Endocrine Flashcards by Rachel Belmont

Thyroid hormones, triiodothyronine ____and thyroxine ___, are regulated by thyroid-stimulating hormone (TSH) secretion from the anterior pituitary

T3; T4

How well did you know this?

Not at all

Perfectly

Thyroid hormones produced in follicular cells of thyroid

Regulators of _____; required for normal growth and development of tissues

METABOLISM

How well did you know this?

Not at all

Perfectly

May be congenital or acquired

Majority are primary, due to intrinsic thyroid gland dysfunction

hypothyroidism

How well did you know this?

Not at all

Perfectly

______hypothyroidism (cretinism) typically due to thyroid dysgenesis (lack of development)

Congenital

How well did you know this?

Not at all

Perfectly

_________hypothyroidism due to defects in TSH production (hyposecretion) usually associated with head/brain conditions

Secondary

How well did you know this?

Not at all

Perfectly

Most common cause of acquired hypothyroidism:

lymphocytic thyroiditis (Hashimoto or autoimmune thyroiditis)

How well did you know this?

Not at all

Perfectly

Irradiation of the thyroid gland
Surgical removal of thyroid tissue
can lead to

hypothyroidism

How well did you know this?

Not at all

Perfectly

_____deficiency (required for T3, T4 formation) leads to _____

iodine; hypothyroidism

How well did you know this?

Not at all

Perfectly

Iodine deficiency (required for T3, T4 formation)
Leads to lack of T3/T4, stimulates ___ secretion
Increased ____causes thyroid cells to secrete large amounts of thyroglobulin, which leads to ____ in hypothyroidism

TSH; TSH; goiter

How well did you know this?

Not at all

Perfectly

Decreased basal metabolic rate
Weakness, lethargy, cold intolerance, decreased appetite
Bradycardia, narrowed pulse pressure, and mild/moderate weight gain
signs of

hypothyroidism

How well did you know this?

Not at all

Perfectly

Elevated serum cholesterol and triglycerides
Enlarged thyroid, dry skin, constipation
Depression, difficulties with concentration/memory
signs of ______

hypothyroidism

How well did you know this?

Not at all

Perfectly

Loss of eyebrow
Menstrual irregularity
signs of _____

hypothyroidism

How well did you know this?

Not at all

Perfectly

Primary diagnosis of hypothyroidism

elevated TSH

How well did you know this?

Not at all

Perfectly

Secondary diagnosis of hypothyroidism

low TSH

How well did you know this?

Not at all

Perfectly

Low levels of T3 and T4 may not occur until later in the disease course OF _____

hypothyroidism

How well did you know this?

Not at all

Perfectly

Goal is return of euthyroid (normal) state

Must progress slowly

hypothyroidism

How well did you know this?

Not at all

Perfectly

Oral levothyroxine

Resolution of symptoms occurs over weeks

hypothyroidism

How well did you know this?

Not at all

Perfectly

_______occurs in severe or prolonged hypothyroidism

Myxedema

How well did you know this?

Not at all

Perfectly

Generalized, non-pitting edema
Decreased level of consciousness, hypotension, hypothermia, history of precipitating event (trauma, sepsis, certain drugs)
May progress to myxedema coma, a life-threatening condition if treatment not received

Myxedema

How well did you know this?

Not at all

Perfectly

Thyroid hyperfunction with _____synthesis and secretion of T4 and T3 (Graves disease) causes _____

increased; hyperthyroidism

How well did you know this?

Not at all

Perfectly

Thyroid destruction with release of preformed T4 and T3 (Hashimoto thyroiditis)

hyperthyroidism

How well did you know this?

Not at all

Perfectly

Graves disease, autoimmune, tumor related, inflammatory examples of _______

primary hyperthyroidism

How well did you know this?

Not at all

Perfectly

primary hyperthyroidism IS ______

autoimmune

How well did you know this?

Not at all

Perfectly

Stimulation of TSH receptors by TSH (hypersecretion of TSH) caused by ________

secondary hyperthyroidism

How well did you know this?

Not at all

Perfectly

Most common form of _____: autoantibodies bind and stimulate TSH receptors leading to diffuse toxic goiter which is _____

hyperthyroidism; Graves disease

Associated with certain genetic markers Thyromegaly symptoms of ______

hyperthyroidism

Exophthalmos (immune mediated so may not resolve with treatment) Widening of the palpebral fissure resulting in exposed sclera Lid lag, vision changes, photophobia symptoms of _______

hyperthyroidism

Changes in behavior, insomnia, restlessness, tremor, irritability, palpitations, heat intolerance, diaphoresis, diarrhea, inability to concentrate that interferes with work performance; enlarged thyroid gland Increased basal metabolic rate leads to weight loss, although appetite and dietary intake increase Amenorrhea/scant menses symptoms of ______

hyperthyroidism

Elevated serum T4 and T3 (confirm) _____

hyperthyroidism

24-hour radioactive iodine uptake study can confirm diagnosis of _____ and exclude presence of thyroid neoplasms

Graves disease

Primary hyperthyroidism has _____ TSH, secondary has ____

low; high

Beta-blockers to block acute symptoms Antithyroid drugs, thionamides (propylthiouracil, methimazole) treat

hyperthyroidism

Radioactive iodine treatment (destroys part of thyroid for

Graves disease

Surgical removal of the thyroid gland typically reserved for tumors Pituitary adenoma treated surgically treatment for

hyperthyroidism

Life-threatening thyrotoxicosis that occurs when excessive amounts of thyroid hormones are acutely released into circulation

thyroid storm

Elevated temperatures, tachycardia, arrhythmias, congestive heart failure Extreme restlessness, agitation, and psychosis Precipitating event: stress, gland manipulation symptoms of ____

thyroid storm

Aggressive management to achieve metabolic balance Antithyroid drugs are given followed by iodine administration treat _____

thyroid storm

Beta-blockers to alleviate cardiac symptoms Antipyretic therapy Fluid replacement treat ______

thyroid storm

Surgical removal of tumors Fatal if not treated treat _______

thyroid storm

______glands located at the upper and lower poles of the thyroid

Parathyroid

Detect serum calcium concentration and help maintain constant levels through the regulation of calcium absorption and resorption from bone

Parathyroid hormone

Calcium needs vitamin _____ to be absorbed

Serum _____levels provide the feedback to regulate parathyroid hormone (PTH) secretion

calcium

_____ in calcium causes PTH release | ______ calcium levels lead to suppression of PTH secretion

decrease; elevated

Important regulator of serum calcium levels Acts on bones, intestine, and renal tubules to increase calcium levels actions of ______

PTH

In bone, increases osteoclastic activity (releases calcium into extracellular fluid) Increases renal calcium reabsorption Increases phosphate excretion by the kidney actions of ________

PTH

Serum _____ levels altered in parathyroid disorders

calcium

Calcitonin influences processing of _______, increases _____ formation, and decreases blood _____ levels

calcium; bone, calcium

Causes: idiopathic, genetic, parathyroid adenoma, hyperplasia of parathyroid glands, chronic renal failure (reduced vitamin D)

Hyperparathyroidism

Bone resorption and formation rates are increased

Hyperparathyroidism

Excessive parathyroid gland secretion rarely causes hypercalcemic crisis Malignant cells can release PTH-like hormones; are a more frequent cause of hypercalcemic crisis

Hyperparathyroidism

Despite an elevated ____ level, PTH continues to be secreted in _____

calcium; Hyperparathyroidism

Some drugs such as lithium and thiazides can increase calcium levels in _____

Hyperparathyroidism

_____ inhibits thyroid hormone production | Amiodarone causes ______toxicity

lithium; thyroid

Kidney stones Bone demineralization (osteoporosis) Polyuria and dehydration symptoms of ______

Hyperparathyroidism

Anorexia, nausea, vomiting, constipation Bradycardia, heart block, and cardiac arrest symptoms of ______

Hyperparathyroidism

Manifestations result from high serum calcium levels and bone demineralization High serum calcium levels decrease neuromuscular excitability symptoms of _______

Hyperparathyroidism

serum calcium levels elevated with low to normal phosphorus | diagnoses

Primary Hyperparathyroidism

Urinary excretion of calcium and phosphorus are elevated; serum PTH levels are elevated diagnose ______

Hyperparathyroidism

Surgical removal of parathyroid gland Hydration (to prevent stones) and ambulation to maintain bone density treat ______

Hyperparathyroidism

For ______crisis: rapid volume expansion with 0.9% NS; diuretics in ______

hypercalcemic; Hyperparathyroidism

May be idiopathic, autoimmune | Secondary: parathyroid or thyroid surgery; may be temporary or permanent

Hypoparathyroidism

Can occur with removal of parathyroid gland Congenital lack of parathyroid tissue and idiopathic hypoparathyroidism are causes of hypoparathyroidism in children and infants

Hypoparathyroidism

Circumoral numbness, paresthesias of the distal extremities, muscle cramps, spasms, fatigue, hyperirritability symptoms of _______

Hypoparathyroidism

anxiety, depression, prolonged Q-T intervals, increases in intracranial pressure symptoms of ______

Hypoparathyroidism

Severe symptoms: carpopedal spasm, laryngospasm, and seizures Tetany: Chvostek or Trousseau sign Manifestations result from low serum calcium levels; increased neuromuscular excitability

Hypoparathyroidism

Serum calcium level is ______ and phosphorous is _____ to diagnose hypoparathyroidism

low; high

Antibodies to parathyroid gland present if autoimmune mechanism involved

Hypoparathyroidism

Acute hypocalcemic crisis (tetany, laryngospasm, and convulsions)—IV calcium and calcitriol, an activated form of vitamin D Long-term treatment: oral calcium supplement with vitamin D to treat ______

Hypoparathyroidism

________secreted by the posterior pituitary gland

ADH (vasopressin)

Increased serum osmolality stimulates secretion of ____

ADH

_____acts directly on renal collecting ducts and distal tubules, increasing membrane permeability to and reabsorption of water, resulting in concentrated ____ in _______

ADH; urine; Diabetes Insipidus

Damage to hypothalamus ADH-producing cells Brain injury, tumors, or procedures in _____

Diabetes Insipidus

Means large diuresis of inappropriately dilute urine

Diabetes Insipidus

______ diabetes: involves hypothalamus or pituitary gland | _______ diabetes: involves kidneys

central; nephrogenic

Low urine-specific gravity Nocturia symptoms of ______

diabetes

``` Hypernatremia due to water deficit Dry mucous membranes, poor skin turgor, decreased saliva and sweat production Disorientation, lethargy, seizures Manifestations from cell shrinkage symptoms of _____ ```

diabetes

HALLMARK of diabetes

Polyuria, polydipsia

Dilute urine, high osmolality, hypernatremia along with abnormally low serum ADH levels diagnoses ______

diabetes

Water deprivation test with vasopressin Central DI, urine concentration increases; nephrogenic DI, little or no response diagnoses ____

diabetes

ADH with desmopressin (DDAVP); free access to fluids; home testing of urine-specific gravity treats _______

diabetes

Which of the following laboratory results are consistent with diabetes insipidus? A) Decreased serum osmolality, increased urine osmolality B) Hypernatremia and low serum levels of ADH C) Elevated serum calcium, decreased serum phosphorus D) High serum IGF-1 and elevated serum GH level

B) Hypernatremia and low serum levels of ADH

Excessive ADH from ectopic production from tumors, notably primary lung malignancies Excess ADH stimulates renal tubules to reabsorb water despite decreased blood osmolality