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PAS- PATHOPHYSIOLOGY > CHAPTER 22 > Flashcards

CHAPTER 22 Flashcards

1
Q 
diseases of the posterior pituitary 
posterior pituitary functioning:
-hyperfunction:
-antidiuretic hormone effects:
--\_\_\_\_\_
-examples of diseases 
--\_\_\_\_\_ secretion
  • hypofunction
  • antidiuretic hormone effects
  • -_____
  • examples of diseases
  • -_____
  • -_____
  • -_____
  • -_____
A 
too much
syndrome of inappropriate antidiuretic syndrome (SIADH)
too little
diabetes insipidus
neurogenic 
nephrogenic 
dipsogenic
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2
Q

hyponatremia

-_____ is under Hyponatremia

A

SIADH

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3
Q

Diseases of the Posterior Pituitary

  • Syndrome of inappropriate antidiuretic hormone (SIADH) secretion
  • -Levels of antidiuretic hormone (ADH) are abnormally high.
  • -_____ secretion of _____ is the most common cause; is also common after surgery and some cancers.
  • -Water retention and dilutional hyponatremia : Action of ADH on _____ increases their permeability to _____, thus increasing _____ by the _____.
  • -For diagnosis, normal renal, adrenal, and thyroid function must exist.
A 
Ectopic
ADH
renal collecting ducts
water
water reabsorption
kidneys
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4
Q

Clinical manifestations Lab values

  • Hyponatremia: _____ mEq/L
  • Hypoosmolality: _____ mOsm/kg
  • Urine hyperosmolality: _____ than serum osmolality
  • _____
  • Weight _____
  • Serum sodium levels below _____ mEq/L: Can cause severe and sometimes irreversible _____ damage
A 
Sodium <135
<280
Higher
Hypervolemia
gain
110 to 115
neurologic
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5
Q

clinical manifestations of diseases of the posterior pit

name 5

A 
Lethargy
Hyponatremia
perhaps seizure
 decreased plasma osmolarity
 concentrated urine
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6
Q 
Diseases of the Posterior Pituitary
-\_\_\_\_\_-Sodium levels are high..
Insufficiency of ADH
-\_\_\_\_\_ and \_\_\_\_\_
-Partial or total inability to concentrate the \_\_\_\_\_
-Neurogenic
--Insufficient amounts of \_\_\_\_\_
-Nephrogenic
--Insensitivity of the \_\_\_\_\_ to ADH
-Dipsogenic
--Excessive \_\_\_\_\_ intake, lowering \_\_\_\_\_ to the point that it falls below the threshold for ADH secretion
A 
Diabetes insipidus
Polyuria
polydipsia
urine
ADH
renal collecting tubules
fluid
plasma osmolarity
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7
Q

diseases of the posterior pituitary
Diabetes insipidus

Is characterized by the inability of the _____ to _____ to _____.
–Excretion of large volumes of _____ urine
Increase in plasma osmolality: _____ mOsm or more, depending on adequate water intake
Urine output: _____ L/day; normal output: _____ L/day

Lab Clinical manifestations

  • _____, _____, continual thirst
  • Low urine-specific gravity: <1.010
  • Low urine osmolality (<200 mOsml/kg)
  • _____

Clinical manifestations
-Polydipsia, nocturia, _____,, _____, increased _____, large volume of dilute urine

–The basic criteria for diagnosing DI include a ______ while sodium levels are _____.

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 _____

A 
kidney
increase permeability 
water
dilute
300
8 to 12
1 to 2
Polyuria
nocturia
Hypernatremia
polyuria
hypernatremia
plasma osmolality
low urine-specific gravity
high
Neurogenic
treatable
Nephrogenic
insensitivity
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8
Q

diseases of the anterior pituitary
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
-Treatment
–Replacement of deficient hormone(s)

A

Panhypopituitarism

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9
Q

diseases of the anterior pituitary
Hyperpituitarism
-Clinical manifestations
–Headache and fatigue
—_____-pressure of the tumor on the optic chiasm
—Hypersecretion of pituitary from _____
—Hyposecretion of neighboring _____

A

Visual changes
tumor
anterior pituitary hormones

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10
Q

If there is pressure exerted by a pituitary tumor
-If the tumor exerts sufficient _____, then _____ and _____ may occur because of lack of _____ and _____

-These result in the symptoms of _____ and _____.

A 
pressure
thyroid
adrenal hypofunction
thyroid-stimulating hormone (TSH)
adrenocorticotropic hormone (ACTH)
hypothyroidism
hypocortisolism
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11
Q

Visual disturbances are a result of a pituitary adenoma

-Due to the pressure of the _____ on the _____!!!!

A

tumor

optic chiasm

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12
Q

Diseases of the AnteriorPituitary
Hypersecretion of GH
-Giantism
–_____ in children and adolescents because the the _____ have not yet closed.
-_____- Hypersecretion of growth hormone
–Hypersecretion of GH during _____
–Slowly progressive _____
—Co-morbid conditions: _____; _____; _____; _____, leading to _____
—Other malignancies: Common

A 
GH hypersecretion
Epiphyseal plates
Acromegaly
adulthood
pituitary adenoma
Cardiac hypertrophy
hypertension
atherosclerosis
type 2 diabetes mellitus
coronary artery disease
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13
Q

diseases of the anterior pituitary
Hypersecretion of prolactin
-Caused by _____
–Most common _____ active pituitary tumor
–In women: _____, _____, _____, and _____
In men: _____, _____

Treatment
Bromocriptine, cabergoline, and pergolide (dopaminergic agonists): Rapid reduction in the size of the tumor and a reversal of the gonadal effects
Resistant or intolerant to medication: Transsphenoidal surgery, endonasal endoscopic surgery, and radiotherapy

A 
prolactinomas
hormonally
Amenorrhea
halactorrhea
hirsutism
osteoporosis
Hypogonadism
erectile dysfunction
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14
Q

alterations of thyroid function

  • _____: Hypersecretion of thyroid hormone- _____
  • -Cause is an _____; develops autoantibodies. _____ immunoglobulin that causes overproduction of thyroid hormones.
  • Clinical manifestations
  • -Ophthalmopathy
  • –Exophthalmos: Increased secretion of hyaluronic acid, orbital fat accumulation, inflammation, and edema of the orbital contents
  • –Diplopia: Double vision
  • -Pretibial myxedema (Graves dermopathy): Leg swelling
  • Treatment
  • -Antithyroid drugs, radioactive iodine, or surgery
  • -Does not reverse infiltrative ophthalmopathy or pretibial myxedema
A

Hyperthyroid condition
Graves disease
autoimmune disease
Thyroid-stimulating

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15
Q

graves disease

  • The level of _____ (_____) in individuals with Graves disease is usually _____.
  • Palpation of the _____ of a person diagnosed with Graves disease would detect a _____ that is diffusely _____.
A 
thyroid-stimulating hormone (TSH)
low
neck
thyroid
enlarged
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16
Q

Alterations of ThyroidFunction
thyrotoxic crisis (thyroid storm)
-Clinical manifestations
–_____; _____, especially atrial _____; _____-output heart failure; agitation or delirium; and _____, vomiting, or _____

A 
Hyperthermia
tachycardia
tachydysrhythmias
high
nausea
diarrhea
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17
Q

alterations of thyroid function

  • Primary hypothyroidism
  • -A deficiency of chemical: _____ deficiency (_____): Most common worldwide
A

Iodine

endemic goiter

18
Q

alterations of thyroid function
Hypothyroidism (cont’d)
-Thyroid carcinoma
–Most common endocrine malignancy from ionizing radiation
–Changes in voice and swallowing and difficulty in breathing, related to a tumor growth impinging the trachea or esophagus
–Some may have normal T3 and T4 levels
–Diagnosis is with _____

A

fine- need aspiration biopsy

19
Q

alterations of thyroid function
Hypothyroidism (cont’d)
-Clinical manifestations
–Low _____ , decreased _____, _____ intolerance, _____, _____, _____, and slightly lowered _____; also possible _____ hypertension
–_____- Hyposecretion of thyroid hormone
—Nonpitting, boggy edema, especially around the eyes, hands, and feet; thickening of the tongue
–Myxedema coma
—Medical emergency, diminished level of consciousness; hypothermia without shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis, and coma

A 
basal metabolic rate
heart rate
cold
constipation
lethargy
tiredness
basal body temperature
diastolic
Myxedema
20
Q 
Alterations of Parathyroid Function
hyperparathyroidism
-Secondary hyperparathyroidism
--Increase in \_\_\_\_\_, secondary to a \_\_\_\_\_
----\_\_\_\_\_
A

PTH
chronic disease
Chronic renal failure

21
Q

alterations of parathyroid function
hypoparathyroidism
-Usual cause-Most common cause is _____ in _____

A

Parathyroid damage

thyroid surgery

22
Q

alterations of parathyroid function

  • hypoparathryoidism
  • -clinical manifestations:
  • –Hypocalcemia
  • –Lowering of the threshold for nerve and muscle excitation
  • —-_____; ______; tonic-clonic _____; _____ spasms; death from _____ and _____
A 
Muscle spasms
hyperreflexia
seizures
laryngeal
asphyxiation 
Chvostek
Trousseau signs
23
Q

Type 1 Diabetes Mellitus

  • Clinical manifestations
  • -Long preclinical period with gradual beta cell destruction, leading to insulin deficiency and hyperglycemia
  • –An 80% to 90% loss of function of the insulin-secreting beta cells in the islet of Langerhans occurs before hyperglycemia develops
  • -Polydipsia, _____, polyphagia, weight loss, and fatigue
A

polyuria

24
Q

Why polyuria in Diabetes??
-_____ accumulates in the blood and appears in the _____ as the renal threshold for glucose is exceeded, producing an _____ and the symptoms of _____ and _____.

A 
Glucose
urine
osmotic diuresis
polyuria
thirst
25
Q

Type 2 Diabetes Mellitus

  • Insulin resistance
  • -Response of insulin-sensitive tissues (especially _____, _____, and _____) to insulin is suboptimal.
  • -_____ makes one prone to insulin resistance.

Treatment
-Exercise, diet, treatment of obesity, _____, bariatric surgery

A 
liver
muscle
adipose tissue
Obesity
oral hypoglycemics
26
Q

Hypoglycemics Medications
-_____ (_____) - decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake

_____ (_____) - increase insulin from the pancreas

_____ (_____) -increase insulin from the pancreas

_____ (_____) -block the glucose in the intestinal lining.

A

Biguanide (metformin)
Meglitinides (glinides)
Sulfonylureas (glyburide)
a-Glycosidase inhibitor (miglitol)

27
Q

Gestational Diabetes Mellitus

-If gestational diabetes mellitus develops, then the risk for _____ increases.

A

type 2 diabetes

28
Q

Hypoglycemia

  • Lowered _____ level
  • -Newborns: Less than _____ mg/dl
  • -Children and adults: Less than _____ mg/dl
  • Called insulin shock, insulin reaction

Clinical manifestations
-_____, _____, _____, _____, _____, decreased level of _____, perhaps _____

A 
plasma glucose
35
45 to 60
Tachycardia
diaphoresis
tremor
pallor
confusion
consciousness
seizure
29
Q

Hypoglycemia caused by increased exercise
-_____, lightheadedness, _____, _____, headache, and confusion.

The most probable cause of these symptoms is _____, which is often caused by a lack of _____ as a result of _____ activity.

A 
Hunger
tachycardia
pallor
hypoglycemia
systemic glucose
muscular
30
Q

Diabetic Ketoacidosis

  • Clinical manifestations
  • -_____, decreased level of _____, _____ breathing, _____ smell breath, hyperglycemia, decreased pH, _____, glycosuria
A 
Polyuria
conscious
Kussmaul
acetone
ketonuria
31
Q

chronic complications of diabetes mellitus

  • Microvascular disease
  • -Diabetic _____
  • -Diabetic _____
  • -Diabetic _____

-Macrovascular disease
–_____
–_____
–_____
Infection

A 
retinopathy
nephropathy
neuropathies
Coronary artery disease
stroke
Peripheral arterial disease
32
Q

Microvascular Disease is a result of

  • Characteristics
  • _____ complications are a result of _____ thickening and endothelial cell _____.
A

Microvascular
capillary basement membranes
hyperplasia

33
Q

Diabetic Retinopathy

  • Develops more rapidly in type 2 diabetes.
  • -Retinopathy develops in patients with _____ because of progressive process that accompanies _____, _____, _____ and red blood cell _____ occurs.
A 
diabetes mellitus
retinal capillary permeability
vessel occlusion
rential ischemia
aggregration
34
Q

Diabetic Nephropathy

-_____- The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy.

A

Microalbuminuria

35
Q

Cushing Diseaseand Cushing Syndrome

  • Cushing disease
  • -Hypersecretion of _____ by a _____
  • -Lose diurnal and circadian patterns of ACTH and cortisol secretion
  • -Lack of ability to increase ACTH and cortisol in response to stressors
A 
adrenocorticotropic hormone (ACTH)
pituitary adenoma
36
Q

Cushing Disease or and Cushing SyndromeClinical manifestations

  • _____
  • _____
  • _____
  • _____
A

acne
easy bruising
thin extremities
truncal obesity

37
Q

Hyperaldosteronism

-Primary (_____, primary _____)-_____ of aldoestrone

A

Conn disease
aldosteronism
Hypersecretion

38
Q

Addison Disease

-Primary adrenal insufficiency, hypocortisolism, _____ of _____!!!

A

Hyposecretion

adrenal cortex hormones

39
Q

Disorders of the Adrenal Medulla
hyperfunction
-Tumor of the adrenal medulla
–_____

A

Pheochromocytoma

40
Q

Disordersof the Adrenal Medulla

Adrenal medulla hyperfunction: _____-Hypersecretion of _____!!

A

Pheochromocytomas

adrenal medulla hormones

PAS- PATHOPHYSIOLOGY (17 decks)

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