EXAM 2: Pathophysiology > Endocrine > Flashcards

Endocrine Flashcards

Explain the mechanisms of endocrine control, including hyper-function, hypofunction, positive and negative feedback systems and hypothalamic-pituitary control of hormone levels. Distinguish causes and manifestations of anterior pituitary disorders, growth hormone disorders, thyroid function disorders and adrenal cortical hormone disorders. Identify pituitary disorders, growth hormone disorders, thyroid function disorders, and adrenal cortical hormone disorders based on provided patient scenarios

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Q

what are the 5 mechanisms of endocrine control?

A

hyperfunction
hypofunction
positive feedback systems
negative feedback systems
hypothalamic-pituitary control of hormomes

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Q

what is hyperfunction and what are the causes of it (4)?

HI, EH

A

overproduction of hormones

hormone-secreting tumors
idiopathic

excessive stimulation of gland
hyperplasia

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Q

what is hypofunction and what are the causes of it (6)?

A

underproduction of hormones

AANIIE
autoimmune responses
aging
non-secreting tumors
inflammation
infection/infarction
enzyme deficiency

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Q

_______ fdbck systems: hormone stimulates continued secretion until appropriate levels are reached

A

positive

only a small # are regulated this way

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Q

what is the most common feedback mechanism?

A

negative

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Q

negative fdbck system: hormone secretion is ___________ or _________ either _______ or ____________ so that hormone levels stay within normal limits

A

inhibited
decreased
directly
indirectly

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Q

hormones of the hypothalamus (6)

The drunk girl got some courage

A

TRH
Dopamine (PIF)
GHRH
GnRH
Somatostatin (GHIH)
CRH

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Q

what is the master unit of hormones?

A

pituitary gland

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Q

what is the hypothalamus regulated by? (2)

A

negative feedback (from ant pit)
neuronal input

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Q

the ant pit communicates via

A

blood

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Q

the post pit communicates via

A

nerve axons, neurons

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Q

what are the anterior pituitary hormones? (6)

A Pretty Girl Told Funny Lies

A

ACTH
prolactin
GH
TSH
FSH
LH

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Q

what is the coordinating center of the brain?

A

hypothalamus

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Q

Growth Hormone-Releasing Hormone (GHRH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Stimulates GH release
Effect: Promotes growth and metabolism

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Q

Growth Hormone-Inhibiting Hormone (GHIH) / Somatostatin

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Inhibits GH release
Effect: Reduces growth and metabolism

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Q

Thyrotropin-Releasing Hormone (TRH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Stimulates TSH and prolactin release
Effect: Increases thyroid hormone secretion and lactation

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Q

Corticotropin-Releasing Hormone (CRH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Stimulates ACTH release
Effect: Increases cortisol production from adrenal cortex

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Q

Gonadotropin-Releasing Hormone (GnRH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Stimulates FSH and LH release
Effect: Regulates reproductive processes

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Q

Prolactin-Inhibiting Factor (PIF) / Dopamine

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Hypothalamus
Acts on: Anterior pituitary
Stimulate or Inhibits: Inhibits prolactin release
Effect: Prevents milk production

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Q

Thyroid-Stimulating Hormone (TSH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Anterior pituitary
Acts on: Thyroid gland
Stimulate or Inhibits: Stimulates thyroid hormone (T3/T4) production
Effect: Regulates metabolism

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Q

Adrenocorticotropic Hormone (ACTH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Anterior pituitary
Acts on: Adrenal cortex
Stimulate or Inhibits: Stimulates cortisol release
Effect: Regulates secretion of proteins and stress response

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Q

Follicle-Stimulating Hormone (FSH)

Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Anterior pituitary
Acts on: Ovaries/testes
Stimulate or Inhibits: Stimulates follicle growth (ovaries) and sperm production (testes)
Effect: Regulates reproductive functions and fertility

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Q

Luteinizing Hormone (LH)
Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Anterior pituitary
Acts on: Ovaries/testes
Stimulate or Inhibits: Stimulates ovulation and testosterone production
Effect: Regulates reproductive organs and hormones

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Q

Growth Hormone (GH)
Produced in: ________
Acts on: ________
Stimulate or Inhibits: ________
Effect: ________

A

Produced in: Anterior pituitary
Acts on: Liver, muscles, bones
Stimulate or Inhibits: Stimulates growth and metabolism
Effect: Increases protein synthesis, bone growth, and fat breakdown

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Prolactin (PRL) Produced in: ________ Acts on: ________ Stimulate or Inhibits: ________ Effect: ________

Produced in: Anterior pituitary Acts on: Mammary glands Stimulate or Inhibits: Stimulates milk production Effect: Promotes lactation and growth of breast tissue

anterior pituitary disorders (2)

hyperpituitarism hypopituitarism

posterior pituitary disorders (3)

SIADH DI primary tumors

hypopituitarism is caused by (2) and causes __________ in all of its hormones

hypofunction of the stimulating gland or decreased fbck mechanism deficiencies

HYPOPITUITARISM: GH deficiency Causes: manifestations:

genetic or tumor short stature (the 1st lost/noticed)

HYPOPITUITARISM: prolactin deficiency causes: manifestations:

tumor infarction (blood loss child birth) sheehan syndrome: milk producion affected (none), egg production, metabolism

HYPOPITUITARISM: ACTH deficiency manifestations

loss of adrenal response and renal insufficiency (most serious, last to develop)

over production of pituitary hormones (3)

hyperpituitarism hyperprolactinemia excess ACTH excess GH

HYPOPITUITARISM: FSH and LH deficiency manifestations

M: low testosterone, libido, fatigue, decreased body hair F: no period, atrophy of breast tissue, infertility, low estrogen/progesterone

what causes anterior pituitary disorders?

congenital acquired (tumor, infarction, hypothalamus issue)

what is the difference between functional vs non-functional tumors?

functional: secrete hormones

why are pituitary tumors harmful?

take up space in brain = headaches, blurred vision benign adenomas !!

underproduction of pituitary hormones (5)

hypopituitarism (GH, prolactin, ACTH, thyrotropin, Gn)

GH acts on the ______ to release IGF which helps with ______ growth

liver, bone

what is GH inhibited by?

high glucose and FA cortisol and stress

GH stimulates

cartilage growth, bones, visceral organ, skeleton and cardiac muscle, skin and CT

GH disorder: what is the difference between familial and constitutional short stature?

Familial: bone age = chronological age const: bone age < chronological age

disorders of GH (6)

short stature in children (<3rd %) GH deficiency in children GH deficiency in adults tall stature in children (>97th %) GH excess in kids GH excess in adults

psychosocial dwarfism

stunted growth due to trauma or abuse in childhood (shannon my shayla ): )

causes (3) and manifestations of GH def in children (5)

genetics tumors idiopathic short stature increased subq fat in abd delayed teething immature facial feature underdeveloped nasal bridge

GH excess disorders are caused by ... (4)

hypoglycemia (starvation) decreased FA blood stress (trauma, emotions) exercise

marfan and klinefelter are an example of ...

GH excess disorders

_________ cause GH excess in kids _______ puberty which results in _______

adenoma before gigantism

GH excess in adults is _______ long bones have fused resulting in ________

after acromegaly

manifestations of acromegaly (

large hands and feet barrel chest protruding jaw (all organs/tissues get bigger but not bones)

Altered levels of thyroid hormone affect all major ________ in the body

organs

what are the 4 thyroid hormones?

thyroxine (T4) tri-iodothyronine (T3) thyroid hormone calcitonin

what are the 2 major functions of the thyroid?

increase metabolic/protein synthesis + regulate temp growth and development (in kids)

what does thyroxine do?

turns into T3 (active)

what does T3 do?

active form, acts on other organs

what does the thyroid hormone do?

increases basal metabolic rate

what does calcitonin do?

lowers blood Ca (moves it into bone)

disorders of thyroid gland (3 /6)

Hyperthyroidism (Grave’s Disease, Thyroid Storm) Hypothyroidism (Myxedema Coma, Thyroid Cancer) Parathyroid disorders (hyperparathyroidism, hypoparathyroidism)

what are the 4 systems that thyroid hormone acts on?

metabolic rate ( inc # of target cells) CV/resp (inc blood vol, CO, RR) GI (inc motility and appetitie + weight loss) neuromuscular (tremors, vigorous skelly m)

__________: Results when tissues are exposed to high levels of circulating thyroid hormone

hyperthyroidism

manifestations of hyperthyroidism (revved up!) (7)

overall: increased O2 and fuel use goiter flushed and warm skin (d/t inc bld) fine and soft hair and nails exophthalmos (protruding eyes) CV: tachy, hptn, palpitations NS: restless, itchy, lil ADHD weight loss (inc basal met rate)

what is/causes grave's disease?

autoimmune, abnormal stimulation of thyroid by antibodies type 2 (tissue-specific)

what is grave's disease characterized as? (3)

hyperthyroidism, goiter, opthalopathy

what are the 3 manifestations of grave's disease?

diplopia (double vision) vision loss corneal ulceration (can't close eyes bc of severe protruding)

what causes Thyroid Storm/Thyrotoxic Crisis? (4)

stress, infection, trauma, surgery to thyroid

manifestations of thyroid storm (4)

high fever (105 - 106F) extreme CV effects (tachy, angina, congestive) severe CNS (delirium, restlessness, anxiety) (death)

___________: Lack of thyroid hormone causing insufficient stimulation of metabolism and heat production

Hypothyroidism

___________ cause of hypothyroidism: result from lack of thyroid gland, abnormal synthesis of thyroid hormone, or deficient TSH secretion

congenital

____________ cause of hypothyroidism: result from primary hypothyroidism or secondary or tertiary disorders

acquired

manifestations of hypothyroidism (8)

dry and edematous (skin) myxedema (extreme non-pitting/ mucousy) fatigue and weakness weight gain (rapid, but no eating) intolerance to cold (low metab) brittle hair dec. musc mvmt and reflexes decreased GI motility

long-standing/chronic hypothyroidism can lead to a ___________ coma (life threat)

myxedmatous

manifestations of myxedematous coma (6) | 4 H's and a VC LA

hypothermia hypoventilation hyponatremic hypoglycemic vascular collapse (severe) lactic acidosis (d/t dec O2 to tissue = anaerobic resp)

thyroid cancer: progresses _______, and can cause difficulty _______/_____ and is associated with ______thyroidism

slowly breathing/swallowing hypo

Parathyroid hormone (PTH) is secreted by the ______ glands

parathyroid

what does PTH regulate?

Ca and P for bone metabolism

____ (#) parathyroid glands located on the _____ side of the thyroid gland

4, back

what is the dominant regulator of PTH?

plasma [calcium]

When plasma calcium is high = PTH is _________, and calcium is deposited in the bone

inhibited

When plasma calcium is low = PTH is __________, and calcium is mobilized from the bones

increased

___________: Hypersecretion of PTH

Hyperparathyroidism

primary hyperparathyroidism more common in ...

after 50 women

HYPERPARATHYROIDISM if ca increase, phosphorous ________

decreases

Hyper-secretion of PTH → Hyper________ → Increased ________ of phosphorus → precipitation of calcium in kidneys → risk for osteoporosis and kidney _______

calcemia excretion stones

what causes secondary hyperparathyroidism? (2)

renal failure chronic malabsorption

Hyper/Hypoparathyroidism manifestations are similar to hyper/hypo_________

calcemia

manifestations of hypoparathyroidism? (3)

tetany numbness/tingling stiffness in muscles (chronic: lethargy, anxiety, personality change )

congenital causes of hypoparathyroidism (4)

absence damage PTH def (thyroid surgery) autoimmune

hypoparathyroidism: is Deficient PTH secretion --> ______

Hypocalcemia

adrenal medulla secretes: (2)

catecholamines (norepi/epi) pheochromocytoma

adrenal cortex secretes (3)

adrenal androgens (sex/gonadocorticoids) mineralocorticoids (aldosterone) glucocorticoids (cortisol)

excess pheochromocytoma bc of a ________ manifestations (4)

tumor tachycardia headache palpitations nervous

which hormone plays an essential role in K, Na, and water balance regulation?

aldosterone

what is the target tissue of aldosterone?

distal renal tubules, intestines, sweat and salivary glands

which hormone responds to stress and are essential for survival?

glucocorticoids/cortisol

what is the target tissue of glucocorticoids?

body cells

low Na and high K = _____ aldosterone

increases

what regulates aldosterone?

RAAS and K+ levels

effects of cortisol: (4)

stimulation of carb, glucose, FA metabolism = increases energy regulates emotional behavior suppress immune response block inflammatory response

hypofunction of adrenal cortical hormone = (2)

Adrenal Cortical Insufficiency (Addison’s Disease) Congenital Adrenal Hyperplasia

hyperfunction of adrenal cortical hormone = (2)

Cushing Syndrome Hyperaldosteronism

what causes addison's disease? (5)

Autoimmune destruction, hypoactivity, removal, infections, drugs

pathophysiology of Addison's disease (3)

loss of Na and water K retention ACTH increase

manifestations of addison's disease (6) | ADDS

Added tan (bronze pigmentation of skin) Added K+ (hyperkaemia) Decreased weight (loss of H2O) Decreased BP, hair, energy, surgery, immune response (fatigue, alopecia, hypotension, hypoglycemia) Sodium loss = salt craving

what causes Congenital Adrenal Hyperplasia (CAH)?

Genetic disorder due to Overproduction of ACTH

manifestations of Congenital Adrenal Hyperplasia (CAH)? (2)

Decreased immune response (d/t stress/infection) masculinization in females

manifestations of Cushing syndrome (9)

weight gain adipose tissue redistribution striae (collagen + capillary) metabolic abnormalities (d/t inc glucose) moon face buffalo hump facial hair inc suscpetibilty to infections hptn (na)

etiology/cause of Cushing syndrome

Excess glucocorticoid production --> Elevated ACTH, cortisol, and glucose

cause of Hyperaldosteronism

excess aldosterone (excess renin) = electrolyte imbalance

manifestations of hyperaldosteronism (3)

hypertension (Na and H2O kept) weakness muscle wasting