Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ASforP > Endocrine conditions > Flashcards

Endocrine conditions Flashcards

1
Q

Is hyper or hypothyroidism more common?

A

Hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the Hypothalamic Pituitary Thyroid Axis in simple terms?

A

Thyrotropin Releasing Hormone TRH is released from the hypothalamus and to the pituitary gland
This signals the release of Thyroid simulating TSH from the pituitary gland to the thyroid

The Thyroid then produces Thyroid hormones:
Thyroxine – T4
Triiodothyronine – T3

Negative feedback loop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the general effects of thyroid hormones on bodily systems?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do thyroid hormones affect metabolism regulation?

A

Thyroid hormones stimulate the production of enzymes involved in glucose oxidation and increase the rate of oxygen consumption in cells. This results in an elevated basal metabolic rate (BMR), leading to increased energy expenditure and heat production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do thyroid hormones affect temperature regulation?

A

Thyroid hormones influence metabolism and therfore thermogenesis, the process of heat production in the body. They modulate the efficiency of energy conversion to heat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the cardiovascular affects of thyroid hormones?

A

Thyroid hormones enhance the responsiveness of the cardiovascular system. They increase heart rate, cardiac contractility, and stroke volume, contributing to an overall increase in cardiac output. Additionally, they promote vasodilation, affecting blood pressure regulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the respiratory affects of thyroid hormones?

A

Thyroid hormones impact the respiratory centers in the brain, influencing the rate and depth of breathing.

This ensures that oxygen intake and carbon dioxide elimination match the increased metabolic demands associated with thyroid hormone activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the gastrointestinal affects of thyroid hormones?

A

Thyroid hormones promote the absorption of nutrients from the gastrointestinal tract. They enhance the motility of the digestive system, ensuring efficient processing and absorption of nutrients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the nervous system affects of thyroid hormones?

A

They modulate neurotransmitter synthesis and release, influencing mood, cognition, and overall mental function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do thyroid hormones affect muscle?

A

Thyroid hormones contribute to muscle contractility and tone. They enhance the efficiency of energy use in muscle cells, affecting overall muscle function and strength.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do thyroid hormones affect the reproductive system?

A

Thyroid hormones play a role in the regulation of the menstrual cycle and fertility. They are crucial for normal reproductive function, influencing the development of reproductive organs and the maintenance of hormonal balance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the effects of thyroid hormones on bone?

A

Thyroid hormones affect bone turnover by influencing the activity of osteoblasts and osteoclasts. Proper thyroid function is essential for maintaining bone density and preventing conditions such as osteoporosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the affects of thyroid hormones on cholesterol?

A

Thyroid hormones impact lipid metabolism, regulating the synthesis and breakdown of cholesterol. Changes in thyroid function can alter circulating lipid levels, potentially influencing cardiovascular health.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the effects of thyroid hormones on the skin and hair?

A

Thyroid hormones contribute to the health of the skin and hair. They influence skin hydration, integrity, and hair growth, and imbalances can lead to changes in skin texture and hair quality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How much do the levels of TSH and T4 in the blood vary?

A

TSH secreted by the pituitary gland remains at a constant level in your blood circulation, but the level increases when the T4 levels fall and decrease when T4 levels in the blood rise. This hypothalamic-pituitary-thyroid feedback loop keeps the levels of T4 in your blood stable and reacts to small changes immediately.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is hypothyroidism?

A

An underactive Thyroid gland, causing reduced levels of T3 and T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can cause hypothyroidism?

A

Hashimoto’s Thyroiditis (An autoimmune conditionwhere the body attacks thyroid gland)
Pituitary tumour (Stops the anterior pituitary gland releasing TSH)
Iodine deficiency (Thyroid hormones are made of idodine)
Medications, radioactive iodine treatment and thyroid surgery and conditions affecting the pituitary gland can also result in hypothyroidism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the ‘cellular’ symptoms of hypothyroidism?

A

Weight gain – Reduced cellular metabolism

Reduced body temperature – Heat is a biproduct of cellular metabolism – which is reduced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the cardiovascular symptoms of hypothyroidism?

A

Bradycardia and hypotension – reduction in heart rate and increases in vasoconstriction. T3&T4 maintain vaso-motortone – when reduced tips balance to vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the MSK symptoms of hypothyroidism?

A

Bones - Decreased bone growth and maturation – Thyroid hormone maintains a balance between osteoblasts and osteoclasts

Muscle weakness – myopathy as not regenerating when injured - decrease muscle contraction - shoulder hip areas most common

Skin – hair loss (common outer 3rd of eyebrow)s, brittle and thin nails = decreased cutaneous blood flow to skin, hair and nails – therefore reduces oxygen and nutrients

Dry and pale skin – less blood flow and secretions.

Decreased sebum production, also causes decreased sweating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the neuro symptoms of hypothyroidism?

A

Depression
Fatigue
Lethargy
Memory issues
Decreased sympathetic nervous system activity + more parasympathetic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the reproductive system symptoms of hypothyroidism?

A

Decreased sperm production
Decreased sex drive and erectile dysfunction
Decreased ovulation leading to infertility
Oligomenorrhea and amenorrhea
-due to reduced Thyroid hormones – the feedback loop produces more TSH which in turn creates more prolactin eventually inhibiting the production of testosterone and oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the GI symptoms of hypothyroidism?

A

Constipation
-Slows down GI motility and secretions – does not move as fast and so absorbs more water and electrolytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is hyperthyroidism?

A

An overactive thyroid causing an increased levels of T3 and T4 Thyroid hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes hyperthyroidism?

A

Graves disease (An autoimmune disease where the thyroid is over stimulated by autoimmune response to produce thyroid hormones.)
Thyroiditis (viral infection can trigger the release of hormones that were stored in the thyroid gland)
Iodine intake
Tumour of pituitary gland
Excess thyroid medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Graves disease?

A

Graves’ diseaseis a condition where the immune system causes the thyroid gland to become overactive and produce too much hormone. Your thyroid gland might be enlarged and referred to as a diffuse toxicgoitre.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the ‘cellular’ symptoms of hyperthyroidism?

A

Weight loss = increased cell metabolism activity

Increased body temperature = sweat more ad can cause dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the cardiovascular symptoms of hyperthyroidism?

A

Tachycardia = Increase sensitivity of beta receptors on heart tissue increases heart rate

Hypertension = Increased contractility – increased stroke volume – increased cardiac output – hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the MSK symptoms of hyperthyroidism?

A

Osteoporosis/fractures (Bone tissue too high favours osteoclasts - more calcium pulls from bone)
Muscle weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the neuro symptoms of hyperthyroidism?

A

Anxiety/insomnia/irritability (Increased SNS – constant fight of flight)

Eye lid retraction and lag (SNS acts on muscles of eye – ‘Levator palpable superirois’)

Exophthalmos (over stimulation of some cells in the retro-orbital space causing excess water accumulatio, swelling and increases the adipose tissue - the eyes become prominent)
-most common in Graves disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the GI symptoms of hyperthyroidism?

A

Diarrhoea = increased GI secretions, therefore can decrease volume in blood and can lead to hypovolaemia

32
Q

What are the reproductive system symtpoms of hyperthyroidism?

A

Reduced libido
Reduced sperm production
Infertility
Menstural abnormalities (Increased sex hormone binding globulins which bind oestrogen and testosterone – resulting in low circulating oestrogen and testosterone in the blood)

33
Q

What are the intergummentary symptoms of hyperthyroidism?

A

Increased hair growth
Increased nail growth
Increased sweating and sebum (oily skin)
Flushed skin (blood supply increased)

34
Q

What is the normal onset age for hypothyroidism?

A

Anyone can develop hypothyroidism, but people ages 50 years and above are at greater risk, and women are at higher risk than men.

35
Q

What are the symptoms of hypothyroidism in children?

A

Slow speech
Droopy eyelids
Puffy and swollen face
Enlarged thyroid, producing a goiter-like growth on the neck

36
Q

What are the symptoms of DKA?

A

Fatigue/drowsiness
Confusion
TLoC/LoC
Stomach pain
Nausea
Vomiting (red flag symptom)
Need to urinate/polyurea
Thirst
Sweet smelling breath (not everyone can smell this)
Blurred vision (long term sign)

High blood sugar levels
High ketones

37
Q

What is Kussmaul breathing?

A

Deep laboured breathing aiming to blow off CO2 - common in DKA patients

38
Q

What are the risk factors for DKA?

A

Illness and infection
Poor insulin therapy
Pancreatitis
Hyperthyroidism
Emotional/physical trauma/stress
Alcohol/drugs
Pregnancy
Medications - some antipsychotics and steroids
Age <5yrs
Hispanic/black background

39
Q

Where fluids are indicated for DKA patients, what clinical feature will change your management, why?

A

Whether they are shocked or non-shocked

It was previously thought that rapid fluid administration in DKA contributed to cerebral oedema.

40
Q

What is the association between DKA and cerebral oedema?

A

<1% of DKA patients will develop cerebral oedema but there is a strong association with cerebral oedema and mortality.

You must be alert and constantly asses DKA patients for neurological signs.

41
Q

What are the risk factors for Graves disease?

A

Several environmental factors including pregnancy (mainly postpartum), iodine excess, infections, emotional stress, smoking, and interferon alfa trigger immune responses on susceptible genes to eventually cause Graves’ disease.

42
Q

What are TSIs, what do they do and where do they come from?

A

Thyroid Stimulation Immunoglobulins.
TSIs are antibodies that tell the thyroid gland to become more active and release excess amounts of thyroid hormone into the blood.

Considerable evidence has accumulated that these immunoglobulins are antibodies to a thyroid plasma membrane antigen whose precise nature remains to be identified.

43
Q

What is Cushing’s syndrome?

A

Cushing’s syndrome (hypercortisolism) is a collection of signs and symptoms due to prolonged exposure to glucocorticoids such as cortisol.

Cushing’s results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure

44
Q

What causes Cushing’s syndrome?

A

Cushing’s syndrome is caused by either excessive cortisol-like medication, such as prednisalone, or a tumor that either produces or results in the production of excessive cortisol by the adrenal glands.

Cases due to a pituitary adenoma are known as Cushing’s disease.

45
Q

What are the symptoms of Cushing’s syndrome?

A

-Rapid weight gain in the face (sometimes called “moon face”), abdomen, back of the neck (sometimes called “buffalo hump”) and chest.
-A red, round face.
-Wounds that heal poorly.
-High blood pressure (hypertension).
-Excessive hair growth on the face, neck, chest, abdomen, breasts and thighs, or balding.
-Diabetes.

Other signs and symptoms of Cushing syndrome include:
-Purple stretch marks over the abdomen.
-Easy bruising on the arms and legs.
-General weakness and tiredness (fatigue).
-Blurry vision and dizziness.
-Weak muscles and thinner arms and legs.
-Libido changes (sex drive) and erectile dysfunction.
-Stunted growth in children.

46
Q

What’s the difference between Cushing syndrome and Cushing disease?

A

Cushing disease is a type of Cushing syndrome. A benign tumor located in the pituitary gland that secretes too much ACTH (adrenocorticotropic hormone) causes Cushing disease. This increases cortisol secretion from the adrenal glands.

47
Q

What is a pheochromocytoma?

A

A pheochromocytoma is a tumor in the adrenal gland. It causes the gland to make too much of the hormones epinephrine and norepinephrine.

48
Q

What is Addison’s disease?

A

Primary adrenal insufficiency. When the adrenal glands do not produce enough of the necessary hormones, particularly aldosterone and cortisol (among others). And when this insufficiency is due to the adrenal glands themselves (primary) rather than one of the hormones acting on the adrenal glands or a problem elsewhere in the body - this is usually due to damage to the adrenal glands

49
Q

Is primary adrenal insufficiency chronic or acute?

A

It can be both

50
Q

What causes Addison’s disease?

A

Most commonly an autoimmune response, tuberculosis or metasatic carcinoma

51
Q

How does the adrenal glands functional reserve affect the onset of symptoms?

A

The adrenal glands have a high functional reserve, meaning a small amount of functional tissue can uphold normal levels of hormones production.

This means that by the time of symptom onset the damage to the adrenal glands is already significant, sometimes up to 90%.

52
Q

What happens to patients with adrenal insufficiency during times of stress?

A

The adrenal glands cannot increase production of adrenocortical hormones during times of stress. Patients may feel tired, dizzy and exhausted rather than energised. If acute enough this can be an adrenal crisis

They may also experience:
Low blood pressure
Weakness
Weight loss
Skin hyperpigmentation or vitiligo
Nausea
Vomiting
Diarrhea
Constipation
Abdominal pain

53
Q

What is adrenal crisis?

A

Acute adrenal crisis is a medical emergency caused by a lack of cortisol. Patients may experience lightheadedness or dizziness, weakness, sweating, abdominal pain, nausea and vomiting, or even loss of consciousness.

An adrenal crisis may be the first presentation of adrenal insufficiency or can occur in patients on glucocorticoid replacement therapy.

54
Q

What can precipiate an adrenal crisis?

A

Infection
Physical stress (e.g. surgical procedure or trauma)
Forgetting or discontinuing glucocorticoid therapy
Pronounced physical activity
Psychological stress

55
Q

What is the prehospital treatment for adrenal crisis?

A

Prompt recognition and administration of parenteral hydrocortisone, rehydration and management of electrolyte abnormalities. Time-critical transfer to hospital.

56
Q

What are the current classifications for different types of diabetes?

A

The terms of new classification system identifies 4 types:

Type 1
Type 2
“Other specific types” (Of which there are many)
Gestational diabetes

57
Q

What do the terms mellitus and insipidus mean in terms of diabetes?

A

Mellitus - Defined as an increase in the formation of glucose content in the urine

Insipidus - The excess formation of non-glucose urine

Diabetes insipidus is a rare condition where you pee a lot and often feel thirsty. Diabetes insipidus is a dysfunction of the pituitary gland and/or kidneys and is not related to type 1 diabetes or type 2 diabetes (also known as diabetes mellitus)

58
Q

What is the difference between type 1 and type 2 diabetes in general terms?

A

Type 1 diabetes – a lifelong condition where the body’s immune system attacks and destroys the cells that produce insulin.

Type 2 diabetes – where the body does not produce enough insulin, or the body’s cells do not react to insulin properly (insulin resistance).

59
Q

Is type 1 or type 2 diabetes more common?

A

Type 2 diabetes is far more common than type 1. In the UK, over 90% of all adults with diabetes have type 2.

60
Q

What is pre-diabetes?

A

Non-diabetic hyperglycaemia - Blood sugar levels above the normal range, but not high enough to be diagnosed as having diabetes.

61
Q

What are the symptoms of diabetes?

A

-feeling very thirsty
-peeing more frequently than usual, particularly at night
-feeling very tired
-weight loss and loss of muscle bulk (more common with type 1)
-itching around the penis or vagina, or frequent episodes of thrush
-blurred vision

62
Q

Which form of diabetes is more commonly asymptomatic?

A

Type 2 - some people may have type 2 diabetes for years without knowing

63
Q

How can you reduce your risk of type 1 and type 2 diabetes?

A

There are no lifestyle changes you can make to lower your risk of type 1 diabetes.

You can reduce the risk of type 2 diabetes through healthy eating, regular exercise and achieving a healthy body weight.

64
Q

What is diabetes insipidus and what causes it?

A

Diabetes insipidus is a rare condition where you pee a lot and often feel thirsty. Diabetes insipidus is caused by problems with a hormone called vasopressin (AVP), also called antidiuretic hormone (ADH). AVP plays a key role in regulating the amount of fluid in the body. It’s produced by specialist nerve cells in a part of the brain known as the hypothalamus.

65
Q

Which pancreatic cells detect raised glucose levels and release insulin?

A

Beta cells

66
Q

What causes type 1 diabetes?

A

The exact cause of type 1 diabetes is unknown. Mechanism is usually autoimmune islet cell destruction.

Other possible causes include:
-Genetics
-Exposure to viruses and other environmental factors

67
Q

What causes type 2 diabetes?

A

Type 2 diabetes is mainly the result of two problems:

-Cells in muscle, fat and the liver become resistant to insulin. As a result, the cells don’t take in enough sugar.
-The pancreas can’t make enough insulin to keep blood sugar levels within a healthy range.

Exactly why this happens is not known. Being overweight and inactive are key contributing factors.

68
Q

What are some possible complications of diabetes?

A

Heart disease and stroke.
Foot and circulation problems.
Sight problems and blindness.
Pain and loss of feeling (nerve damage)
Kidney problems.
Gum disease.

Mainly to do with hyperglycaemic damage to blood vessels

69
Q

How does hyperglycaemia damage blood vessels?

A

Excess blood sugar decreases the elasticity of blood vessels and causes them to narrow, impeding blood flow. This can lead to a reduced supply of blood and oxygen, increasing the risk of high blood pressure and damage to large and small blood vessels.

70
Q

What is Hyperglycaemic hyperosmolar non-ketotic syndrome (HHNS)?

A

Hyperglycaemic hyperosmolar non-ketotic syndrome (HHNS) is a life-threatening complication of uncontrolled diabetes. This syndrome is characterised by severe hyperglycaemia, a marked increase in serum osmolality, and clinical evidence of dehydration without significant accumulation of ketoacids.

71
Q

What is the treatment for type 1 and type 2 diabetes?

A

If you have type 1 diabetes, you’ll need to use insulin to treat your diabetes. You take the insulin by injection or by using a pump.

If you have Type 2 diabetes, you may have to use insulin or tablets, though you might initially be able to treat your diabetes by eating well and moving more.

72
Q

Why should you have a higher index of suspicion of DKA with patients who are pregnant or abuse alcohol?

A

Their blood sugars will not raise as high during a DKA

73
Q

What is the link between abdo pain and DKA?

A

Present in approx 40-75%.
Furthermore, abdominal rebound tenderness, suggesting the presence of an acute abdomen, affects 12% of DKA patients with abdominal pain.

Many mechanisms have been suggested to underlie the abdominal symptoms in DKA, namely acute hyperglycemia mediated impaired gastrointestinal motility (esophageal, gastric and gallbladder), rapid expansion of the hepatic capsule, and mesenteric ischemia precipitated by volume depletion.

74
Q

What patients might continue to present as hypoglycaemic after glucose administration?

A

Insulin overdoses
Alcoholic/drug use
High BMI
Peripheral shut down/peripheral shutdown - innaccurate BM
Liver disease
Pancreatic cancer

75
Q

What can cause primary and secondary or tertiary adrenal insufficiency?

A

Primary:
Addison’s disease
Congenital adrenal hyperplasia
Surgery/injury to adrenal gland

Secondary:
Steroid dependancy (COPD, Asthma, cancer pts etc.)
Pituitary or hypothalamic tumor
Subarachnoid haemorrhage (if affecting pituitary)

76
Q

How is Addison’s disease diagnosed?

A

Blood test. This test can measure blood levels of sodium, potassium, cortisol and adrenocorticotropic hormone (ACTH). A blood test can also measure antibodies related to autoimmune Addison’s disease.

ACTH stimulation test. ACTH tells the adrenal glands to make cortisol. This test measures the level of cortisol in the blood before and after a shot of human-made ACTH.

Insulin-induced hypoglycemia test. This test is done to find out if the pituitary gland is causing secondary adrenal insufficiency. The test involves checking blood sugar and cortisol levels after a shot of insulin.

Imaging tests. A CT scan of the stomach area checks the size of the adrenal glands and looks for other issues. An MRI of the pituitary gland can test for secondary adrenal insufficiency.

ASforP (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions