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ALU 201 > chapter 9 - endocrinology > Flashcards

chapter 9 - endocrinology Flashcards

1
Q

what is classic endocrine pathway

A

when hormones act systemically on a site distant form the gland

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2
Q

what is paracrine pathway

A

when hormones act locally on adjacent tissue

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3
Q

when is autocrine pathway

A

when hormones act reciprocally on the gland from which they originated

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4
Q

what is a feedback loop

A

a circuit of signaling that operates to turn off the release hormone from a gland once the action of the hormone has had its effect

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5
Q

which gland is known as the master gland and why

A

pituitary, because it produces peptides that regulate the adrenal glands, thyroid glands, ovaries, testes, thereby affecting linear growth, fuel metabolism, water balance, pregnancy, and lactation

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6
Q

what type of prolactinoma does females usually have and what are the symptoms

A

females usually have microadenomas which cause menstrual irregularities and galactorrhea

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7
Q

what type of prolactinoma do males usually have and what are the symptoms

A

males usually have macro adenomas which cause impotence and loss of libido. if large enough can cause headache or visual disturbance

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8
Q

what is medical treatment for prolactinoma

A

bromocriptine (parlodel), pergolide (permax), cabergoline (dostinex)

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9
Q

when can there be mortality risk with prolactinoma

A

if hypopituitarism develops after surgery or after radiation and is not detected or not treated appropriately

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10
Q

what is treatment for hypopituitarism after surgery, tumor or other cause

A

replacement with cortisol due to lack of ACTH, thyroid hormone (lack of TSH), estrogen for females and testosterone for males

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11
Q

what are causes for diabetes insipidus

A

can result from surgery for pituitary lesions, result of lack of antidiuretic hormone (vasopressin)

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12
Q

what is diabetes insipidus

A

lack of vasopressin which causes hypernatremia

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13
Q

what is treatment for diabetes insipidus

A

DDAVP (desmopressin)

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14
Q

can diabetes insipidus shorten life expectancy

A

yes if not adequately treated

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15
Q

what should be underwriting focus for diabetes insipidus

A

primary etiology of the loss of antidiuretic hormone (pituitary tumor or destructive process)

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16
Q

what is acromegaly and what is the most common cause

A

rare pituitary disorder cause by a benign tumor that causes growth hormone production.

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17
Q

how can acromegaly manifest

A

can cause enlargement of feet, hands, mandible, soft tissue swelling, carpal tunnel, HTN, LVH, cardiomyopathy, colon polyps, sleep apnea, glucose intolerance

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18
Q

does acromegaly occur more in males or females

A

equally in males and females

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19
Q

what is treatment of acromegaly

A

removal of the tumor

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20
Q

T3 and T4 cause activation of many different cellular processes, including:

A

increased oxygen consumption, simulation of protein synthesis, enhanced lipolysis, enhanced response to epinephrine and norepinephrine, increased HR and contractibility, increased growth and development

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21
Q

in older individuals hyperthyroidism can trigger ____, so higher risk of _______

A

atrial fibrillation, embolic event

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22
Q

what is mortality risk with hypothyroidism

A

myxedema come, but is rare

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23
Q

thyroid cancers will appear how on ultrasound (hot or cold)

A

will appear hypo functioning or “cold”

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24
Q

where are the adrenal glands located and what is the outer portion called

A

on top of each kidney, cortex

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25
Q

what are the 3 zones of the adrenal gland

A

glomerulosa that produces aldosterone, fasiculata that produces cortisol, the reticular that produces androgens

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26
Q

what is at the center of the adrenal gland and what does it produce

A

medulla, epinephrine and norepinephrine

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27
Q

ACTH from the pituitary affects the production of _____ and ______

A

cortisol and androgens

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28
Q

what hormones are involved in the fight or flight response

A

epinephrine and norepinephrine is partially controlled by ACTH, but the main stimulus for secretion if nervous system input that regulates the fight or flight resonse

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29
Q

what is primary hyperaldosteronism and what does it lead to

A

overproduction of aldosterone by the glomerulosa cells of the adrenal gland, leads to HTN

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30
Q

what are clinical symptoms or primary hyperaldosteronism

A

low potassium levels, muscle weakness, fatigue, increased urination, increased thirst

31
Q

what are the 2 most common etiologies of primary hyperaldostonism

A

aldosterone-producing adenoma and bilateral adrenal hyperplasia

32
Q

what medication is most commonly used to treat HTN from primary hyperaldosteronsm

A

spironolactone

33
Q

is life expectancy normal with primary hyperaldosteronism

A

yes with normalization of BP

34
Q

what are symptoms and signs of hypercorticolism

A

truncal obesity, moon facies, buffalo hump, HTN, striae, hyperglycemia, proximal muscle weakness, amenorrhea, hirsutism, acne, easy bruising, OP, depression, psychosis

35
Q

what is Cushing’s disease

A

excess cortisol production as a result of ACTH from a pituitary microadenoa

36
Q

besides Cushings what are the 2 other etiologies of hypercorticolism

A

primary adrenal tumor or ectopic production of ACTH (usually from small cell carcinoma of lung)

37
Q

what is pheocromocytoma

A

tumor that produces epinephrine and norepinephrine and can be life-threatening

38
Q

what re symptoms of pheocromocytomas

A

Headache, perspiration, palps, HTN, cardiac arrhythmias, high output CHF

39
Q

what do parathyroids produce and what tissues does it act on

A

produces PTH which regulates serum calcium concentration. PTH acts on multiple tissues but mostly on kidney, bone, intestine and increase serum calcium concentration when levels are low

40
Q

what is hyperparathyroidism and what is the most common cause

A

excessive production of PTH, most common cause is single parathyroid adenoma

41
Q

what are signs/symptoms of hyperparathyroidism

A

hyperglycemia, polyuria, thirst, abdominal pain, constipation, kidney stones, mental confusion, coma, OP

42
Q

is there mortality concern with hyperparathyroidism

A

if followed medically some morbidity and mortality if not followed closely. after surgery most people are cured

43
Q

what is hypercalcemia of malignancy caused by

A

elevation of PTH related peptide by a tumor, metastasis to bone, or both

44
Q

is hypercalcemia of malignancy life threatening why or why not

A

yes, because onset usually severe and acute, causing cardiac arrhythmias and/or coma.

45
Q

what is MEN

A

multiple endocrine neoplasia

46
Q

name the 6 hormones that are involved in maintaining normal glucose levels

A

insulin, glucagon, somatostatin, cortisol, epinephrine, growth hormone

47
Q

what is the fuel for the brain

A

glucose

48
Q

where is insulin produced

A

made and and released from the beta cells of the pancreatic islets

49
Q

where is glycagon produced

A

the alpha cells of the pancreatic islets

50
Q

how do insulin and glucagon interact/relate

A

insulin is the hormone of the “fed” state, being utilized after ingestion of food to promote its use. glucagon is the hormone of the fasting state, maintaining glucose levels between meals

51
Q

where is somatostatin produced and what does it do

A

the delta cells of the pancreatic islets. it inhibits both insulin and glucagon to prevent rapid exhaustion of glucose when a meal is eaten

52
Q

what is the role of cortisol, epinephrine and growth hormone in maintaining glucose levels

A

similar to glucagon, maintaining blood glucose in times of stress

53
Q

what is the cause of DM1 and when is it usually diagnosed

A

autoimmune destruction of pancreatic beta cells, usual dx before age 21

54
Q

what is LADA diabetes and at what age is it usually diagosed

A

latent autoimmune diabetes in adults. dx usually over age 35. initially treated as DM2, but needs insulin, has positive results on testing for at least 2 of the 4 antibodies indicative of diabetes

55
Q

what is the cause of DM2

A

insulin is produced bu t peripheral tissues do not respond appropriately. there is insulin resistance.

56
Q

what is MODY

A

maturity-onset diabetes of youth. patient might present with acute DKA and need insulin temporarily then can manage with diet, perhaps occasional sulfonylurea drug. can present like DM1 but clinical behavior more like DM2.

57
Q

what % of females with gestational DM will develop DM2

A

40-60% over the next 5-10 yrs

58
Q

what is the mortality rate for diabetic ketoacidosis

A

10%

59
Q

what are the acute complications of diabetes

A

diabetic ketoacidosis (DM1 and MODY), diabetic hyperosmolar coma (DM@) and acute hypoglycemia (All types)

60
Q

what are chronic complications of diabetes

A

microvascular disease (retinopathy, nephropathy, neuropathy) and microvascular disease (CAD, carotid artery disease, PAD)

61
Q

what is the leading cause of adulthood blindness in the USA

A

diabetes

62
Q

what is the earliest sign of diabetic nephropathy

A

microalbuminuria

63
Q

what is the leading cause of mortality in diabetics

A

macro vascular disease (CVD - MI)

64
Q

what are possible symptoms of hypoglycemia

A

tachycardia, sweating, palms, mental confusion, neurological deficits, coma. can result in death

65
Q

metabolic syndrome can be made up of combination of what conditions/factors

A

abd obesity/obesity, elev TG, low HDL, elev BP, elev fasting blood glucose, microalbuiuria

66
Q

a disease characterized by the destruction of the adrenal glands is:

A

Addison’s disease

67
Q

adrenal insufficiency can be caused by….

A

primary destruction of the adrenal glands (additions disease) or secondary insufficiency (lack of ACTH or exogenous steroid use which suppresses aCTH)

68
Q

fructosamine reflects avg BG for preceding ______ days

A

10-20

69
Q

Which of the following hormones regulate glucose levels?
A. Cortisol
B. Glucagon
C. Insulin

A

B and C only are correct

70
Q

Which statement regarding the cortex of the adrenal gland are correct?
A. It is divided into 4 zones
B. The fasciculata produces cortisol
C. The reticularis produces androgens

A

B and C are correct

71
Q

Does DM2 have a higher genetic predisposition than DM1?

A

No

72
Q

Do African Americans have a higher prevalence than Hispanic Americans for type two diabetes

A

No

73
Q

A disease characterized by the destruction of the adrenal gland is

A

Addisons disease

74
Q

What is the primary secretary product of the thyroid

A

T4

ALU 201 (20 decks)

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