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Patho Exam 4 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

describe the difference between the exocrine and endocrine systems

A

exocrine - ducts

endocrine - ductless

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2
Q

Hormones are chemical messengers that regulate body processes like (5)

A 
o	Growth and development – physical and mental 
o	Metabolism
o	Sexual function
o	Reproduction
o	Mood stability
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3
Q

pineal gland is responsible for

A

receive and modulate information about the day vs. night cycle
o secretes melatonin

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4
Q

what does Growth hormone (GH) stimulate

A

stimulates growth of bone and muscles, determined by genes but maximized by the growth hormones

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5
Q

what does prolactin (PRL) do

A

part of the anterior pituitary gland, prepares females for breast feeding, level is elevated during pregnancy and breast feeding

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6
Q

what does adrenocorticotropic hormone (ACTH) do

A

stimulates the synthesis and secretion of adrenocortical hormone

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7
Q

what does thyroid-stimulating hormone (TSH) do

A

stimulate the synthesis of thyroid hormone

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8
Q

what does follicle-stimulating hormone (FSH) do

A

affects both males/females. In the females it stimulates the growth of ovarian follicles and ovulation. In males, it stimulates sperm production = spermatogenosis

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9
Q

what does luteinizing hormone (LH) do

A

for females, it stimulates the development of corpus luteum, the release of oocytes, and production of estrogen and progesterone but mainly progesterone. In males, stimulates the production of testosterone.

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10
Q

anterior pituitary gland secretes what hormones? (6)

A
  1. Growth hormone (GH)
  2. prolactin (PRL)
  3. adrenocorticotropic hormone (ACTH)
  4. thyroid-stimulating hormone (TSH)
  5. follicle-stimulating hormone (FSH)
  6. luteinizing hormone (LH).
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11
Q

posterior pituitary gland secretes what hormones? (2)

A
  1. oxytocin

2. antidiuretic hormone (ADH) or vasopressin

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12
Q

what does oxytocin do?

A

stimulates the contraction of the pregnant uterus, and milk ejection for breast feeding after childbirth; as opposed to prolactin, it is responsive to the action of breast feeding only

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13
Q

what does ADH/vasopressin do?

A

increase water reabsorption

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14
Q

what does the hypothalamus do?

A

regulates the pituitary gland particularly the anterior pituitary gland; the posterior pituitary gland is controlled by brain.
o The master of the master (pituitary gland)

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15
Q

what does the pancreas do?

A

o Has both exocrine and endocrine function – we focus on endocrine fxn
o Endocrine function- carried out by islets of Langerhans – about 1 million islets of Langerhans

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16
Q

name and describe the 2 main Langerhans cells

A

o Alpha cells- secrete glucagon, increases BG level

o Beta cells- secrete insulin, decreases BG level

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17
Q

where is the thyroid gland located

A

Located at the base of the neck below the larynx

- contains several functional units called follicles

18
Q

what 3 hormones are produced from the thyroid gland follicles

A
  • thyroxine (T4)
  • triiodothyronine (T3)
  • thyrocalcitonin or calcitonin – lowers the blood calcium level
19
Q

when TSH stimulates the thyroid gland to secrete T3 and T4, what happens in the body?

A
  • increase the metabolic rate, necessary for fetal growth and development
  • increases the body’s responsiveness to catecholamines
20
Q

where is the parathyroid gland located?

A

Usually 4 in number; located in the posterior surface of the thyroid gland

21
Q

what does the parathyroid gland do?

A

Secretes parathyroid hormone (PTH)- increases serum calcium level

22
Q

what is within the adrenal glands?

A

Located in each kidney; each gland has inner (medulla) and outer portion (cortex)

23
Q

what does the medulla produce and when?

A

produces epinephrine and norepinephrine during times of stress

24
Q

describe the outermost region of the cortex

A

produces mineralocorticoids-

• Principal mineralocorticoid: Aldosterone

25
Q

describe the middle region of the cortex

A

produces glucocorticoids-
• Principal glucocorticoid: cortisol – affects metabolism, regulates BG level, affects growth, anti-inflammatory functions, decreases the effect of stress
• If the cortisol level is very low, even a mild stress could be life-threatening

26
Q

describe the innermost region of the cortex

A

produces gonadocorticoids (sex hormone)
• Male hormone- Androgen
• Female hormone- Estrogen
• Note: secreted only in minimal amount; hormones from the testes and ovaries mask their effects

27
Q

when does SIADH occur

A

happens when there is excessive secretion of ADH from the posterior pituitary gland or other areas outside the mentioned gland

28
Q

what are the causes of SIADH

A

most common: carcinoma; these include carcinoma of the tongue, lung, duodenum, pancreas, connective tissues, as swell as leukemia, lymphoma, and Hodgkin’s disease.
o Post-surgery monitor their urinary output for SIADH

29
Q

when can transient SIADH be seen?

A

pituitary surgery, use of certain drugs (barbiturates, general anesthetics, vincristine, nicotine, morphine)

30
Q

what is the normal process for increased extracellular fluid volume (decreased urine output) to balance when the body is dehydrated?

A
  1. Elevated serum concentration and/or decrease in extracellular fluid volume/dehydration
  2. stimulates post pituitary gland to secrete ADH
  3. ADH increases kidney’s permeability to water = increased water reabsorption (to the plasma)
  4. decreased urine formation (end result goal: increased extracellular fluid volume).
31
Q

In SIADH, ADH is secreted unrelated to the main stimuli (even if you’re not dehydrated)?

A
  1. Increased ADH = increased water reabsorption in the kidney
  2. extracellular fluid increases in the blood vessels
  3. dilution of serum Na (low serum Na = hyponatremia); highly concentrated urine

S/S- related to low Na level- fatigue, weakness, confusion.

32
Q

what are normal Na levels vs SIADH Na levels

A

Normal 135-145 mEg/L

!!! Na serum level below 115 mEq/L produces confusion, lethargy, muscle twitching, seizure, coma, and possibly irreversible neurologic damage

Take Home point: key feature of SIADH: water retention, low serum sodium and concentrated urine!

33
Q

management for SIADH

A

Treat the underlying cause (hyponatremia in SIADH) = so increasing urine volume and the serum Na level
o Demeclocycline (Declomycin)
o Hypertonic IV
o Diuretic

34
Q

what is diabetes insipidus (DI)

A

result in a deficiency of ADH

- 2 types: neurogenic DI; and Nephrogenic DI

35
Q

describe neurogenic DI

A

ADH is missing or low secondary to malfunction of the post pituitary gland.
o For example, brain tumor and radiation atrophies the pit gland = neurogenic DI

36
Q

describe nephrogenic DI

A

ADH is produced normally but distal tubules and collecting ducts (nephrons) cannot respond to hormone’s signal to reabsorb water.
o Kidneys are insensitive!

37
Q

why is ADH released into the bloodstream

A

ADH is released into the bloodstream when needed to cause kidney to reabsorb water.

38
Q

In DI, water cannot be reabsorbed which leads to what?

A

In DI, water cannot be reabsorbed - > passed out as urine - > large volume of urine

39
Q

clinical manifestations of DI

A

o Change in mentation; insomnia;
o Polydipsia (increased thirst); weight loss from the loss of fluids
o Nocturia (peeing at night); urinary frequency;
o Increased urine output- as much as 4 to 18 liters per day!

40
Q

treatment of DI

A 
o	Treat the underlying cause
   o	Desmopressin (DDAVP)- IV, subcutaneous, intranasal
      •	ONLY for neurogenic DI
   o	Pitressin- intramuscular
      •	Synthetic antidireutic hormone

o Nephrogenic: thiazide diuretic, prostaglandin inhibitors (NSAIDs)
• If the person is already peeing gallons, why give diuretics, the etiology must be nephrogenic, the pee will lessen

Patho Exam 4 (6 decks)

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