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Pathophysiology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

what’s the difference between steroids and peptides?

A

steroids go into the cell

peptides are water soluble so they attach outside the cell

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2
Q

hormones use a ____________ mechanism to activate/deactivate certain aspects of the _____

A

lock and key

DNA

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3
Q

how can tumors of glands (aka ________) cause a hormone disorder?

A

adenoma
the tumor can block production of hormone
or they can start producing too much of a hormone

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4
Q

how can autoimmune disorders cause hormone imbalances?

A

antibodies can stimulate gland

or destroy it

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5
Q

if a cell stops responding adequately to a hormone, this is called _________. it will present as (excess or deficiency)?

A

cellular resistance

deficiency

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6
Q

what are the three reasons (hypothalamic pituitary axis) that the adrenals might have irregular output?

A

hypothalamus,
pituitary,
adrenals

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7
Q

what’s the relationship between the hypothalamus and the pituitary?

A

the hypothalamus “controls” the pituitary

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8
Q

name the hormones secreted by each in this chain:
hypothalamus:
pituitary:
thyroid:

also, is it the anterior or the posterior pituitary involved here?

A

TRH (thryrotropin releasing hormone)
TSH (thyroid stimulating hormone)
Thyroid Hormone (T3 and T4)

anterior pituitary

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9
Q

which two hormones are secreted by the hypothalamus and stored in the posterior pituitary before secretion?

A

Anti Diuretic Hormone (ADH)

Oxytocin

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10
Q

name the hormones secreted by each in this chain:
hypothalamus:
pituitary:
adrenal:

also, is it the anterior or the posterior pituitary involved here?

A

corticotropin releasing hormone (CRH)
Adrenocorticotrophic hormone (ACTH)
cortisol

anterior

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11
Q

the ____________ secretes _____________ which causes lactation from mammary glands

A

anterior pituitary

prolactin

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12
Q

growth hormone aka __________ is produced and secreted by the __________

A

somatotropin

anterior pituitary

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13
Q

luteinising hormone and follicle stimulating hormone are produced and secreted by the ______________

A

anterior pituitary

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14
Q

as far as endocrine disorders are concerned, what’s the difference between a primary and secondary disease?

A

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

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15
Q

The liver converts somatotropin into ___________, which increases mass of ____________ and length of _________ by increasing uptake of ___________. somatotropin itself also decreases ___________ tissue

A 
insulin-like growth factor 1 (IGF1)
muscle
bones
glucose (for ATP)
adipose
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16
Q

what is it called when there is a deficiency of growth hormone aka _________

A

pituitary dwarfism

somatotropin

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17
Q

what is a common cause of pituitary dwarfism?

A

pituitary adenoma

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18
Q

what is the treatment for pituitary dwarfism?

A

supplement growth hormone

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19
Q

pituitary dwarfism vs. ____________. which one results in disproportionate growth, and which one results in proportionate growth?

A

achondroplasia

pituitary dwarfism results in proportional growth

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20
Q

what is it called when there is excess growth hormone?

A

pituitary gigantism

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21
Q

what is a common cause of pituitary gigantism?

A

pituitary adenoma

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22
Q

what is a complication due to high levels of IGF1 in pituitary gigantism?

A

person can develop insulin resistance and therefore diabetes type 2

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23
Q

What happens to the heart in pituitary gigantism?

A

heart failure – too much tissue for the heart to supply with oxygen!

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24
Q

acromegaly vs pituitary gigantism

A

acromegaly happens in adults,

gigantism happens in children

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25
Q

what happens to the skin, bones, and jaw in acromegaly? why?

A

skin gets thick
bones get lumpy
jaw gets big

the growth plates have already fused, so the bones get deformed as they grow

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26
Q

when should prolactin levels rise and be high?

A

they should rise during pregnancy and be high after giving birth

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27
Q

what is it called when there is too much prolactin?

A

hyperprolactinemia

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28
Q

what causes hyperprolactinemia?

A

prolactin-producing pituitary adenoma

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29
Q

what are the s/s of hyperprolactinemia in women?

A

galactorrhea (excess lactation)
painful swollen breasts
atrophy of other reproductive tissues (ovaries, vaginal lining) and loss of reproductive functions such as menses
infertility

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30
Q

what are the s/s of hyperprolactinemia in men?

A

gynecomastia (breast development)
hypogonadism
erectile dysfunction

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31
Q

what is the function of the thyroid hormone?

A

regulates the rate at which you convert glucose into ATP (aka: food into energy). essentially, it regulates the metabolism

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32
Q

what is it called when the thyroid gland grows really big?

A

goiter

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33
Q

what are the two main causes of goiter?

A
  1. endemic goiter (iodine deficiency)

2. hyperthyroidism (grave’s disease)

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34
Q

Explain the mechanism behind endemic goiter

A

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

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35
Q

what is the mechanism behind hyperthyroidism causing goiter?

A

In Grave’s disease, the autoimmune response creates antibodies that are similar to TSH. this overstimulates the thyroid.

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36
Q

what are the s/s of grave’s disease

A 
insomnia
palpitations
trembling
anxiety
tachycardia
feeling of heat and sweat
weight loss
(ht blood xu)
exophthalmus (bulging eyes)
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37
Q

describe lab findings for TRH, TSH, and T3/T4 in grave’s disease

A

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

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38
Q

what’s the treatment for grave’s?

A

destroy the thyroid and then supplement the hormones with synthroid

39
Q

what is it called when the iodine deficiency is congenital?

A

cretinism

40
Q

what are the three congenital causes of hypothyroidism?

A

damage to hypothalamus/pituitary/thyroid axis, cretinism, being born w/o thyroid

41
Q

what are the s/s of congenital hypothyroidism? Think about what happens w/o metabolism at such an early age

A

stunted physical growth and mental retardation

42
Q

what is the autoimmune cause of hypothyroidism?

A

hashimoto’s thyroiditis

43
Q

what is the mechanism behind hashimoto’s thyroiditis?

A

auto-antibodes destroy the thyroid gland

44
Q

what are the TRH, TSH, and T3/T4 labs for hashimoto’s?

A

high TRH
high TSH
low t3/t4

45
Q

what are the s/s of hashimotos?

A 
yang xu
fatigue
weight gain
cold
bradycardia
---> can lead to impaired circulation
dry brittle hair nails and skin
edema
myxedema
46
Q

what is the treatment for hashimotos?

A

synthroid (synthetic thyroid hormone)

47
Q

what are the labs for a hypothalamus-caused hyperthyroid problem?

A

trh high
tsh high
t3t4 high

48
Q

what are the labs for hypothalamus induced hypothyroidism?

A

trh low
tsh low
t3t4 low

49
Q

what are the labs for a pituitary-caused hyperthyroid problem?

A

trh low
tsh high
t3t4 high

50
Q

what are the labs for a pituitary caused hypothyroid problem?

A

trh high
tsh low
t3t4 low

51
Q

parathyroid hormone is secreted by the ________. how many glands are there?

A

parathyroid

4

52
Q

what does parathyroid do and how does it do it? (3 ways)

A

gets Ca++ (calcium ions) into the blood

  1. breaks down bones
  2. gets GI to absorb more calcium
  3. tells kidneys not to pee out so much calcium
53
Q

what is the function of calcium ions?

A

action potentials in the brain

needed for muscle contractions

54
Q

what is the typical cause of hyperparathyroidism

A

parathyroid adenoma

55
Q

what are the symptoms of hyperparathyroidism

A

“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

56
Q

what is the treatment for hyperparathyroidism?

A

remove the gland that’s malfunctioning

57
Q

what are the outside and inside parts of the adrenals called?

A

the outside is the cortex

the inside is the medulla

58
Q

the adrenal medulla produces __________

A

epinephrine

59
Q

what is the function of epinephrine?

A

fight or flight/sympathetic hormone

60
Q

what are the three hormones produced by the adrenal cortex?

A

glucocorticoids/cortisol
mineralcorticoids/aldosterone
DHEA/androgen

61
Q

what is the function of cortisol, how does it accomplish its function, and when is it released?

A

it raises levels of glucose/blood sugar by breaking down fat and muscles in the periphery in times of stress

62
Q

what is the function of aldosterone, how does it accomplish its function, and when does it get released?

A

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

63
Q

what does the body do with androgens?

A

converts it to testosterone and estrogen

64
Q

what’s the difference between cushing syndrome and cushing disease

A

syndrome is when there are high cortisol levels in the blood

disease is when it’s caused by a pituitary adenoma

65
Q

what are the telltale signs of cushing syndrome?

A

muscle wasting at the periphery, with excess fat stored in “moon face”, truncal area, and buffalo hump.

66
Q

what are the other s/s of cushing syndrome?

A

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

67
Q

what are the labs of a person with cushing disease?
ACTH
Cortisol
glucose

A

high ACTH
high Cortisol
high glucose

68
Q

what are the labs of a person with cushing syndrome where the pituitary is healthy?
ACTH
cortisol
glucose

A

ACTH low
cortisol high
glucose high

69
Q

what is the main cause of addison disease?

A

autoantibodies destroy the adrenal cortex, resulting in reduction of
cortisol
aldosterone
DHEA/androgens

70
Q

what are the s/s due to cortisol deficiency in addison disease?

A

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
71
Q

what are the s/s due to aldosterone deficiency in addison disease?

A

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
72
Q

what are the s/s due to DHEA deficiency in addison disease for women?

A

low testosterone and therefore sparse pubic hair

73
Q 
what would the following labs be in addison disease?
glucose
Na
K
ACTH
will there be antibodies in the blood?
A 
glucose low
na low
k high
ACTH high
yes there will be antibodies in the blood
74
Q

what is one side effect of having high ACTH in addison disesase?

A

this stimulates melanocytes and creates hyperpigmentation of the skin

75
Q

what two hormones does the pancreas create?

A

insulin

glucagon

76
Q

insulin ________ blood sugar when levels are too __________

glucagon ________ blood sugar when levels are too __________

A

decreases; high

increases; low

77
Q

how does insulin work?

A

it tells the adipose tissues to store glucose as fat

it tells liver and muscles to store glucose as glycogen

78
Q

how does glucagon work?

A

cortisol can preemptively raise blood sugar levels. if they continue to drop too low, then glucagon kicks in and raises them more

79
Q

type ____ diabetes is an autoimmune condition that comes on during childhood in which the autoimmune cells destroy the pancreas’ ability to create ________

A

1

insulin

80
Q

what are the three P’s of type 1 diabetes?

A

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)

81
Q

insulin ___________ fat breakdown, which is why type 1 diabetes leads to weight _________

A

inhibits

loss

82
Q

why might a person with type 1 diabetes get frequent infections?

A

fungus and bacteria love excess sugar in blood

83
Q

why might a person with type 1 diabetes need an amputation?

A

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.

84
Q

in type 1 diabetes, what can happen to the ketones and why?

A

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

85
Q

what is the lab for glucose levels in type 1 diabetes?

A

high glucose

86
Q

why might a person with type 1 diabetes have a hypoglycemic attack?

A

if they inject too much insulin, their blood sugar will suddenly drop too low

87
Q

insulin dependent diabetes is type ____

non-insulin dependent diabetes is type ____

A

1

2

88
Q

describe why the lock and key stops working for diabetes type 2

A

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.

89
Q

what are the signs and symptoms of diabetes type 2?

A 
polyuria
polydipsia
impaired circulation
frequent infections
fatigue
(same as type 1 but w/o weight loss and hunger)
90
Q

what will the labs for insulin and glucose be in type 2 diabetes

A

both high

91
Q

what does ADH do? when is it released?

A

it tells the kidneys to retain fluid (reabsorb additional water). it’s released whenever blood becomes too viscous or the blood pressure drops

92
Q

what is it called when either

  1. there is not enough ADH
  2. kidneys are not responding to it
A

diabetes insipidus

93
Q

what are the symptoms of diabetes insipidus

A

polyuria
polydipsia
low blood pressure

94
Q

what are the labs that distinguish diabetes insipidus from diabetes mellitis

A

insipidus has normal glucose levels and low blood pressure

Pathophysiology (17 decks)

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