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B8W5 > ENDOCRINE HOMEOSTASIS AND INTERVENTIONS > Flashcards

ENDOCRINE HOMEOSTASIS AND INTERVENTIONS Flashcards

1
Q

what is endocrinology?

A

the study of glands and hormones they produce

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2
Q

what’s the difference between exocrine and endocrine?

A

Exocrine: hormones secreted externally or into a lumen e.g sweat gland
Endocrine: hormones secreted internally e.g islets of pancreas

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3
Q

what are hormones?

A

chemical messengers produced by endocrine glands which have a specific effect on target tissues.

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4
Q

describe the 2 types of hormones?

A

lipid soluble (need transport proteins and receptors are inside the cell) and water soluble (no need for transport proteins, receptors in cell membrane)

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5
Q

outline the hypothalamic-pituitary adrenal axis?

A

stress stimulates the hypothalamus to release corticotropin releasing hormone which stimulates the anterior pituitary to release adrenocorticotropin releasing hormone. this then stimulates the adrenal cortex to release cortisol which can act on various tissues

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6
Q

what’s the mechanism for when cortisol levels are too high?

A

it will inhibit the hypothalamus so that CRH can’t be released

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7
Q

what is adrenal insufficiency?

A

when the adrenal glands don’t produce enough cortisol

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8
Q

what are the 3 types of adrenal insufficiency?

A

primary adrenal insufficiency (pathology in the adrenal gland)
secondary adrenal insufficiency (pathology in anterior pituitary)
tertiary adrenal insufficiency (pathology in the hypothalamus)

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9
Q

what is Addison’s disease?

A

primary adrenal insufficnecy

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10
Q

describe the pathophysiology of Addison’s disease?

A

autoimmune destruction of the adrenal cortex so it produces less cortisol. we get higher levels of CRH and ACTH because they are trying to stimulate the adrenal cortex to produce cortisol

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11
Q

why does Addison’s disease cause hyperpigmentation?

A

as high ACTH levels stimulatesmelanocytes to produce more melanin

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12
Q

describe the pathophysiology of secondary adrenal insufficiency?

A

destruction of pituitary gland so less ACTH produced which means the adrenal cortex produces less cortisol but we lose the negative feedback loop so CRH levels are high

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13
Q

describe the pathophysiology of tertiary adrenal insufficiency?

A

damage to the hypothalamus means less CRH is produced so ACTH and cortisol levels are low

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14
Q

what test do you do if you suspect Addison’s disease

A

synacthen stimulation test

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15
Q

what is synacthen?

A

synthetic adrenocorticotropin releasing hormone

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16
Q

how do you carry out a synacthen test?

A

Take the baseline cortisol then give intramuscular synacthen. Check the blood after 30 minutes to measure cortisol. If there’s a suboptimal rise in cortisol then we suspect adrenal insufficiency.

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17
Q

what test do you use to diagnose secondary adrenal insufficiency?

A

the insulin stress test

18
Q

how do you carry out the insulin stress test?

A

Take baseline cortisol. Give them insulin and this will cause hypoglycemia which stimulates stress. This stress causes CRH, ACTH, and cortisol to be released. If there’s a suboptimal rise in cortisol, then we suspect secondary adrenal insufficiency.

19
Q

what’s the other name for Cushing syndrome/disease?

A

hypercortisolemia

20
Q

what are the symptoms of Cushing’s syndrome?

A 
protein depletion= poor wound healing
hyperglycaemia
hyperlipidaemia
osteoporosis
round face
weight gain
hypertension
more prone to metabolic diseases
21
Q

what’s the difference between Cushing’s disease and Cushing’s syndrome?

A

Cushing’s syndrome is a disorder caused by the body’s exposure to an excess of the hormone cortisol
Cushing disease is when a pituitary tumor causes the body to make too much cortisol.

22
Q

what is the pathophysiology of Cushing’s syndrome?

A

Due to adrenal cortex producing excess cortisol we see negative feedback to the hypothalamus and pituitary causing low CRH and ACTH levels.

23
Q

what test is used to diagnose whether it’s Cushing’s disease or Cushing’s syndrome?

A

the dexamethasone suppression test

24
Q

what is the body’s normal response to dexamethasone?

A

suppression of endogenous cortisol due to inhibition of ACTH release from pituitary gland

25
Q

what does the thyroid gland secrete? and for what function?

A

T3 and T4- growth, development, and metabolism

26
Q

what is hyperthyroidism?

A

excess T3 and T4 secretion which causes negative feedback inhibition of the hypothalamus so less thyrotropin-releasing hormone and less thyroid stimulating hormone from the anterior pituitary is secreted

27
Q

what are the symptoms of hyperthyroidism?

A 
weight loss
increased appetite
heat intolerance
irritability
tremor
28
Q

what are the signs of hyperthyroidism?

A

tremor
tachycardia
exophthalmos
goitre (enlarger thymus that moves up and down with deglutition)

29
Q

what is hypothyroidism?

A

low T3 and T4 so no inhibition on the hypthalamus= TRH and TSH levels high

30
Q

what are the signs and symptoms of hypothyroidism?

A 
dry hair
weight gain
reduced appetite
thin eyebrows
peri-oribital oedema
puffy face
dry skin
intolerance to cold
31
Q

describe the hyothalamo-pituitary gonadal axis?

A

Hypothalamus produces gonadotrophin releasing hormone with stimulates the pituitary gland to produce LH and FSH. These act on the testis to produce testosterone and the ovaries to produce oestrogen

32
Q

what is primary hypogonadism?

A

not enoygh sex hormones caused by a problem with the gonads

this means there’s no inhibition on the hypothalamus and pituitary gland so we have ahigh levels of GnRH, LH and FSH

33
Q

what is secondary hypognadism?

A

problems in the anterior pituitary which causes low levels of LH and FSH and this means low levels of oestrogen and testosterone but the hypothalamus isn’t inhibited so we get high levels of GnRH

34
Q

describe the positive feedback mechanism of prolactin?

A

When the baby begins to suck, nerve cells in the mother’s breast send a message to the hypothalamus.
On receiving the message, the hypothalamus stimulates the pituitary to produce prolactin.
The prolactin secreted by the pituitary gland stimulates the milk glands in the mother’s breast.
The more the baby sucks, the more prolactin is secreted, and the more milk is produced.

35
Q

what is sopamines effect on prolactin?

A

it inhibits it so sopamine antagonists can cause hyperprolactinemia

36
Q

how do you treat hyperprolactinemia?

A

with dopamine agonists

37
Q

describe the negative feedback loop involved in producing insulin-like growth hormone 1?

A

GnRH from the hypothalamus stimulates the pituitary gland to produce growth hormone which then acts on the liver to produce insulin-like growth hormone 1 (stimulates cells for growth and development). when levels get too high then it inhibits the hypothalamus and pituitary gland

38
Q

what is gigantism?

A

excess growth hormone from the pituitary gland

39
Q

which molecule inhibits growth hormone release?

A

somatostatin

40
Q

what does the posterior pituitary secrete?

A

vasopressin and oxytocin

41
Q

what is the function of vasopressin?

A

maintain bp and produces diaresis

42
Q

What is the function of oxytocin?

A

contracting uterine muscles and lactation

B8W5 (5 decks)

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