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Pathophys > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Name a minimum of 4 endocrine organs:

A
  • pituitary glands (aka hypophysis)
  • adrenal glands
  • thyroid
  • pancreas
  • parathyroid glands
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2
Q

Name a minimum of 4 organs that are NOT considered endocrine organs but still secrete hormones:

A
  • GI tract
  • liver
  • gonads
  • kidneys
  • heart
  • ovaries
  • testes
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3
Q

What is a chemical secreted by a cell or group of cells directly into the blood called?

A

a hormone

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4
Q

_____ are transported to a distant target and act in low concentrations to affect growth development, homeostasis, or metabolism.

A

hormones

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5
Q

What 3 things do hormones affect?

A
  • growth development
  • homeostasis
  • metabolism
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6
Q

Why are hormones secreted directly into blood?

A

bc endocrine glands don’t have ducts, must travel by blood

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7
Q

What glands have ducts?

A

exocrine glands

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8
Q

Most hormones are ______.

A

peptides

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9
Q

T/F hormones don’t need a second messenger to get into a cell:

A

FALSE

hormones need a second messenger to get into cells

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10
Q

Name the first, second, and third group of hormones:

A

1st = peptide hormones
2nd = steroid hormones
3rd = amine hormones

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11
Q

Which group of hormones are derived from cholesterol and can get through a lipid bilayer?

A

2nd group (steroid hormones)

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12
Q

Which group of hormones doesn’t use a second messenger system because they diffuse into their target tissues?

A

2nd group (steroid hormones)

(I know Roop said hormones need a second messenger but I guess this group doesn’t?)

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13
Q

_____ hormones affect DNA then RNA then proteins to carry out what it is supposed to do.

A

steroid

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14
Q

Which group of hormones are derived from tyrosine or tryptophan?

A

3rd group (amine hormones)

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15
Q

What do tyrosine derivatives include?

A

catecholamines (epi, NE, & thyroid hormones)

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16
Q

Give an example of the nervous system and endocrine system working together:

A

the hypothalamus (NS) and pituitary gland (endo)

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17
Q

What does the hypothalamus secrete? (hint: 2 things)

A
  • releasing hormones (-RH)
  • inhibitory hormones (-IH)
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18
Q

What does the pituitary gland release?

A

stimulating hormone

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19
Q

The stalk that connects the pituitary to the brain is called what?

A

infundibulum

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20
Q

The posterior pituitary is an extension of the ____ ____.

A

neural tissue

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21
Q

What is the true endocrine gland of epithelia origin?

A

anterior pituitary

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22
Q

Which two hormones are antagonistic?

A

parathyroid hormone & calcitonin

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23
Q

The parathyroid hormone _____ blood calcium levels.

A

increases

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24
Q

Calcitonin _____ blood calcium levels.

A

decreases

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25
Q

Endocrine disorders fall into two groups, what are they?

A
  • excess hormone
  • hormone deficiency
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26
Q

Hormone disorders are usually do to what?

A

adenomas or benign tumors

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27
Q

List several things that are a possible result of a hormone disorder:

A
  • ICP
  • decrease sensitivity of receptors
  • autoimmune disease
  • genetic illness
  • infection/inflammation
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28
Q

What is the most important hormone gland?

A

pituitary gland

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29
Q

The pituitary glands sits in a depression called the ____ ____ in the _____ bone.

A

sella turcica; sphenoid bone

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30
Q

An adenoma growing on the pituitary could cause what?

A

ICP

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31
Q

Cancerous lesions can produce hormones. What is this called?

A

paraneoplastic syndrome

(ex: bronchogenic carcinoma produces ADH)

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32
Q

In diabetes mellitus, there are two reasons for decreased insulin from the B cells of islets of Langerhans of the pancreas. What are these two reason?

A
  • B cells are being destroyed
  • insulin resistance (receptors not responding to insulin)
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33
Q

What type of hormone is insulin?

A

anabolic hormone

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34
Q

3 things increase when insulin is moving glucose into cells. What are they?

A
  • inc glycogen synthesis
  • inc protein synthesis
  • inc triglyceride synthesis
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35
Q

What two organs do not need insulin for glucose transport into cells?

A

brain and GI tract

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36
Q

There are two types of diabetes mellitus (Type I and Type II). Which type is considered an autoimmune disease and develops in infancy/childhood?

A

Type I (insulin dependent)

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37
Q

Type I diabetes is an autoimmune disease against what?

A

B cells of islets (destroyed)

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38
Q

What type of antibodies should you look for in patients with diabetes type I?

A

islet cell antibodies (ICAs)

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39
Q

A decrease in insulin causes a decrease in transportation of glucose from blood to cells. What can this cause?

A

hyperglycemia

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40
Q

What is it called when glucose stays in tubules to make urine?

A

glycosuria

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41
Q

What is it called when excess glucose in urine exerts osmotic pressure?

A

osmotic diuresis

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42
Q

The action of solutes pulling water out of cells is called what?

A

osmotic diuresis

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43
Q

Glycosuria causes osmotic diuresis, which leads to polyuria and dehydration. Dehydration results in polydipsia and decreases glucose in cells, which the brain interprets as starving due to lack of nutrients entering the cells. This causes increased hunger. What is this called? (hint: one of the three “P’s”)

A

polyphagia

(I wrote this out in steps bc I didn’t know how to make it into a flashcard lol. Think about it LOGICALLY)

  • glycosuria
  • osmotic diuresis
  • polyuria
  • dehydration
  • polydipsia
  • decreased glucose
  • polyphagia
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44
Q

What is it called when a patient has increased urination?

A

polyuria

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45
Q

What is it called when a pt has increased thirst?

A

polydipsia

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46
Q

What is it called when a patient complains of increased hunger?

A

polyphagia

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47
Q

What are the 3 P’s you look for in a patient you suspect has diabetes? What is the ‘P’ that patients usually complain of first?

A
  • polyuria (FIRST P)
  • polydypsia
  • polyphagia
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48
Q

85% of all patients with Type II diabetes have what in common?

A

obesity

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49
Q

Type II diabetes is mostly due to _____ _____.

A

insulin resistance (this decreases the production of insulin)

(sometimes type II patients can have a problem with B cells but not common)

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50
Q

Which diabetes type is seen in adulthood and can sometimes have a genetic component?

A

Type II

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51
Q

As the number of Type II diabetes cases increase, what is also increasing?

A

metabolic syndrome

(we are seeing more of this as more people get type II diabetes)

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52
Q

Metabolic syndrome is a cluster of conditions that occur together. What are these conditions?

A
  • obesity
  • type II diabetes
  • cardiovascular changes
  • vascular problems
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53
Q

3-8% of pregnant women will develop what?

A

gestational diabetes

(for the sake of these flashcards, I will not use inclusive language but it’s something to thing about as a future provider… pregnant PEOPLE)

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54
Q

Gestational diabetes occurs in the _____ ____ of pregnancy then resolves a couple months after delivery.

A

second half

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55
Q

T/F gestational diabetes will resolve after a women gives birth and she won’t have to worry about diabetes ever again.

A

FALSE

5-10% of women will develop Type II diabetes later in life after gestational diabetes has resolved.

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56
Q

Briefly explain how the body goes into ketoacidosis.

A
  • dec glucose into cells
  • cells break down fat for energy
  • liver unable to process excess fat
  • converts to ketones
  • metabolic acidosis
  • ketonuria
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57
Q

What ions are increased in metabolic acidosis that cause a patient to blow off CO2 and hyperventilate?

A

H ions

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58
Q

How does the body compensate for metabolic acidosis? (hint: think respiratory)

A

increases respiration = Kussmaul respiration

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59
Q

What is Kussmaul’s respiration?

A

deep rapid breathing

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60
Q

What is one keto acid the body produces in ketoacidosis that give a patient a fruity smelling breath?

A

ACETONE

(acetone gives diabetic patients a fruity smelling breath. if pt has fruity breath they are probably in DKA!)

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61
Q

10% of diabetic patients slip into a diabetic coma. Briefly explain how this occurs. (hint: its logical)

A
  • osmolality (glucose in blood exerts osmotic pressure)
  • pulls water from cells and brain cells
    = coma and sometimes death
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62
Q

You have a patient you suspect has diabetes. How do you confirm this diagnosis?

A

fasting blood glucose

(higher than 126 mg on more than 2 occasions = diabetes)

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63
Q

How do you monitor a patients blood glucose levels long term? (hint: a blood test)

A

HbA1c

(excess glucose binds to Hb!! this blood test checks the average blood sugar level over past 3 months)

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64
Q

Excess glucose binds to _____.

A

hemoglobin

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65
Q

Why should you check a patients A1C every 3 months?

A

because of RBC turnover

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66
Q

If a patient has an A1C greater than ___%, they are diabetic.

A

6.5%+

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67
Q

What are 4 treatments for diabetes?

A
  • change diet
  • exercise in moderation
  • oral meds for type 2
  • insulin for type 1
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68
Q

The B cells in the pancreas have 2 voltage gated ion channels. What are they?

A

calcium & potassium

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69
Q

What transporter transports glucose into a cell?

A

GLUT

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70
Q

______ phosphorylates glucose to trap it in the cell.

A

glucokinase

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71
Q

Increased ATP in the pancreas is detected by _______ receptor subunit of KATP channel and closes it.

A

sulfonylurea receptor subunit (SUR1)

(SUR1 detects ATP and closes the potassium (K) ATP channel)

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72
Q

When ATP is low, K channels are always _____.

A

open

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73
Q

What receptor is sensitive to ATP?

A

SUR1 (sulfonylurea receptor 1)

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74
Q

K channels are also called _____ channels.

A

LEAKY

(they are always open and ATP sensitive bc of the SUR1 receptor)

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75
Q

When K channels are closed, positive ions are not lost. What does this do to B cells?

A

B cells depolarize

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76
Q

Depolarization opens ____ channels and ____ diffuses in and binds to proteins.

A

Ca; calcium

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77
Q

When K channels are closed it causes a release of _____-containing granules.

A

insulin-containing granules

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78
Q

What is in secretory vesicles?

A

insulin

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79
Q

How do B cells know how to release insulin?

A

glucose enters via GLUT transporters, detects glucose and releases insulin

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80
Q

Are calcium channels always open or closed naturally?

A

closed

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81
Q

What is the most popular sulfonylurea medication for diabetics?

A

glyburide (Diabeta)

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82
Q

Sulfonylurea medications (Diabeta) for diabetes bind to which receptor to close K+ channels?

A

SUR receptor (stimulates insulin secretion)

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83
Q

Metformin (Glucophage) ______ insulin resistance and works at the receptors.

A

decreases insulin

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84
Q

Rosiglitazone (Avandia) _____ tissue sensitivity to insulin and works at the receptors.

A

increases tissue sensitivity

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85
Q

Why can’t you give insulin orally?

A

because it gets broken down in the gut

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86
Q

What is an injectable medication for Type 1 diabetics?

A

Humulin (synthetic insulin)

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87
Q

What should you always explain to a patient with diabetes?

A

diabetes is NOT a sugar disease, its a SYSTEMIC disease

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88
Q

What could cause hypoglycemia in diabetics? (hint: 3 things)

A
  • intense exercise (could use up all glucose)
  • fasting (diabetics should never skip or miss a meal)
  • error in dosage (gave themselves too much insulin)
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89
Q

Hypoglycemia is most commonly seen in type 1 or type 2 diabetics?

A

Type 1
(sometimes seen in type 2 pts on sulfonylurea meds)

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90
Q

Hypoglycemia is also known as what?

A

insulin shock (excess insulin)

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91
Q

In hypoglycemia (insulin shock) what is affected first?

A

the nervous system

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92
Q

In hypoglycemia, the sympathetic nervous system is stimulated. What symptoms does this cause?

A
  • increased pulse
  • skin becomes pale + moist
  • tremors
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93
Q

If a patient is in a hypoglycemic state, what CNS symptoms would be presented?

A
  • slurred speech
  • tremors
  • confusion
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94
Q

In a hypoglycemic state, the body tries to compensate with gluconeogenesis which can result in rebound hyperglycemia. What is this called?

A

Somogyi phenomenon

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95
Q

What is Somogyi phenomenon?

A

as the body tries to compensate by increasing gluconeogenesis due to hypoglycemia, the body goes into hyperglycemia

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96
Q

What is gluconeogenesis on a basic level?

A

making glucose from noncarbohydrate sources

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97
Q

What is the remedy for hypoglycemia?

A

concentrated carbohydrate (ORANGE JUICE)

98
Q

What will happen if hypoglycemia is not treated?

A

seizures, coma, death

99
Q

An overload of ketones present in the blood of a diabetic patient is called what?

A

diabetic ketoacidosis

100
Q

On a basic level, how does diabetic ketoacidosis occur?

A

body burns fat when cells don’t get glucose and produces ketones, making the blood acidic

101
Q

T/F vascular problems happen in small vessels only:

A

FALSE
both in small and large vessels

102
Q

________ is when basement membranes of capillaries become thick and hard.

A

microangiopathy

103
Q

Microangiopathy can cause capillaries to become obstructed or ruptured which can lead to _____ _____.

A

tissue necrosis

104
Q

What is the leading cause of blindness in diabetic patients?

A

diabetic retinopathy
(30% of diabetics will end up w this)

105
Q

Nonproliferative retinopathy is when blood vessels in the eye become _____.

A

weak

106
Q

How does blindness occur in non-proliferative retinopathy? (hint: 4 steps)

A
  • microaneurysms in eye
  • rupture and release what’s in capillaries
  • fat in capillaries leaks and accumulates
  • hardens around macula

= blindness

107
Q

What is a result of ischemia of the retina due to lack of nutrients?

A

cotton wool spots

(white spots in back of eye)

108
Q

Torturous blood vessels in the eye that can cause the retina to detach is called what?

A

proliferative retinopathy

109
Q

What is the leading cause of ESRD (end stage renal disease) in the world?

A

diabetic nephropathy

110
Q

_________ is when basement membranes of glomerular capillaries becomes thick.

A

glomerulosclerosis

111
Q

What is glomerulosclerosis with nodules called?

A

Kimmelstiel-Wilson nodules

(ONLY FOUND IN DIABETICS)

112
Q

In glomerulosclerosis, thick capillaries result in a decrease in _____ _____ of basement membranes.

A

heparan sulfate

113
Q

What inhibits filtration of proteins like albumin?

A

heparan sulfate

114
Q

Is proteoglycan positively or negatively charged?

A

negative

115
Q

Hydrostatic pressure means fluid is going ___.

A

out

116
Q

What is the purpose of oncotic pressure?

A

to keep fluid in

117
Q

What protein keeps blood vessels from collapsing?

A

albumin

118
Q

Proteinuria is cause by _____ leaking out in the kidneys when proteoglycan decreases.

A

albumin

119
Q

Diabetic nephropathy is a complication of type 1 and type 2 diabetes where poorly controlled diabetes can cause damage to blood vessel clusters in your kidneys that filter waste from your blood. This can lead to kidney damage and cause high blood pressure. What is the final stage of diabetic nephropathy called?

A

ESRD
end stage renal disease

(the continuation of capillary degeneration will eventually cause diabetic nephropathy and lead to ESRD)

120
Q

Macroangiopathy only affects ____ blood vessels.

A

large

121
Q

Macroangiopathy is a specific form of accelerated atherosclerosis in diabetics. What 3 problems can this lead to?

A
  • MI
  • stroke
  • PVD
122
Q

What is a MAJOR problem that you will likely see in all your diabetic patients?

A

PVD

123
Q

Atheromas in large blood vessels may cause ulcers in diabetics due to the obstruction of blood flow. If the ulcer is left untreated, what may have to happen?

A

amputation

124
Q

What is a long-term complication of diabetes involving the nerves?

A

neuropathy

125
Q

In diabetes, ischemia of the nerves can occur resulting in degeneration of myelinated and nonmyelinated nerves. Pts will usually complain of numbness, tingling, and weakness. What is your diagnosis?

A

neuropathy

126
Q

60% of diabetic patient with neuropathy will experience stocking and glove neuropathy. Describe this:

A

pattern of numbness in distal portions of the nerves

(pt feels like they are wearing gloves and stockings because they can’t feel hands and feet)

127
Q

What is the most common, chronic complication of diabetes involving the nerves?

A

distal symmetric polyneuropathy (DSPN)

(starts in feet)

128
Q

Bladder incontinence and impotent are symptoms of what type of neuropathy?

A

autonomic neuropathy

129
Q

Why are diabetics so prone to infections?

A

because of vascular complications

  • dec neutrophil chemotaxis & phagocytosis
  • high sugar levels breed pathogens
  • inc fungal infections (periodontal disease, thrush)
130
Q

Another common vascular problem seen in diabetics is cataracts because increased glucose is reduced to sorbitol by ______ ______.

A

aldose reductase

131
Q

______ accumulates in the lens of the eye in diabetic patients causing cataracts.

A

sorbitol

132
Q

Where is the parathyroid located and what does it secrete?

A
  • 4 glands on posterior aspect of thyroid
  • secretes PTH (parathyroid hormone)
133
Q

The parathyroids increase plasma _____ concentration in the plasma and ______ excretion at kidneys.

A

calcium; phosphate

134
Q

Hypoparathyroidism can lead to what two conditions?

A

hypocalcemia & hyperphosphatemia

135
Q

Hypocalcemia ______ contractions of the heart and can possibly lead to heart failure.

A

decrease contractions

(heart failure due to lack of Ca and dec muscle contractions)

136
Q

Decreased calcium in the heart causes more _____ ions in the neurons. What is this called?

A

more sodium ions = depolarization

137
Q

Hyperexcitability of nerves leads to spontaneous contractions in muscles. What is this called?

A

tetany

138
Q

Tetany can be confirmed by what two signs?

A
  • Chvostek sign
  • Trousseau sign
139
Q

How do you test for Chvostek sign and how do you determine it’s positive?

A
  • tap facial nerve anterior to ear

+ sign = facial muscles twitching on other side of face

140
Q

How do you test for Trousseau sign and how do you determine it’s positive?

A
  • inflate sphygmomanometer above systolic for 3 min

+ sign = carpal spasms

141
Q

How does hyperparathyroidism cause hypercalcemia?

A

PTH causes Ca to leave kidneys, GI tract & bone increasing calcium in the body (hypercalcemia)

142
Q

80-87% of hyperparathyroidism is caused from what?

A

benign adenoma

(can also be caused from carcinoma or hyperplasia)

143
Q

What are the 3 sources PTH (parathyroid hormone) is acting on?

A
  • gut
  • bone
  • kidneys
144
Q

Hypercalcemia increases cardiac contractions and causes arrhythmias. What 3 conditions does this lead to and which is the most serious problem?

A
  • depresses NS (muscle weakness/lethargy)
  • osteoporosis (most serious problem!!)
  • kidney stones
145
Q

Calcitriol is the most active form of what vitamin?

A

vit D

146
Q

What increases the absorption of calcium from GI tract and mobilizes calcium from bone?

A

calcitriol
(most active form of vitamin D)

147
Q

What do you need to work with PTH to remove calcium from the small intestines and bone?

A

calcitriol

148
Q

Where is vitamin D converted to active vitamin D (calcitriol or D3)?

A

the kidneys

149
Q

Renal disease is a result of decreased _____, decreased _____, and increased ____.

A

dec calcitriol
dec calcium
inc PTH

150
Q

The retention of phosphate ions is seen in renal disease. What is it called when there’s an increase of phosphate?

A

hyperphosphatemia

151
Q

What type of relationship does calcium and phosphate have? Explain this relationship:

A
  • reciprocal/inverse relationship
  • low Ca = high phos.
  • low phos. = high Ca
152
Q

Secondary hyperparathyroidism has to do with the kidneys increasing _____ due to a decrease in the production of _____.

A

PTH; calcitriol

(kidneys not producing calcitriol which increases PTH)

153
Q

If there’s a problem with the pituitary hormones it doesn’t always mean its a problems with he pituitary gland. What else could be a problem if there’s a problem with the hormones of the pituitary?

A

problem with hypothalamus

154
Q

What could occur as a result of a tumor on the optic chiasm?

A

hemianopsia

(loss of half of vision in half of visual field)

155
Q

10% of brain tumors are what type of adenomas?

A

pituitary adenomas

156
Q

Growth hormone (GH) in the pituitary is called _____ and works indirectly through the liver to produce other hormones like ____.

A

somatotropin; IGFs (insulin-like growth factors)

157
Q

What are two methods for somatotropin/GH?

A
  • can work directly on bone and soft tissue
  • can work through IGF
158
Q

Dwarfism could be due to what 3 things?

A
  • decrease in GH
  • decrease in GHRH (growth hormone releasing hormone)
  • adenoma
159
Q

List 2 characteristics of dwarfism:

A
  • short stature
  • perfectly proportioned
160
Q

Gigantism is caused by an excess of ____ before the _____ plates have closed.

A

GH; epiphyseal

161
Q

Bones that can’t grow in length but grow in thickness are called what?

A

acromegaly

162
Q

What 4 body areas does acromegaly affect?

A

head, feet, face, skull

163
Q

What is prognathia? (hint: seen in pts with acromegaly)

A

protruding mandible

164
Q

What does prognathia cause and what do pts with prognathia suffer from?

A
  • causes misalignment or occlusion of teeth
  • suffers from cardiovasc disease (affects heart tissue)
165
Q

ADH is also called what?

A

vasopressin

166
Q

Diabetes insipidus results from what?

A

decrease in ADH

167
Q

Low ADH leads to what 2 things?

A

polyuria & dehydration

168
Q

Central diabetes insipidus is caused by the destruction of certain posterior ______ cells and ______ nuclei of the hypothalamus.

A

pituitary; supraoptic

(should be producing ADH but isn’t!)

169
Q

Nephrogenic diabetes insipidus is caused by a problem with receptor in collecting ducts of the ______.

A

kidneys

170
Q

Nephrogenic diabetes insipidus could be caused by what 2 things?

A
  • genetics
  • medications like lithium
171
Q

Syndrome of inappropriate ADH (SIADH) is characterized by an excess production of ADH due to what?

A

ectopic source

(ectopic antidiuretic hormone (ADH) secretion has been described in neuroendocrine tumors presenting as hyponatremia due to the syndrome of inappropriate ADH secretion)

172
Q

What leads to hyponatremia in SIADH?

A
  • xs ADH
  • retention of water
  • diluted salt concentration
    = hyponatremia
173
Q

List some signs a pt with hyponatremia will present with.

A
  • confused
  • weak
  • slurred speech
  • possible coma
174
Q

What are some treatments for SIADH?

A
  • sodium supplements
  • diuretics
  • find out the cause of xs ADH
175
Q

If your patient has a thyroid issue, what should you be thinking they also have a problem with?

A

hypothalamus or anterior pituitary

176
Q

TRH is produced in the _______ and stimulates ___ to be released from the anterior pituitary.

A

hypothalamus; TSH

177
Q

What are the two thyroid hormones?

A
  • T3 (triiodothyronine)
  • T4 (thyroxine)
178
Q

What is a goiter and what can it put pressure on?

A
  • enlarged thyroid gland
  • can put pressure on esophagus/trachea
179
Q

Endemic goiters usually occur where due to what?

A

parts of the world where iodine is low

180
Q

If there’s no iodine in someones diet, how does this effect their thyroid hormones?

A
  • no iodine = can iodinate T3 and T4
  • increase in TRH and TSH
  • thyroid gland accumulates precursors of T3 and T4
  • thyroid gland increases in size
181
Q

T3 and T4 must have _____ to be thyroid hormones

A

iodine

182
Q

What is the major metabolic hormone in the body?

A

thyroid hormone
(effects every part of body)

183
Q

Goitrogens, naturally occurring substances that can interfere with the function of the thyroid gland, block ___ synthesis.

A

TH synthesis

184
Q

Goitrogens are found in what?

A
  • certain veggies
  • water supply in some areas
  • lithium
  • sulfonylureas
185
Q

Excess activity of the thyroid gland can cause a nodular goiter called a what?

A

toxic goiter

186
Q

What is the most common cause of hyperthyroidism?

A

Grave’s disease

187
Q

T/F Graves’ disease is symmetrically enlarged with no nodules.

A

TRUE

188
Q

In Graves’ disease, the body produces antibodies against what?

A

TSI (thyroid stimulating immunoglobulin)

189
Q

TSI (thyroid stimulating immunoglobulin) binds to what?

A

TSH receptors

190
Q

In Graves’ disease, follicles become _____ and _____.

A

smaller and smaller

191
Q

Infiltration of ______ and ______ follicles are seen in Graves’ disease.

A

lymphocytes and lymphoid follicles

192
Q

In hyperthyroidism, a hyper metabolic response occurs and increases the production of ____.

A

TH

193
Q

In patients with a goiter, metabolic rate _____ causing erythematous, warm skin.

A

increases

194
Q

What is exophthalmos?

A

protrusion of the eyes with decreased blinking

195
Q

In patients with exophthalmos, decreased blinking is caused by what that could eventually damage the optic nerve?

A

eye is infiltrated with mucopolysaccharides, lymphocytes and fluid

196
Q

In patients with Graves’ disease, hyperthyroidism, and goiters, there is an increase in metabolic rate. How does the body compensate for this increased metabolic rate?

A
  • tachycardia
  • HTN
  • restlessness/tremors
  • inc hunger
  • inc GI motility
197
Q

Uncontrolled hyperthyroidism will cause a thyroid _____ or _____ crisis.

A

thyroid storm; thyrotoxic crisis

198
Q

What are two treatments for Graves’ disease / hyperthyroidism?

A
  • radioactive iodine
  • removal of thyroid gland (last resort)
199
Q

Mild hypothyroidism is on the increase in the US. What is used to treat hypothyroidism?

A

levothyroxine (Synthroid)

200
Q

Severe hypothyroidism is called ________ thyroiditis, which is an autoimmune disease where the thyroid gland is destroyed.

A

Hashimoto thyroiditis

201
Q

In severe hypothyroidism, metabolic rate is low. What are some signs you would see presented in a patient with hypothyroidism?

A
  • cold intolerance
  • pale, cool skin
  • bradycardia
  • weight gain
202
Q

______ is where the skin retains water and hair becomes dry and brittle.

A

myxedema

203
Q

Untreated congenital hypothyroidism is due to a decrease in _____ in pregnancy.

A

iodine

204
Q

Congential hypothyroidism or under activity of thyroid glands during early childhood leading to stunted growth and mental retardation is called what?

A

cretinism

205
Q

Cretinism is caused by what?

A

a lack of iodine in mothers diet during pregnancy

206
Q

“2 organs in 1” is referring to what gland?

A

adrenals

207
Q

What part of the adrenal gland is responsible for producing and secreting 80% of our steroid hormones?

A

adrenal cortex

208
Q

Pheochromocytoma is a benign tumor of the ________.

A

adrenal medulla

209
Q

In the adrenal cortex, steroid hormones are being made from what?

A

cholesterol

210
Q

Cushing’s syndrome is due to chronic excess ________.

A

glucocorticoids

211
Q

Cushing’s syndrome can be caused from what 4 things?

A
  • pituitary tumor
  • paraneoplastic syndrome
  • iatrogenic problem
  • use of too much glucocorticoids
212
Q

One finding of Cushing’s syndrome is a round puffy face. What is this called?

A

moon face

213
Q

In Cushing’s syndrome, fat deposits in what 2 areas?

A

abdomen & back of neck

214
Q

In Cushing’s syndrome, deposition of fat in the back of the neck is called what?

A

buffalo hump

215
Q

In Cushing’s syndrome, fragile skin with red striae is due to what?

A

subcutaneous fat underneath stretching the skin

216
Q

In Cushing’s syndrome, hirsutism is the growth of _____ due to what?

A

growth of hair due to increase in androgens

217
Q

In Cushing’s syndrome, osteoporosis inhibits _____ _____ but increases _____ _____.

A

bone deposition; bone absorption

218
Q

In Cushing’s syndrome, excess protein catabolism causes what?

A

muscle wasting

219
Q

Cortisol is essential for life but depresses the immune system and causes inflammation of there’s too much. In Cushing’s syndrome, excess of cortisol increases _____ and _____.

A

metabolism and catabolism

220
Q

In Cushing’s syndrome, gluconeogenesis is increased. What could this cause?

A

diabetes

(body will become intolerant to glucose)

221
Q

Cortisol is increased in patients with Cushing’s syndrome. It will also increase ____, which will increase the viscosity of blood.

A

EPO

222
Q

What two natural vasodilators can be blocked in patients with Cushing’s syndrome?

A

nitric oxide & prostaglandins

223
Q

What is the treatment for patients with Cushing’s syndrome?

A

find and treat the cause!

(ex: adenocarcinoma)

224
Q

Addison’s disease is caused by what?

A

tumor or autoimmune disease destroying gland

225
Q

In Addison’s disease, all zones in the _____ _____ are destroyed.

A

adrenal cortex

226
Q

In Addison’s disease, there will be a decrease in glucose and the adrenocortical hormone if what zone is affected?

A

zona fasciculata

227
Q

The zona glomerulosa of the adrenal cortex produces what?

A

aldosterone

228
Q

What is aldosterone necessary for?

A

reabsorption of sodium

229
Q

What is the treatment for Addison’s disease?

A

hormone replacement therapy

230
Q

Conn’s syndrome is a rare health problem that occurs when the adrenal glands make too much _______.

A

aldosterone

231
Q

What is another name for Conn’s syndrome?

A

primary aldosteronism

232
Q

Conn’s syndrome (primary aldosteronism) is caused by what?

A

aldosterone secreting tumor

233
Q

In Conn’s syndrome, too much aldosterone can cause reabsorption of sodium into the blood stream. What 4 things will follow this?

A
  • xs sodium
  • xs water
  • inc blood volume
  • inc BP
234
Q

In Conn’s syndrome, too much aldosterone can cause potassium secretion. What is it called when excess potassium leaves the cell?

A

hypokalemia

235
Q

A patient who is hypokalemic (low potassium levels) will present with what symptoms?

A

muscle weakness & cramping

(low potassium affects the muscles!)

236
Q

In Conn’s syndrome, excess potassium leaves ______ cells.

A

principle cells

(potassium secretion happens at P cells)

237
Q

Aldosterone can also affects ______ cells in Conn’s syndrome.

A

intercalated

238
Q

If intercalated cells are affected in Conn’s syndrome, this causes ______ ion secretion

A

hydrogen

239
Q

If a patient has an excess of aldosterone and an excess of H ions, what disease state will they enter?

A

metabolic alkalosis

240
Q

What 3 conditions will a patient with Conn’s syndrome have if they have an excess amount of sodium, low potassium, and an excess amount of aldosterone and hydrogen ions?

A
  • hypertension
  • hypokalemia
  • metabolic alkalosis

Pathophys (6 decks)

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