Chapter 22 Flashcards
disorders of the adrenal medulla
hyperfunction
_____ of adrenal medulla
-_________
tumor
pheochromocytoma
If there is pressure exerted by a pituitary tumor
If the tumor exerts sufficient pressure, then ______ and _______ hypofunction may occur because of lack of _____ and _____
These result in the symptoms of _______ and _______
thyroid, adrenal
TSH, ACTH
hypothyroidism
hypocortisolism
Diabetes insipidus (cont’d)
Treatment
______: This form of diabetes insipidus (DI) is ______ with exogenous antidiuretic hormone ADH Administration of the synthetic vasopressin analog desmopressin acetate (DDAVP)
________: this form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate _______
neurogenic
treatable
nephrogenic
insensitivity
diabetic nephropathy
Most common cause of end-stage kidney disease in the Western world
________- The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy
microalbuinuria
posterior pit clinical manifestations lab values: \_\_\_\_\_\_\_\_: Sodium <135 mEq/L \_\_\_\_\_\_\_\_\_\_: <280 mOsm/kg \_\_\_\_\_\_\_\_\_: Higher than serum osmolality -\_\_\_\_\_\_\_\_\_ -\_\_\_\_\_\_\_\_\_\_ Serum sodium levels below \_\_\_ to \_\_\_ mEq/L: Can cause severe and sometimes irreversible \_\_\_\_\_\_\_ damage
hyponatremia hypoosmolality urine hyperosmolality hypervolemia weight gain 110, 115 neurologic
diabetes insipidus and SIADH both present with
excessive thirst
diseases of anterior pit
_________
Commonly from benign, slow-growing pituitary adenoma
Clinical manifestations
- Headache and fatigue
- Visual changes-pressure of the tumor on the _______
- ______ of pituitary from tumor
- ______ of neighboring anterior pituitary hormones
hyperpituitarism
optic chiasm
hypersecretion
hyposecretion
alterations of thyroid function
Rare but life threatening within 48 hours if not treated.
Results from excessive stress
clinical manifestations: 1 2 \_\_\_\_\_ especially \_\_\_\_\_\_\_ 3 4 \_\_\_\_\_\_ or \_\_\_\_\_\_ 5 6
Hyperthermia; tachycardia, especially atrial tachydysrhythmias; high-output heart failure; agitation or delirium; and nausea, vomiting, diarrhea
hyponatremia:
_______ is under hyponatremia
SIADH
type 2 diabetes
Insulin resistance
-Response of insulin-sensitive tissues (especially ____, _____, and ______ tissue ) to insulin is suboptimal.
-______ makes one prone to insulin resistance.
treatment:
liver, muscle, adipose tissue
obesity
hypoglycemics
chronic complications of diabetes
microvascular disease
1
2
3
macrovascular disease
1
2
3
diabetic retinopathy diabetic nephropathy diabetic neuropathies coronary artery disease stroke peripheral arterial disease
diseases of the anterior pit
Hypopituitarism (cont’d)
_________- a lack of all hormones associated with the anterior pituitary is:
-Adrenocorticotropic hormone (ACTH) deficiency
Cortisol deficiency
-Thyroid-stimulating hormone (TSH) deficiency
Altered metabolism
-Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) deficiency
Lack of secondary sex characteristics
-Growth hormone (GH) deficiency
Lack of growth in children
Panhypopituitarism
gestational diabetes
if the gestational diabetes melliitus develops, then the risk for type __ diabetes increases
2
Visual disturbances are a result of ________
Due to the pressure of the tumor on the _________!!!!
pituitary adenoma
optic chiasm
diseases of post pit
Diabetes insipidus-Sodium levels are _____..
-Insufficiency of _____
-_____and _____
-Partial or total inability to concentrate the ______
Neurogenic
-Insufficient amounts of ____
Nephrogenic
-Insensitivity of the _____________s to ADH
Dipsogenic
-_______ fluid intake ________ plasma osmolarity to the point that it falls below the threshold for ADH secretion
high ADH polyuria, polydipsia urine ADH renal collective tubules excessive lowering excessive lowering
alterations of thyroid function
Primary hypothyroidism
-A deficiency of chemical: ______ deficiency ( ______): Most common worldwide
iodine
endemic goiter
CHART for diseases of post pit
functioning: hypofunction
antidiuretic hormone effects:
examples of diseases:
too little Diabetes insipidus Neurogenic Nephrogenic Dipsogenic
posterior pit clinical manifestations 1 2 3 4 decreased \_\_\_\_\_\_\_\_\_ 5 concentrated \_\_\_\_\_\_
lethargy hyponatremia seizure plasma osmolarity concentrated urine
diseases of post pit Diabetes insipidus (cont’d)
Lab Clinical manifestations
- _____, _____ continual ______
- Low _______ gravity: <1.010
- Low urine ______ (<200 mOsml/kg)
- ________
Clinical manifestations
-_______, _____, _____, _____increased ________, large volume of _____ urine
The basic criteria for diagnosing DI include a ___ urine-specific gravity while sodium levels are ____
polyuria, nocturia, thirst
urine specific
osmolality
hypernatremia
polydipsia, nocturia, polyuria, hypernatremia, plasma osmlality
dilute
low
high
Microvascular Disease is a result
characteristics
-Microvascular complications are a result of capillary basement membranes ____ and _____cell _____
thickening
endothelial
hyperplasia
CHART for diseases of post pit
functioning: hyperfunction
antidieuretic hormone effects:
examples of diseases:
too much
Syndrome of inappropriate antidiuretic hormone (SIADH) secretion
cushing disease and cushing syndrome
Cushing disease
Hypersecretion of ____ by a pituitary adenoma
ACTH
alterations of parathyroid function
Secondary hyperparathyroidism
-Increase in ___, secondary to a chronic ______
Chronic _______
PTH
disease
renal failure
cushing disease or and c ushing syndrome clinical manifestations 1 2 3 4
acne
easy bruising
thin extremities
truncal obesity
addison disease
hypersecretion of ________ hormones
adrenal cortex
type 1 diabetes mellitus
why polyuria???
______ accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic _____ and the symptoms of ____and ____
glucose
dieuresis
polyuria
thirst
hypoglycemia
- lowered _____ level
- newborns: less than _
- children and adults: less than __ to __
clinical manifestations
_______, ______, _____, ______, _______, decreased level of ______, perhaps ______
plasm glucose 35 45, 60 tachycardia diaphoresis tremor pallor confusion consciousness seizure
diseases of the anterior pit
Hypersecretion of GH
_______
-GH hypersecretion in children and adolescents because the the ________ have not yet closed.
_______- Hypersecretion of growth hormone
- Hypersecretion of GH during adulthood
- Slowly progressive __________
1. Co-morbid conditions: Cardiac _______; _______; _______; type _ diabetes mellitus, leading to __________
2. Other malignancies: Common
giantism epiphyseal plates acromegaly pituitary adenoma hypertrophy hypertension atherosclerosis 2 coronary artery disease
diabetic rietinopathy
is the leading cause of blindness
Retinopathy develops in patients with diabetes mellitus because of progressive process that accompanies retinal capillary ______, vessel _____, rential ______ and red blood cell _______occurs.
permeability
occlusion
ischemia
aggregation
alterations of thyroid function
Hyperthyroid condition: Hypersecretion of thyroid hormone- ______ disease
Cause is an ________disease; develops autoantibodies. Thyroid-stimulating immunoglobulin that causes _______ of thyroid hormones.
graves disease
autoimmune
overproduction
Syndrome of inappropriate antidiuretic hormone (SIADH) secretion
Levels of antidiuretic hormone (ADH) are abnormally high.
_______ secretion of ADH is the most common cause; is also common after _____ and some ______
Water ______ and ________: Action of ADH on renal collecting ducts increases their _______ to water, thus increasing water _______ by the kidneys.
ectopic surgery cancers retention dilutional hyponatremia permeability reabsorption
diabetic ketoacidosis
clinical manifestations
______, decreased level of _______, ______ breathing, ______ smell breath, ________, decreased __, ______, _______
polyuria conscious kussmaul acetone hyperglycemia pH ketonuria glycosuria
Graves disease
The level of ___ in individuals with Graves disease is usually ___
_____ of the neck of a person diagnosed with Graves disease would detect a thyroid that is diffusely ____
TSH
low
palpation
enlarged
Hypoglycemia caused by ______ exercise
______, _______, ______, ____, ______, and _______.
The most probable cause of these symptoms is hypoglycemia, which is often caused by a lack of ______glucose as a result of muscular activity.
increased hunger lightheadedness tachycardia pallor headache confusion systemic
hyperaldosteronism Primary (\_\_\_\_ disease, primary aldosteronism)-Hypersecretion of aldoestrone
conn
diseases of post pit
Diabetes insipidus
Is characterized by the inability of the kidney to increase ______ to water.
- Excretion of large volumes of ____ urine
- Increase in plasma osmolality: ____ mOsm or more, depending on adequate water intake
- Urine output: _ to _L/day; normal output: _ to _ L/day
permeability dilute 300 8, 12 1,2
alterations in thyroid function
hypothyroidism
diagnosis is with _____ - _____________
clinical manifestations:
-___ basal metabolic rate , decreased ____, ___intolerance,_____, ______, _____, and slightly lowered ___body temperature; also possible ______ hypertension
-________- Hyposecretion of thyroid hormone
fine-need aspiration biopsy low heart rate cold constipation lethargy tiredness basal diastolic myxedema
hypoparathyroidism
usual cause - MCC is parathyroid damage in thyroid ______
Clinical manifestations:
- ______ spasms; _________; ________ seizures; ______ spasms; death from _________
- _______ and ______ signs
surgery muscle spasms hyperreflexia tonic-clonic asphyxiation chvostek trousseau
diseases of the anterior pit Hypersecretion of prolactin Caused by \_\_\_\_\_\_\_\_ Most common \_\_\_\_\_\_ active pituitary tumor In women: 1 2 3 4
In men:
1
2
prolactinomas hormonally amenorrhea galactorrhea hirsutism osteoporosis hypogonadism erectile dysfunction
hypoglycemics medications:
I. Biguanide (metformin)- decreases _____ glucose production and increases _____ sensitivity and _______glucose uptake
II. Meglitinides (glinides)- increase _____from the pancreas
III. Sulfonylureas (glyburide)-increase ____ from the pancreas
IV. a-Glycosidase inhibitor (miglitol)- ____ the glucose in the ______ lining.
hepatic insulin peripheral insulin insulin block intestinal
