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Patho Exam 2 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

The decreased secretion of PTH or decreased hormonal response to PTH in the tissues due to removal (surgery) or destruction (autoimmune) of parathyroid gland

A

Hypoparathyroidism

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2
Q
  • loss of receptors on target tissue
  • production of antibodies that block ability of hormone to bind receptor
A

Alterations in Target Tissue Responsiveness

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3
Q

Peptide and Catecholamines

  • Synthesis:
  • Release:
  • Transport:
  • Receptor:
  • Mechanism:
A
  • synthesized in advance and stored in vesicles
  • released by exocytosis with calcium signal
  • transported without a carrier to target tissue
  • receptor found on target cell surface
  • uses second messenger systems
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4
Q

How is Hashimoto’s diagnosed and how is it treated

A
  • Hashimoto’s diagnosis involves detection of these autoantibodies, along with low serum levels of TH.
  • Elevated TSH levels will also be detected in primary hypothyroidism as the body tries to stimulate the thyroid gland to produce more TH
  • Treatment involves replacement of TH.
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5
Q

Reduction of one or more hormones secreted from the adrenal cortex

A

Adrenal insufficiency

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6
Q

______ has both exocrine and endocrine functions

A

Pancreas

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7
Q

Steroid and Thyroid Hormones

  • Synthesis:
  • Release:
  • Transport:
  • Receptor:
  • Mechanism:
A
  • synthesized on demand and cannot be stored
  • released by diffusion once made
  • transport requires a protein carrier to target tissue
  • receptor found inside the cell (cytoplasm or nucleus)
  • alters gene transcription
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8
Q

What does the adrenal medulla produce?

A
  • Catecholamines (neurohormones)
    • Epinephrine
    • Norepinephrine

Released in response to sympathetic stimulation

*Short term stress*

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9
Q

A major metabolic hormone

A

Thyroid hormone

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10
Q

Deficits of growth hormone in children leads to _____ that may be congenital or acquired

A

Dwarfism

  • Congenital-symptoms appear early and include
    • short stature, obesity, immature appearance/voice, delay in skeletal maturation, hyperlipidemia with normal intelligence.
  • Acquired—abnormalities of the hypothalamus and pituitary lead to obesity, skeletal maturation delayed, increased cardiovascular mortality other syndromes
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11
Q

gland that influences all major body systems

A

thyroid

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12
Q

Excess PTH is associated with _____

A

Renal Calculi

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13
Q

An autoimmune disease involving the production of antibodies against the TSH receptor

A

Grave’s Disease

  • antibodies overstimulate the thyroid gland to produce TH independently of TSH
  • This leads to excess TH and goiter
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14
Q

Growth hormone excess is commonly caused by _____ that may occur in acute illness, chronic renal failure, or cirrhosis

A

secretory pituitary adenoma

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15
Q

_____ is released from the parathyroid gland, whihc are tiny masses of glandular tissue on the posterior surface of the thyroid gland

A

PTH (parathyroid hormone)

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16
Q

an autoimmune destruction of the thyroid gland and production of autoantibodies against thyroglobulin, throidal peroxidase and the TSH receptor that blocks receptor function

A

Hashimoto’s Thyroiditis (Disease)

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17
Q

Untreated hypothyroidism that may be life threatening

A

Myxedema Coma

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18
Q

Causes of Goiter in hypo and hyperthyroidism

A
  • Hypothyroidism- the gland enlarges in an attempt to produce more thyroid​
    • ​insufficient iodine intake is the most common cause of increased thyroid-stimulating hormone, leading to goiter
    • diffuse enlargement of the thyroid is most commonly caused by prolonged stimulation by TSH
  • ​Hyperthyroidism- the thyroid enlarges due to overstimulation
    • ​enlargemetn may be stimulated by autoantibodies (as in Graves’ disease)
    • nodular goiters may be caused by malignancy, dietary iron deficiency, and Graves’
  • ​Dysphagia and dyspnea may result from extremely large goiters
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19
Q

the active form of thyroid hormone

A

Triiodothyronine (T3)

  • Most T3 is formed by converting T4 into T3 in the tissues
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20
Q

Adult Symptoms include weakness, fatigue, cold intolerance, constipation, dry skin, bradycardia, delayed deep tendon reflexes, anemia, hyponatremia, depression

A

Hypothyroidism

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21
Q

List some of the s/s of Addison’s Disease and treatments

A
  • Signs and Symptoms
    • Hyperpigmentation (increased ACTH stimulates melanocytes)
    • Hypoglycemia, Hypotension
    • Decreased mineralcorticoid activity
      • Fluid/electrolyte abnormalities
      • Changes in WBC ratios
    • Weakness, fatigue, anemia, anorexia, vomiting, diarrhea, muscle/joint pains
  • Treatments
    • ​Replace missing hormones
    • Hydrocortisone, has the ability to counter the loss of mineralcorticoids and glucocorticoids
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22
Q

Whole body effects of ___ lead to increases in

  • cardiac output; ventilation; food intake; mobilization of glycogen, protein and fat stores; C02 and heat production
A

Thyroid hormone

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23
Q

Tertiary endocrine disorders

A

due to dysfunction of the hypothalamus

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24
Q

Involves autoimmune production of an antibody against the TSH receptor that continually stimulates TSH action on the thyroid

A

Grave’s Disease

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25
Q

Name the three steroid hormones that the adrenal cortex produces

A
  • Mineralcorticoids (outer layer)
    • regulates minerals (sodium and potassium)
  • Glucocorticoids (middle layer)
    • Cortisol- promotes metabolism and response to long-term stress by regulating glucose levels
  • Sex hormones (inner layer)
    • Androgens
    • Some estrogens
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26
Q

_____ disorders commonly involve either an excess or a deficiency of hormone levels, usually due to hyperfunction or hypofunction

A

Endocrine

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27
Q

_____ and _____ are decreased in secondary hypothyroidism

A

TSH and TH

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28
Q
  • Also known as thyroitoxicosis
  • accelerates all metabolic processes
  • characterized by an increases synthesis and secretion of T3/T4 giving rise to an increased metabolic rate
A

Hyperthyroidism

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29
Q

_____ is elevated in primary hypothyroidism

A

TSH

30
Q
  • congenital defect resulting in loss of gland or key enzyme
  • destruction of the gland due to:
    • ischemia, infection, inflammation, autoimmunity, or neoplastic growth
  • aging or atrophy of a gland may result in decrease function
A

Hypofunction

31
Q

Pancreatic islets are hormone-producing tissue that release both _____ and _____

A

Insulin and glucagon

  • beta islet cells release insulin in response to high blood glucose levels
  • alpha islet cells release glucagon in response to low blood glucose levels
32
Q

Most common cause in adults of hypothyroidism

A

Hashimoto’s Disease

33
Q

Disease caused by adrenal atrophy secondary to autoimmune adrenalitis

  • results in 90% loss of adrenal cortices
  • often stable until an illness/stress
  • decrease in adrenal secretion of cortisol
  • increase in ACTH release
A

Addison’s Disease

34
Q

hypersecretion of GH in children before closure of epiphyseal plates results in symmetric linear growth

A

Gigantism

35
Q

Name the clinical consequences of diabetes mellitus

A
  • Microvascular disease
    • thickening of arterioles and capillaries leads to decreased perfusion
    • ischemia can damage vulnerable tissues, such as those in the eye
  • ​Atherosclerosis
    • ​fibrous plaque formation can lead to CAD and stroke
    • Most common with T2DM
  • ​Neuropathies
    • ​changes in the schwann cells, which produce myelin that aid in neural conduction
  • ​Infection
    • ​a loss of sensation, decreased perfusion, increased glucose foster microbial growth
    • impaired white blood cell function
36
Q

Cortisol is produced by the ______ in response to ____-term stress

A

Cortisol – Adrenal Cortex– long term stress

  • acts to alter metabolism to maintain elevated glucose levels
  • acts to suppress inflmamatory and immune responses
  • glucocorticoid
37
Q

The major form of thyroid hormone that is secreted by the thyroid follicles

A

Thyroxine (T4)

38
Q

Hormone levels are regulated by ______

A

negative feedback inhibition

39
Q
  • excessive endogenous hormone production
  • excessive administration of exogenous hormones
  • autoimmune stimulation of the gland
A

Hyperfunction

40
Q

Enhanced activity of the parathyroid glands that results in the hypersecretion of PTH that results in elevated serum calcium levels and excessive secretion of potassium by the kidneys

A

Hyperparathyroidism

  • Primary—caused by adenoma (~85%), hyperplasia (~15%), or rare carcinoma of the parathyroid glands.
  • Secondary—chronic renal failure, decreased synthesis of vitamin D, or renal phosphate retention promote hyperplasia of the parathyroid gland and increased synthesis and release of PTH.
  • Persons are often asymptomatic, but may may present with fatigue, hypertension, constipation, renal stones, bone pain.
41
Q

A reduction in the amount of thyroid hormone produced

A

Hypothyroidism

  • cretinism in children (TH deficiency in an embryo or neonate)
  • myxedema in adults
42
Q

Lipid-soluble hormones include ____ and _____

A

Steroid and thyroid hormones

43
Q

An enlargement of the thyroid gland

A

goiter

  • can be caused by hyperthyroid or hypothyroid
44
Q

Neurohormones (E/NE) are produced by the _______ in response to ____-term stress

A

Neurohormones– Adrenal Medulla- Short-term stress

45
Q

Signs/Symptoms of Cushing’s Syndrome

A
  • largely result from excess cortisol
    • altered fat metabolism and redistribution (“moon” face or “buffalo hump”)
    • muscle wasting (weakness)
    • accelerated bone metabolism (fx, renal calculi)
    • altered glucose metabolism (diabetes)
    • increased risk of infection (anti-inflammatory)
    • increase androgens
      • ​hirsutism, acne, irrular menstruation
  • Treatment:
    • ​surgery, irradiation, medicines
46
Q

Thyroid gland produces _____ and _____

A

thyroid hormone and calcitonin

47
Q

Hypothyroidism is almost always _______

  • Primary or secondary
A
  • is almost always primary (95% are a disorder of gland itself)
  • may be secondary (caused by complications in pituitary or hypthalamic functions)
  • may be congenital or acquired
48
Q
  • A metabolic disorder characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency
  • Decreased responsiveness to insulin due to decreased receptor number or sensitivity
  • Genetic component but obesity is most important factor
A

Type 2 DM (NIDDM, Adult-onset)

  • accounts for 90-95% of DM
  • Underlying causes are considered genetic and environmental, with increased risk among individuals with a positive family history
49
Q

____ are released from endocrine glands, travel through the blood, and interact with a target organ

A

Hormones

50
Q

The most common cause of hyperthyroidism

A

Graves’ Disease

51
Q

Hypersecretion of GH in adults results in

  • thickening of tissues on hands, feet, nose and mandible
  • arthritis
  • hypertension, CAD, CHF
A

Acromegaly

52
Q

What are some of the treatments for Graves’ Disease

A
  • Surgery
  • Radioactive iodine to ablate part of the thyroid
  • Thiouracil to block TH synthesis
  • lithium to block TSH secretion
  • iodine to block the additional production of TH
53
Q

Primary endocrine disorders

A

originate in the gland responsible for producing/releasing the hormone

54
Q

Secondary endocrine disorders

A
  • caused by decreased hormone production or release from the pituitary
  • target gland is essentially normal but its function is abnormal by defective levels of stimulating hormones
55
Q

Prolonged untreated hyperthyroidism may decompensate and become _______ which may be triggered by illness or surgery

A

Thyrotoxic Crisis

56
Q

A life-threatening situation that occurs as a result of insufficient glucocorticoids and may be precipitated by severe infection, trauma, surgery and dehydration

Presents with confusion, headache, N/V, muscular weakness, hypotension, dehydration and vascular collapse

Clinical manifestations: hypoglycemia, hyperkalemia, hyponatremia

Tx: fluid and glucocorticoid replacement, followed by mineralcorticoid replacement

A

Adrenal Crisis

57
Q

Often occurs because of excess production of ACTH from a pituitary tumor

A

Cushing’s Disease

58
Q

Occurs when there is a lack of ACTH from the anterior pituitary, may occur with exogenous glucocorticoid therapy or with a pituitary or hypothalamic tumor

A

Secondary insufficiency

  • Signs and symptoms may be similar to primary but aldosterone secretion is normal and hyperpigmentation is usually absent
  • presence of cushingoid fetures accompanys adrenal insufficiency due to exogenous glucocorticoids
59
Q

What are some of the consequences of Grave’s Disease

A
  • hypermetabolism
    • weight loss, muscle weakness, increased ventilation to meet oxygen demand, increased heat production
  • increased sympathetic nerve activity
    • incrased expression of beta-adrenergic receptors, increased sympathetic activation
60
Q

Reduces plasma calcium levels by causing calcium to be deposited into the bone

A

Calcitonin

61
Q

_____ released when glucose levels are high (absorptive phase), and acts to take glucose into cells, thereby lowering blood glucose levels.

_____ released when plasma glucose levels decrease (post-absorptive), thereby raising plasma glucose levels by stimulating glucogenolysis, lipolysis, and gluconeogenesis.

A

Insulin

Glucagon

Insulin acts to take glucose into cells, lowering blood glucose levels

Glucagon raises plasma glucose levels and acts the opposite of insulin

62
Q

_____ is released from the thyroid gland and stimulates uptake of calcium when blood levels are high

A

Calcitonin

63
Q

refers to the physiologic manifestations of excess glucocorticoids or hypercorticalism from any cause

A

Cushing’s Syndrome

  • Causes include
    • excess production of ACTH from a tumor in pituitary (Cushing disease)
    • adrenal tumor
    • ectopic ACTH-releasing tumar (small cell lung carcinoma)
    • glucocorticoid treatment (iatrogenic Cushing syndrome)
64
Q

_____ can have profound and diverse effects

  • mental function, cardiac function, energy utilization
  • Symptoms are insidious and nonspecific
A

Thyroid dysfunction

65
Q

Decreased calcium levels cause _____ and _____

May be life threatening and can cause _____

A

Decreased calcium levels causes increased neuromuscular and symptoms of tetany

May be life-threatening with vocal cord palsy, stridor, and seizures

66
Q

Why does primary adrenal insufficiency occur and what are the two major causes of it?

A
  • When there is damage to the adrenal cortex
  • Is mainly caused by autoimmune disease and tuberculosis
67
Q

Complete or near absence of insulin due to the desctruction of the beta cells (autoimmune, viral, genetic)

A

Type 1 Diabetes Mellitus

(IDDM, juvenile)

  • associated with high plasma glucose levels, metabolic disorders, and ketoacidosis
    • Often presents with DKA
  • treatment with exogenous insulin
68
Q
  • Regulates metabolism and is important for growth and development
  • Permissive for growth promoting actions of growth hormone
  • Essential the development of the nervous system
    • increases protein synthesis in many types of cells
    • regulates the rate at which oxidative phosphorylation takes place
    • controls oxygen consumption and the production of heat and this determines the basal metabolic rate.
A

Thyroid Hormone

69
Q

_____ also called somatotropin, is a general metabolic hormone that promotes growth of skeletal muscle and stimulates extension of the long bones before puberty, by acting on the epiphyseal plate

A

Growth hormone Metabolic effects include:

  • stimulation of protein anabolism and fat catabolism, while sparing glucose to helps maintain glucose homeostasis.
70
Q

Water soluble hormones include ____ and _____

A

peptides and catecholamines

Patho Exam 2 (6 decks)

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