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Patho Exam 3 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

endocrine + nervous system=?

A

homeostasis

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2
Q

interface happens where

A

hypothalamus

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3
Q

5 general functions of endocrine system:

A

1] differentiate reproductive and CNS of fetus
2] growth during adolescent and childhood
3] coordinates reproductive systems
4] maintains best internal environment through life
5] fight or flight- initiate responses

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4
Q

Neural connection in postr pituitary but control antr and postr pituitary

A

hypothalamic control

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5
Q

whats the disruption for hypothalamic control

A

excess/deficiency of hormones

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6
Q

whats a secondary disruption of hypothalamic control

A

compression of optic nerve with visual issues

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7
Q

two hormones in posterior pituitary

A 
antidiuretic hormone (ADH)
oxytocin
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8
Q

etiology of hypo/hyperfunction

A

Tumor in hypothalamus, pituitary or endocrine glands◦ Inflammation (acute, chronic)

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9
Q

chronic issues lead to?

A

hormone replacement therapy

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10
Q

first places to look for any changes

A

in tumor

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11
Q

neuroendocrine response to stress is to?

A

increase sympathetic response by stimulating adrenal cortex

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12
Q

stimulating adrenal cortex gives you what

A

catecholamines

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13
Q

examples of catecholamines

A

epinephrine, norepinephrine, dopamine

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14
Q 
Increased HR
Peripheral vasoconstriction
Elevated BP
Increased blood glucose levels
Stimulates breakdown of fats
Stressors: exercise, temperature changes, emotional stress

effects of what?

A

stimulating adrenal cortex –> catecholamines

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15
Q

what hormones stimulate pituitary

A

ADH, prolactin, GH, ACTH

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16
Q

cortisol is where?

A

adrenal cortex

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17
Q

Regulates metabolism to elevate blood glucose level, plasma lipid level
◦
create ketones
◦ Inhibits fibroblast proliferation, results in poor wound healing and increased risk for infection◦ Helps with fight or flight
◦ Anti-inflammatory protective mechanism

A

cortisol

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18
Q

can be adaptive or destructive

A

cortisol

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19
Q

Modulate transmission of pain perceptions (sedation, euphoria)

A

endorphins

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20
Q

Skeletal and visceral growth via metabolism◦ Stressors: exercise, surgery

A

growth hormone

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21
Q

affects breast tissue and creates milk production

A

prolactin

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22
Q

Male characteristics, libido

◦ Decreases after exercise, surgery

A

testosterone

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23
Q

msk sx of endocrine disease

A 
Proximal muscle weakness; painlessHand contractures/ROM deficits
Carpal tunnel (fluid volume)
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24
Q

Usually ?? symptoms where overuse injuries are ??

  • for carpal tunnel
A

bilateral

unilateral

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25
Q

Rheumatic symptoms

A

diabetes mellitus

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26
Q

Muscle weakness (proximal), atrophy,myalgias, fatigue

A

Thyroid disorders
Parathyroid disorders
Diabetes Mellitus

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27
Q

Carpal tunnel syndrome(Bilateral)

3

A

Diabetes Mellitus
Pregnancy
Hypothyroidism

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28
Q

Periathritis
Calcific Tendonitis (shoulders)
Gout

A

thyroid disorders

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29
Q

Spondyloarthropathy
Osteoarthritis

(spine type)

A

diabetes mellitus

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30
Q

posterior pituitary makes what two hormones?

A

oxytocin

ADH

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31
Q

Contraction of uterus, makes breast milk

A

oxytocin

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32
Q

controls body fluid level in kidneys

  • Cardiac responses
  • Target of morphine, tranquilizers, anesthetics
A

ADH

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33
Q

anterior pituitary makes what two hormones?

A

prolactin

GH

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34
Q

milk production

A

prolactin

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35
Q

growth via protein synthesis and fat metabolism

Sx: dwarfism, gigantism

A

GH

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36
Q

Master gland for regulating other endocrine glands

◦ Influenced by hypothalamus

A

pituitary gland

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37
Q

Hyperpituitarism
◦ Hypopituitarism
◦ Local compression of brain tissue

-disorders of what lobe?

A

anterior lobe

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38
Q

Diabetes Insipidus
◦ SIADH

  • disorders of what lobe?
A

posterior lobe disorders

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39
Q

pituitary tumors can be

A

primary or secondary

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40
Q

functional pituitary tumors will……

A

secrete hormones

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41
Q

headaches for pituitary tumors will

A

increase ICP

decrease drainage from 3rd ventricle

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42
Q

visual disturbances for pituitary tumors will

A

occur in optic chiasm

cause bilateral temporal hemianopia

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43
Q

oversecretion of one or more hormones

A

hyperpituitarism

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44
Q

acromegaly in adults occurs due to

A

GH

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45
Q

Sx: Excessive growth
Overgrow long bones
Hypertrophy of soft tissuesWidened joint spaces

A

acromegaly

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46
Q 
Due to adenoma or exposure to glucocorticoids5:1 women to men
Childbearing years
Obesity
Glucose intolerance
Muscle wasting
Osteopenia
Moon face
Easy bruising
Abdominal striae
Acne
A

hyperpituitarism

ACTH increases due to Cushings Disease

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47
Q 
Diaphoresis
◦ Milk production from breasts◦ Sleep apnea
◦ Carpal tunnel
◦ Joint pain
◦ Weakness
A

Sx of hyperpituitarism

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48
Q

first 2 things we looks for when diagnosing hyperpit.

A

levels of GH

MRI of brain

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49
Q

resection of tumor
◦ beam radiation
◦ drug therapy- use of drugs afterwards to regulate hormones

tx for?

A

hyperpit.

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50
Q

Detn by level of GH, IGF-I; can develop bone tumors

prognosis for?

A

hyperpit.

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51
Q

decreased or absent hormone secretion by anterior pituitary

A

hypopit.

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52
Q

partial or total failure of all 6 hormones

A

panhypopit.

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53
Q

More than ??% of pituitary must be destroyed to demonstrate sx

A

75%

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54
Q 
Removal/destruction of pituitary gland◦ Non secreting pituitary tumors
◦ Postpartum hemorrhage 
◦ Anorexia
◦ Anemia
◦ GI dysfunction

etiology of?

A

hypopit.

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55
Q

depends on hormone lacking

sx for?

A

hypopit.

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56
Q

Stimulates liver to create insulin-like growth factors◦ Decreased growth, delayed puberty

A 
GH deficiency
(dwarfism)
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57
Q

Decreased LH/FSH= sexual/reproductive disorders

A

hypothyroidism

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58
Q

whats the 2ndary dx to hypopit.?

A

hyperthyroidism

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59
Q

Removal of tumor
◦ Hormone replacement therapy

tx for?

A

hypopit and hypothyroidism

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60
Q 
Fatigue 
• Muscle weakness
• Weight loss 
• Decreased appetite 
• Joint stiffness
• Low BP
• Headaches
• Erectile dysfunction
• Infertility 
• Hot flashes, irregular or no periods, loss of pubic hair, and inability to produce milk for breast-feeding inwomen 
• Short stature in children

-signs and symptoms for?

A

hypopit.

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61
Q
  • Normal birth length
  • Develop change in growth curve by age 2-3 yo•Normal intelligence level
  • Obesity
  • Delayed skeletal maturation
  • Delayed puberty
  • Short stature
A

congenital GH deficiency

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62
Q
  • Tumor or treatment for tumor•?Increased cardiac disease
  • Central adiposity
  • Insulin resistance
  • Poor lipid profile
A

acquired GH deficiency

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63
Q
  • Amenorrhea
  • Breast atrophy
  • Testicular atrophy
  • Diminished libido
  • Minimal pubic and axillary hair•Hypothermia
  • Hypotension
  • Hypoglycemia

for which hypopit disease?

A

gonadotropin deficiency

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64
Q
  • Bloodwork:
  • Serum cortisol
  • Serum prolactin
  • Serum thyroxine, TSH
  • Serum testosterone
  • Serum estrogen
  • LH/FSH
  • GH
  • MRI of brain
  • Xray of hands in children
A

tests and measures for hypopit.

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65
Q
  • Removal of tumor
  • Hormone replacement therapy- lifetime• Adrenal hormones- steroids
  • TSH- synthroid
  • Sex hormones
  • GH

tx for?

A

hypopit.

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66
Q

whats a posterior lobe disorder?

A

diabetes insipidus

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67
Q

RARE imbalance of water due to ADH deficiency

A

diabetes insipidus

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68
Q

injury to hypothalamus, posterior pituitary

A

etiology for diabetes insipidus

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69
Q

Vasopression (ADH), diuretics
-Resect tumor

tx for?

A

diabetes insipidus

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70
Q

what are the hormones like for endocrine system

A

slow onset

long duration/effect

71
Q

SIADH stands for?

A

syndrome of inappropriate antidiuretic hormone secretion

72
Q

Excessive ADH release with water imbalance

A

SIADH

73
Q

Trauma/infection of pituitary
◦ Ectopic ADH production by malignancy/tumor
◦ Stress of surgery, systemic disorders, chemotherapy drugs (vincristine)

-etiology for?

A

SIADH

74
Q

hyponatremia –> lethargy, nausea, anorexia, weakness, coma

  • sx for?
A

SIADH

75
Q

Correct sodium imbalance
◦ Surgery, chemo, radiation of tumor◦ Restriction of fluid intake
◦ Diuretics

tx for?

A

SIADH

76
Q

Correct sodium imbalance
◦ Surgery, chemo, radiation of tumor◦ Restriction of fluid intake
◦ Diuretics

tx for?

A

SIADH

77
Q

the thyroid is stimulated by ?

A

pituitary

78
Q

pituitary creates ?

A

TSH

79
Q

Thyroxine- 4

◦ Triiodothyronine- T3◦ Calcitonin

A

thyroid hormones

80
Q

actions of the thyroid

A

Regulate basal metabolism
◦ Promotes growth and development◦ Metabolizes fat
◦ Exchange of electrolytes, protein

81
Q

thyroid disorders are more common in?

A

women and thos with family hx

82
Q 
Effects multiple systems:◦ Nails
◦ Hair
◦ Eyes
◦ GI tract
◦ Lungs
◦ Heart
◦ Nervous tissue
◦ Bones
◦ Muscles
A

thyroid disorders

83
Q

Excessive secretion of thyroid production

A

hyperthyroidism

84
Q

Autoimmune disease
◦ Increased T4 production
◦ Women 20-40 yo
◦ Can occur during pregnancy

A

Graves disease

85
Q

hyperthyroidism is of what origin?

A

auto-immune

86
Q
  • Enlargement of thyroid (goiter)•Nervousness
  • Heat intolerance
  • Weight loss
  • Increased appetite
  • Diaphoresis
  • Diarrhea
  • Tremor
  • Tachycardia
  • Exophthalmos (eye protrusion)

signs and sx of?

A

hyperthyroidism

87
Q

hyperthyroidism MSK signs and symptoms

A

periarthritis
calcification in joints
proximal muscle weakness

88
Q

Decreased or normal TSH
◦ Elevated T3, T4
◦ Increased radioactive iodine uptake

dx for?

A

hyperthyroidism

89
Q

Spontaneous remission◦ Medications
◦ Radioactive iodine
◦ Surgery

tx for?

A

hyperthyroidism

90
Q

Decreased thyroid hormones◦ DECREASED METABOLISM

A

hypothyroidism

91
Q

what are the 2 types of hypothyroidism?

A

type 1- hormone deficient

type 2- hormone resistant

92
Q 
Autoimmune- Hashimoto’s Thyroiditis◦ 
Surgery 
◦ Overmedicated hyperthyroidism 
◦ Diet
◦ Congenital

etiology for?

A

hypothyroidism

93
Q

Rare, 1 in 5000

A

congenital hypothyroidism

94
Q

Mental retardation◦ Motor retardation

◦ Delayed puberty

A

cretinism

95
Q 
Slowed metabolism
◦ Decreased GI tract mobility
◦ Weight gain
Bradycardia
Slowed neurological function
◦ Slow speech
◦ Decreased short term memory
◦ Increased sleep
◦ HA
Cerebellar ataxia
◦ Mood chages
Increased cholesterol and triglyceridesAnemia

sx of?

A

hypothyroidism

96
Q 
MSK Symptoms:
•Proximal hip weakness
•Myalgia
•Stiffness in small joints (arthritis)
•Paresthesia without objective findings•Joint edema
•Increased bone density
•Carpal tunnel syndrome
A

hypthyroidism

97
Q 
General Symptoms:
•Fatigue
•Dry skin
•Hair loss
•Cold intolerance
•Hoarse voice
A

hypothyroidism

98
Q

TSH elevated
◦ T3 normal
◦ T4 decreased
◦ CPK-MB elevated (cardiac muscle)

dx for?

A

hypothyroidism

99
Q 
Synthetic thyroids (synthroid, levoxyl)◦
Side effects: afib, osteoporosis

tx for?

A

hypothyroidism

100
Q

Severe CAD- atherosclerosis
◦
Increased triglycerides, cholesterol

prognosis for?

A

hypothyroidism

101
Q
  • Rare
  • Slow growing
  • Women, 20-60 yo
A

thyroid cancer

102
Q

risk factors for thyroid cancer

A

low iodine

radiation exposure

103
Q

•Symptoms: nodule, vocal cord paralysis, lymphadenopathy

A

thyroid cancer

104
Q

most common types of thyroid cancer

A

papillary and follicular carcinoma

105
Q

Develops in one lobe
Slow growing
Spread to lymph nodes

A

papillary carcinoma

106
Q

spreads to lung, bones

A

follicular carcinoma

107
Q 
Surgery
◦ Adioactive iodine
◦ Chemo
◦ Radiation
◦ 5 year survival rate: 97%

tx for?

A

thyroid cancer

108
Q

manages calcium levels in the body

A

parathyroid hormone

109
Q

MSK symptoms:
◦ Periarthritis
◦ Tendonitis
◦ Calcification

A

parathyroid

110
Q

Primary: too much PTHHYPERcalcemia◦ Usually caused by tumor

A

hyperparathyroidism

111
Q 
Thirst
Frequent urinationHTN
Heartburn
Mental confusion
Kidney stones
Joint pain

sx of?

A

hyperparathyroidism

112
Q

Secondary: low calcium levels in the blood and increase production of PTH

A

parathyroidism

113
Q

Etiology: low vitamin D, kidney disease (phosphate)

A

hyperthyroidism

114
Q 
Risk Factors: most lead to hypocalcemia◦ Onset after 60 yo
◦ Benign tumor
◦ Renal failure
◦ Paget’s disease
◦ Multiple myeloma
◦ CA with bone metastasis
◦ Laxative abuse
◦ Vit D deficiency
A

hyperparathyroidism

115
Q

Diagnosis:
◦ PTH measurement- hypercalcemic◦ Electrolyte measurement
◦ Xray of bones (demineralization)

A

hyperparathyroidism

116
Q

Treatment:
◦ Parathyroidectomy
◦ IV hydration to drop Ca levels

A

hyperthyroidism

117
Q 
Decreased secretion of PTH
◦ HYPOcalcemia
◦ Increased phosphate
◦ Tetany
◦ Decreased bone reabsorption
A

hypoparathyroidism

118
Q 
Etiology:
◦ Iatrogenic
◦
◦
◦
◦
◦
◦
Removed during thyroidectomyInfarction of parathyroid
Scar tissue
Tumor
Trauma
Low vitamin D
A

hypoparathyroidism

119
Q 
CNS effects
◦ Irritability
◦ Anxiety
◦ Agitation
MSK effects
◦ Increased osteoclasts
◦ Tetany
◦ Spasm of respiration musclesCardiac effects
◦ Dysrhythmia
A

hypoparathyroidism

120
Q

Diagnosis:
◦ Electrolyte levels
◦ Decreased PTH

A

hypoparathyroidism

121
Q 
Treatment:
◦ Tetany- emergent
◦ IV calcium
◦ Vit D supplementation◦ Maintain open airway
◦ Medications
◦ NO SURGERY
A

hypoparathyroidism

122
Q

adrenal cortex secretes what 3 things/

A

mineralocorticoids
glucocorticoids
sex steroids

123
Q

what 2 secretions of adrenal cortex regulate blood pressure?

A

mineralocorticoids

glucocorticoids

124
Q

Aldosterone- reabsorb Na, excrete K

A

mineralocorticoid

125
Q

Cortisol- food metabolism, response to stress, dec inflammation

A

glucocorticoid

126
Q

Testosterone
Estrogen
Progesterone

A

sex steroids

127
Q

adrenal medulla secretes

A

epinephrine

128
Q

INC heart rate
INC heart contraction
INC BP through vasoconstrictionINC blood glucose

effects of what hormone?

A

epinephrine

129
Q

Insufficient cortisol and aldosterone secretion

Men and women, 40-60 yo

A

addisons disease

130
Q 
Primary form: rare
◦ Complication from TB◦ Autoimmune
◦ Neoplasm
◦ Infection
◦ Radiation

what disease?

A

addisons disease

131
Q

Risk factors:
◦ Surgery
◦ Pregnancy◦ Trauma
◦ Infection

A

addisons disease

132
Q

Dehydration
◦ Hypotension
◦ Increased workload on heart◦ Poor coordination

effects of ____ for ____ disease

A

decreased aldosterone

addisons disease

133
Q 
Hypoglycemia
◦ Hypotension
◦ Weakness
◦ Nausea
◦ Emotional disturbance
◦ Paranoia
◦ Increase in skin color on extensor surfaces

effects of _____ for _____ disease

A

decreased cortisol

addisons disease

134
Q

Diagnosis:

◦ Decreased serum cortisol

A

addisons disease

135
Q

Treatment:

◦ Corticosteroids

A

addisons disease

136
Q

Prognosis

◦ Fatal if untreated

A

addisons disease

137
Q

Etiology:
◦ Tumor in hypothalamus or pituitary◦ Rapid taper of corticosteroids
◦
Suppresses ACTH

A

secondary adrenal insufficiency

138
Q

Symptoms:

◦ Cortisol deficiency only: arthralgia, myalgia

A

secondary adrenal insufficiency

139
Q

Symptoms:

◦ Cortisol deficiency only: arthralgia, myalgia

A

secondary adrenal insufficiency

140
Q

Treatment
◦ ACTH replacement therapy
◦ Manage fluid/electrolyte balance

A

secondary adrenal insufficiency

141
Q

excessive cortisol levels

A

cushings

142
Q

Etiology:
◦ Tumor of adrenal gland
◦ High dose of steroids (usual PT presentation)◦ Excess of ACTH

A

cushings syndrome

143
Q

MSK symptoms:
Proximal muscle wasting
Osteoporosis, fractures
Weakened muscle, skin tissue (stretch marks)

A

cushings

144
Q 
General symptoms:
Hyperglycemia
Hypertension
Decreased wound healingCushionoid face
Increased weight
Buffalo hump
A

cushings

145
Q

adipose tissue

roles

A

Conserve energy
◦ Vasoconstriction (angiotensin)
◦ Inflammation (leptin)
◦ Angiogenesis (vascular endothelial growth factor)

146
Q

how does obesity occur?

A

Leptin alters hunger in the hypothalamus, INCREASE in humans

147
Q

Metabolic disease that is defective in secretion of insulin, action of insulin, or both

A

diabetes mellitus

148
Q

Deficiency of insulin production and secretion◦ Autoimmune disease of pancreas
◦ Require insulin injections

A

type 1 diabetes

149
Q

Cellular resistance to insulin and inadequate insulin secretion response◦
Controlled with diet, exercise, oral hypoglycemic agents

A

type 2 diabetes

150
Q

Decreased insulin sensitivity OR Increased insulin resistance

A

prediabetes

151
Q

Decreased glucose into cells for energy= what?

A

INC glucose levels in bloodstream

152
Q 
Risk Factors:
◦ Family hx
◦ African American
◦ BMI >25
◦ Age >45 yo
◦ Sedentary lifestyle
◦ PMH gestational DM or delivery of 9 lb baby◦ Insulin resistance
◦ Vascular disease
◦ HTN
◦ HDL 250
◦ Smoker

risk factors for?

A

type 2 diabetes

153
Q

Symptoms of:
•Hyperglycemia
•Blood and urine glucose•Ketone abnormalities

A

diabetes

154
Q

Testing: diabetes

  1. Classic sx plus casual plasma glucose of > ???? mg/dL
  2. Fasting plasma glucose >????mg/dL (after 8 hrs)
  3. 2 hr postload glucose >???? mg/dL in oral glucose tolerance test4. A1c > ????
A

200
126
200
6.5

155
Q

Autoimmune destruction of beta cellsinsulin deficiency◦ Excess glucose from kidneysurineexcretepolydipsia

A

type 1 DM

156
Q

Risk factors:
◦
◦
Likely to have another autoimmune disorder (Graves, Addisons)HLA/chromosomal abnormality (Down syndrome)

A

type 1 DM

157
Q

major metabolic problems of type 1 DM

A

decreased use of glucose
increased fat metabolism –> ketones
impaired protein utilization

158
Q 
Symptoms: 
◦ Hyperglycemia
◦ Polyuria
◦ Polydipsia
◦ Weight loss with polyphagia◦ Blurred vision
◦ Fatigue
◦ Diabetic ketoacidosis
A

type 1 DM

159
Q 
Treatment:
◦ Exogenous insulin
Fingersticks to determine amount1-4 x/day injections ie. Humalog
Insulin pump- constant
◦ Dietary management
A

type 1 DM

160
Q

Difficulty with effective insulin action at the cellular level◦ Need to prevent HYPERglycemia

A

type 2 DM

161
Q 
Risk factors:
◦ Obesity
◦ Sedentary lifestyle◦ Smoking
◦ Gestational DM
◦ HTN
◦ Dyslipidemia
A

type 2 DM

162
Q 
Symptoms:
◦ Polydipsia
◦ Polyuria
◦ Visual blurriness
◦ Neuropathic pain
◦ Infections
◦ Blood lipid abnormalities◦ Comborbidities:
◦
◦
◦
◦
CVD
Neuropathy
Retinopathy
Nephropathy
A

type 2 DM

163
Q

common symptoms for type 1 and 2 DM

A

polydipsia
polyuria
visual bluriness

164
Q 
Treatment:
◦ PREVENTION
◦
◦
◦
Exercise
Diet
Decrease BP
◦ Screening at 45 yo
◦ Medications: metformin
A

type 2 DM

165
Q

comorbidities for DM

A 
atherosclerosis
retinopathy
nephropathy
infection
neuropathy
166
Q

inc glucose, inc fat
metabolism
• CAD, CVA, peripheral vascular disease• Diabetic cardiomyopathy
• Hypertension

A

atherosclerosis

167
Q

ischemia

A

retinopathy

168
Q

end stage renal disease

A

nephropathy

169
Q

skin, UTIs

A

infection

170
Q

Peripheral neuropathic pain◦ Foot ulcers

A

neuropathy

171
Q 
MSK:
◦ Syndrome of limited joint mobility- hands
◦ Tenosynovitis
◦ Carpal tunnel
◦ Adhesive capsulitis
◦ Diffuse idiopathic skeletal hyperostosis (DISH)◦ RA with Type 1
◦ OA with Type 2
◦ Osteoporosis
A

comorbidities for diabetes

172
Q 
Long Term Complications happen where for each thing?
\_\_\_\_\_\_\_: dialysis, kidney transplant
\_\_\_\_\_\_\_: MI, CVA
◦ Baby aspirin
◦ Cholesterol lowering drugs (statins)
\_\_\_\_\_\_\_:
◦ Diabetic ulcers --> prevent amputation
A

kidney
cardiac
integument

173
Q

Shaky, hungry, HA, dizzy◦ Diaphoretic
◦ Shallow respirations
◦ Tachycardia
RAPID ONSET

pt implications for what?

A

hypoglycemia

174
Q

Lethargic
◦ Dull, confused
fruity, acetone smell to breath
GRADUAL ONSET

pt implications for what?

A

hyperglycemia

Patho Exam 3 (3 decks)

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