Endocrine/Diabetes Flashcards
The endocrine system is dependent on:
negative feedback systems
Known as the hypophysis
Pituitary gland
Disorder of under secretion of ADH
Diabetes insipidus
Renal-related etiology of Diabetes Insipidus
sick kidneys have decreased response of renal tubules to ADH
CNS related etiologies of DI that cause the pituitary to diminish its secretion of ADH can include:
pituitary tumor
Acute abnormality that puts pressure on the pituitary gland
Regardless of etiology, decreased ADH causes:
water to indiscriminately flow from peritubular capillaries into kidney tubules > very dilute urine
S/S of DI
large amounts of very dilute urine (polyuria)
Polidypsia
S/S of dehydration due to water being pulled from B to T
Disorder of too much ADH secretion
SIADH
Abnormally high levels of ADH can cause:
diluted plasma compartment & lower serum osmo > small amounts of very concentrated urine
Decreased urine output in SIADH is caused by
the body holding onto water inappropriately
S/S of inappropriate water retention:
peripheral & pulmonary edema
S/S of dehydration
Dry mucous membranes, poor skin turgor
SIADH is typically caused by:
Ectopically produced ADH
Drugs that effect the brain
Brain trauma/tumors
SIADH is characterized by:
Abnormally high levels of ADH
Decreasing urination results in
Increased vascular fluid Volume
Hormones secreted by the thyroid gland
Thyroxine & triiodothyronine
Calcitonin
Calcitonin increases calcium movement from ___ to ___
Blood to bone
T3 & T4 are dependent on uptake of ___
Iodide
T3 and T4 act on ____
Receptor cells of many different organs
Drop in serum T3 & T4 levels results in
Stimulation of the pituitary to secrete TSH
State of having excess T3 &T4
Hyperthyroidism
Lab work of Hyperthyroidism would show ___ T4 levels and ___ TSH levels
Elevated; lower than normal
Bulging eyes from deposits of excess tissue behind the eyes
Exophthalmus
Enlargement of the thyroid
Goiter
Hyperthyroid goiter is due to ___
Hypertrophy from pathologic overactivity
Hypothyroid goiter is caused by:
Compensatory Hyperplasia & hypertrophy
Inflammation from autoimmune attack
GI effects of hyperthyroidism
Increased appetite, diarrhea
Cardiovascular effects of hyperthyroidism
Tachycardia, increased afterload, sometimes HF
Body changes due to hyperthyroidism
Weight loss
increased body temp
Warm, flushed, sweaty skin
Hyperthyroid crisis state
Thyroid storm
State of deficient T3 & T4 production/release
Hypothyroidism
Autoimmune thyroiditis
Hashimoto’s
Autoimmune thyroiditis (Hashimoto’s) is caused by
Autoantibodies destroying thyroid tissue & replacing with lymphocytes & scar tissue
Congenital hypothyroidism with stunted mental & physical growth
Cretinism
Lab work for hypothyroidism will show ___ T4 levels and ___ TSH levels
Low; higher than normal
Changes in the dermis that cause water to get trapped under the skin cause
Myxedema
Hypothyroid crisis state
Myxedema crisis/coma
Tx of hypothyroidism
Synthetic thyroid hormone (levothyroxine)
Lower than normal serum calcium
Hypocalcemia
Higher than normal serum calcium
Hypercalcemia
Chief hormone regulators of calcium movement
Calcitonin & PTH
Calcitonin enhances movement of calcium from:
From blood to bone
PTH enhances movement of calcium from:
Bone back into circulation (resorption)
PTH helps move calcium back into circulation by:
Increasing osteoclastic activity
In a state of hypocalcemia, PTH secretion is ___ and calcitonin secretion is ___
Increased; suppressed
I’m a state of hypercalcemia, PTH secretion is ___ and calcitonin secretion is ___
Suppressed; increased
Suppression of PTH secretion results in:
Decreased osteoclast activity
Pathologically porous bone
Osteoporosis
Osteoporosis is caused by ___ as part of aging & genetics
Increased resorption thru increased osteoclast activity
Osteoporosis in post-menopausal women is due to:
Loss of estrogen
Condition of having somewhat less than normal bone density
Osteopenia
Medications that treat osteoporosis aim to:
Decrease osteoclastic activity
Urologic complication of hypercalcemia
Kidney stones
“After eating”
Post prandial
Hyperglycemia stimulates the secretion of
Insulin
Hypoglycemia triggers the secretion of:
Regulatory hormones
Regulatory hormones include:
Glucagon, epinephrine, cortisol, growth hormone
Glucagon is secreted by the
Pancreas
GH is secreted by
The pituitary
An endogenous steroidal hormone that affects many metabolic activities of the bbody
Cortisol
Mineralocorticoid that directs the kidneys to hold onto Na+ in blood
aldosterone
Two main components of Cushing’s syndrome
hypercortisolism & hyperaldosteronism
Hypercortisolism is usually called ___ when the high levels of cortisol are due to receiving long term steroid treatment
Cushing’s syndrome
Hypercostisolism is usually called ___ when two general situations are present
Cushing’s disease
A PT is said to have Cushing’s disease in these 2 situations:
- pathologic over secretion of ACTH
2. Adrenal cortex hyper-secretes cortisol due to a tumor or other malfunction
Over-secretion of aldosterone by the adrenal cortex
hyperaldosteronism
“cushioned appearance” is due to ___
hyperlipidemia causing fat deposition in the trunk, face, and back
Common occurrence with increased levels of cortisol & aldosterone regarding glucose
hyperglycemia and development of DM2
hyperglycemia in hypercorticolism & hyperaldosteronism is due to:
pathologically increased glycogenolysis & gluconeogenesis
S/S of hyperaldosteronism
weight gain, edema, & HTN due to increased Na+ & H2O retention;
hypokalemia
Disease that results from a state of hypocortisolism & hypoaldosteronism
Addison’s disease
Addison’s dz is caused by: ___ & ___
hypo secretion of aldosterone from pituitary & autoantibody attack of the adrenal gland
S/S of Addison’s dz:
hypocortisolism
Hypoaldosteronism
S/S of hypocortisolism
hypoglycemia
Anorexia, N/V/D
S/S of hypoaldosternism
polyuria > hypotension from decreased blood volume
Addisonian crisis is a state of ___
severe hypotension due to fluid loss
“Passing too much honey flavored urine”
diabetes mellitus
2 tests for DM
Fasting blood sugar & A1-c
Indirect way to measure average daily glucose levels
glycosylated hemoglobin
Hemoglobin molecules that pick up glucose
glycosylated hemoglobin or Hgb A1c
Normally, no more than about ___ of the total Hgb molecules should be glycosylated
4-6%
DM1 is due to ___
total lack of insulin secretion from the pancreas
DM2 is due to ___
abnormally low insulin production
or
impaired insulin utilization
DM1 is a result of genetics & possible environmental factors that cause ___
autoimmune destruction of pancreatic beta cells
If not treated, the effects of DM1 can lead to:
diabetic ketoacidosis
S/S of DM1
hyperglycemia glycosuria polyuria polydipsia dehydration
Compensatory mechanism for DKA
kussmaul respirations to blow off CO2
Only definitive treatment for DM1
insulin
If not treated, DKA can progress to:
diabetic coma
In most cases, the cause of DM2 is:
obesity
Obesity causes DM2 due to:
decreased number of insulin receptors present on fat cells
Effect of Hyperglycemia on beta cells due to insulin resistant fat cells:
beta cells to go into overdrive secreting insulin
Pancreatic overdrive from hyperglycemia causes:
hyperinsulinemia
Due to the presence of some insulin being present in DM2, there is usually no:
S/S of metabolic acidosis
Extreme state of DM2
HHNKS (hyperglycemic-hyperosmolar-nonketotic syndrome
DM1 has a __ onset where as DM2 has a __ onset
acute; insidious (slow)
Problems present in both DM1 and DM2
macroangiopathy
microangiopathy
neuropathy
Glucose toxicity that damages large & medium sized vessels
macroangiopathy
Glucose toxicity that damages small sized vessels
microangiopathy
Glucose toxicity also impairs:
phagocytic function
Cluster of traits that increases risk for VC disease that includes DM2 hyperglycemia
metabolic syndrome
Defined as BGL <70
hypoglycemia
Severe hypoglycemia is most commonly seen as a result of:
taking too much insulin or taking it without eating
Hypocalcemia is caused by:
hypoparathyroidism & hyper secretion of calcitonin
S/S of hypocalcemia are associated with:
muscle spasms/irritability
Clinical sign of nerve hyper excitability seen with hypocalcemia
Chvostek’s sign
S/S associated with hypercalcemia
weakness/lethargy
Hormone that increases glycogenolysis
Glucagon
In general, DM is characterized by:
hyperglycemia & glucosuria
2 most common causes of Addison’s dz
deficient ACTH secretion from pituitary malfunction;
Adrenal gland atrophy & hypofunction from autoimmune disorder
What is the function of aldosterone?
directing the kidneys to hold onto Na+ and therefore H2O in exchange for potassium secretion
Effect of Addison’s dz on BGL
hypoglycemia
Normal FBS
70-99
What 2 substances are secreted from the adrenal cortex?
cortisol & aldosterone
Etiology of DM2
Obesity > fat cells have decreased insulin receptors > insulin resistance > decreased ability to transport glucose inside cells > hyperglycemia
___ stimulates gluconeogenesis & glycogenolysis
Glucagon
___ ___ & ___ cause S?S of shakiness, irritability, and sweating in hypoglycemia
epinephrine, cortisol, growth hormone
PTH release is triggered by ___
Hypocalcemia
Calcitonin release is triggered by:
hypercalcemia
State of excess PTH release
hyperparathyroidism
Decreased osteoclastic activity results in ___
decreased calcium resorption
