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Patho > Chapter 41 Disorders of Endocrine Control of Growth and Metabolism > Flashcards

Chapter 41 Disorders of Endocrine Control of Growth and Metabolism Flashcards

1
Q

What is hypofunction?

A

underproduction of a hormone

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2
Q

what is hyperfunction?

A

over production of a hormone

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3
Q

What can hypofunction lead to?

A

congenital defects, disruption in blood flow, infection, inflammation, autoimmune responses

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4
Q

Why can drug therapy cause atrophy of the testes?

A

because you are having hormones come from an external source so the testes don’t need to produce as much hormone as it is already provided so it atrophies with disuse.

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5
Q

Can hyperfunction lead to hormone producing tumors of the gland?

A

yes

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6
Q

What are the categories of endocrine disorders?

A

primary, secondary, tertiary

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7
Q

What is a primary endocrine disorder?

A

Issue is with the gland itself - a disorder that originates in the target gland that is responsible for producing said hormone.

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8
Q

What are secondary endocrine disorders?

A

alterations in the stimulation of the hormone - target gland is normal but its function is altered by defective levels of hormones or releasing factors from the pituitary system

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9
Q

What are tertiary endocrine disorders?

A

result from hypothalamic dysfunction, the pituitary and the target organ are under stimulated

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10
Q

What are the 4 categories of pituitary tumors?

A

primary, secondary, functional and nonfunctional

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11
Q

what are primary pituitary tumors?

A

tumors that start in the pituitary

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12
Q

What are secondary pituitary tumors?

A

metastatic tumors - they come from somewhere else but end up in the pituitary

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13
Q

What are functional pituitary tumors?

A

tumors that secrete pituitary hormones

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14
Q

What are non functional pituitary tumors?

A

tumors that do not secrete pituitary hormones

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15
Q

What is hypopituitarism?

A

decreased secretion of the pituitary hormones

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16
Q

What are the manifestations of hypopituitarism?

A

chronically unfit, weakness and fatigue, loss of appetite, impairment of sexual function, cold intolerance

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17
Q

What are the hormones responsible for normal body growth?

A

GH, Insulin, thyroid hormone, androgens

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18
Q

What does growth hormone do?

A

helps you grow - stimulates linear bone growth, stimulates growth and division of cells, enhances amino acid transport, increases the rate that cells use fatty acids, decreases the rate that cells use carbs (helps control blood glucose levels)

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19
Q

When do children usually secrete GH?

A

at night

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20
Q

What are some causes of short stature?

A

gh deficiency, chromosomal abnormalities, protein-calorie malnutrition, chronic diseases, poorly controlled diabetes, malabsorption syndromes, trauma…

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21
Q

Why does a growth hormone deficiency occur in children

A

can either be congenital or idiopathic – for some reason you aren’t making enough GH or not making enough of another factor

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22
Q

How is a GH deficiency treated in children?

A

recombinant GH – rhGH

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23
Q

Can you take rhGH as a sports enhancer? If so why?

A

yes because it helps to repair your tissues faster

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24
Q

How does a GH deficiency affect adults?

A

increased atherosclerosis and cardiovascular disease, insulin resistance, dyslipidemia

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25
How does excessive GH affect children versus adults?
Children: causes gigantism, causes increased linear bone growth. Adults: acromegaly, enlargement of the heart and other organs, metabolic disturbances
26
What is Isosexual Precocious Puberty?
early activation of the hypothalamic pituitary gonadal axis. Causes development of sexual characteristics in boys under 9 and girls under 7
27
How can isosexual precocious puberty affect your appearance as an adult?
Generally you grow faster as a kid and then the epiphyses close early so they are tall as kids but generally shorter as adults compared to others because the other people kept growing
28
What is the treatment for isosexual precocious puberty?
surgery, drugs which are recombinant growth hormone antagonists
29
What does the thyroid hormone do?
increases/regulates metabolic rate, essential for normal growth and brain development
30
Does hypothyroidism or hyperthyroidism cause goiters?
both can cause goiters
31
What is congenital hypothryoidism?
deficiency of thyroid hormone in newborns that can cause retardation and deformities
32
How does a newborn/fetus receive thyroid hormone in congenital hyperthyroidism?
the mother will provide the hormone until birth, then after birth they are screened with blood tests and treated with hormone replacement if it is found
33
Can congenital hypothyroidism cause problems for the mother?
yes because the mother provides the hormone until she gives birth, the body produces more hormone to compensate for the fetus' lack of it then she will have an overproduction at the time of birth
34
What is cretinism and what can cause it?
Cretinisim is a term used to describe impaired physical growth and mental retardation that can occur from congenital hypothyroidism
35
What is myxedema?
Associated with severe hypothyroidism. Accumulation of mucopolysaccharides substance in the connective tissues -- causes skin swelling and thickening
36
what is primary hypothyroidism?
it is a dysfunction of the thyroid gland
37
What is secondary hypothyroidism?
it is due to dysfunction of the hypothalamus
38
What is the most common cause of hypothyroidism?
Hashimoto thyroiditis: an autoimmune disease that attacks the thyroid gland
39
what are the manifestations of hypothyroidism?
weakness, fatigue, bradycardia, constipation, cold intolerance, myxedema
40
What is the treatment for hypothyroidism?
Synthroid which stimulates the pituitary
41
is Synthroid a hormone replacement?
not technically, it stimulates the pituitary to release the hormone
42
What are the manifestations of hyperthyroidism?
irritability, anxiety, weight loss, tachycardia, sweating, ophthalmia
43
What 2 syndromes can come from hyperthyroidism?
thyrotoxicosis and graves disease
44
what is thyrotoxicosis?
syndrome that comes from high levels of thyroid
45
What is graves disease?
autoimmune disease caused by a TSH receptor on the thyroid that gets bound with an antibody which makes them think the thyroid think the pituitary is telling it to make thyroid hormone -- artificial stimulation that produces excess of the hormone
46
What is the most common cause of hyperthyroidism?
Graves disease
47
What population and age range is Graves most common in?
in women and occurs between 20-40 years
48
What can hyperthyroidism cause?
increased metabolic rate, higher 02 consumption, sympathetic nervous system responsiveness
49
What are the treatments for hyperthyroidism?
removal of part or all the thyroid, destruction of the thyroid gland with radioactive iodine, meds that block the ability of the thyroid to make hormones
50
What hormones does the adrenal gland make?
mineralocorticoids, glucocorticoids, adrenal sex hormones, congenital adrenal insufficiency
51
What are mineralocorticoids and what do they do?
Hormone of the adrenal gland. Functions in sodium, potassium and water balance. It is secreted when you're dehydrated and tells the body to reabsorb sodium and water
52
Name an example of mineralocorticoids
aldosterone
53
What are glucocorticoids and what do they do?
a hormone from the adrenal gland, it aids in regulating the metabolic functions of the body and in controlling the inflammatory stress. Increase glucose production by liver, promotes protein breakdown and metabolizes fatty acids. It is part of the fight or flight.
54
What is an example of glucocorticoids?
cortisol
55
What are adrenal sex hormones?
they are the source of androgens that are required for important changes in the body during puberty
56
Where are androgens synthesized?
in the testes, ovaries, and the adrenal glands
57
What is congenital adrenal insufficiency?
an autosomal recessive disorder that blocks the production of cortisol
58
Describe the process of congenital adrenal insufficiency
Your body doesn't have enough cortisol and the pituitary says you need to make ACTH and then the adrenal gland gets stimulated and then overgrowth and excess of adrenal androgens and mineralocorticoids and then adrenal hyperplasia takes place
59
What can congenital adrenal insufficiency cause in women?
Masculinization/Virilization which is when the adrenal gland makes too much androgens and females can develop male characteristics (unwanted hair growth)
60
How is congenital adrenal insufficiency treated?
cortisol replacement or surgery to remove some of the hyperplasia in order to abate the excess amount of hormones
61
What is the primary disease of adrenal cortical insufficiency?
Addison's Disease
62
What is Addison's Disease?
autoimmune destruction of the adrenal gland
63
What hormone is elevated in Addison's Disease?
ACTH
64
What hormones are lacking in Addison's Disease?
Mineralocorticoids and glucocorticoids
65
What do the elevated levels of ACTH in Addison's disease cause?
hyperpigmentation of the skin
66
What are the manifestations of Addison's Disease?
Hyponatremia and hypoglycemia
67
What is Hyponatremia?
low sodium in the blood
68
What are the symptoms of hyponatremia?
confusion, decreased ability to think, headaches, nausea, poor balance, confusion, seizures and potentially coma
69
What are the symptoms of hypoglycemia?
hypotension, dehydration, weakness, poor tolerance to stress, and fatigue
70
What is secondary Adrenal Cortical Insufficiency?
Result of hypopituitarism or because the pituitary was removed, the lack of ACTH causes adrenal cortical insufficiency
71
What happens during Acute Adrenal Crisis?
life threatening situation where illness or stress causes the body to not make enough cortisol resulting in nausea, vomiting, muscle weakness, dehydration and vascular collapse
72
What is the treatment for Acute Adrenal Crisis?
hormone replacement (hydrocortisone) and mineralocorticoids, regular meals, salt replacement, removal of pituitary tumors
73
What is the syndrome associated with glucocorticoid hormone excess?
Cushing syndrome
74
What is Cushing Syndrome?
a tumor causes an excess production of ACTH
75
What forms of cushing syndrome are there?
Pituitary form where the tumor is on the pituitary gland, adrenal form where the tumor is on the adrenal gland, and ectopic form where the tumor is somewhere else in the body but has the gene for ACTH
76
What happens with cushing syndrome?
exaggerations of cortisol's action, altered fat metabolism where there are more fatty acids in the blood and are deposited somewhere in the body, altered glucose metabolism, hypertension, hirsutism...
77
What are some clear signals someone has cushing syndrome
Buffalo hump = fatty deposits on the shoulders, moon face, unwanted hair growth in women.
78
How do you treat cushing syndrome?
treat the underlying cause first (usually the tumor or the cause of the tumor) and then surgically remove the tumor wherever it is

Patho (5 decks)

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