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Bioscience II Brandon > Endorine D/O PPt- Josh > Flashcards

Endorine D/O PPt- Josh Flashcards

I am going to just try and hit the highlights in a crunch on time.... but that usually translate into 3 million slides.. FUCK

1
Q

Endocrine System:

5 general fxns

A
  1. Reproduction & CNS development in Fetus
  2. Growth and Development
  3. Reproductive system Coordination
  4. homeostsis of body
  5. adaptive responses when homeostsis is threatened
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2
Q

Endocrine System:

is a group of glands throughout the body , that synthesize chemical messengers called what?

A

Hormones

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3
Q

Endocrine System:

name 10 glands

A
  1. Pineal gland
  2. Hypothalamus
  3. Pituitary
  4. Thyroid
  5. Parathyroid
  6. Thymus
  7. Adrenal glands
  8. Pancrease
  9. Ovary
  10. Testis
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4
Q

Endocrine System: what Hormomes are released? And what is the function?

Hypothalamus

A
  • gonadatropin-releasing hormone (GnRH)
  • Oxytocin & ADH formation
  1. hemostasis
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5
Q

Endocrine System: what Hormomes are released? And what is the function?

Pineal

A
  • Melatonin
  • Seratonin
  1. basic needs/ Body Clock
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6
Q

Endocrine System: what Hormomes are released? And what is the function?

Pituitary Ant (adenohypophysis)

A
  • TSH
    1. thyroid activity
  • ACTH
    1. Adrenal cortex activity, fats, gylcogen, stress resistance
  • Somatropin
    1. bone growth; fat & sugar levels
  • FSH
    1. Ova & sperm maturation
  • Luteinising (LH)
    1. Corpus Lutem formation; Lactation
  • Interstitial Cell Stimulating (ICSH)
    1. Secretion of testosterone
  • Prolactin
    1. Lactation
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7
Q

Endocrine System: what Hormomes are released? And what is the function?

Posterior pituitary

(neurohypophysis)

A
  • Oxytocin
    1. uterine muscles
  • ADH
    1. Kidney fxn; prevent H2O loss
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8
Q

Endocrine System: what Hormomes are released? And what is the function?

thyroid

A
  • Thyroxine (T4)
  • Tri-iodothyronine (T3)
  1. cellular metabolism
  2. protein breakdown
  3. glucose uptake
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9
Q

Endocrine System: what Hormomes are released? And what is the function?

Parathyroid

A
  • Parathormone
  1. Ca++ balance & utilization
  2. functioning on nervous system
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10
Q

Endocrine System: what Hormomes are released? And what is the function?

Thymus

A
  • Thymosin (blood)
  • Thymopoetine (protein)
  1. Immunity
  2. Neuromuscular activity
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11
Q

Endocrine System: what Hormomes are released? And what is the function?

Pancreas

A
  • Glucagon
  1. rises blood sugar levels
  2. releases glucose into blood
  • Insulin
  1. Lowers blood sugar
  2. converts glucose for uptake
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12
Q

Endocrine System: what Hormomes are released? And what is the function?

ovaries

A
  • Oestrogens
    1. primary & secondary sexual maturity
  • Progesterone
  1. Menstrual flow
  2. fetal development
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13
Q

Endocrine System: what Hormomes are released? And what is the function?

testes

A
  • Tesosterone
    1. Male primary & secondary sexual maturity
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14
Q

Endocrine System: what Hormomes are released? And what is the function?

Adrenal cortex

A
  • Aldosterone
  1. MINERALOCORTICOID regulating Na+
  2. K+ Balance
  3. Water regulation
  • Cortisone
  • Cortisol
  • Corticosterone
  1. GLUCOCORTICOIDS maintaining fuel reserve/ reaction to stress/ antiflammatory & tissue repair
    * Androgens & Oestrogens
  2. Reproductive organ fxn
  3. secondary sexual characteristics
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15
Q

Endocrine System: what Hormomes are released? And what is the function?

Adrenal medulla

A
  • Adrenaline (80%)
  • Noradrenaline (20%)
  1. fight or floght
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16
Q

Mechanisms of Hormonal Communication:

what are the 3 ways hormones communicate

A
  • AUTOcrine
  • PARAcrine
  • ENDOcrine
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17
Q

Mechanisms of Hormonal Communication:

AUTOcrine?

A

within cell

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18
Q

Mechanisms of Hormonal Communication:

PARAcrine

A

B/t local cells ( aka just pancreas)

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19
Q

Mechanisms of Hormonal Communication:

ENDOcrine

A

B/t remote cells (AKA ADH and collecting duct of kidney)

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20
Q

Regulation of Hormone Release:

what are the 3 mechanisms for regulation of hormone release?

A
  1. Chemical factors (Blood sugar or Ca++ levels)
  2. Endocrine Factors ( hormone from one gland stimulating another)
  3. Neural control
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21
Q

what is teh most common type of feedback system in the endocrine system

A

negative feedback

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22
Q

what the fuck is the HPA- axis?

A

the Hypothalmic-Pituitary-Adrenal axis

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23
Q

Hypothalmic-Pituitary-Adrenal axis (HPA)

what do they release

A
  • Hypothalamus releases CRH to stimulate
  • Anterior pituitary to release ACTH to stimulate
  • adrenal cortex to release CORT (and epi and Norepi)

cool thing is the CORT has a negative feedback loop to re stimulate the hypothalamus

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24
Q

Hypothalmic-Pituitary-Adrenal axis (HPA)

when does this even kick in?

A

Stress baby stress

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25
Hormone receptors: what are the 2 different ways the hormones are soluble
* water * lipid
26
Hormone receptors: what form is usuall free (unbound) in plasma
water soluble
27
Hormone receptors: what form is usually bound to protein
lipid soluble
28
Hormone receptors: only what form of hormones can signal a target cell
free
29
Hormone receptors: water soluble hormones bind w/ receptors where?
In or on the cell membrane
30
Hormone receptors: steroid hormones are lipid soluble and bind how
diffuse across cell membrane
31
Pancreatitis: the pancrease in unique b/c of what functions
Both endocrine and exocrine fxns
32
what are the pancrease endocrine fxns
secretes insulin glucagon somatostatin pancreatic polypeptide
33
Pancreas endocrine fxns make up what % of pancreas
1-2%
34
what are the exocrine fxn of pancrease
secretes enzymes and ducts that secrete alkaline fluids w/ digestive fxns AKA digestion
35
what cells of the pancrease are for digestion- these are the cells that secrete the digestive fluids
Acinar
36
exocrine fxn make up what % of pancreas fxn
80-85%
37
what is the inflammation of the pancrease- d/t damage from digestive enzymes that are activated before they are secreted into the duodenum and begin attacking the pancreas
Pancreatitis:
38
Pancreatitis: what are the 2 types
1. Chronic 2. Acute
39
Pancreatitis: which type is IRREVERSIBLE
Chronic
40
Pancreatitis: how can acute be reversed
removal of underlying cause
41
Pancreatitis: what 2 things are responsible for 60-80% of all cases
Gall stones ETOH
42
Pancreatitis: what are other causes
* Meds- Flagyl/tetracycline/ ACEi/ Corticosteroids * Infection * Trauma * Sx -thoracic and Abd & CPB * Metabolic D/o- hypercalcemia & hyperlipidemia
43
Pancreatitis: what is a severe form of acute pancreatitis where necrosis and infectin result
Acute Necrotizing pancreatitis
44
Acute Necrotizing Pancreatitis: Patho
* inflammation leads to necrosis * Necrotic tissue becomes infected * the Acinar cells, ductal tissues, and islets of Langerhans become infected * vascular injury leads to massive hemorrhage w/in pancrease
45
Acute Pancreatitis: patho
* injury or disruption of Acinar cells permit leakage of pancreatic enzymes * Activated proteolases and lipases break tissue and cell membranes down * Causing inflammation, edema, vascular damage, hemmorrhage, necrosis, and fibrosis *
46
Acute Pancreatitis: S/S
Mid epigastric pain that radiates to back N/V Fever Leukocytosis Ileus abd pain acites tetany (hypoCa++) tachypenia Atelectasis pulmedema effusion
47
Acute Pancreatitis: what is teh halmark diagnosis
## Footnote elevated serum amylase and lipase
48
Acute Pancreatitis: which lab is more sensitive and specific for diagnosin AP
Serum Lipase
49
Acute Pancreatitis: what is a scale for the prediction of severe Acute Pancreatitis:
Ranson's Criteria
50
Acute Pancreatitis: what opioid is better and why? Morphine or Demerol
Demerol less sphincter of oddi spasm
51
Chronic Pancreatitis: is irreversible damage caused but what?
* ETOH * Gall stones * Autoimmune d/o * genetic mutation * Smoking * Obesity
52
Pancreatitis: Anesthesia Implications what do we do for these peps (just name what all you think)
* Aspiration precautions * RSI * Glucose monitoring * Fluid and electrolyte monitoring * Blood products * Fluid resuscitation * Coags * Renal fxn ( \>0.5 mL/kg/hr) * Pulmonary assessemnt
53
Thyroid: 2 hormones released
1. T3- tri-idothyronine 2. T4- Thyroxine
54
Thyroid: how is T3 formed
* by the conversion of T4 to T3 @ target cells
55
Thyroid: which hormone has a higher potency and results in 80% of the metabolic activity?
T3
56
Thyroid: T3 makes up what % of circulating hormone
10% (good thing b/c it is way more potent)
57
Thyroid: what is teh major hormone secreted by the thyroid gland
T4- thyroxine
58
## Footnote Thyroid: T4-thyroxine makes up what % of ciurculating thyroide hormone
90%
59
regulation of thyroid hormone: name the 5 steps in its release
1. HYPOTHALAMUS releases THYROTROPIN-RELEASING HORMONE (TRH) 2. makes the ANTERIOR PITUITARY release THYROID STIMULATION HORMONE (TSH) 3. makes the THYROID GLAND release T4 THYROXINE (OR JUST THYROID HORMONES) 4. goes to target celles and convert to T3 tri-idothyronine 5. negative feedback to hypothalamus
60
Thyroid: normal quanities of thyroid hormones depend on what?
exogenous iodine
61
Thyroid: what is teh best source of exogenous iodine
Diet
62
Thyroid: what is teh best test of thyroid hormone action at the cellular level
TSH
63
HypoThyroid: what automimmune disease os assocoated with this
hashimotos's
64
HypoThyroid: what is a s/s of this ( main sign of extreme condition)
Myxedema
65
HyperThyroid: what is a main s/s of severe hyperthyroid
exothalmos----big ass eyes
66
Adrenal Disorders: what are the main adrenal d/o
1. pheochromocytoma 2. Cushing's 3. Adrenal insufficiency
67
Adrenal Glands: are paired pyramid shaped organs, each gland consist of 2 separate portions... what are they
1. Inner medulla 2. outer cortex
68
Adrenal Glands: the inner medulla secretes what?
* Epi * Norepi * Dopamine
69
Adrenal Glands: the outer cortex secretes what?
* aldosterone * mineralocorticoids * androgens * estrogens * glucococorticoids (cortisol)
70
Pheochromocytoma: they are associated with hyperfunctioning of the what?
adrenal medulla ## Footnote
71
Pheochromocytoma: these are tumors of what cells?
chromaffin
72
## Footnote Pheochromocytoma: since associated with tumors of the chromaffin cells, we should probally know what those cells do.... so what do those cells secrecte?
* epi * nor epii * dopamine (fuck thats not goooood!!) just give them a beta blocker that will fix it.... no don't j/k they will die!!!!!!!!
73
Pheochromocytoma: s/s
* HTN ( most freq) * H/A * sweating * pallor * palpatations
74
Pheochromocytoma: Pre-op how long should these peps be alpha blocked
* undetermined but anywhere from 3 days to 2 or more weeks
75
Pheochromocytoma: Pre-op it is recomended to stop alpha blockers how long before surgery to avoid vascular unresponsivness immediatly following removal of sx ( some say give a 1/2 dose AM of surgery)
24-48 hours
76
Pheochromocytoma: Pre-op what are guidelines for sx
* No BP \> 160/90 24 hrs preop * No orthostatic BP \< 80/45 * No ST segment or T wave abnormalities * No marked S/S of catecholamine excess- No more than 1 PVC Q 5 min
77
Pheochromocytoma: Intra-op Avoid drugs or maneuvers that promotes what?
* catecholamine release
78
Pheochromocytoma: Intra-op lines
CVL A-line CVP +/- PA cath
79
Pheochromocytoma: Intra-op B/p meds to have
* Nipride * Magnesium * Nicardipine * Phentolamine * Esmolol
80
Pheochromocytoma: Intra-op prepare for sudden decrease in BP after the tumors blood supply is ligated... so how should you treat this?
* Volume support * DIRECT\_ACTING vasopressor -phenylephrine
81
Pheochromocytoma: Intra-op what can happen to BGL after tumor removal
low- hypoglycemia
82
Pheochromocytoma: Post-op what is the most common cause of death postop
Hypotension so give vasopressors- IV fluids
83
Pheochromocytoma: Post-op d/t hypoglycemia what to ypou want to do
* BG monitoring 24 hours * Dextrose IV fluids
84
Pheochromocytoma: Post-op where are these pt's transfered to from PACU
ICU for 24 hours ensure adequate pain control
85
Cushing's Disease: is a d/o of the ______ or \_\_\_\_\_\_\_\_
Adrenal cortex anterior pituitary
86
Cushing's Disease: is an excess of what?
Glucocorticoid
87
## Footnote Cushing's Disease: is an excess of what
cortisol
88
Cushing's Disease: s/s
* Moon face * obese * OSA
89
Adrenal Insufficiency: what d/o is caused by glucocorticoid/ mineralocorticoid deficiency
Addisons disease
90
recap which one is excesss glucocorticoid/cortisol
Cushings ## Footnote (your fat like a cushin to much cortisol)
91
recap which one is the deficiency of glucocorticoid/ mineralocorticoid
Addisons's (you need to add some)

Bioscience II Brandon (11 decks)

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