Chapter 4 - Endocrine Diseases and Disorders

Question 1

Gigantism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 1

(1) Abnormal growth and stature (tall as the name suggests)
(2) Proportional overgrowth of all body tissue; sexual and mental development may be retarded
(3) Anterior pituitary adenoma causes oversecretion of GH before puberty
(4) Reduction of GH secretion through surgery to reduce gland size and/or medications to suppress it

Question 2

Acromegaly
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 2

(1) Chronic metabolic condition of adults caused by hypersecretion of GH
(2) Noticeable growth of hands, feet, and jaw. Possible joint pain
(3) Hypersecretion of GH usually caused by a pituitary adenoma
(4) Surgery to remove tumor and/or medications to reduce pituitary gland size

Question 3

Hypopituitarism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 3

(1) Condition caused by deficiency or absence of any of the anterior pituitary hormones
(2) Complex; metabolic dysfunction, sexual immaturity, growth retardation. Varies with specific hormone deficiency. Deficiency in hormones that stimulate other glands may result in atrophy of those glands (Ie. TSH affects the thyroid function)
(3) Can be pituitary tumor or tumor of hypothalamus. Can be a congenital deficiency; can be acquired such as from damage from radiation or trauma.
(4) Removal of tumor if that is the cause, hormone supplement therapy

Question 4

Dwarfism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 4

(1) Deficiency in pituitary GH in children; results in adult height less than 4’10”
(2) Physical growth retardation; does not develop secondary sex characteristics; often linked to other defects
(3) Congenital, cranial tumor, hemorrhage. Deficiency in growth hormone resulting from hypothalamus is secondary hypopituitarism and can result from head trauma, tumor, or infection
(4) Somatotropin (a hormone replacement for GH) is administered. Other hormone therapy, such as sex hormones, may also be necessary

Question 5

Diabetes Insipidus
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 5

(1) Disturbance in water metabolism resulting in excess thirst and dilute urine
(2) Polyuria, polydipsia, fatigue; symptoms of dehydration including: dry mucous membranes, hypotension,
(3) Deficiency in ADH from posterior pituitary gland. Can be genetic or trauma (tumor or other). Or nephrogenic (kidneys not using ADH appropriately)
(4) Vasopressin (ADH) injections, nasal spray, or oral desmopressin acetate. In nephrogenic cases, thiazide diuretics are used

Question 6

Simple goiter
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 6

(1) Enlargement of thyroid gland evidenced by enlargement of the neck
(2) Enlargement of thyroid can be asymptomatic or cause difficulty swallowing or breathing if severe. Hyperthyroidism may occur, entailing: weight loss, increased appetite, diarrhea, heat intolerance, sweating, tachycardia
(3) Can result from shortage of iodine In the diet; which is needed for T3 and T4 production. TSH tries and fails to stimulate thyroid to make more, resulting in increased size
(4) Administration of saturated potassium iodide, occasionally T4 is administered.

Question 7

Hashimoto thyroiditis (chronic lymphocytic thyroiditis)
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 7

(1) Chronic disease of the immune system causing it to attack the thyroid
(2) Causes goiter and hypothyroidism (which entails sensitivity to cold, fatigue, weight gain, depression, bradycardia, and other symptoms)
(3) Mainly genetic; autoantibodies attack the thyroid and its tissue is replaced by fibrous tissue
(4) Lifelong replacement of thyroid hormones

Question 8

Graves disease
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 8

(1) Condition of primary hyperthyroidism
(2) Increased metabolism, heart palpitations, high HR, nervousness, insomnia, weight loss, perspiration, heat intolerance, muscle weakness, onycholysis (separation of nail from nail bed), exophthalmos of the eyes
(3) Believed to be genetic and autoimmune in nature
(4) Antithyroid drugs; other treatments for specific symptoms

Question 9

Cretinism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 9

(1) Congenital hypothyroidism
(2) Mental and physical growth retardation, lack of muscle tone, protruding abdomen, other distinctive physical characteristics
(3) Error in development causing incompetent thyroid, congenital absence of enzymes needed for T3 or T4 synthesis, maternal thyroid deficiency or antithyroid drugs. Common in areas with iodine deficiency
(4) Early treatment w/ thyroid hormone can reduce severity and facilitate normal physical growth. Hormone replacement therapy will be needed throughout life

Question 10

Myxedema and myxedema coma
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 10

(1) Hypothyroidism with distinctive clinical features related to low metabolism. Myxedema coma is the result of severe, untreated hypothyroidism exacerbated by an acute event
(2) Slowing function of multiple organs leads to: fatigue, muscular weakness, hair loss, weight gain, constipation, cold intolerance. Myxedema coma is a medical emergency that is often fatal
(3) Thyroid gland’s ability to synthesize T4 is impaired
(4) Lifelong hormone replacement. Myxedema coma requires immediate administration of T4 and treatment of underlying problems

Question 11

Thyroid cancer
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 11

(1) Neoplasm of the thyroid gland
(2) Symptoms may not manifest until condition is advanced. Hard and painless lump on thyroid gland, vocal cord paralysis, obstructive symptoms, cervical lymphadenopathy
(3) Genetics, radiation exposure,
(4) Surgery (thyroidectomy), chemo and/or radiation in some cases

Question 12

Hyperparathyroidism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 12

(1) Overactivity of one or more of the four parathyroid glands resulting in excess production of PTH
(2) Since PTH increases blood-calcium level by increasing bone demineralization and absorption from digestion, the excess PTH may cause symptoms that include: hypercalcemia, increased breakdown of skeleton, irritable nerve and muscle tissue, muscle weakness and atrophy, gastrointestinal pain, nausea, conduction defects in the heart, bone tenderness, arthritis-like pain,
(3) A growth on the parathyroid gland, idiopathy hyperplasia of the gland. Secondary hyperparathyroidism may be caused by increased PTH induced by low calcium or vitamin D, which is caused by renal disease or other disorders
(4) Very individualized and Variable; adenomas can be removed surgically, some of the 4 glands may be removed if hyperplasia is the cause. When the condition is secondary, the underlying cause must be treated and blood serum calcium levels reduced

Question 13

Hypoparathyroidism
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 13

(1)Secretion of PTH by parathyroid glands is reduced
(2) Since PTH increases blood-calcium level by increasing bone demineralization and absorption from digestion, the lack of PTH may cause symptoms including: hypocalcemia, excessive deposits of calcium in tissue, hyperexcitable nervous system, numbness/tingling fingertips/toes/ears/nose, muscular spasms of hands and feet, tetany (if severe), emotional changes
(3) Surgical destruction of parathyroid glands, injury to parathyroid glands, ischemia, radiation, neoplasia, or other disease process, congenital absence of glands.
(4) Calcium replacement therapy with vitamin D for life. In emergency, calcium gluconate is administered intravenously

Question 14

Cushing syndrome
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 14

(1) Chronic hypersecretion of the adrenal cortex which results in increased cortisol
(2) Fatigue, muscular weakness, weight gain, changes in body appearance, hypertension, edema, easy bruising, red/purple striae, decreased short term memory. Clinical evidence of hyperlipidemia, hyperglycemia, osteoporosis, and atherosclerosis may be present.
(3) Hyperplasia of the adrenal gland, excess corticotropin/ACTH from pituitary gland, tumor of adrenal cortex, or abnormal production of corticotropin in another organ.
(4) Depends on cause; surgical removal of tumor if that is the cause

Question 15

Addison Disease
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 15

(1) Partial or complete failure of adrenocortical function
(2) Symptoms gradually manifest and include: fatigue, weakness, anorexia, agitation, confusion, weight loss, gastrointestinal disturbances, bronze discoloration of the skin, reduced cardiac output, irregular pulse, postural hypotension, emotional disturbances. Reduced aldosterone causes inability to retain salt and water which can contribute to life-threatening electrolyte imbalances
(3) Destruction of the adrenal gland may result from: an autoimmune process, tuberculosis, hemorrhage, fungal infection, neoplasm, or surgery
(4) Hormone replacement, correction of salt and potassium levels,

Question 16

Diabetes Mellitus
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 16

(1) Chronic disorder of carbohydrate, fat, and protein metabolism caused by inadequate production of insulin by the pancreas or use of insulin by the cells
(2) A reduction in insulin causes hyperglycemia, cells metabolize fats and proteins allowing ketone bodies to accumulate, ketonuria, acidosis, polyuria, polyphagia, polydipsia, weight loss, fatigue, pruritus. Poorly managed diabetes can lead to retinopathy, neuropathy, renal failure, atherosclerosis, cerebrovascular incidents, impaired resistance to infection
(3) Often familial but may be acquired. In type 1, an infection often triggers the autoimmune process that destroys pancreas beta cells. Type 2 tends to occur in older, overweight adults
(4) Insulin replacement therapy for type 1; diet and exercise moderation for type 2. Various medications may be used for people with type 2

Question 17

Gestational diabetes
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 17

(1) Damaged ability to process carbohydrates that has an onset during pregnancy
(2) Detected 24-28 weeks into gestation; asymptomatic or symptoms including: polydipsia, polyuria, polyphagia
(3) Increased destruction of insulin by placenta plays a role in the pathogenesis of GDM. The fetus stresses the insulin-glucose balance of the mother and elevated estrogen and progesterone blocks insulin action.
(4) Control of diet, moderate exercise such as walking, blood-glucose must be monitored and insulin may be used

Question 18

Hypoglycemia
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 18

(1) Abnormally low glucose in blood
(2) Sweating, nervousness, weakness, hunger, dizziness, trembling, headache, palpitations; severe hypoglycemia can cause: confusion, visual disturbances, behavior similar to drunkenness, stupor, coma, and seizures
(3) insulin overdose or intense exercise or absence of fuel in diabetic patient, significantly high blood alcohol, other drugs, fasting, idiopathic excessive secretion of insulin by pancreas, adenoma or carcinoma of pancreas, gastrointestinal or hereditary or endocrine disorders
(4) Intravenous infusion of glucose, glucagon, correct underlying issue

Question 19

Precocious puberty in boys
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 19

(1) Onset of puberty before age 9
(2) Early development of secondary sex characteristics, gonadal development, spermatogenesis. Altered growth pattern, emotional disturbance, public and facial hair, gonads and penis increase in size, sebaceous gland activity increases
(3) Genetics, pituitary dysfunction, testicular tumor, ingestion of sex steroids
(4) Treatment may not be needed if idiopathic. Tumors removed if they are the cause. Medications may be taken to delay puberty

Question 20

Precocious puberty in girls
(1) Description
(2) S&S
(3) Etiology
(4) Treatment

Answer 20

(1) Onset of puberty before age 8
(2) Increased growth rate, breast enlargement, pubic and underarm hair, menstruation before age 10
(3) Idiopathic oftentimes. Can be caused by intracranial tumors, encephalopathy, meningitis, endocrine disorders, ovarian or adrenal neoplasms
(4) Depends on cause. Tumors require surgery or radiation, hormone therapy to prevent menstruation,