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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
Q

Hormone receptors:

what are the 2 different ways the hormones are soluble

A
  • water
  • lipid
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26
Q

Hormone receptors:

what form is usuall free (unbound) in plasma

A

water soluble

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27
Q

Hormone receptors:

what form is usually bound to protein

A

lipid soluble

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28
Q

Hormone receptors:

only what form of hormones can signal a target cell

A

free

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29
Q

Hormone receptors:

water soluble hormones bind w/ receptors where?

A

In or on the cell membrane

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30
Q

Hormone receptors:

steroid hormones are lipid soluble and bind how

A

diffuse across cell membrane

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31
Q

Pancreatitis:

the pancrease in unique b/c of what functions

A

Both endocrine and exocrine fxns

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32
Q

what are the pancrease endocrine fxns

A

secretes

insulin

glucagon

somatostatin

pancreatic polypeptide

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33
Q

Pancreas endocrine fxns make up what % of pancreas

A

1-2%

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34
Q

what are the exocrine fxn of pancrease

A

secretes enzymes and ducts that secrete alkaline fluids w/ digestive fxns

AKA digestion

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35
Q

what cells of the pancrease are for digestion- these are the cells that secrete the digestive fluids

A

Acinar

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36
Q

exocrine fxn make up what % of pancreas fxn

A

80-85%

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37
Q

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

A

Pancreatitis:

38
Q

Pancreatitis:

what are the 2 types

A
  1. Chronic
  2. Acute
39
Q

Pancreatitis:

which type is IRREVERSIBLE

A

Chronic

40
Q

Pancreatitis:

how can acute be reversed

A

removal of underlying cause

41
Q

Pancreatitis:

what 2 things are responsible for 60-80% of all cases

A

Gall stones

ETOH

42
Q

Pancreatitis:

what are other causes

A
  • Meds- Flagyl/tetracycline/ ACEi/ Corticosteroids
  • Infection
  • Trauma
  • Sx -thoracic and Abd & CPB
  • Metabolic D/o- hypercalcemia & hyperlipidemia
43
Q

Pancreatitis:

what is a severe form of acute pancreatitis where necrosis and infectin result

A

Acute Necrotizing pancreatitis

44
Q

Acute Necrotizing Pancreatitis:

Patho

A
  • 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
Q

Acute Pancreatitis:

patho

A
  • 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
Q

Acute Pancreatitis:

S/S

A

Mid epigastric pain that radiates to back

N/V

Fever

Leukocytosis

Ileus

abd pain

acites

tetany (hypoCa++)

tachypenia

Atelectasis

pulmedema

effusion

47
Q

Acute Pancreatitis:

what is teh halmark diagnosis

A

elevated serum amylase and lipase

48
Q

Acute Pancreatitis:

which lab is more sensitive and specific for diagnosin AP

A

Serum Lipase

49
Q

Acute Pancreatitis:

what is a scale for the prediction of severe Acute Pancreatitis:

A

Ranson’s Criteria

50
Q

Acute Pancreatitis:

what opioid is better and why? Morphine or Demerol

A

Demerol less sphincter of oddi spasm

51
Q

Chronic Pancreatitis:

is irreversible damage caused but what?

A
  • ETOH
  • Gall stones
  • Autoimmune d/o
  • genetic mutation
  • Smoking
  • Obesity
52
Q

Pancreatitis: Anesthesia Implications

what do we do for these peps (just name what all you think)

A
  • Aspiration precautions
  • RSI
  • Glucose monitoring
  • Fluid and electrolyte monitoring
  • Blood products
  • Fluid resuscitation
  • Coags
  • Renal fxn ( >0.5 mL/kg/hr)
  • Pulmonary assessemnt
53
Q

Thyroid:

2 hormones released

A
  1. T3- tri-idothyronine
  2. T4- Thyroxine
54
Q

Thyroid:

how is T3 formed

A
  • by the conversion of T4 to T3 @ target cells
55
Q

Thyroid:

which hormone has a higher potency and results in 80% of the metabolic activity?

A

T3

56
Q

Thyroid:

T3 makes up what % of circulating hormone

A

10%

(good thing b/c it is way more potent)

57
Q

Thyroid:

what is teh major hormone secreted by the thyroid gland

A

T4- thyroxine

58
Q

Thyroid:

T4-thyroxine makes up what % of ciurculating thyroide hormone

A

90%

59
Q

regulation of thyroid hormone:

name the 5 steps in its release

A
  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
Q

Thyroid:

normal quanities of thyroid hormones depend on what?

A

exogenous iodine

61
Q

Thyroid:

what is teh best source of exogenous iodine

A

Diet

62
Q

Thyroid:

what is teh best test of thyroid hormone action at the cellular level

A

TSH

63
Q

HypoThyroid:

what automimmune disease os assocoated with this

A

hashimotos’s

64
Q

HypoThyroid:

what is a s/s of this ( main sign of extreme condition)

A

Myxedema

65
Q

HyperThyroid:

what is a main s/s of severe hyperthyroid

A

exothalmos—-big ass eyes

66
Q

Adrenal Disorders:

what are the main adrenal d/o

A
  1. pheochromocytoma
  2. Cushing’s
  3. Adrenal insufficiency
67
Q

Adrenal Glands:

are paired pyramid shaped organs, each gland consist of 2 separate portions… what are they

A
  1. Inner medulla
  2. outer cortex
68
Q

Adrenal Glands:

the inner medulla secretes what?

A
  • Epi
  • Norepi
  • Dopamine
69
Q

Adrenal Glands:

the outer cortex secretes what?

A
  • aldosterone
  • mineralocorticoids
  • androgens
  • estrogens
  • glucococorticoids (cortisol)
70
Q

Pheochromocytoma:

they are associated with hyperfunctioning of the what?

A

adrenal medulla

71
Q

Pheochromocytoma:

these are tumors of what cells?

A

chromaffin

72
Q

Pheochromocytoma:

since associated with tumors of the chromaffin cells, we should probally know what those cells do…. so what do those cells secrecte?

A
  • 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
Q

Pheochromocytoma:

s/s

A
  • HTN ( most freq)
  • H/A
  • sweating
  • pallor
  • palpatations
74
Q

Pheochromocytoma: Pre-op

how long should these peps be alpha blocked

A
  • undetermined but anywhere from 3 days to 2 or more weeks
75
Q

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)

A

24-48 hours

76
Q

Pheochromocytoma: Pre-op

what are guidelines for sx

A
  • 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
Q

Pheochromocytoma: Intra-op

Avoid drugs or maneuvers that promotes what?

A
  • catecholamine release
78
Q

Pheochromocytoma: Intra-op

lines

A

CVL

A-line

CVP

+/- PA cath

79
Q

Pheochromocytoma: Intra-op

B/p meds to have

A
  • Nipride
  • Magnesium
  • Nicardipine
  • Phentolamine
  • Esmolol
80
Q

Pheochromocytoma: Intra-op

prepare for sudden decrease in BP after the tumors blood supply is ligated… so how should you treat this?

A
  • Volume support
  • DIRECT_ACTING vasopressor -phenylephrine
81
Q

Pheochromocytoma: Intra-op

what can happen to BGL after tumor removal

A

low- hypoglycemia

82
Q

Pheochromocytoma: Post-op

what is the most common cause of death postop

A

Hypotension

so give vasopressors- IV fluids

83
Q

Pheochromocytoma: Post-op

d/t hypoglycemia what to ypou want to do

A
  • BG monitoring 24 hours
  • Dextrose IV fluids
84
Q

Pheochromocytoma: Post-op

where are these pt’s transfered to from PACU

A

ICU for 24 hours

ensure adequate pain control

85
Q

Cushing’s Disease:

is a d/o of the ______ or ________

A

Adrenal cortex

anterior pituitary

86
Q

Cushing’s Disease:

is an excess of what?

A

Glucocorticoid

87
Q

Cushing’s Disease:

is an excess of what

A

cortisol

88
Q

Cushing’s Disease:

s/s

A
  • Moon face
  • obese
  • OSA
89
Q

Adrenal Insufficiency:

what d/o is caused by glucocorticoid/ mineralocorticoid deficiency

A

Addisons disease

90
Q

recap

which one is excesss glucocorticoid/cortisol

A

Cushings

(your fat like a cushin to much cortisol)

91
Q

recap

which one is the deficiency of glucocorticoid/ mineralocorticoid

A

Addisons’s

(you need to add some)

Bioscience II Brandon (11 decks)

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