Endocrinology Flashcards
Primary endocrine disorders involve what organ(s)?
target endocrine organs e.g. gonads, adrenal cortex, thyroid, mammary gland, liver, kidney
Secondary endocrine disorders involve what organ(s)?
anterior pituitary/adenohypophysis
Tertiary endocrine disorders involve what organ(s)?
hypothalamus
List actions of cortisol
- gluconeogenesis - increase blood sugar
- suppress immune system - reduce inflammation
- reduce bone formation
- raise blood pressure
T3 and T4 function to ____________
determine basal rate of metabolic reactions
Prolactin functions to ___________. It is known as the _________ out of the trophs.
inhibit secretion of FSH, TSH, GH, ACTH
Balancer
Aspirin is contraindicated in hyperthyroidism because _________
aspirin competes with T3 and T4 on liver hepatocytes, leading to higher T3/T4 levels in the blood
The most common etiology of hypothyroidism is _______
The most common auto-immune etiology of hypothyroidism is ___________
aging
Hashimoto’s disease
The most common hyperthyroid disorder is _______.
The most common etiologies are ______.
Grave’s disease
Toxic adenoma, toxic goiter, thyroiditis.
Describe the pathogenesis of Grave’s disease
auto-immune reaction results in production of self-antibodies (IgG), over-stimulating TSH receptors of the thyroid gland
What are hallmark features of Grave’s disease?
exopthalmos, heat intolerance, nervousness, insomnia, fine and silky hair alopecia, alternating diarrhea, tremors, irregular menstruations or AMENORRHEA,
Describe the pathogenesis of Hashimoto’s disease.
Immune system produces immunoglobulins against thyroid follicles, eventually damaging core substate thyro-globulin
What are clinical presentations of hypothyroidsim?
cold intolerance, facial myxedema, fatigue, weight gain, brittle and dry hair alopecia, decreased BMR, irregular/HEAVY menstruation
Cushing Syndrome is an endocrine condition characterized by excessive production of ___________
cortisol
The most common cause of Cushing’s syndrome is _________
long term steroid medications to suppress inflammation
Cushing’s disease is a type of Cushing’s syndrome where _______
anterior pituitary adenoma secretes excessive ACTH which stimulates adrenal gland to produce more cortisol, aldosterone, sex hormone precursors
In Cushing’s disease, ACTH levels are ____ and cortisol levels are _____
elevated
elevated
What are clinical hallmarks of Cushing’s syndrome?
buffalo hump, central obesity, thin lower limbs, hirsutism, aterial hypertension, diabetes mellitus, osteoporosis, altered mental status (depression, anxiety, psychosis) due to excesses cortisol
Cretinism is an outdated medical term for _________. It is generally reversible in the following time frame ________.
- congenital hypothyroidism
- within 1-2 months after birth
The hallmark of congenital hypothyroidism is ______
profound mental retardation
Gigantism is an excess _____ production initiated __________. Acromegaly is an excess GH production with the beginning of _________, after _________of the long bones are already closed.
- GH production
- before puberty
- adulthood
- epiphyseal plates
Addison’s Disease is ________ insufficiency. The causes of Addison’s disease are ___________
- adrenal
- largely unknown, possibly infection, neoplasia, auto-immune
Describe typical menses in hypothyroidism.
Describe typical menses in hyperthyroidism.
- heavy, painful menses
- oligomenorrhea, amenorrhea
What is the potential impact of pituitary adenoma on vision?
enlarged pituitary can impact the optic chiasm, eventually leading to blindness
ACTH and MSH share the same _______. Thus, endocrine disorders where ACTH levels are elevated such as _______ will also show signs of darkened skin pigmentation.
precursor molecule (proopiomelanocortin / POMC)
Cushing’s disease, primary Addison’s disease
Primary Addison’s disease is a deficiency in ______ release from the __________, thus leading to compensation and over production of ________. Signs and symptoms include __________ as a result of primary ________ deficiency.
- glucocorticoid
- adrenal cortex
- ACTH (MSH)
- fatigue, muscle weakness, hypotension, craving salt, brown/bronze discolorations
- cortisol
Primary Addison’s disease is also known as __________
brown diabetes
Secondary or tertiary Addison’s disease present with all the signs of primary Addison’s except ___________ because ____________
- brown/bronze discolorations
- hypothalamus is not secreting CRH or anterior pituitary not secreting ACTH so MSH is not secreted either
Addisonian crisis indicates __________. It can be caused by __________
- severe adrenal insufficiency
- bacterial meningitis, abruptly ceasing long term steroid medication
Describe the pathology of primary diabetes mellitus.
Describe the pathology of secondary diabetes mellitus.
- auto-immune injury of beta pancreatic islet cells
- resistance of insulin receptors on cellular membranes
Obesity and diabetes mellitus type 2 are linked together because _________, affecting blood vessels and pancreatic secretion of insulin.
The more cholesterol is available in the human body, the more ______ hormones will be produced, which, in turn, ________ secretion and action of insulin and ________resistance of insulin receptors.
- excessive adipose tissues predispose to accumulation of toxins and proinflammatory mediators
- adrenal
- down regulates
- increases
The clinical hallmark of diabetes mellitus is _______ because ______________
wasting body syndrome
it relies on catabolism of proteins and fat than cellular accommodation of glucose
DM should be suspected when on two random occasions, fasting blood glucose test shows glucose concentration in blood above _________.
What is a normal range of fasting blood glucose?
125-126 mg/dL
70-99 mg/dL
OGTT stands for _______. Diagnosis of DM will be established if OGTT in ___ hours shows blood glucose level at _______
Oral Glucose Tolerance Test
2
200 mg/dL or higher
The best test for long term control of DM management is _____. Normal values are not to exceed ___
glycosylated hemoglobin test (HbA1c)
6%
Central Diabetes insipidus is _______ while nephrogenic diabetes insipidus is _________. Either case results in dysfunction of _______ leading to presentation of __________
- deficient production of ADH by hypothalamus
- resistance of kidney to ADH
- water reabsorption in distal convoluted tubules and collecting ducts
- urine that is diluted (low specific gravity) and abundant
SIADH stands for ______. In this syndrome, the ______ secretes too much ______ which results in _____________
- Syndrome of Inappropriate Secretion of ADH
- hypothalamus
- ADH
- increased reabsorption of water and urine being very scanty and hyperconcentrated
Signs and symptoms that suggest Diabetes mellitus are _______
polyuria, polydipsia, polyphagia
Thyroid storm is a rare but severe and potentially life-threatening complication of ___________. It is characterized by ________
hyperthyroidism
a high fever (often above 40°C/104°F), fast and often irregular heart beat, vomiting, diarrhea and agitation
The negative feedback regulation is ________ in any secondary endocrine disorder.
interrupted
