Endocrine

Question 1

_____________ secretes releasing hormones and inhibiting hormones that control anterior pituitary.

Also synthesizes vasopressin and oxytocin which go to the posterior pituitary

Answer 1

Hypothalamus

Question 2

Originate in the target organ

Answer 2

Primary Disorder

Question 3

Originate in the pituitary, causing a problem in the target organ (pituitary adenoma)

Answer 3

Secondary Disorder

Question 4

Originate in hypothalamus and cause a problem in both the pituitary and the target organ (irradiation to the brain)

Answer 4

Tertiary Disorder

Question 5

ADH released by the post. pit. in response to:

Answer 5

• Decrease in blood volume
• Decrease in BP
• Increase in osmolarity of body fluids

Question 6

Actions of ADH

Answer 6

• Water re-absorption in the kidney
• Direct vasoconstriction
• Rise in arterial pressure (short term)

Question 7

• Failure of neg. feedback mechanism that regulates ADH secretion
• Too much ADH secreted
• Caused by activation of baroreceptors in carotid arteries, cardiopulmonary receptors

Answer 7

Syndrome of Inappropriate ADH Secretion (SIADHS)

Etiology: Lung tumors, stressful conditions, TB, pneumonia, positive pressure breathing

Question 8

S/Sx of SIADHS

Answer 8

Increased water retention and dilutional hyponatremia

Diagnostic test: Low serum Na+ and high specific gravity

Question 9

Inadequate ADH secretion

Inability of kidneys to reabsorb water

Causes: Neoplastic or inflammatory processes (cancer, abscesses, meningitis), surgical or radiation injury, severe head trauma, intracranial surgery

Answer 9

Diabetes Insipidus

Treat with vasopression or desmopressin

Question 10

S/Sx of D.I

Diagnostic Test

Answer 10

Polyuria (3-20L/day)
Intense thirst and polydipsia
Dryness of mouth and skin
Hypertonic dehydration

Urine will be pale and dilute, increased serum osmolality, hypernatremia

Question 11

Hyposecretion of Growth Hormone

Answer 11

Can cause short stature in children

Treatment: GH injections (recombinant DNA therapy)

Question 12

Hypersecretion of Growth Hormone

Answer 12

• results in gigantism in children due to pituitary adenoma
• in adults, causes acromegaly (increase in bone size, voice deepening, vertebral changes, glucose intolerance, enlargement of heart*)

Question 13

Iodine attaches tyrosine molecules to form _________ and _________

Answer 13

thyroxine (T4) and triiodothyronine (T3)

T4 –> T3 before it can act

Question 14

________ - lowers blood calcium levels by inhibiting the release of Ca from bones

Answer 14

Calcitonin

Question 15

Most common endocrine disorder after diabetes

Most cases primary

Answer 15

Hypothyroidism

Hashimoto’s thyroiditis - autoimmune
(Congenital - cretinism)

Question 16

Primary hypothyroidism

Answer 16

Elevated TSH and low T3, T4

Myxedema (puffiness of face and swelling around eyes) coma-severe and life-threatening

Question 17

Pharm treatment for hypothyroidism

Answer 17

Levothyroxine (T4) (Synthroid)

Question 18

Low secretion of TSH from pit. and high T3, T4 levels

Answer 18

Hyperthyroidism

Less common than hypothyroidism
-Grave’s Disease (Autoimmune): exophthalmos, diffuse goiter, thyrotoxicosi

Question 19

Extreme hyperthyroidism, rarely seen due to improved diagnosis and treatment

Answer 19

Thyroid Storm aka Thyroid crisis

Question 20

___ secretion pulls calcium from the body stores (bones) and diet to increase calcium serum levels

Answer 20

Parathyroid hormone (PTH)

Question 21

• Effects: Loss of bone calcium due to excessive osteoclast activity, resulting in hypercalcemia
• Assessment Findings: Bone weakness (increased risk of fracture, deformity, and pain), muscular and neurological symptoms, kidney stone formation

Answer 21

Hyperparathyroidism

Etiology- parathyroid tumor, gland hyperplasia, autoimmune

Question 22

Hypocalcemia

-Assessment findings-increased neuromuscular excitability, cardiac effects, skeletal effects (if deficiency is long-term)

Answer 22

Hypoparathyroidism

Question 23

Hypocalcemia can cause a

Answer 23

Trousseau’s Sign

Question 24

Primary adrenal insufficiency

Destruction of all layers of the adrenal gland

Autoimmune (most common)

Answer 24

Addision’s Disease (hyperpigmentation - bronzing due to elevated ACTH)

Life-threatening process
7-14 days; need lifelong replacement of affected hormones

Question 25

Results in low _____ ______ levels, elevated ____ levels due to lack of feedback inhibition

Answer 25

adrenal cortisol

ACTH

Question 26

Rapid withdrawal of glucocorticoids

Answer 26

Secondary Adrenal Cortical insufficiency

etiology: hypopituitarism, removal of pituitary

Question 27

Excess production of ACTH by pituitary tumor

Answer 27

Cushing Disease

Question 28

_____ ___: Excessive cortisol production caused by an adrenal tumor

Answer 28

Adrenal form

Question 29

_____ ________: caused by a nonpituitary ACTH secreting tumor

Answer 29

Cushing syndrome

Question 30

Hyperaldosteronism

Renal retention of sodium and water; loss of potassium

Answer 30

Primary: Aldosterone-secreting adenoma
Secondary: Renal ischemia which activates the Renin-Angiotension-Aldosterone mechanism (RAAS)

Question 31

Excess catecholamine secretion (epinephrine and norepinephrine)

Answer 31

Adrenal medulla hypersecretion (PHEOCHROMOCYTOMA)