Endocrinology Part 3 Flashcards
What are the effects of hyperthyroidism?
Fatigue Nervous Anxiety Insomnia Psychosis High temp Heat intolerance Diarrhea TachyC Arrhythmia Angina Inc. DTRs High glucose Low LDL Weight loss w/ inc appetite Tremor Goiter
What is Grave’s disease?
An autoimmune production of an antibody (TSI) that stimulates the TSH receptor causing hyperthyroidism
Has diffuse goiter and exophthalamus (eyes forward)
What is seen clinically with a thyroid tumor?
High levels of T3/T4 --> feedback causes low TSH Nodular goiter (not always) RAIU = shows hot spot with cold tumor
What is seen clinically with a pituitary adenoma?
High levels of TSH causing thyroid to produce high levels of hormone
Has diffuse goiter, high RAIU
What is seen clinically with acute thyroiditis?
Thyroid inflammation causing thyroid release of high levels of hormone
- can be initial phase of Hashimoto’s thyroiditisis
What is seen in Plummer’s disease?
Large multi-nodular goiter
Normal hormone levels until exposed to iodide
What is thyroid storm?
Large release of thyroid hormones associated with a non-thyroid triggering event (pregnancy, surgery, infection)
If not treated = HF, arrhythmias, seizures, MI
What causes an increase exogenous thyroid hormones?
Overdose of thyroid replacement
Will not have goiter, decreased RAIU
How can you treat hyperthyroidism?
PTU High dose I Beta blockers Radioactive iodide Surgery
What are the three zones of the adrenal cortex? (outside to inside)
Zona glomerulosa –> zona fasciculata –> zona reticularis
What enzyme is unique to the ZG?
P450 Aldosterone synthase
Enzyme unique to ZF?
P450 C11 & P450C17
Hormone unique to ZF?
Cortisol
ZF regulation
Inc release by ACTH
Enzyme unique to ZR
P450 C11 & P450 C17
Hormone unique to ZR?
Androgens
ZR regulation
Inc release by ACTH
Hormone unique to ZG
Aldosterone
ZG regulation
INc by AngII & plasma K+
What is the main glucocorticoid and what receptor does it use?
Cortisol
Glucocorticoid receptor
What are the main actions of cortisol?
It is the “stress” hormone
It stabilizes plasma glucose, BP, and the immune system
How does cortisol affect metabolism?
It is catabolic
Increases proteolysis, lipolysis, gluconeogenesis ==> leads to increased plasma glucose
How does cortisol affect the cardiovascular system?
Increases blood pressure by increasing alpha receptors, EPI, and angiotensinogen
How does cortisol affect the immune system?
Reduces the immune response and reduces inflammation
How does cortisol affect growth and development?
Inc surfactant in the fetal lung
Dec GH/IGF-1 if in excess in children
How does cortisol affect the eyes?
Increases intraocular pressure and formation of cataracts
