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Med Con III > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Functions of the Endocrine System (2)

A
  1. helps maintain physiological homeostasis
  2. includes tissues that secrete hormones into the blood
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2
Q

How do hormones work?

A

bind to specific receptors that allow the hormone to exert its effect

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3
Q

secretion of most hormones are regulated by a _____ feedback system

A

negative
-specific hormones are turned on or off by specific physiological changes

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4
Q

The hypothalamus is a major link between ____ and _____ systems

A

nervous and endocrine system

the nervous system triggers the release of hormones by the endocrine system

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5
Q

What are the two parts of the pituitary? (both are attached to the hypothalamus)

A
  1. posterior pituitary- storage
  2. anterior pituitary- active part of endocrine
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6
Q

Why is the hypothalamus so important?

A
  1. synthesizes and secretes regulatory hormones
    -releaseing hormones- simulates release of anterior pituitary hormones
    -releases inhibitory hormones- inhibits releases of ant pituitary hormones
  2. synthesizes 2 hormones that are stored in the posterior pituitary
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7
Q

what is the role of the posterior pituitary and what hormones are there?

A

storage
-oxytocin
-vasopressin

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8
Q

what is the flow of events for anterior pituitary hormones to be released

A

hypothalamus—releases a hypothalamic releasing or inhibiting hormone into the Hypophyseal portal system—the anterior pituitary recognizes the hormones and releases the proper anterior pituitary hormone

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9
Q

Corticotropin releasing hormone from hypothalamus releases what from anterior pituitary?

A

adrenocorticotropic hormone

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10
Q

Growth hormone-releasing hormone causes releases of what from anterior pituitary?

A

growth hormone while somatostatin inhbits it

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11
Q

Thyrotropin releasing hormone releases what from anterior pituitary?

A

Thyroid stimulating hormone and prolactin

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12
Q

Explain the hormone that causes the following Pituitary disorders:
1. Acromegaly/gigantism-
2. Cushing’s Disease-
3. Diabetes Insipidus-

A
  1. acromegaly/gigantism- too much growth hormone
  2. cushing’s diseases- too much cortisol
  3. diabetes insipidus- too little vasopressin (ADH)
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13
Q

What are the common symptoms of a pituitary disorder?

A

Headache
visual changes (double vision, vision loss, drooping eyelid)

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14
Q

whats the difference between Gigantism and Acromegaly?

A

Gigantism- excessive secretion of GH in children
Acromegaly- excessive secretion of GH in adults

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15
Q

What two hormones are stored by the posterior pituitary?

A
  1. ADH vasopressin
  2. oxytocin
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16
Q

what does ADH vasopressin do?

A

sensitive to changes in blood tonicity, releases more vasopressin upon water loss
increased water resorption in the kidneys

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17
Q

When is ADH released?

A

reduced blood volume (baroreceptors sense low BP)
Increased plasma osmotic pressure (osmoreceptors in the hypothalamus sense increased solute in blood)

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18
Q

Does ADH increase or decrease during happy hour

A

increased because it is sensitive to the decreased blood volume and dehydration

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19
Q

What are common characteristics of Diabetes Insipidus?

A

peeing alot and having excessive thirst and increased appetite

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20
Q

What are the 2 causes of diabetes insipidus?

A
  1. posterior pituitary does secrete ADH
  2. insensitivity of kidney to ADH
21
Q

What do you need to do if you are exercising with a patient with DI?

A

make sure the patient stays hydrated
watch for signs of dizziness, hypotension
muscle weakness

22
Q

what are the 3 Ps of Diabetes insipidus?

A

polydipsia- excessive thirst
ployuria- increased urination
polyphagia- increase appetite

23
Q

Do patients with DI have an problem with glucose metabolism

A

no

24
Q

what are some adrenal gland disorders?

A

Hyper-functioning
1. cushing’s disease/syndrome
2. hyperaldosteronism (conn’s syndrom)
3. pheochromocytoma

Hypofunctioning
1. hypoaldosteronism/addison’s disease

25
Q

explain the release of cortisol

A

hypotalamus releases corticotropin—-corticotropin hormone goes to anterior pituitary—-ant pituitary releases adrenocorticotropic hormone into vascular system

ACTH is carried in the blood to the adrenal cortex stimulating the adrenal cortex and sythesis of cortisol–stress hormone

26
Q

normally as cortisol synthesis increases what happens to the CRH production

A

as cortisol increases then CRH from the hypothalamus should decreases and ACTH should decrease as well

27
Q

What are the functions of cortisol?

A

Stress hormone- think fight or flight
1. counter-regulatory to insulin- promotes hyperglycemia
2. decreases bone formation (decrease osteoblast formation) and decreases CA++ absorption
3. acts as a diuretic
4. inhibits production/release of inflammatory mediators

28
Q

Does cortisol production have a role in osteoporosis?

A

yes

29
Q

Hyper-secretion of cortisol causes what disease

A

cushing’s disease and syndrome

30
Q

what are some hallmarks of patients with cushing’s disease?

A
  1. rapid weight gain in central area
    -moon face
    -buffalo hump
  2. skin- thinning of skin and capilllary–bruising easily
    -poor wound healing
  3. muscle wasting and weakness
  4. tachycardia; hypertension
  5. osteoporosis
  6. hyperglycemia/DM
    -stres response
  7. immunosuppression/increased infection risk
31
Q

What is the treatment of cushing’s diseases/syndrome

A

depends on the reason for excess cortisol
- pituitary tumor removal-disease
-syndrome- adrenal tumor removal

32
Q

What is the primary functions of the Thyroid Gland (4)

A
  1. increased basal metabolic rate
  2. important for brain and muscular development
  3. increases HR/contractility and cardiac output
  4. CNS arousal state
33
Q

what are common signs/sx of hyperthyroidism

A

-unintended weight loss
-anxiety
-heat intolerance
-fatigue
-tachycardia/hypertension/afib
-tremors
-hyperglycemia
-osteopenia (longterm)

34
Q

what is graves disease?

A

autoimmune disease- hyperthyroidism
-causes bulging of eye anteriorly
-thyroid eye disease

35
Q

Typical treatment for hyperthyroidism

A

medication that inhibits the conversion of T4 to T2
betablockers for the CV

36
Q

What are sx/symptoms of hypothyroidism

A

-lethargy and fatigue
-bradycardia
-edema
-weight gain
-cold intolerance
-dry skin/brittle hair and fingernails
-goiter

37
Q

What is the function of the parathyroid gland and how many are there?

A
  1. secretes parathyroid hormone
  2. regulates plasma calcium (osteoclast activity)
  3. regulates phosphate level

there are 4

38
Q

Too much Parathyroid hormone increase risk of _____-

A

osteoporosis

39
Q

Function of parathyroid hormone?

A

increases blood calcium concentrations when serum CA++ is too low (hypocalcemia)

-stimulates osteoclasts to relasese more CA++ from bone
-deceases CA++ by kidney
-activates vitamin D which stimulates the uptake of Ca++ from diet

40
Q

What are some modifiable risk factors for osteoporosis?

A

vitamin D deficiency
lack of physical activity
weight loss
cigarette smoking
alcohol consumption
stress

41
Q

what are non-modifiable risk factors for osteoporosis

A

-history of falls
-older age
-gender
-white and asian
-prior fracture
-family history of osteoporosis

42
Q

What are medical conditions that are associated with increased risk of osteoporosis?

A

-prolonged corticosteroid use
-hypogonadism
-hyperparathyroidism
-chronic liver and renal
-inflammatory diseases
-DM
-dementia

43
Q

Increased/decreased survival age after hip fracture

A

decreased

44
Q

___ fractures are associated with morbidity and decreased ability to cary out independent activities of daily living

A

ALL fractures

45
Q

DXA scans help diagnose osteoporosis how?

A

T score compare bone mineral density to a healthy 30 year old femal

z scores compare bone density to average people of own age and gender

46
Q

Bisphosphonates are used for what?

A

FDA approved drug for osteoporosis

47
Q

How do bisphosphonates work

A

inhibit bone resorption by attaching to bony surfaces and inhibiting the action of osteoclast

48
Q

What are Interventions used to prevent osteoporosis?

A

stop smoking
medication
check risk factors
reduce alcohol
weight bearing exercise
vitamin D and Calcium increase

49
Q

What are some key items to remember when working with a patient with osteoporosis?

A

typically same FITT principles but emphasis on extension while avoiding loaded trunk flexion/rotation activities

Med Con III (27 decks)

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