Endocrine System Flashcards
1
Q
What are 5 functions of the endocrine system?
A
- Differentiation of the reproductive and central nervous system fetus
- Stimulation of sequential growth and development
- Coordination of the male and female reproductive
- Maintenance of an optimal internal environment
- Initiation of corrective and adaptive responses
2
Q
The endocrine system is a system of ___
A
Glands
3
Q
What is the endocrine system stimulated by?
A
-Central Nervous System
-Physiologic state
4
Q
____ are produced, secreted, and sent to the site of action
A
Hormones
5
Q
____ are highly specific to each hormone
A
Receptors
6
Q
____ refers to the “fit” of the receptor and the ligand
A
Specificity
7
Q
Receptors and ligands are similar to a ___ and ___ mechanism
A
Lock and key
8
Q
_____ is the strength of the attraction between the ligand and the receptor
A
Affinity
9
Q
___ ____ is the production of more receptors when more hormone is needed
A
Up-regulation
10
Q
With down-regulation, less _____ are expressed so there is less protein and less action
A
Receptors
11
Q
____ is when the presence of one hormone permits or impacts the effectiveness of another hormone (ex: high thyroid hormone makes more receptors for epinephrine)
A
Permissiveness
12
Q
Hormones are made in one place and released into the ____ where they can travel to a distant cell where they have their action
A
Bloodstream
13
Q
There are ___ soluble and ____ soluble hormones
A
Water and lipid
14
Q
Hormone release is controlled via ___ ___
A
Feedback loops
15
Q
With a ___ feedback loop, hormone release is inhibited by some other action or substance
A
Negative
16
Q
One example of a negative feedback loop is ____, in which high levels shut off additional production
A
Cortisol
17
Q
With a ____ feedback loop, something stimulates the release of more hormone
A
Positive
18
Q
One example of a positive feedback loop is ____ release during breastfeeding; the pituitary releases it and stimulates milk production and so as long as the baby keeps suckling, it will continue to be released
A
Oxytocin
19
Q
Mechanism of the physiological axis:
A
The hypothalamus stimulates the pituitary gland which stimulates either the thyroid, adrenal, or gonad gland
20
Q
The ____ links the brain to the endocrine system and the rest of the body
A
Hypothalamus
21
Q
The hypothalamus is important for ___ ___ ___ function and also provides feedback and produces hormones
A
Autonomic nervous system
22
Q
____ will stimulate the anterior pituitary gland
A
Neurohormones
23
Q
The formal endocrine glands include…
A
-Pituitary (anterior and posterior)
-Thyroid
-Adrenals
-Gonads
-Endocrine pancreas
24
Q
Hormones released by the anterior pituitary (adenohypophysis) include…
A
-ACTH
-TSH
-FSH
-LH
-Prolactin
-Growth hormone
-Melanocyte-stimulating hormone
-Lipotropin
-Endorphins
25
Hormones released by the posterior pituitary (neurohypophysis) gland:
-Oxytocin
-Arginine
-Vasopressin
26
Hormones released by the thyroid gland:
-Thyroxine (T4)
-Triiodothyronine (T3)
27
Mechanism of the hypothalamus-pituitary-thyroid (HPA) axis:
-The hypothalamus secretes TRH
-TRH stimulates TSH production and release
-TSH stimulates T3 and T4
28
Thyroxine (T4) makes up ___% of circulating hormone and will be converted to T3
90
29
Triiodothyronine (T3) is ___ ___
Biologically active
30
___% of triiodothyronine (T3) is released from the endocrine gland, and the remaining is converted from T4 in the periphery
15%
31
What are 4 functions of the thyroid hormone?
1. Increases cellular metabolism
2. Increases blood pressure maintenance
3. Some growth functions (skeletal)
4. Temperature maintenance (primarily increases)
32
Adrenal glands are located above the ___ on either side
Kidneys
33
Adrenal glands get stimulus from the ____
Pituitary
34
The adrenal glands are a very ____ structure
Vascular
35
The adrenal gland is broken up into different ____ that make different hormones
Zones
36
The ____ is the outer layer of the adrenal gland
Cortex
37
The cortex of the adrenal gland contains the ___ ____, which is the outermost layer
Zona glomerulosa
38
The zona glomerulosa produces mineralocorticoides like ____
Aldosterone
39
The cortex also contains the ___ ____ (one layer in from the glomerulosa)
Zona fasiculata
40
The zona fasiculata produces things like ____, which helps with low blood pressure and also regulates the autonomic nervous system
Cortisol
41
The ___ ___ is the next innermost layer
Zona reticularis
42
The zona reticularis produces ___ ___
Androgenous steroids (sex hormones)
43
____ are produced in the medulla
Catecholamines
44
The ___ axis functions in the production of cortisol
HPA
45
Gonads are very important for ___ ___
Reproductive function
46
In the HPA axis, the hypothalamus is ____, the pituitary is ____ and the thyroid, adrenal, and gonal are ____
Tertiary, secondary, primary
47
Syndrome of ____ ___ ____ causes increased secretion of the hormone which leads to excess water retention which leads to hyponatremia and hypervolemia
Inappropriate antidiuretic hormone
48
Syndrome of inappropriate antidiuretic hormone is caused by ____ ____ dysfunction
Posterior pituitary
49
Syndrome of inappropriate antidiuretic hormone can be caused by...
-Tumors
-Head trauma
-Medications
50
____ ___ is caused by decreased posterior pituitary function
Diabetes Insipidus
51
What are the two types of diabetes insipidus?
-Neurological DI
-Nephrogenic DI
52
Neurological diabetes insipidus can be seen in people with high ____ consumption
Alcohol
53
Nephrogenic diabetes insipidus can be caused by poor binding of receptors and this can be seen with ___ ___
Renal transplant
54
With diabetes insipidus, people don't have enough ___ ___ ____ which leads to too much water being excreted, highly concentrated blood, and hypernatremia
Antidiuretic hormone
55
What hormones are produced by the anterior pituitary gland?
-ACTH
-TSH
-FSH
-LH
-Prolactin
-Growth hormone
-
56
With ____, there is too much production of thyroid hormones which ramps up the metabolic rate and oxygen consumption
Hyperthyroidism
57
What are some possible causes of hyperthyroidism?
-Graves disease (autoimmune disorder)
-Adenoma (benign tumor of the gland)
-Thyroiditis (inflammation of the thyroid gland)
-Overtreatment of hypothyroidism
-Sudden discontinuation of antithyroid meds
-Iodine overload
58
What are some manifestations of hyperthyroidism?
-Tachycardia
-High sweat output
-Increased growth and development
-Anxiety
-Heat intolerance
-Diarrhea
-Bulging eyes
-Goiter
-Dyspnea
-Weight loss
59
A hyperthyroid crisis, also known as a ___ ___, can be caused by pre-existing hypersecretion, stress, or increased catecholamine receptors
Thyroid storm
60
A thyroid storm causes sudden onset of ____ symptoms
Hyperthyroid
61
With ____, there is not enough production of thyroid hormone
Hypothyroidism
62
What are some possible causes of hypothyroidism?
-Surgical removal of the gland
-Tertiary disorders of the hypothalamus
-Secondary disorders of the pituitary
-Primary disorders of the thyroid gland
-Hashimoto's
-Pituitary radiation or removal
63
Manifestations of hypothyroidism include...
-Bradycardia
-Lethargy
-Decreased level of consciousness
-Coma
-Hypothermia
-Hypoventilation
-Decreased GI motility
-Constipation
-Weight gain
64
____ ____ is a primary disorder of the thyroid gland
Myxedema coma
65
Myxedema coma can be caused by ____ with pre-existing hypothyroidism (low-level hypothyroidism, commonly undiagnosed)
Stress
66
What are manifestations of myxedema coma?
-Extreme hypothyroid state
-Lowered metabolic rate (severe)
-Altered mental status
-Hypothermia
-Hypoglycemia
-Hypotension
-Hyponatremia
-Bradycardia
-Hypoventilation
67
Interstitial accumulation of _____ may cause myxedema
Mucopolysaccharide
68
____ ____ ____ is an adaptive response
Sick euthyroid syndrome
69
With sick euthyroid syndrome, rather than ___ being converted to ___, it is converted to ___
T4 to T3; rT3
70
rT3 is identical to T3 except flipped in conformation which makes it ___ ___
Biologically inactive
71
In hospitalized patients, we often see low ___ but high ___ because there is less metabolic driving hormone which explains why we rent and heal while we are sick
T3; rT3
72
With sick euthyroid syndrome, we see ____ levels of thyroid stimulating hormone
Normal
73
What can stimulate sick euthyroid syndrome?
-Fasting
-Sepsis
-Trauma
-Burns
-Cardiopulmonary bypass
-Malignancy
-Heart failure
-Myocardial infarction
-Hypothermia
-Chronic renal failure
-Cirrhosis
-Diabetic ketoacidosis
74
What are two adrenal hormones produced by the pituitary?
-Cortisol
-Aldosterone
75
Adrenal insufficiency is also known as ___ ___
Addison's Disease
76
Addison's Disease causes sudden and severe drop in ___ ___
Hormone levels (aldosterone and cortisol)
77
Many times, Addison's Disease goes ____ until it is far gone and severe
Undetected
78
Possible causes of Addison's Disease (adrenal insufficiency) include...
-Decompensation in patients with chronic adrenal insufficiency
-Destruction of the adrenal glands
-Discontinuation of corticosteroid therapy
-Kidney injury
-Genetic disorders
-Pituitary disorders
-Pituitary of Hypothalamus damage
-Infection
79
What are some clinical presentations of Addison's Disease?
-Hypoglycemia
-Hypotension
-Hyponatremia
-Hyperkalemia
-Hyperpigmentation
80
____ causes elevated cortisol levels in the body
Hypercortisolism
81
What are two possible causes of hypercortisolism?
-Exogenous glucocorticoid ingestion
-Tumors
82
Cushing's Disease is ____ _____ hypercortisolism
Adrenocorticotropic hormone (ACTH) dependent
83
Cushing's Disease can be caused by...
-Pituitary-driven rise in adrenocorticotropic Hormone
-Ectopic adrenocorticotropic hormone release
-Exogenous adrenocorticotropic hormone administration
84
With Cushing's Disease, increased adrenocorticotropic hormone stimulates increased ____ production
Cortisol
85
___ ___ is adrenocorticotropic hormone-independent hypercortisolism
Cushing's Syndrome
86
With Cushing's Syndrome, the ___ ___ increases cortisol output
Adrenal gland
87
With Cushing's Syndrome, adrenocorticotropic hormone level is often ____
Decreased
88
What are some manifestations of hypercortisolism?
-Sodium and water retention
-Buffalo hump and back pain
-Osteoporosis
-Cardiac hypertrophy
-Hypertension
-Diabetes
-Polydipsia
-Catabolism
-Moon face/tomato face
-Muscle wasting
-Fat accumulation
-Pendulous abdomen and breasts
-Thin arms and legs
-Thin skin
-Easily bruising
89
___ hyperaldosteronism is due to a problem of the adrenal glands themselves (usually due to a noncancerous tumor of the adrenal gland)
Primary
90
____ hyperaldosteronism is due to a problem somewhere else in the body that causes the adrenal glands to release too much aldosterone
Secondary
91
Hyperaldosteronism causes alterations in ___ and ____ balance
Fluid and electrolyte
92
Secondary hyperaldosteronism occurs due to excessive activation of the ___-___-___ system due to a tumor, renal artery stenosis, or edematous disorders like heart failure, pregnancy, cor pulmonale, or cirrhosis with ascites
Renin-angiotensin-aldosteronism
93
What are some manifestations of hyperaldosteronism?
-Hypertension
-Edema
-Hypernatremia
-Hypokalemia
94
____ is a unique disorder of the adrenal gland
Pheochromocytoma
95
Pheochromocytoma causes an excess of _____ production
Catecholamine
96
Pheochromocytoma is caused by ____
Tumors
97
Manifestations of pheochromocytoma:
-Hypertension
-Headache
-Diaphoresis
-Palpitations
-Tachycardia
-Anxiety and emotional lability
-Weight loss
98
Diabetes is heavily influenced by the ____
Pancreas
99
The pancreas produces enzymes for ____ as well as pancreatic enzymes
Digestion
100
____ is released from the pancreas in response to increased protein and glucose in the blood, usually due to the absorption of food
Insulin
101
4 steps of endocrine glucose management:
1. Glucose binds to a GLUT1 transporter protein that has its binding site open to the outside of the cell (T1 conformation)
2. Glucose binding causes the GLUT1 transporter to shirt to its T2 conformation with the binding site open to the inside of the cell
3. Glucose is released to the interior of the cell, initiating a second conformational change in GLUT1
4. Loss of bound glucose causes GLUT1 to return to its original T1 conformation, ready for a further transport cycle
102
4 steps of endocrine release of insulin:
1. When the insulin receptor binds insulin, the activated receptor phosphorylates the IRS-1 protein; IRS-1 can lead to recruitment of GRB2, activating the Ras pathway
2. IRS-1 activates PI 3-kinase, which catalyzes the addition of a phosphate group to the membrane lipid PIP2, thereby converting it to PIP3; PTEN can convert PIP3 back to PIP2.
3. PIP3 binds a protein kinase called Akt, which is activated by other protein kinases
4. Akt catalyzes phosphorylation of key proteins, leading to an increase in glycogen synthase activity and recruitment of the glucose transporter, GLUT4, to the membrane
103
Insulin upregulates...
-Glucose uptake in muscles and adipose tissue
-Glycolysis
-Glycogen synthesis
-Protein synthesis
-Uptake of ions (especially potassium and phosphate)
104
Insulin downregulates...
-Gluconeogenesis
-Glycogenolysis
-Lipolysis
-Ketogenesis
-Proteolysis
105
_____ has the opposite effect of insulin and is released with low blood glucose
Glucagon
106
____ is a hormone that regulates a variety of bodily functions by hindering the release of other hormones, the activity of the GI tract, and the rapid reproduction of cells
Somatostatin
107
___ ___ is a metabolic disorder when there is either not enough insulin or inadequate response to insulin (or both)
Diabetes mellitus
108
____ intolerance is a common condition associated with diabetes mellitus
Glucose
109
With type 1 diabetes, the body does not produce insulin due to ___ ___ ___
Beta cell destruction
110
Only about ___-__% of diabetics are type 1
5-10
111
Individuals with type 1 diabetes are prone to ____
Ketoacidosis
112
What are some symptoms of type 1 diabetes?
-Ketoacidosis
-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss
113
With thype 2 diabetes, there is a defect in ___ ___ and its' use in the body
Insulin secretion
114
___% of diabetics are type 2
90
115
Type 2 diabetes is no longer an ___ onset disorder
Adult
116
Type 2 diabetes is ____ diabetes
Secondary
117
Type 2 diabetes is associated with...
-Poor diet
-Low activity
-Insulin resistance
-Defect in insulin selection so the body doesn't produce enough or the body can't respond to it
118
Symptoms of type 2 diabetes:
-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss
119
With ___ ___, women who are not diabetic develop diabetes during pregnancy (secondary diabetes)
Gestational diabetes
120
Gestational diabetes has features of ___ ___ diabetes
Type 2
121
Gestational diabetes occurs in about ___% of pregnancies
10
122
___-___% of women who develop gestational diabetes go on to develop type 2 diabetes after birth
5-10
123
Symptoms of gestational diabetes:
-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss
124
Diabetic ketoacidosis is much more common in type ___ diabetes
1
125
Diabetic ketoacidosis is caused by an absolute lack of ___
Insulin
126
Precipitating factors of diabetic ketoacidosis:
-Infection
-New onset diabetes
127
Physical or emotional ___ can increase risk of diabetic ketoacidosis
Stress
128
Pathophysiology of diabetic ketoacidosis:
-Increased cortisol
-Lack of insulin
-Increased gluconeogenesis
-Increased fatty acid metabolism
129
Symptoms of diabetic ketoacidosis:
-Frequent urination
-Dehydration
-Increased lipolysis
-Sweet-smelling breath
-Altered consciousness
-Coma
130
Hyperosmolar nonketotic state is more common in type ___ diabetes
2
131
Hyperosmolar nonketotic state is brought on by ___ ___
Physiologic stress
132
Hyperosmolar nonketotic state has a much ____ onset than diabetic ketoacidosis
Slower
133
With hyperosmolar nonketotic state, there is reduced ____ uptake at the cellular level, causing higher blood glucose levels
Glucose
134
The hyperosmolar nonketotic state causes dumping of ___ and ___ into the blood which causes a hyperglycemia state and dehydrated cells
Water and electrolytes
135
With hyperosmolar nonketotic state, blood glucose levels are around 1200 which is much ____ that with diabetic ketoacidosis
Higher
136
Symptoms of hyperosmolar nonketotic state:
-Dry mouth
-hyperglycemia
-Extreme thirst
-Warm skin without sweat
-Fever
-Confusion
-Vision loss
-Hallucinations
137
____ may occur in diabetics as a response to treatment or not eating (can also happen in people without diabetes)
Hypoglycemia
138
Symptoms of hypoglycemia:
-Cellular energy failure
-Adrenal gland goes into overdrive and secretes catecholamines
-Increased gluconeogenesis
-Anxiety
-Tachycardia
-Nausea
-Confusion
-Weakness
-Seizures
139
The ____ ____ states that early morning hyperglycemia occurs due to a rebound effect from late-night hypoglycemia
Somogyi Phenomenon
140
What are some manifestations of the Somogyi phenomenon?
-Nightmares
-Morning headache
-Inconsistent glucose levels (morning glucose level may show the initial hypoglycemia or the rebound hyperglycemia)
