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Endocrine Disorders Flashcards

1
Q

What are the 3 causes of endocrine disorders?

A
  1. Target hormone receives too much/little hormone
  2. Hormones arrive at target gland, but find abnormal cell receptor functions
  3. Altered intracellular response to the hormone-receptor complex.
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2
Q

Why do target tissue sometimes receive too much/little hormone?

A

Actual over/underproduction
Feedback system fail, so incorrect amount is released
Inadequate blood supply to target
Hormone is inactivated too fast/slow

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3
Q

What are examples of abnormal cell receptor functions?

A

Decreased number of receptors
Impaired receptor function (doesn’t recognnize hormone)
Antibodies in area that are competitive inhibitors

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4
Q

What does it mean to have an altered intracellular response?

A

Series of reactions inside cell that make hormone work do not work properly

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5
Q

Name and describe the 3 types of disorders involving glands in the HPT axis

A

Primary - Problem with target gland responsible for producing hormone (eg. Gonads, estrogen)

Secondary - Problem with pituitary gland releasing/inhibiting hormone release (eg. Ant. Pit. FHS or LH)

Tertiary - Problem with hypothalamus producing control hormone for pituitary (stimulating hormones)

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6
Q

What are the general causes of HP system dysfunctions? How are they caused?

A
  1. most common: interruption of portal blood flow or damage to pituitary stalk
    Caused by brain tumor lesions,aneurysms, ruptured head injuries
  2. Hypo disorders causing lack of releasing hormone from hypo
    Caused by tumors, stroke, head trauma, surgery, malnutrition, radiation, and genetics
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7
Q

Describe diabetes insipidus, its cause, and manifestations.

A

unable to concentrate urine in periods of water restriction
caused by insufficient production/transport/release of ADH
Manifestations include polyuria and thirst

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8
Q

Is diabetes insipidus a disease of the posterior or anterior pituitary?

A

Posterior

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9
Q

What is SAIDH and its cause?

A

Syndrome of Inappropriate AntiDiuretic Hormone secretion
When ADH levels are too high
caused by ectopic production of ADH by tumors in other organs

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10
Q

What are the clinical manifestations of SAIDH? How do they start?

A

hyponatremia (too little Na+) causes anorexia, fatigue, confusion, lethargy, and in bad cases convulsions.

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11
Q

Is SAIDH part of the posterior or anterior pituitary?

A

Posterior

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12
Q

What is hypopituitarism? What is the cause?

A

It’s an inadequate supply of hypothalamic releasing hormones or inability of pituitary gland to produce hormones
Common cause is problem with pituitary gland: infarction, tumor, aneurysm

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13
Q

What happens if there is a problem with the ant. pituitary gland? What are the manifestations?

A

damage may result in deficiencies in some or all pit. hormones, depending on which area is affected
Manifestations include decreased hormones from target glands

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14
Q

How is hyperpituitarism caused? What happens to the body?

A

Caused by benign slow-growing tumor (adenoma)
This tumor may oversecrete hormones from the tissue that the tumor came from, as well as undersecrete hormones from the surrounding tissues

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15
Q

which hormones are affected by hyperpituitarism? what other issue may arise from a tumor in the pituitary?

A

GH and prolactin are affected
As the tumor grows, it’s mass could put pressure on the optic chiasm and cause vision disturbances.

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16
Q

Describe hyperthyroidism and the types.

A

When the thyroid secretes too much T3 and T4, there is risk of thyrotoxicosis.
There is primary (eg. Grave’s disease) and secondary (eg. Pituitary adenoma secreting TSH)

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17
Q

What is exophthalmos? What is it a sign of?

A

This is when the eyeballs protrude out of the eye socket. It is a manifestation of Grave’s disease.

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18
Q

What is hypothyroidism?

A

The most common thyroid function disorder
Primary accounts for 99% of diagnoses, and is mostly a result of autoimmune reactions.
Secondary may result from a pit. tumor pushing against surrounding pituitary cells, causing decreased TSH levels.

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19
Q

What is Hashimoto’s disease?

A

It’s a primary hypothyroid disorder, where antibodies, reactive T lymphocytes, etc destroy the thyroid gland.

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20
Q

What are the manifestations of hypothyroidism?

A

low metabolic rate, cold intolerance, lethargy, and myxedema (connective tissue swelling)

21
Q

What 3 steroid hormones are produced by the adrenal cortex?

A

Mineralocorticoids, Glucocorticoids, and Adrenal sex hormones.

22
Q

What hormone do mineralocorticoids have and what are their functions?

A

They primarily use aldosterone
they function in Na+, K+, and H2O balance

23
Q

What hormone do glucocorticoids have and what are their functions?

A

They primarily use cortisol
These regulate metabolic functions, control inflammatory responses, and respond to stress using gluconeogenesis

24
Q

What hormone do adrenal sex hormones have and what are their functions?

A

They use androgens to produce estrogen and testosterone

25
What does cortisol do?
helps gluconeogenesis, protein breakdown, and fat mobilization It's an anti-inflammatory Physic effect - helps mood Enhances epinephrine to help maintain BP
26
What is Addison Disease?
Its a primary adrenal cortical insufficiency autoimmune system destroys adrenal cortex, so its hormones (aldosterone and cortisol) are lost ACTH levels are elevated because of lack of feedback negative inhibition (bc no cortisol)
27
How do secondary adrenal cortical insufficiencies occur?
results from hypopituitarism, or bc pit. gland has been removed mainly due to withdrawal of glucocorticoids used therapeutically
28
What are the manifestations of adrenal cortical insufficiency?
hyperpigmentation, weight loss, hypoglycemia, fatigue. poor stress tolerance, Na+ and H2O loss from urine, potassium retention, and hypotension
29
Describe an Acute Adrenal Crisis and its treatment
A medical emergency due to the lack of cortisol. It's a life threatening response stress/minor illness - nausea, weakness, hypotension - hypovolemic shock - death Treatment involves immediate replacement of the steroid hormones
30
The 3 main forms of an excess of glucocorticoid hormone are:
Pituitary form: from excessive ACTH production by tumor in pit. gland Adrenal form: caused by a benign or malignant tumor Ectopic form: non-pituitary ACTH-secreting tumor
31
What is Cushing's Disease?
The pituitary form of excess glucocorticoid hormone
32
What are the manifestations of glucocorticoid excess?
Hyperglycemia, development of insulin resistance, round face, protruding abdomen, osteoporosis, increased Na+ and H2O reabsorption, increased K+ secretion, and inhibited inflammatory and immune responses
33
What are prediabetes?
An impaired fasting plasma glucose and impaired glucose tolerance
34
How it diabetes mellitus? How does it form?
It's a disorder of carbohydrates, proteins, and fat metabolism It comes from a supply and demand imbalance with insulin
35
How can an insulin imbalance arise?
absolute iron deficiency, impaired insulin release by pancreatic beta cells, inadequate/defective insulin receptors, or production of inactive insulin or insulin that is destroyed before it can reach its destination
36
What are the three P's of diabetes and what do they mean?
Polyuria - excessive urination Polydipsia - excessive thirst from dehydration Polyphagia - Excessive hunger: cells are in a state of starvation, so the person feels hungry even if they're not
37
What are the three P's of diabetes and what do they mean?
Polyuria - excessive urination Polydipsia - excessive thirst from dehydration Polyphagia - Excessive hunger: cells are in a state of starvation, so the person feels hungry even if they're not
38
Define type 1 diabetes. How does it develop?
It's defined as Beta cell destruction leading to absolute insulin deficiency Develops when the body's immune system destroys pancreatic beta cells, which make insulin and regulate glucose
39
Who normally gets Type I diabetes? What are the risk factors?
Usually children and young adults Risk factors include autoimmune, genetic, and environmental factors
40
What is the pathogenesis for Type I diabetes?
1. Autoimmune T cell-mediated disease destroys beta cells 2. Autoantigens develop on surface of beta cells, which then circulate blood and lymph 3. Autoantigens stimulate cellular and humoral immune responses resulting in beta cell destruction 4. Hyperglycemia develops
41
What are the clinical manifestations of Type I diabetes?
hyperglycemia, glycosuria (glucose in urine), the 3 P's, blood glucose fluctuations, weight loss due to protein and fat breakdown, diabetic ketoacidosis (DKA)
42
Define Type II diabetes
a condition characterized by hyperglycemia resulting from the impaired utilization of insulin accounts for 90-95% of all diagnosed cases
43
How does Type 2 diabetes occur?
1. Insulin resistance 2. Compensatory hyperinsulinemia prevents significant hyper glycemia, possibly for years 3. Beta cell dysfunction occurs, leading to decreased # of beta cells and reduced normal beta cell function 4. cells are "exhausted" from increased demand for insulin 5. Decreased insulin leads to significant hyperglycemia
44
What are the risk factors of Type 2 diabetes?
older age, obesity, family history, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity
45
Describe insulin resistance and how it relates to obesity
Below-optimal response of insulin-sensitive tissues (liver, muscle, adipose tissue) to insulin adipose tissue creates hormones that link to decreased insulin sensitivity '' '' releases inflammatory cytokines that are toxic to beta cells
46
What are the clinical manifestations of Type 2 diabetes?
overweight, possibly with recent unexplained weight loss hyperglycemia and glycosuria metabolic syndrome fatigue, itching, recurring infections, visual changes fasting blood glu. test >7mmol/L (2 occasions) Oral glu. tolerance test >11.1mmol/L
47
What is metabolic syndrome?
a collection of disorders that have a high risk of developing type 2 diabetes central obesity, dyslipidemia (lipid imbalance), prehypertension, elevated fasting blood glu levels
48
What's the difference between type I and type II diabetes?
I - Not enough glucose II - Insulin resistance

Pathophys (4 decks)

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