Endocrine

Question 1

Hypothalamus

Answer 1

Part of diencephalon that connects to pituitary gland through the infundibular or pituitary stalk. Regulates ANS (body temp, appetite, sweating, thirst, sexual behavior, rage, fear, blood pressure, sleep) and other endocrine glands through impact on pituitary gland.

Question 2

Pituitary gland

Answer 2

Releases hormones that regulate several other endocrine glands. Influenced by seasonal changes or emotional stress. Secretes endorphins and reduces sensitivity to pain. Controls ovulation and production of sex hormones.

Question 3

Thyroid gland

Answer 3

Controls rate at which cells burn the fuel from food. Increase in thyroid hormones will increase the rate of chemical reactions within body.

Question 4

Parathyroid glands

Answer 4

Maintains normal blood levels of calcium and phosphate. Parathyroid hormone increases reabsorption of calcium and phosphate from bones to blood. Clotting, neuromuscular excitability, and cell membrane permeability are dependent on normal calcium levels.

Question 5

Adrenal glands

Answer 5

Located on top of each kidney. Adrenal cortex produces corticosteroids that regulate water and sodium balance, response to stress, immune system, sexual development and function, and metabolism. Adrenal medulla produces epinepherine that increases heart rate and blood pressure with increased stress.

Question 6

Pancreas

Answer 6

In upper left quadrant of abdomen. Produces glucagon and insulin. Ensure consistent level of glucose in blood stream and maintain stores of energy in body.

Question 7

Ovaries

Answer 7

Secretes estrogen and progesterone.

Question 8

Testes

Answer 8

Secretes androgens (testosterone)

Question 9

Steroid hormones

Answer 9

E.g. prostaglandins
Do not circulate in blood and only exert effects where produced.
Related to inflammation, pain mechanisms, vasodilation, vasoconstriction, nutrient metabolism, and blood clotting.

Question 10

Amine hormones

Answer 10

E.g. catecholamines (epinephrine, norepinephrine, and dopamine).
Produced in adrenal medulla. Sympathetic nervous system stimulation releases the catecholamines into the blood stream, playing a role in flight or fight response. Increases cardiac contraction, constricts blood vessels, activates glycogen breakdown, blocks insulin secretion, increases metabolic rate, and dilates airways within lungs.

Question 11

Peptide hormones

Answer 11

E.g. insulin

Insulin released when there is elevation in the level of blood glucose, increasing uptake of glucose for metabolism.

Question 12

Hypopituitarism

Answer 12

Rare disorders with symptoms that may include dwarfism, delayed growth and puberty, sexual and reproductive disorders, and diabetes insipidus.
Orthostatic hypotension. Bilateral hemianopsia.

Question 13

Hyperpituitarism

Answer 13

Symptoms include gigantism or acromegaly, galactorrhea (abnormal lactation in males or females), amenorrhea, infertility, and impotence.
Bilateral carpal tunnel syndrome, arthritis, osteophyte formation

Question 14

Addison’s Disease

Answer 14

Hypofunction of adrenal cortex.
Etiology: Decreased production of cortisol and aldosterone.
Signs/symptoms: Hypotension, weakness, anorexia, weight loss, altered pigmentation, if untreated shock and death.
Treatment: Corticosteroids and mineralcorticoids

Question 15

Cushing’s Syndrome

Answer 15

Hyperfunction of adrenal gland.
Etiology: Excessive cortisol production.
Sings/symptoms: Hyperglycemia, growth failure, truncal obesity, purple abdominal striae, moon shaped face, buffalo hump, weakness, acne, hypertension, depression, poor concentration, and memory loss.

Question 16

Hypothyroidism

Answer 16

Slows metabolic processes. Symptoms include fatigue, weakness, decreased HR, weight gain, constipation, delayed puberty, and retarded growth/development.

Question 17

Hyperthyroidism

Answer 17

Symptoms include increase in nervousness, excessive sweating, weight loss, increase in BP, exophthalmos, myopathy, chronic periarthritis, and enlarged thyroid gland.

Question 18

Grave’s disease

Answer 18

Most specific cause of hyperthyroidism. Most common in women over age 20.
Etiology: Autoimmune disease in which antibodies produced by immune system overstimulate thyroid gland.
Signs/symptoms: enlarged thyroid gland, heat intolerance, nervousness, weight loss, tremor, and palpitations.
Treatment: Pharmacological intervention and/or removal of thyroid glad using radiation or surgery.

Question 19

Hypoparathyroidism

Answer 19

Symptoms include hypocalcemia, neurological symptoms like seizures, cognitive defects, short stature, tetany, muscle pain, and cramps.
Treatment includes rapid elevation in serum calcium levels through IV. Long term treatment includes pharmacological management and dietary modifications.

Question 20

Hyperparathyroidism

Answer 20

Symptoms include renal stones and kidney damage, depression, memory loss, muscle wasting, bone deformity, and myopathy.
Acute treatment includes pharmacological intervention that lowers serum calcium using diuretics or antiresorptive meds. Surgical intervention required to remove disease parathyroid gland.

Question 21

Type I Diabetes Mellitus

Answer 21

Pancreas fails to produce enough or any insulin. Normally diagnosed in childhood but can occur at any age. Known as insulin-dependent or juvenile diabetes.
Etiology: Genetic predisposition in combination with viral or environmental trigger may cause immune response that damages pancreas.
Signs/symptoms: Rapid onset of symptoms, polyphagia, weight loss, ketoacidosis, polyuria, polydipsia, blurred vision, dehydration, and fatigue.
Treatment: Insulin injections, exercise, and nutritional management.

Question 22

Type II Diabetes Mellitus

Answer 22

Usually occurs over the age of 45 but can occur in children. Usually can produce some insulin but resistant to insulin receptor sites.
Etiology: Hyperglycemia, obesity.
Signs/symptoms: Same as type 1 DM but ketoacidosis does not occur. Gradual onset.
Treatment: Blood glucose control through diet, exercise, oral medication, or insulin injections.

Question 23

Gestational Diabetes

Answer 23

Increase in insulin resistance during pregnancy, usually in last trimester. Believed that hormones that assist the fetus to grow may lead to insulin resistance. Usually return to normal glucose metabolism after pregnancy. Babies at risk for increase glucose levels and increased size. Baby may have breathing difficulties, jaundice, and hypoglycemia after birth.

Question 24

Diabetes Testing

Answer 24

Fasting plasma glucose: > 125 mg/dL is positive
Oral glucose tolerance test: blood glucose test 2 hours after sugary drink. > 200 mg/dL is positive
A1c testing: based on attachment of glucose to hemoglobin over past 2-3 months. > 6.5% is positive

Question 25

Male hypogonadism

Answer 25

Deficiency of testosterone due to failure of testes to respond to FSH and LH. Most common cause is Klinefelter’s syndrome. Secondary hypogonadism occurs when there is a failure of the hypothalamus or pituitary to produce hormones that stimulate testosterone production.
If present before puberty, symptoms include decrease body hair, underdeveloped skeletal muscles, long arms/legs secondary to delay in closure of epiphyseal growth plates.
If onset in adulthood, symptoms include decrease libido, erectile dysfunction, infertility, decreased cognitive skills, mood changes, and sleep disturbances.
Treatment includes hormone replacement.

Question 26

Female hypogonadism

Answer 26

Primary hypogonadism results if gonad does not produce sufficient sex steroid to suppress secretion of LH and FSH at normal levels. Most common primary cause is Turner syndrome. Secondary occurs if there is failure of hypothalamus or pituitary to produce hormones that stimulate production of estrogen.
If onset prior to puberty, symptoms will include gonadal dysgenesis, short stature, failure to progress through puberty, amenorrhea, premature gonadal failure.
If onset after puberty, amenorrhea occurs.
Treatment includes hormone replacement.

Question 27

Bone Mineral Regulating Agents

Answer 27

Action: Enhance and maximize bone mass and prevent bone loss/rate of reabsorption. Typical agents include estrogen, calcium and vitamin D, biphosphonates, calcitonin, and anabolic agents.
Indications: Paget’s disease, osteoporosis, hyperparathyroidism, rickets, hypoparathyroidism, and osteomalacia
Side effects: GI distress, dyspepsia, dysphagia, anorexia, bone pain, cardiac arrhythmias

Question 28

Hormone Replacement Agents

Answer 28

Action: Restore normal endocrine function
Indications: decrease in endogenous hormone secretion
Side effects: Vary by hormone replacement type

Question 29

Hyperfunction Agents

Answer 29

Action: Manage hyperactive endocrine function to inhibit hormone function.
Indications: Hyperactive or excessive endocrine function, excessive hormone levels.
Side effects: Vary