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Patho Exam #4 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

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

A

T3; T4

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2
Q

Thyroid hormones produced in follicular cells of thyroid

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

A

METABOLISM

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3
Q

May be congenital or acquired

Majority are primary, due to intrinsic thyroid gland dysfunction

A

hypothyroidism

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4
Q

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

A

Congenital

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5
Q

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

A

Secondary

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6
Q

Most common cause of acquired hypothyroidism:

A

lymphocytic thyroiditis (Hashimoto or autoimmune thyroiditis)

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7
Q

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

A

hypothyroidism

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8
Q

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

A

iodine; hypothyroidism

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9
Q

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

A

TSH; TSH; goiter

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10
Q

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

A

hypothyroidism

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11
Q

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

A

hypothyroidism

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12
Q

Loss of eyebrow
Menstrual irregularity
signs of _____

A

hypothyroidism

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13
Q

Primary diagnosis of hypothyroidism

A

elevated TSH

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14
Q

Secondary diagnosis of hypothyroidism

A

low TSH

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15
Q

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

A

hypothyroidism

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16
Q

Goal is return of euthyroid (normal) state

Must progress slowly

A

hypothyroidism

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17
Q

Oral levothyroxine

Resolution of symptoms occurs over weeks

A

hypothyroidism

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18
Q

_______occurs in severe or prolonged hypothyroidism

A

Myxedema

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19
Q

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

A

Myxedema

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20
Q

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

A

increased; hyperthyroidism

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21
Q

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

A

hyperthyroidism

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22
Q

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

A

primary hyperthyroidism

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23
Q

primary hyperthyroidism IS ______

A

autoimmune

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24
Q

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

A

secondary hyperthyroidism

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25
Q

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

A

hyperthyroidism; Graves disease

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26
Q

Associated with certain genetic markers
Thyromegaly
symptoms of ______

A

hyperthyroidism

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27
Q

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 _______

A

hyperthyroidism

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28
Q

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 ______

A

hyperthyroidism

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29
Q

Elevated serum T4 and T3 (confirm) _____

A

hyperthyroidism

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30
Q

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

A

Graves disease

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31
Q

Primary hyperthyroidism has _____ TSH, secondary has ____

A

low; high

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32
Q

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

A

hyperthyroidism

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33
Q

Radioactive iodine treatment (destroys part of thyroid for

A

Graves disease

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34
Q

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

A

hyperthyroidism

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35
Q

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

A

thyroid storm

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36
Q

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

A

thyroid storm

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37
Q

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

A

thyroid storm

38
Q

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

A

thyroid storm

39
Q

Surgical removal of tumors
Fatal if not treated
treat _______

A

thyroid storm

40
Q

______glands located at the upper and lower poles of the thyroid

A

Parathyroid

41
Q

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

A

Parathyroid hormone

42
Q

Calcium needs vitamin _____ to be absorbed

43
Q

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

44
Q

_____ in calcium causes PTH release

______ calcium levels lead to suppression of PTH secretion

A

decrease; elevated

45
Q

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

46
Q

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

47
Q

Serum _____ levels altered in parathyroid disorders

48
Q

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

A

calcium; bone, calcium

49
Q

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

A

Hyperparathyroidism

50
Q

Bone resorption and formation rates are increased

A

Hyperparathyroidism

51
Q

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

A

Hyperparathyroidism

52
Q

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

A

calcium; Hyperparathyroidism

53
Q

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

A

Hyperparathyroidism

54
Q

_____ inhibits thyroid hormone production

Amiodarone causes ______toxicity

A

lithium; thyroid

55
Q

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

A

Hyperparathyroidism

56
Q

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

A

Hyperparathyroidism

57
Q

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

A

Hyperparathyroidism

58
Q

serum calcium levels elevated with low to normal phosphorus

diagnoses

A

Primary Hyperparathyroidism

59
Q

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

A

Hyperparathyroidism

60
Q

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

A

Hyperparathyroidism

61
Q

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

A

hypercalcemic; Hyperparathyroidism

62
Q

May be idiopathic, autoimmune

Secondary: parathyroid or thyroid surgery; may be temporary or permanent

A

Hypoparathyroidism

63
Q

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

A

Hypoparathyroidism

64
Q

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

A

Hypoparathyroidism

65
Q

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

A

Hypoparathyroidism

66
Q

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

A

Hypoparathyroidism

67
Q

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

68
Q

Antibodies to parathyroid gland present if autoimmune mechanism involved

A

Hypoparathyroidism

69
Q

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 ______

A

Hypoparathyroidism

70
Q

________secreted by the posterior pituitary gland

A

ADH (vasopressin)

71
Q

Increased serum osmolality stimulates secretion of ____

72
Q

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

A

ADH; urine; Diabetes Insipidus

73
Q

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

A

Diabetes Insipidus

74
Q

Means large diuresis of inappropriately dilute urine

A

Diabetes Insipidus

75
Q

______ diabetes: involves hypothalamus or pituitary gland

_______ diabetes: involves kidneys

A

central; nephrogenic

76
Q

Low urine-specific gravity
Nocturia
symptoms of ______

77
Q 
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 \_\_\_\_\_
78
Q

HALLMARK of diabetes

A

Polyuria, polydipsia

79
Q

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

80
Q

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

81
Q

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

82
Q

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

A

B) Hypernatremia and low serum levels of ADH

83
Q

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

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

84
Q

Adrenal insufficiency and hypothyroidism can cause increased ADH secretion and hyponatremia

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

85
Q

Hyponatremia
High urine osmolality
Low serum osmolality

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

86
Q

Weakness, muscle cramps, N/V, postural BP changes, poor skin turgor, fatigue, anorexia, lethargy

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

87
Q

Confusion, hemiparesis, seizures, coma

Manifestations from cellular swelling

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

88
Q

Treat underlying cause
Free water restriction
to treat _______

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

89
Q

If severe symptoms, IV administration of saline with diuretics is used
to treat _____

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

90
Q

Hyponatremia should be corrected slowly to avoid rapid changes in brain cell volume in _____

A

Syndrome of Inappropriate Antidiuretic

Hormone (SIADH)

91
Q

If hyponatremia persists, drugs such as _____ may be used to block the effects of ADH

Patho Exam #4 (7 decks)

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