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Pathopharm 2 > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

What are the endocrine functions?

A

Growth and development, reproductive system, internal environment,emergency demands of body.

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2
Q

General characteristics of all hormones?

A

Rates & rhythms of secretion, feedback systems, target cells, excreted by kidneys or deactivated by liver.

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3
Q

The pancreas is?

A

Both endocrine (sugar) and exocrine (gastric enzymes & polypeptides).

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4
Q

Houses of islets of Langerhans?

A

Secretion of insulin and glucagon.

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5
Q

Alpha?

A

Glucagon

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6
Q

Beta?

A

Insulin

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7
Q

Exocrine cells (Delta & F cells)

A

Delta-somatostatin

F cells- pancreatic enzymes

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8
Q

Insulin

A

-Secretion promoted by increased blood glucose, GI hormones, & amino acids.
-Facilitates glucose into cells.
-Cellular uptake of Vitamin K, Phosphate, and Magnesium.
synthesizes proteins, lipids & nucleic acids.

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9
Q

Amylin

A

Delays nutrient uptake & suppresses glucagon secretion

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10
Q

Thyroid gland

A
  • Secrete calcitonin (slows ca)
  • Secrete thyroid hormone
  • if TH ^ then TSH>
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11
Q

Iodine

A

Needed for thyroid functioning and production of TH

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12
Q

Thyroid hormones

A
  • TH secreted in response to TSH
  • 90% T4 (inactive) 10% T3 (active)
  • Affect growth & maturation, cell metabolism, heat production & O2 consumption
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13
Q

Parathyroid glands

A
  • Small behind thyroid
  • Produce PTH
  • Antagonist of calcitonin
  • Vitamin D needed
  • if CA^ then PTH>
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14
Q

Vitamin D deficiency

A

Affect over 75% of all Americans and over 90% Americans with pigmented skin.

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15
Q

Decreased serum Levels of Vitamin D have been linked to…

A

-Infections, cancer, diabetes, dementia, heart disease, chronic pain, & autoimmune disorders.

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16
Q

Adrenal cortex

A
  • 80% of total weight

- stimulated y ACTH

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17
Q

Adrenal medulla

A

Innervated by the autonomic nervous system.

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18
Q

Glucocorticoid hormones

A
  • Effects carbohydrate metabolism= increase blood glucose

- Anti-inflammatory, growth suppressing, and decreases immune response

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19
Q

Glucocorticoid hormones decreased levels

A

-Lead to decreased appetite, decreased RBC production, and increased intestinal calcium absorption (Addison’s)

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20
Q

Glucocorticoid hormones increased

A
  • Moon facies, changes in fat, hirsutism, decreases immune response (Cushing’s)
  • Sleep habits
  • Cortisol release
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21
Q

Mineralocorticoid hormones

A
  • Affects ion transport by epithelial

- Na retention and K and H loss

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22
Q

Aldosterone

A

-Regulated by the renin angiotensin system

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23
Q

Adrenal medulla (chromaffin cells) pheochromocytes

A

release catecholamines = flight or fight response= hyperglycemia

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24
Q

Endocrine and Nervous system regulate metabolic activities

A
  • Neuro (fast and short)

- Endocrine (slow and long)

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25
Q

Negative feedback

A
  • TH goes up and TSH goes down

- Sugar goes up and insulin goes up (decreased sugar)

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26
Q

Hormone receptors

A

-located in plasma membrane or in intracellular compartment of target cell

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27
Q

Hormones are released…

A

-Into circulatory by endocrine glands

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28
Q

Water-soluble hormones (nonsteroid)

A
  • High molecular weight
  • Cannot diffuse
  • First messenger (on cell)
  • Second messenger (in cell)
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29
Q

Lipid soluble hormones (steroid)

A

-Diffuse across and bind to cytosolic or nuclear receptors

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30
Q

Target cell (Up and Down receptors)

A
  • Increased receptors

- Decreased receptors

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31
Q

Hormone effects (Direct and Permissive)

A
  • D-changes in cell function insulin on muscle cells

- P-seconday effects on the body

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32
Q

Excess hormone levels

A
  • Tumor produces high levels
  • Excretion by liver or kidney impaired
  • Congenital condition
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33
Q

Deficit of hormones

A
  • Tumor
  • inadequate tissue receptors
  • agonist increased
  • malnutrition
  • atrophy surgical removal of gland
  • congenital
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34
Q

Blood tests

A
  • Check serum hormone levels
  • Radio immunoassay
  • Immunochemical methods
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35
Q

Urine tests

A
  • Stimulation or suppression tests

- Biopsy, ultrasound, MRI

36
Q

Endocrine treatment

A
  • Deficit- replacement therapy

- excessive-surgery, meds, radiation

37
Q

Pituitary hormones

A

-Adenomas are most common disorder

38
Q

Adenomas

A
  • May cause ICP

- headache, seizures, drowsiness, visual defect

39
Q

Adenomas effect on hormone secretion

A
  • Depend on cell and location

- Cause excessive or decrease in hormones

40
Q

Dwarfism

A

-Defect in growth hormone production and release

41
Q

Giantism

A

-Excess GH prior to puberty and fusion epiphysis

42
Q

Acromegaly

A
  • Excess GH secretion in adults
  • adenoma
  • bones broad and big
  • soft tissue grow on hands, feet, change in facial features
43
Q

Diseases of Anterior Pituitary (Hypopituitarism)

A

-Pituitary infarction, hemorrhage, shock, head trauma, infections, tumors (long or short term)

44
Q

Anterior Pituitary (Hyperpituitarism)

A
  • Benign slow growing adenoma
  • Headache, fatigue, and visual changes
  • hyposecretion of neighboring hormones***
45
Q

Panhypopituitarism

A

-Deficiency of ACTH, TSH, FSH, LH, and GH

46
Q

PP (Diabetes Insipidus)

A
  • Insufficiency of ADH
  • Inability to concentrate in urine (pee a lot)
  • Neurogenic(tumor or brain)- insuff. ADH
  • Nephrogenic(renal damage)- inadequate resp. to ADH
47
Q

Diabetes Insipidus treatment

A

-Replacement treatment required

48
Q

Diabetes Insipidus manifestations

A
  • Enhanced water secretion
  • hyperatremia
  • hyper-osmolality
  • polyuria
  • polydipsia
  • dilute urine
  • hypotensive (tachycardia)
  • pulse diminiahed
49
Q

Syndrome of Inappropriate ADH syndrome

A
  • Excess ADH

- temporary, stress, ectopic source- tumor

50
Q

SIADH treatment

A
  • Diuretics

- sodium supplements

51
Q

SIADH manifestations

A
  • Water retention
  • hypoatremia
  • hypo-osmolality
  • oliguria
  • concentrated urine
  • hypertension (bradycardia)
  • bounding pulse
52
Q

Diabetes Mellitus

A
  • Basic problem is inadequate insulin effects on receptor tissues
  • deficit of insulin secretion
  • production of insulin antagonists
53
Q

Diabetes results in…

A

-Abnormal carbohydrate, protein, and fat metabolism

54
Q

Certain tissues transport glucose without insulin…

A

-CNS, kidney, myocardium, gut, skeletal muscle, (skeletal only partially)

55
Q

Type 1 DDM

A
  • Autoimmune in pancreas (destruction of beta cells)
  • insulin replacement required
  • acute onset in children and adolescents
  • not linked to obesity
56
Q

Type 2 NIDDM

A
  • Non-insulin dependant
  • oral hypoglycemic meds
  • decrease production or increase resistance
  • slow and insidious in over 50+
  • obesity
  • metabolic syndrome
  • teens and adults
57
Q

General manifestations of Diabetes

A
  • Insulin deficit result in decreased transport of glucose
  • polyphagia
  • fatigue
58
Q

Blood glucose rises- hyperglycemia…

A
  • Excess glucose in urine- glucosuria
  • dehydration-hyperosmolar filtrate
  • polyuria
  • polydipsia
59
Q

glipizide (Glucotrol)

A
  • Second line
  • stimulates beta cells to release insulin
  • hypoglycemia, hematologic effects
  • Admin: 30 mins before meals (rapid onset, short duration)
  • Alcohol disulfiram
  • Sulfamides, Nsaids, asprin
60
Q

repaglinide (Prandin)

A
  • Release of beta cells from pancreas
  • can cause hypotension
  • 30 mins before a meal
  • skip a meal skip a dose
  • do not excess 4 doses per day
61
Q

metformin (Glucophage)

A
  • Decrease production of glucose by liver
  • decrease of intestinal absorption of glucose
  • increase uptake of glucose by tissues (decrease resistance)
  • No insulin secretion No hypotension!!!!
  • renal disease, alcoholism, hepatic disease
62
Q

First-line metformin

A
  • obese patients
  • elderly may react adversly
  • once a day with meals or twice with morning and evening
  • iodine containing lead to acute renal failure and lactic acidosis
  • stopped day of test and 48 hours after
63
Q

Lactic acidosis

A
  • Renal impairment
  • hepatotoxicity and hypoxia
  • cardiac failure, MI, pulmonary disease, alcoholism
64
Q

Lactic acidosis symptoms

A
  • Hyperventilation, cold and clammy, muscle pain, lethary

- may need dialysis

65
Q

rosiglitazone (Avandia)

A
  • Reduce insulin resistance of tisssue

- moderate weight gain, edema, mild anemia

66
Q

rosiglitazone (Avandia) Administration

A
  • Orally once or twice a day with or without food
  • only given with patients who cannot tolerate them metformin or sulfonylureas
  • can be combined with both for synergistic effect
67
Q

rosiglitazone (Avandia) contraindications

A
  • Cardiovascular disease and failure

- liver failure= ALT and AST

68
Q

rosiglitazone (Avanda) interactions

A

-Insulin= increase risk of heart failure and edema

69
Q

Precose

A

-Result in delayed absorption of glucose

70
Q

Precose Admin

A

-First bite of meal; skip dose skip meal

71
Q

Precose adverse effects

A
  • Gas, diarrhea, abd pain
  • hypoglycemia if with insulin or sulfa
  • **DEXTROSE to reverse hypoglycemia
72
Q

sitagliptin (Januvia)

A
  • Delay breakdown of incretin hormones
  • promote release of insulin and lower glucagon secretion
  • result: reduce fasting and postprandial glucose
73
Q

sitagliptin (Januvia) adverse effects

A

-Upper resp. infection, headache, and diarrhea
-hypoglycemia
-pancreatitis
Admin: with or without food

74
Q

Pramlintide (symlin)

A
  • Natural hormone release from beta cells with insulin in response to food
  • slow gastric emptying
  • suppresses glucagon secretion and hepatic glucose production
  • increase statiety
75
Q

Pramlintide (symlin) adverse effects

A

-Hypoglycemia with insulin/ injection reaction

76
Q

Pramlintide (symlin) admin

A
  • No mixing in same syringe
  • rotate sites
  • peak=20 min.
  • room temp=28 days
77
Q

exenatide (Byetta)

A

-Mimics incretin hormone

78
Q

exenatide (Byetta) adverse effects

A
  • Hypoglycemia w/ sulfonylureas
  • n/v diarrhea
  • pancreatitis
79
Q

exenatide (Byetta) admin

A
  • 60 min. prior to meds

- peak=2 hours

80
Q

exenatide (Byetta) interactions

A
  • Hypoglycemia w/ sulfa

- absorption of oral slowed antibiotics and oral cont.

81
Q

Insulin’s in general

A
  • Substitute endogenous hormone
  • metabolize carbohydrates, proteins, and lipids
  • store glucose in liver
  • glycogen to fat stores
  • promote vitamin K uptake into cells (decrease serum K+)
82
Q

(-logs) Aspart and Lispro

A
  • Rapid 5-15 mins
  • peak 1-2 hours
  • no IV
  • must eat after injecton
83
Q

Short-acting (Regular)

A
  • 30-60 mins
  • peak 2.5 hour
  • can give IV
  • DKA
84
Q

Intermediate acting (NPH)

A

-Cloudy
-onset 1-2
-peak: 4-8
roll

85
Q

Long-acting glargine (Lantus) & detemir (Levemir)

A
  • Clear
  • 24 hour lasting
  • once daily
  • basal insulin (peakless)

Pathopharm 2 (1 decks)

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