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Clin Med Exam 1 > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

endocrine

A

ductless

blood stream

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2
Q

exocrine

A

ducts for transportation

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3
Q

paracrine

A

secrete hormones for LOCAL effect

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4
Q

pancreas

A

an example of a gland that is classified as all three types of glands

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5
Q

pituitary

A

“master gland”

regulates most levels of hormones

anterior –> adenohypophysis

posterior –> neurohypophysis

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6
Q

thyroid and parathyroid

A

metabolism

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7
Q

adrenal

A

fight or flight

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8
Q

pancreas

A

digestion and sugar metabolism

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9
Q

gonads

A

sexual characteristics and reproduction

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10
Q

thyroid hormones

A

thyroxine (T4)

triiodothyronine (T3)

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11
Q

thyroid hormone’s principal effects

A

increase cellular metabolism

facilitate normal growth and development

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12
Q

parathyroid hormone

A

parathormone (PTH)

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13
Q

parathyroid hormone principal effects

A

increase blood calcium

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14
Q

pancreas hormone

A

glucagon

insulin

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15
Q

pancreas hormone principal effects

A

increase blood glucose

decrease blood glucose

increase carb, fat and protein storage

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16
Q

adrenal cortex hormone

A

glucocorticoids

mineralocorticoids

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17
Q

adrenal cortex hormones principal effects

A

regulate glucose metabolism

enhance response to stress

regulate fluid and electrolyte levels

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18
Q

adrenal medulla

A

epinephrine

norepinephrine

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19
Q

adrenal medulla principal effect

A

vascular and metabolic effect that facilitate increased physical activity

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20
Q

gonad hormones

A

testosterone

estrogens

progesterone

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21
Q

gonad hormones principal effects

A

spermatogenesis –> male sexual characteristics

female reproductive cycle and sexual characteristics

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22
Q

5 general functions of endocrine system

A

differentiation of fetus

development

reproduction

homeostasis

fight of flight response

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23
Q

where does the endocrine meet the hypothalamus

A

hypothalamic-pituitary surface

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24
Q

what does inflammation of a gland result in

A

hypofunction

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25
Q

hyperthyroidism

A

excessive secretion of thyroid hormone

increased body metabolism

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26
Q

what is the most common cause of hyperthyroidism

A

Grave’s disease

increased T4 (autoimmune)

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27
Q

what do high levels of T3/T4 cause

A

TSH to be suppressed d/t negative feedback loop

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28
Q

hyperthyroidism manifestations

A

enlargement of thyroid

nervousness

heat intolerance

weight loss w/ increased appetite

sweating

diarrhea

tremor

palpitations

exophthalmos (bulging eyes)

intolerance to exercise

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29
Q

treatment hyperthyroidism

A

antithyroid medications

radioactive iodine

surgery

beta-adrenergic blockers

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30
Q

hypothyroidism

A

deficiency of thyroid hormone

decreased body metabolism

type 1 and type 2

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31
Q

type 1 hypothyroidism

A

thyroid is the issue

low T3/T4 and high TSH

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32
Q

type 2 hypothyroidism

A

pituitary/hypothalamus is the issue

low T3 and T4 and TSH

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33
Q

hypothyroidism manifestations

A

fatigue

cold sensitivity

fluid retention

forgetfulness

depression

dry skin/hair

edema

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34
Q

hypothyroidism treatment

A

increased activity and exercise (need to be cognizant of Rhabdo)

synthetic T3/T4

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35
Q

goiter hyperthyroidism

A

may be d/t lack of iodine, inflammation, or tumors

an increase in TSH thyroglobulin release into glandular tissue

hypertrophy of gland

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36
Q

thyroiditis

A

inflammation of the thyroid

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37
Q

types of thyroiditis

A

active suppurative

subacute granulomatous

lymphatic/chronic

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38
Q

acute suppurative thyroiditis

A

cause by bacteria pus forming

very rare

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39
Q

subacute granulomatous thyroiditis

A

caused by viral agents

uncommon

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40
Q

lymphotic/chronic thyroiditis

A

women are more affected (autoimmune basis)

destruction of thyroid (d/t infiltration of lymphocytes and antithyroid antibodies) decreased serum levels of T3/T4 stimulating the pituitary gland to increase TSH

begins w/ hyperthyroidism, after enough destruction, hypothyroidism develops

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41
Q

thyroid cancer

A

tumors are usually benign but make up 90% of all endocrine tumors

women are affected more than men

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42
Q

types of thyroid cancer

A

papillary

follicular

medullary

anaplastic

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43
Q

papillary thyroid cancer

A

most common

develops IN follicular cells

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44
Q

follicular thyroid cancer

A

slow

develops FROM follicular cells

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45
Q

medullary thyroid cancer

A

develops in C cells

5% of thyroid cancers

46
Q

anaplastic thyroid cancer

A

rare

fast

poorly differentiated

47
Q

red flag symptoms of thyroid cancer

A

vocal cord paralysis

ipsilateral cervical lymphadenopathy

fixation of nodule

48
Q

treatment of thyroid cancer

A

removal of thyroid, hypothyroidism or possible damage to laryngeal nerve

49
Q

when do you refer out for thyroid cancer

A

if you notice an asymptotic nodule or unusual swelling

50
Q

what does the parathyroid do

A

secretes PTH to regulate calcium and phosphate metabolism

calcitonin

vitamin D

51
Q

what does PTH do

A

Ca and PO4 from bone (demineralization)

absorption of Ca and excretion of PO4 by kidneys

absorption of Ca in GI tract

targets osteoblasts therefore osteoclast activity

52
Q

calcitonin and PTH

A

secreted by parafollicular cells

promote bone mineralization

53
Q

vitamin D and PTH

A

increases Ca absorption

54
Q

calcitonin actions

A

plasma Ca concentration

cellular uptake of Ca

renal excretion of Ca

bone formation

55
Q

hyperparathyroidism

A

overactivity of parathyroid

56
Q

primary hyperparathyroidism

A

PTH and serum calcium

57
Q

secondary hyperparathyroidism

A

d/t malfunction of another organ

ex: renal failure

58
Q

tertiary hyperparathyroidism

A

exclusive to dialysis pts who have secondary hyperparathyroidism

59
Q

manifestations of hyperparathyroidism

A

bone damage

hypercalcemia

kidney damage

60
Q

treatment of hyperparathyroidism

A

surgical removal

fall/fracture prevention

61
Q

hypoparathyroidism

A

insufficient secretion of PTH and low serum calcium

high serum phosphate

TETANY

62
Q

latrogenic

A

acquired w/ hypothyroidism d/t accidental removal of gland or infarction

63
Q

hypoparathyroidism manifestations

A

neuromuscular irritability

weak bones

64
Q

hypothyroidism treatment

A

fall/fracture prevention

65
Q

adrenal cortex outer cortex

A

mineralocorticoids

glucocorticoids

androgens

zones

66
Q

zones of outer cortex

A

zona glomerulosa –> mineralocorticoids (aldosterone)

zona fasciculata –> corticosteroids (cortisol)

zona reticularis –> androgens

67
Q

adrenal cortex inner cortex

A

epinephrine and norepinephrine

68
Q

primary adrenal insufficiency

A

Addison’s disease

69
Q

addison’s disease

A

insufficient cortisol and aldosterone release d/t disorder w/in adrenal gland

metabolic disturbances and fluid/electrolyte imbalances

70
Q

how do patients appear with addison’s disease

A

bronzed or tanned d/t increased skin pigmentation

71
Q

hallmark –> primary adrenal insufficiency

A

positive response to synthetic ACTH administration

72
Q

treatment for primary adrenal insufficiency

A

DO NOT STRESS PATIENT

aquatic therapy contraindicated d/t low BP

73
Q

secondary adrenal insufficiency

A

d/t disorder @ pituitary-hypothalamus unit or too rapid withdrawal of corticosteroid drugs

only cortisol deficient, aldosterone is normal

74
Q

secondary adrenal insufficiency treatment

A

synthetic ATCH

75
Q

adrenocortical hyperfunction

A

excessive glucocorticoids, mineralocorticoids and androgens

76
Q

example of adrenocortical hyperfunction

A

cushing’s syndrome

hypercortisolism

77
Q

cushing’s syndrome

A

as a result of hyperfunction of adrenal gland

excess of corticosteroid medication or excess ACTH stimulation from pituitary

78
Q

cushing’s syndrome manifestations

A

poor would healing

thinning of skin

muscle weakness

osteoporosis

79
Q

cushingoid apparence

A

buffalo hump

thin extremities

skin striations

moon face

high BP

80
Q

Conn’s syndrome

A

primary aldosteronism d/t adrenal lesion that results in hypersecretion of aldosterone

tetany

81
Q

aldosterone effects on the body

A

tubular reabsorption of sodium and water

excretion of potassium and hydrogen ions

82
Q

hyperlipidemia

A

adipose tissue = endocrine gland b/c it stores triglycerides

obesity can lead to diabetes, cancer and inflammation

83
Q

osteoporosis

A

most common metabolic bone disease

negative calcium balance (parathyroid affects calcium levels)

84
Q

pharmacology of endocrine disorders

A

glucocorticoids

mineralocorticoids

mineralocorticoid antagonists

85
Q

glucocorticoid pharmacology

A

effects on glucose, protein and lipids metabolism

adverse effects: adrenocortical suppression drug induced Cushing’s , breakdown of supporting tissues

86
Q

mineralocorticoid pharmacology

A

aldosterone involved in maintaining fluid and electrolyte balance

adverse effects; HTN

87
Q

diabetes mellitus

A

chronic, systemic disorder characterized by hyperglycemia and disruption of the metabolism of carbs, fats and proteins

insulin defects –> 1st issue is in the blood vessels that leads to other symptoms

leading cause of blindness and renal failure in adults

insulin transports glucose into the cell for use as energy and storage as glycogen

88
Q

islet of Langerhans (diabetes)

A

a cells

b cells

d cells

f cells

89
Q

a cells

A

secretes glucagon

near periphery

90
Q

b cells

A

secrete insulin

central

91
Q

d cells

A

secrete somatostatin

92
Q

f cells

A

secrete pancreatic polypeptide

93
Q

type 1 diabetes mellitus

A

deficiency of insulin production and secretion (may be autoimmune)

94
Q

metabolic problems w/ DM 1

A

decreased utilization of glucose

increased fat mobilization

impaired protein utilization

metabolic ketoacidosis

95
Q

DM1 manifestations

A

polyuria

polydipsia

weight loss w/ polyphagia

blurred vision

loss of beta cell function w/in 5 years

96
Q

microvascular complications DM1

A

nephropathy

retinopathy

97
Q

type II DM

A

combination of cellular resistance to insulin action and an inadequate compensatory insulin secretory response

more common in black, native, hispanic, mexican and asian Americans

98
Q

metabolic symptoms of DM II

A

not as severe as type I

99
Q

DM type II manifestations

A

abnormal thirst

urination

visual blurring

neuropathic complications

infections

significant blood lipid abnormalities

100
Q

when do microvascular complications occur DM II

A

much later than type I

101
Q

blood levels of diabetes

A

fasting glucose plasma is greater than or equal to 126 mg/dL after 8 hours of fasting

glucose tolerance test: after ingesting a sugary drink, pt is tested after an hour, greater or equal to 200 mg/dL

A1C is equal to or greater than 6.15%

102
Q

complications of diabetes

A

atherosclerosis –> lipid accumulation in blood vessels

CV, retinopathy, nephropathy, MS problems, sensory, motor, autonomic neuropathy

limited joint mobilization –> collagen (glucose metabolite) get “stuck” and can lead to vascular disease ischemia

103
Q

when should you screen for diabetes?

A

CDC –> 25

ADA –> 45

104
Q

treatment of diabetes

A

insulin adverse effects –> hypoglycemia (glucagon is not used to treat)

drugs

treatment of neuropathy

105
Q

drugs used to treat diabetes

A

Metformin

Incretin mimetics

Sulfonylureas and Benzoic acid derivatives

Biguanides and Thiazolidinediones

Alpha-glucosidase inhibitors

Immunosuppressants

106
Q

metformin

A

lowers blood glucose levels, increases insulin sensitivity

107
Q

Incretin mimetics

A

increase insulin secretion by mimicking GI hormones

108
Q

Sulfonylureas and Benzoic acid derivatives

A

: act on beta cells to secrete insulin

109
Q

Biguanides and Thiazolidinediones

A

: inhibits glucose production

110
Q

Alpha-glucosidase inhibitors

A

: delays glucose absorption by inhibiting sugar breakdown

111
Q

immunosuppressants

A

: type I to fight autoimmune response that destroys beta cells

112
Q

A Treatments of neuropathy

A

Aldose reductase inhibitors, anticonvulsants, selective serotonin reuptake inhibitors

Clin Med Exam 1 (8 decks)

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