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
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
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
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.
5
Q
Reduction of one or more hormones secreted from the adrenal cortex
A
Adrenal insufficiency
6
Q
______ has both exocrine and endocrine functions
A
Pancreas
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
8
Q
What does the adrenal medulla produce?
A
-
Catecholamines (neurohormones)
- Epinephrine
- Norepinephrine
Released in response to sympathetic stimulation
*Short term stress*
9
Q
A major metabolic hormone
A
Thyroid hormone
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
11
Q
gland that influences all major body systems
A
thyroid
12
Q
Excess PTH is associated with _____
A
Renal Calculi
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
14
Q
Growth hormone excess is commonly caused by _____ that may occur in acute illness, chronic renal failure, or cirrhosis
A
secretory pituitary adenoma
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)
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)
17
Q
Untreated hypothyroidism that may be life threatening
A
Myxedema Coma
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
19
Q
the active form of thyroid hormone
A
Triiodothyronine (T3)
- Most T3 is formed by converting T4 into T3 in the tissues
20
Q
Adult Symptoms include weakness, fatigue, cold intolerance, constipation, dry skin, bradycardia, delayed deep tendon reflexes, anemia, hyponatremia, depression
A
Hypothyroidism
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
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
23
Q
Tertiary endocrine disorders
A
due to dysfunction of the hypothalamus
24
Q
Involves autoimmune production of an antibody against the TSH receptor that continually stimulates TSH action on the thyroid
A
Grave’s Disease
25
Name the three steroid hormones that the adrenal cortex produces
* **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**
26
\_\_\_\_\_ disorders commonly involve either an excess or a deficiency of hormone levels, usually due to hyperfunction or hypofunction
Endocrine
27
\_\_\_\_\_ and _____ are decreased in secondary hypothyroidism
TSH and TH
28
* **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
**Hyperthyroidism**
29
\_\_\_\_\_ is elevated in primary hypothyroidism
TSH
30
* 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
Hypofunction
31
Pancreatic islets are hormone-producing tissue that release both _____ and \_\_\_\_\_
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
**Most common cause in adults of hypothyroidism**
**Hashimoto's Disease**
33
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
Addison's Disease
34
**hypersecretion of GH in children before closure of epiphyseal plates results in symmetric linear growth**
**Gigantism**
35
Name the clinical consequences of diabetes mellitus
* 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
Cortisol is produced by the ______ in response to \_\_\_\_-term stress
**Cortisol -- Adrenal Cortex-- long term stress**
* acts to alter metabolism to maintain elevated glucose levels
* acts to suppress inflmamatory and immune responses
* **glucocorticoid**
37
The major form of thyroid hormone that is secreted by the thyroid follicles
Thyroxine (T4)
38
Hormone levels are regulated by \_\_\_\_\_\_
negative feedback inhibition
39
* excessive endogenous hormone production
* excessive administration of exogenous hormones
* autoimmune stimulation of the gland
Hyperfunction
40
**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**
**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
A reduction in the amount of thyroid hormone produced
**Hypothyroidism**
* cretinism in children (TH deficiency in an embryo or neonate)
* **myxedema in adults**
42
**Lipid-soluble hormones include ____ and \_\_\_\_\_**
**Steroid and thyroid hormones**
43
**An enlargement of the thyroid gland**
**goiter**
* **can be caused by hyperthyroid or hypothyroid**
44
Neurohormones (E/NE) are produced by the _______ in response to \_\_\_\_-term stress
Neurohormones-- Adrenal Medulla- Short-term stress
45
Signs/Symptoms of Cushing's Syndrome
* 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
Thyroid gland produces _____ and \_\_\_\_\_
thyroid hormone and calcitonin
47
Hypothyroidism is almost always \_\_\_\_\_\_\_
* Primary or secondary
* 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
* 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
**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
\_\_\_\_ are released from endocrine glands, travel through the blood, and interact with a target organ
Hormones
50
**The most common cause of hyperthyroidism**
**Graves' Disease**
51
**Hypersecretion of GH in adults results in**
* **thickening of tissues on hands, feet, nose and mandible**
* **arthritis**
* **hypertension, CAD, CHF**
**Acromegaly**
52
What are some of the treatments for Graves' Disease
* 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
**Primary endocrine disorders**
**originate in the gland responsible for producing/releasing the hormone**
54
**Secondary endocrine disorders**
* **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
Prolonged untreated hyperthyroidism may decompensate and become _______ which may be triggered by illness or surgery
Thyrotoxic Crisis
56
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
Adrenal Crisis
57
**Often occurs because of excess production of ACTH from a pituitary tumor**
**Cushing's Disease**
58
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
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
What are some of the consequences of Grave's Disease
* 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
Reduces plasma calcium levels by causing calcium to be deposited into the bone
Calcitonin
61
\_\_\_\_\_ 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.
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
\_\_\_\_\_ is released from the thyroid gland and stimulates uptake of calcium when blood levels are high
Calcitonin
63
**refers to the physiologic manifestations of excess glucocorticoids or hypercorticalism from any cause**
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
\_\_\_\_\_ can have profound and diverse effects
* mental function, cardiac function, energy utilization
* Symptoms are insidious and nonspecific
Thyroid dysfunction
65
**Decreased calcium levels cause _____ and \_\_\_\_\_**
**May be life threatening and can cause \_\_\_\_\_**
**Decreased calcium levels causes increased neuromuscular and symptoms of tetany**
**May be life-threatening with vocal cord palsy, stridor, and seizures**
66
Why does primary adrenal insufficiency occur and what are the two major causes of it?
* When there is damage to the adrenal cortex
* Is mainly caused by autoimmune disease and tuberculosis
67
**Complete or near absence of insulin** due to the desctruction of the beta cells (autoimmune, viral, genetic)
**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
* 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.
Thyroid Hormone
69
\_\_\_\_\_ 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
Growth hormone Metabolic effects include:
* stimulation of protein anabolism and fat catabolism, while sparing glucose to helps maintain glucose homeostasis.
70
**Water soluble hormones include ____ and \_\_\_\_\_**
**peptides and catecholamines**
