (hypocortisolism and hypoaldosteronism)

A
  • Addison’s disease
  • bronze pigmentation of skin
  • weight loss
  • weakness
  • hypoglycemia
  • low sodium, high potassium
48
Q

Primary hyperaldosteronism (Conn syndrome, primary aldosteronism)

A
  • is most commonly caused by a small solitary adrenocortical adenoma
  • hypertension with hyperkalemic alkalosis
49
Q

Primary hyperthyroidism

A
  • Graves disease
  • toxic multinodular goiter
  • solitary toxic adenoma
  • follicular thyroid carcinoma
50
Q

Primary hypothyroidism

A
  • is caused by the destruction of thyroid tissue or defective hormone synthesis
51
Q

Primary thyroid disorder

A

result in alterations of thyroid hormone (TH) levels with secondary feedback effects on pituitary TSH levels

52
Q

Prolactinoma

A

are the most common of the hormonally active pituitary adenomas

53
Q

Secondary hypothyroidism

A
  • is caused by pituitary disease with decreased TSH secretion or hypothalamic dysfunction with decreased thyrotropin-released hormone (TRH) secretion
54
Q

Somogyi effect

A
  • is the occurrence of hypoglycemia at about 0300 caused by too much intermediate-acting insulin given at dinner, followed by rebound hyperglycemia caused by normal early morning secretion of counter-regulatory hormones
55
Q

Subclinical hypothyroidism

A

occurs when the TSH is greater than 4.5 mU/L, but the thyroxine (T4) levels are normal

56
Q

Syndrome of innapproriate antidiuretic hormone (SIADH) secretion

A
  • increased ADH
  • small amount of concentrated urine
  • low Na
57
Q

TSH deficiency

A
  • is rarely seen in isolation but occurs in conjunction with other pituitary hormone deficiencies
  • symptoms develop 4 to 8 weeks after hypothyrotropinemia occurs and includes cold intolerance, skin dryness, mild myxedema, lethargy, and decreased metabolic rate
  • the symptoms are usually less severe than those associated with primary hypothyroidism
58
Q

Virilization

A
  • the development of male sex characteristics
  • caused by hypersecretion of androgens

Pathophysiology (8 decks)

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