Endocrine System Flashcards
1
Q
What are the endocrine functions?
A
Growth and development, reproductive system, internal environment,emergency demands of body.
2
Q
General characteristics of all hormones?
A
Rates & rhythms of secretion, feedback systems, target cells, excreted by kidneys or deactivated by liver.
3
Q
The pancreas is?
A
Both endocrine (sugar) and exocrine (gastric enzymes & polypeptides).
4
Q
Houses of islets of Langerhans?
A
Secretion of insulin and glucagon.
5
Q
Alpha?
A
Glucagon
6
Q
Beta?
A
Insulin
7
Q
Exocrine cells (Delta & F cells)
A
Delta-somatostatin
F cells- pancreatic enzymes
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.
9
Q
Amylin
A
Delays nutrient uptake & suppresses glucagon secretion
10
Q
Thyroid gland
A
- Secrete calcitonin (slows ca)
- Secrete thyroid hormone
- if TH ^ then TSH>
11
Q
Iodine
A
Needed for thyroid functioning and production of TH
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
13
Q
Parathyroid glands
A
- Small behind thyroid
- Produce PTH
- Antagonist of calcitonin
- Vitamin D needed
- if CA^ then PTH>
14
Q
Vitamin D deficiency
A
Affect over 75% of all Americans and over 90% Americans with pigmented skin.
15
Q
Decreased serum Levels of Vitamin D have been linked to…
A
-Infections, cancer, diabetes, dementia, heart disease, chronic pain, & autoimmune disorders.
16
Q
Adrenal cortex
A
- 80% of total weight
- stimulated y ACTH
17
Q
Adrenal medulla
A
Innervated by the autonomic nervous system.
18
Q
Glucocorticoid hormones
A
- Effects carbohydrate metabolism= increase blood glucose
- Anti-inflammatory, growth suppressing, and decreases immune response
19
Q
Glucocorticoid hormones decreased levels
A
-Lead to decreased appetite, decreased RBC production, and increased intestinal calcium absorption (Addison’s)
20
Q
Glucocorticoid hormones increased
A
- Moon facies, changes in fat, hirsutism, decreases immune response (Cushing’s)
- Sleep habits
- Cortisol release
21
Q
Mineralocorticoid hormones
A
- Affects ion transport by epithelial
- Na retention and K and H loss
22
Q
Aldosterone
A
-Regulated by the renin angiotensin system
23
Q
Adrenal medulla (chromaffin cells) pheochromocytes
A
release catecholamines = flight or fight response= hyperglycemia
24
Q
Endocrine and Nervous system regulate metabolic activities
A
- Neuro (fast and short)
- Endocrine (slow and long)
25
Negative feedback
- TH goes up and TSH goes down
| - Sugar goes up and insulin goes up (decreased sugar)
26
Hormone receptors
-located in plasma membrane or in intracellular compartment of target cell
27
Hormones are released...
-Into circulatory by endocrine glands
28
Water-soluble hormones (nonsteroid)
- High molecular weight
- Cannot diffuse
- First messenger (on cell)
- Second messenger (in cell)
29
Lipid soluble hormones (steroid)
-Diffuse across and bind to cytosolic or nuclear receptors
30
Target cell (Up and Down receptors)
- Increased receptors
| - Decreased receptors
31
Hormone effects (Direct and Permissive)
- D-changes in cell function insulin on muscle cells
| - P-seconday effects on the body
32
Excess hormone levels
- Tumor produces high levels
- Excretion by liver or kidney impaired
- Congenital condition
33
Deficit of hormones
- Tumor
- inadequate tissue receptors
- agonist increased
- malnutrition
- atrophy surgical removal of gland
- congenital
34
Blood tests
- Check serum hormone levels
- Radio immunoassay
- Immunochemical methods
35
Urine tests
- Stimulation or suppression tests
| - Biopsy, ultrasound, MRI
36
Endocrine treatment
- Deficit- replacement therapy
| - excessive-surgery, meds, radiation
37
Pituitary hormones
-Adenomas are most common disorder
38
Adenomas
- May cause ICP
| - headache, seizures, drowsiness, visual defect
39
Adenomas effect on hormone secretion
- Depend on cell and location
| - Cause excessive or decrease in hormones
40
Dwarfism
-Defect in growth hormone production and release
41
Giantism
-Excess GH prior to puberty and fusion epiphysis
42
Acromegaly
- Excess GH secretion in adults
- adenoma
- bones broad and big
- soft tissue grow on hands, feet, change in facial features
43
Diseases of Anterior Pituitary (Hypopituitarism)
-Pituitary infarction, hemorrhage, shock, head trauma, infections, tumors (long or short term)
44
Anterior Pituitary (Hyperpituitarism)
- Benign slow growing adenoma
- Headache, fatigue, and visual changes
- hyposecretion of neighboring hormones***
45
Panhypopituitarism
-Deficiency of ACTH, TSH, FSH, LH, and GH
46
PP (Diabetes Insipidus)
- 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
Diabetes Insipidus treatment
-Replacement treatment required
48
Diabetes Insipidus manifestations
- Enhanced water secretion
- hyperatremia
- hyper-osmolality
- polyuria
- polydipsia
- dilute urine
- hypotensive (tachycardia)
- pulse diminiahed
49
Syndrome of Inappropriate ADH syndrome
- Excess ADH
| - temporary, stress, ectopic source- tumor
50
SIADH treatment
- Diuretics
| - sodium supplements
51
SIADH manifestations
- Water retention
- hypoatremia
- hypo-osmolality
- oliguria
- concentrated urine
- hypertension (bradycardia)
- bounding pulse
52
Diabetes Mellitus
- Basic problem is inadequate insulin effects on receptor tissues
- deficit of insulin secretion
- production of insulin antagonists
53
Diabetes results in...
-Abnormal carbohydrate, protein, and fat metabolism
54
Certain tissues transport glucose without insulin...
-CNS, kidney, myocardium, gut, skeletal muscle, (skeletal only partially)
55
Type 1 DDM
- Autoimmune in pancreas (destruction of beta cells)
- insulin replacement required
- acute onset in children and adolescents
- not linked to obesity
56
Type 2 NIDDM
- Non-insulin dependant
- oral hypoglycemic meds
- decrease production or increase resistance
- slow and insidious in over 50+
- obesity
- metabolic syndrome
- teens and adults
57
General manifestations of Diabetes
- Insulin deficit result in decreased transport of glucose
- polyphagia
- fatigue
58
Blood glucose rises- hyperglycemia...
- Excess glucose in urine- glucosuria
- dehydration-hyperosmolar filtrate
- polyuria
- polydipsia
59
glipizide (Glucotrol)
- 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
repaglinide (Prandin)
- 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
metformin (Glucophage)
- 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
First-line metformin
- 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
Lactic acidosis
- Renal impairment
- hepatotoxicity and hypoxia
- cardiac failure, MI, pulmonary disease, alcoholism
64
Lactic acidosis symptoms
- Hyperventilation, cold and clammy, muscle pain, lethary
| - may need dialysis
65
rosiglitazone (Avandia)
- Reduce insulin resistance of tisssue
| - moderate weight gain, edema, mild anemia
66
rosiglitazone (Avandia) Administration
- 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
rosiglitazone (Avandia) contraindications
- Cardiovascular disease and failure
| - liver failure= ALT and AST
68
rosiglitazone (Avanda) interactions
-Insulin= increase risk of heart failure and edema
69
Precose
-Result in delayed absorption of glucose
70
Precose Admin
-First bite of meal; skip dose skip meal
71
Precose adverse effects
- Gas, diarrhea, abd pain
- hypoglycemia if with insulin or sulfa
* ****DEXTROSE to reverse hypoglycemia
72
sitagliptin (Januvia)
- Delay breakdown of incretin hormones
- promote release of insulin and lower glucagon secretion
- result: reduce fasting and postprandial glucose
73
sitagliptin (Januvia) adverse effects
-Upper resp. infection, headache, and diarrhea
-hypoglycemia
-pancreatitis
Admin: with or without food
74
Pramlintide (symlin)
- 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
Pramlintide (symlin) adverse effects
-Hypoglycemia with insulin/ injection reaction
76
Pramlintide (symlin) admin
- No mixing in same syringe
- rotate sites
- peak=20 min.
- room temp=28 days
77
exenatide (Byetta)
-Mimics incretin hormone
78
exenatide (Byetta) adverse effects
- Hypoglycemia w/ sulfonylureas
- n/v diarrhea
- pancreatitis
79
exenatide (Byetta) admin
- 60 min. prior to meds
| - peak=2 hours
80
exenatide (Byetta) interactions
- Hypoglycemia w/ sulfa
| - absorption of oral slowed antibiotics and oral cont.
81
Insulin's in general
- 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
(-logs) Aspart and Lispro
- Rapid 5-15 mins
- peak 1-2 hours
- no IV
- must eat after injecton
83
Short-acting (Regular)
- 30-60 mins
- peak 2.5 hour
- can give IV
- DKA
84
Intermediate acting (NPH)
-Cloudy
-onset 1-2
-peak: 4-8
roll
85
Long-acting glargine (Lantus) & detemir (Levemir)
- Clear
- 24 hour lasting
- once daily
- basal insulin (peakless)
