Endocrine Flashcards
what’s the difference between steroids and peptides?
steroids go into the cell
peptides are water soluble so they attach outside the cell
hormones use a ____________ mechanism to activate/deactivate certain aspects of the _____
lock and key
DNA
how can tumors of glands (aka ________) cause a hormone disorder?
adenoma
the tumor can block production of hormone
or they can start producing too much of a hormone
how can autoimmune disorders cause hormone imbalances?
antibodies can stimulate gland
or destroy it
if a cell stops responding adequately to a hormone, this is called _________. it will present as (excess or deficiency)?
cellular resistance
deficiency
what are the three reasons (hypothalamic pituitary axis) that the adrenals might have irregular output?
hypothalamus,
pituitary,
adrenals
what’s the relationship between the hypothalamus and the pituitary?
the hypothalamus “controls” the pituitary
name the hormones secreted by each in this chain:
hypothalamus:
pituitary:
thyroid:
also, is it the anterior or the posterior pituitary involved here?
TRH (thryrotropin releasing hormone)
TSH (thyroid stimulating hormone)
Thyroid Hormone (T3 and T4)
anterior pituitary
which two hormones are secreted by the hypothalamus and stored in the posterior pituitary before secretion?
Anti Diuretic Hormone (ADH)
Oxytocin
name the hormones secreted by each in this chain:
hypothalamus:
pituitary:
adrenal:
also, is it the anterior or the posterior pituitary involved here?
corticotropin releasing hormone (CRH)
Adrenocorticotrophic hormone (ACTH)
cortisol
anterior
the ____________ secretes _____________ which causes lactation from mammary glands
anterior pituitary
prolactin
growth hormone aka __________ is produced and secreted by the __________
somatotropin
anterior pituitary
luteinising hormone and follicle stimulating hormone are produced and secreted by the ______________
anterior pituitary
as far as endocrine disorders are concerned, what’s the difference between a primary and secondary disease?
primary is when hormone levels are irregular due to the gland that produces those hormones
secondary is when the gland is malfunctioning due to a dysfunction in a different gland
The liver converts somatotropin into ___________, which increases mass of ____________ and length of _________ by increasing uptake of ___________. somatotropin itself also decreases ___________ tissue
insulin-like growth factor 1 (IGF1) muscle bones glucose (for ATP) adipose
what is it called when there is a deficiency of growth hormone aka _________
pituitary dwarfism
somatotropin
what is a common cause of pituitary dwarfism?
pituitary adenoma
what is the treatment for pituitary dwarfism?
supplement growth hormone
pituitary dwarfism vs. ____________. which one results in disproportionate growth, and which one results in proportionate growth?
achondroplasia
pituitary dwarfism results in proportional growth
what is it called when there is excess growth hormone?
pituitary gigantism
what is a common cause of pituitary gigantism?
pituitary adenoma
what is a complication due to high levels of IGF1 in pituitary gigantism?
person can develop insulin resistance and therefore diabetes type 2
What happens to the heart in pituitary gigantism?
heart failure – too much tissue for the heart to supply with oxygen!
acromegaly vs pituitary gigantism
acromegaly happens in adults,
gigantism happens in children
what happens to the skin, bones, and jaw in acromegaly? why?
skin gets thick
bones get lumpy
jaw gets big
the growth plates have already fused, so the bones get deformed as they grow
when should prolactin levels rise and be high?
they should rise during pregnancy and be high after giving birth
what is it called when there is too much prolactin?
hyperprolactinemia
what causes hyperprolactinemia?
prolactin-producing pituitary adenoma
what are the s/s of hyperprolactinemia in women?
galactorrhea (excess lactation)
painful swollen breasts
atrophy of other reproductive tissues (ovaries, vaginal lining) and loss of reproductive functions such as menses
infertility
what are the s/s of hyperprolactinemia in men?
gynecomastia (breast development)
hypogonadism
erectile dysfunction
what is the function of the thyroid hormone?
regulates the rate at which you convert glucose into ATP (aka: food into energy). essentially, it regulates the metabolism
what is it called when the thyroid gland grows really big?
goiter
what are the two main causes of goiter?
- endemic goiter (iodine deficiency)
2. hyperthyroidism (grave’s disease)
Explain the mechanism behind endemic goiter
iodine is necessary for the production of T3 and T4, so the body makes all the precursors to T3 and T4 but can’t make the final product. it gets swollen with the precursors
what is the mechanism behind hyperthyroidism causing goiter?
In Grave’s disease, the autoimmune response creates antibodies that are similar to TSH. this overstimulates the thyroid.
what are the s/s of grave’s disease
insomnia palpitations trembling anxiety tachycardia feeling of heat and sweat weight loss (ht blood xu) exophthalmus (bulging eyes)
describe lab findings for TRH, TSH, and T3/T4 in grave’s disease
low TRH
low TSH
high T3/T4
TSH’s evil antibody twin is making high T3/T4 and the TRH and TSH levels drop low to slow it down
what’s the treatment for grave’s?
destroy the thyroid and then supplement the hormones with synthroid
what is it called when the iodine deficiency is congenital?
cretinism
what are the three congenital causes of hypothyroidism?
damage to hypothalamus/pituitary/thyroid axis, cretinism, being born w/o thyroid
what are the s/s of congenital hypothyroidism? Think about what happens w/o metabolism at such an early age
stunted physical growth and mental retardation
what is the autoimmune cause of hypothyroidism?
hashimoto’s thyroiditis
what is the mechanism behind hashimoto’s thyroiditis?
auto-antibodes destroy the thyroid gland
what are the TRH, TSH, and T3/T4 labs for hashimoto’s?
high TRH
high TSH
low t3/t4
what are the s/s of hashimotos?
yang xu fatigue weight gain cold bradycardia ---> can lead to impaired circulation dry brittle hair nails and skin edema myxedema
what is the treatment for hashimotos?
synthroid (synthetic thyroid hormone)
what are the labs for a hypothalamus-caused hyperthyroid problem?
trh high
tsh high
t3t4 high
what are the labs for hypothalamus induced hypothyroidism?
trh low
tsh low
t3t4 low
what are the labs for a pituitary-caused hyperthyroid problem?
trh low
tsh high
t3t4 high
what are the labs for a pituitary caused hypothyroid problem?
trh high
tsh low
t3t4 low
parathyroid hormone is secreted by the ________. how many glands are there?
parathyroid
4
what does parathyroid do and how does it do it? (3 ways)
gets Ca++ (calcium ions) into the blood
- breaks down bones
- gets GI to absorb more calcium
- tells kidneys not to pee out so much calcium
what is the function of calcium ions?
action potentials in the brain
needed for muscle contractions
what is the typical cause of hyperparathyroidism
parathyroid adenoma
what are the symptoms of hyperparathyroidism
“bones, stones, moans, groans, with fatigue overtones”
bones: super breakable, even if they bump into something
stones: increased risk of kidney stones
moans: thick blood leads to poor circulation, which leads to lethargy and depression
groans: pain from kidney stones
fatigue overtones
also tachycardia for some reason having to do with the Ca++ depolarizing the SA node
what is the treatment for hyperparathyroidism?
remove the gland that’s malfunctioning
what are the outside and inside parts of the adrenals called?
the outside is the cortex
the inside is the medulla
the adrenal medulla produces __________
epinephrine
what is the function of epinephrine?
fight or flight/sympathetic hormone
what are the three hormones produced by the adrenal cortex?
glucocorticoids/cortisol
mineralcorticoids/aldosterone
DHEA/androgen
what is the function of cortisol, how does it accomplish its function, and when is it released?
it raises levels of glucose/blood sugar by breaking down fat and muscles in the periphery in times of stress
what is the function of aldosterone, how does it accomplish its function, and when does it get released?
it increases blood volume and pressure
it tells the kidneys to retain sodium (Na+) and release potassium (K+)
it’s released whenever blood pressure/volume drops, like if you’re dehydrated
what does the body do with androgens?
converts it to testosterone and estrogen
what’s the difference between cushing syndrome and cushing disease
syndrome is when there are high cortisol levels in the blood
disease is when it’s caused by a pituitary adenoma
what are the telltale signs of cushing syndrome?
muscle wasting at the periphery, with excess fat stored in “moon face”, truncal area, and buffalo hump.
what are the other s/s of cushing syndrome?
thinning skin (tissue broken down for glucose)
stretch marks
osteoporosis
frequent illness (cortisol suppresses immunity)
high blood pressure because high glucose in the vessels attracts water inward.
fat redistribution causes cessation of menses
what are the labs of a person with cushing disease?
ACTH
Cortisol
glucose
high ACTH
high Cortisol
high glucose
what are the labs of a person with cushing syndrome where the pituitary is healthy?
ACTH
cortisol
glucose
ACTH low
cortisol high
glucose high
what is the main cause of addison disease?
autoantibodies destroy the adrenal cortex, resulting in reduction of
cortisol
aldosterone
DHEA/androgens
what are the s/s due to cortisol deficiency in addison disease?
the person can’t raise their blood sugar (glucose) in response to stress. this results in hypoglycemia
so, when they are stressed:
lightheaded dizzy anxious nervous trembling/shaking irritable/hangry fatigue feeling cold fainting headaches
what are the s/s due to aldosterone deficiency in addison disease?
they can’t reabsorb sodium or maintain the volume of their blood whenever there’s a drop
blood volume: lightheaded dizzy fainting difficulty concentrating
sodium deficiency: muscle twitches arrhythmia lethargy seizures
what are the s/s due to DHEA deficiency in addison disease for women?
low testosterone and therefore sparse pubic hair
what would the following labs be in addison disease? glucose Na K ACTH will there be antibodies in the blood?
glucose low na low k high ACTH high yes there will be antibodies in the blood
what is one side effect of having high ACTH in addison disesase?
this stimulates melanocytes and creates hyperpigmentation of the skin
what two hormones does the pancreas create?
insulin
glucagon
insulin ________ blood sugar when levels are too __________
glucagon ________ blood sugar when levels are too __________
decreases; high
increases; low
how does insulin work?
it tells the adipose tissues to store glucose as fat
it tells liver and muscles to store glucose as glycogen
how does glucagon work?
cortisol can preemptively raise blood sugar levels. if they continue to drop too low, then glucagon kicks in and raises them more
type ____ diabetes is an autoimmune condition that comes on during childhood in which the autoimmune cells destroy the pancreas’ ability to create ________
1
insulin
what are the three P’s of type 1 diabetes?
polyuria - excessive urination (water follows the glucose out of body)
polydipsia - excessive thirst (excessive urination leads to excessive thirst)
polyphagia - excessive hunger (weight loss leads to hunger)
insulin ___________ fat breakdown, which is why type 1 diabetes leads to weight _________
inhibits
loss
why might a person with type 1 diabetes get frequent infections?
fungus and bacteria love excess sugar in blood
why might a person with type 1 diabetes need an amputation?
the increased blood sugar makes blood viscous. this impairs circulation to the point of vision problems, neuropathies, ulcerations, and necrosis. bacteria and fungus thrive on the blood sugar so they will infect the necrotic areas.
in type 1 diabetes, what can happen to the ketones and why?
fat starts getting broken down for energy at very vast rates, creating ketone bodies, which are acidic in nature. too much of this leads to ketoacidosis, which can be fatal
what is the lab for glucose levels in type 1 diabetes?
high glucose
why might a person with type 1 diabetes have a hypoglycemic attack?
if they inject too much insulin, their blood sugar will suddenly drop too low
insulin dependent diabetes is type ____
non-insulin dependent diabetes is type ____
1
2
describe why the lock and key stops working for diabetes type 2
lifestyle and poor diet makes it so that the body’s fat and glycogen stores are full and there is no need for ATP. insulin is desperately trying to use the lock and key to store some of the excess glucose coming in through the diet but the cells have stopped responding to it.
what are the signs and symptoms of diabetes type 2?
polyuria polydipsia impaired circulation frequent infections fatigue (same as type 1 but w/o weight loss and hunger)
what will the labs for insulin and glucose be in type 2 diabetes
both high
what does ADH do? when is it released?
it tells the kidneys to retain fluid (reabsorb additional water). it’s released whenever blood becomes too viscous or the blood pressure drops
what is it called when either
- there is not enough ADH
- kidneys are not responding to it
diabetes insipidus
what are the symptoms of diabetes insipidus
polyuria
polydipsia
low blood pressure
what are the labs that distinguish diabetes insipidus from diabetes mellitis
insipidus has normal glucose levels and low blood pressure
