enocrine system Flashcards
The endocrine system and the nervous system control and integrate boy function to maintain _______
Homeostasis
The endocrine system sends its messages in the form of hormones via _______
The bloodstream
What are the 5 general functions of the endocrine system?
- Differentiation of reproductive and CNS of developing fetus
- Stimulation of sequential growth
- Coordination of the male and female reproductive systems
- Maintenance of optimal internal environment throughout lifespan
- Initiation of corrective and adaptive response when emergency demands occur
What is the main integrative center for the endocrine and ANS? What regulates the endocrine system?
Hypothalamus by neural and hormonal pathways
Negative feedback system
What can now be classified as an endocrine gland and why?
Adipose issue because it secretes several hormones responsible for metabolism, hunger,vasoconstriction, and cellular growth
What may differ when we get older in terms of maintain homeostasis?
The way we achieve equilibrium hormone levels
What are PT Implications for endocrine and metabolic disease?
Reported symptoms of fatigue, muscle weakness, and muscle or bone pain
The lack of progress in therapy should signal the possibility of systemic origin of musculoskeletal symptoms
What can be an indicator of underlying endocrine disease?
Rheumatoid Arthritis
What is acromegaly?
Excessive secretion of growth hormone after normal completion of body growth
Should be screened for weakness,changes in joint mobility, and poor exercise tolerance
What are the primary hormones produced by the thyroid?
Thyroxine T4, Triiodothyronine T3, and Calcitonin
Both T3 and T4 regulate what?
The metabolic rate of the body and increase protein synthesis
Thyroid function is regulated by what?
Hypothalamus and pituitary feedback controls
What is the target and basic action of calcitonin?
Skeleton; calcium and phosphorus metabolism, construct bone, and reduce serum calcium
What is hyperthyroidism?
Does it affect women or men more?
Generalized elevation of body metabolism, the effects of which are manifested in almost every system
Affects woman more than men (4:1)
What is Graves Disease?
The most common form (85% of cases) of hyperthyroidism
This condition increases T4 production
About what % of people with Graves’ disease gave circulating ____ that react against thyroglobulin
_____ reacts against a component of the hydroid cell membranes, stimulating enlargement of the _____
Results with ____ and _____
About 95% of people with Graves Disease gave circulating antibodies called Thyroid Stimulating immunoglobins that react against thyroglobulin
TSI react agasint a component of the hydroid cell membranes, simulating enlargement of the thyroid gland and secretion of excess thyroid hormone
Results with increased sympathetic nervous system activity and nutritional deficiency
What are the 3 major forms of therapy that can help hyperthyroidism?
Anti thyroid medication, radioactive iodine, and surgery
Pathogenesis of hypothyroidism Type 1 Primary?
Effects?
Reduced functional thyroid tissue mass or impaired hormonal synthesis —> increased TSH secretion from anterior pituitary gland
Slowing of all body processes leads to bradycardia
Decreased GI tract mobility ‘
Slowed neurological functioning
Decrease in body heat production
Pathogenesis of Hypothyroidism Type 2?
Is it a big case of hyperthyroidism?
The result of failure of the pituitary gland to synthesize and release adequate amounts of TSH
Small % of cases of hypothyroidism
What is one clinical manifestation of hypothyroidism?
Myxedma- baggy edema around eyes hands and feet
In hypothyroidism, TSH, T3 and T4 levels are what?
TSH levels are elevated
T3 levels are not changed drastically
T4 levels decrease gradually until below normal
Where are the two parathyroid glands located?
Posterior surface of each lobe of the thyroid gland
These parathyroid glands secrete PTH, which regulates what Things?
Regulates calcium and phosphorus
PTH exerts what 3 effects?
- Increasing the release of calcium and phosphate from bone
- Increasing the absorption of calcium and excretion of phosphate by kidneys
- Promoting calcium absorption in the GI Tract
Characteristics of hyperparathyroidism?
Increased bone resorption
Elevated serum calcium levels
Depressed serum phosphate levels
Hypercalciuria and hyperphosphaturia
Decreased neuromuscular irritability
Characteristics of hypoparathyroidism?
Depressed bone resorption
Depressed serum calcium levels
Elevated serum phosphate levels
Hypocalciuria and hypophosphaturia
Increased neuromuscular activity
Parathyroid gland target and basic action?
Target: bone , kidney, and intestinal tract
Basic Action: essential for calcium and phosphorus metabolism and calcification of bone
Are woman or men more affected by hyperparathyroidism?
Women more affected 2:1
Usually after 60 years old or post menopause
Difference between Primary, Secondary, and tertiary hyperparathyroidism?
Primary: one or more of the parathyroid glands enlarge, normal regulatory relationship between serum and calcium levels and PTH is interrupted
Secondary: glands are hyper plastic from malfunction of another organ system, compensatory response to hypocalcemia due to renal failure
Tertiary: exclusively in dialysis clients who have long-standing secondary hyperparathyroidism, glands become autonomous in function and unresponsive to serum calcium levels
Pathogenesis of hyperparathyroidism?
It maintains ____ by increasing what and what??
PTH is not regulated by the pituitary or the hypothalamus and maintains normal blood calcium levels by increasing bone resorption and GI absorption of calcium
PTH also maintains an inverse relationship between what?
Serum calcium and phosphate level by inhibiting phosphate reabsorption in the renal tubules
What happens if hyperparathyroidism is left untreated?
Serum Calcium Levels are?
Serum Phosphorus?
Urine calcium?
Hyperparathyroidism exacerbates many conditions among older adults such as osteoporosis and CAD
Serum calcium and PTH levels are elevated, serum phosphorus may be low normal or depressed, and urine calcium can range from low to high
What can disorders of the parathyroid glands can cause what?
Periarthritis and tendinitis
What does hypoparathyroidism cause?
What is most common?
Hypocalcemia and produces a syndrome opposite that of hyperparathyroidism with abnormally serum calcium levels, high serum phosphate levels
Latrogenic (acquired) most common
Idiopathic causes: affect more in children; may be an autoimmune disorder with a genetic basis
The outer cortex of the adrenal glands secretes…
- Mineralocorticoids- steroid hormones that regulate fluid and mineral balance
- Glucocorticoids- steroid hormones responsible for controlling the metabolism of glucose
- Androgens- sex hormones
What do the centrally located adrenal medulla secrete?
Epinephrine and norepinephrine
What are the major factors in the body’s response to stress?
The adrenal cortex and medulla
What is Addison disease?
Most causes are considered?
Insufficient cortisol release from the adrenal glands causing a wide range of problems
Most causes occurred as a complication of tuberculosis but now most cases are considered idiopathic or autoimmune
What is Cushing syndrome?
It is a result of…
An excess of cortisol in the body
1. Hyper function of adrenal gland
2. An excess of corticosteroid medication
3. An excess of ACTH stimulation from pituitary gland
Differences between Cushing syndrome, Cushing disease, and pseudo-Cushing syndrome?
Syndrome- hypercortiolism resulting from adrenal gland oversecretion, or from hyper physiologic doses of corticosteroid medications.
Disease- when the hypercortiolism results from oversecretion of ACTH from the pituitary
Pseudo-Cushing- occurs when conditions such as depression, alcoholism, etc cause changes like Cushing syndrome
What is conn syndrome?
What is the major cause?
An excess of aldosterone enhances what from the kidneys?
Adrenal lesion results in hypersecretion of aldosterone
A secreting tumor called aldosteronoma
Sodium reabsorption
What is the largest endocrine organ in the body?
What are adipokines?
Adipokines act locally as?
What are their functions?
Adipose tissue
The proteins released by adipocytes after being induced by neurotransmitter and glucose
Autocrine hormones or through the bloodstream as endocrine hormones
Maintain the balance of energy by regulating appetite, energy expenditure, insulin sensitivity, and lipid uptake
Difference between brown fat and white fat?
Brown fat- a specialized tissue that is important in thermoregulation, converting energy from food into heat, the amount of brown fat decreases into adulthood, some does remain in specific locations through life span
White fat- the classic adipose tissue responsible for storage of triglycerides to provide a long term resolver of energy for the body, involved in cardiovascular and metabolic complications, inflammatory, and immune related disorders
Fat accumulated in lower body results in?
Fat in the abdominal area results in?
Subcutaneous fat and pear shaped figure
Visceral fat and apple shape figure
Visceral fat produces?
Cytokines that increase the risk of CVD by promoting insulin resistance and low level chronic inflammation
What are stronger predictors of BMI?
Waist circumference and waist to height ratios
“Keep your waist circumference to less than half your height”
What is linked with serious health consequences?
Central obesity
WHO Classification of Weight Status?
Underweight- <18.5
Normal range- 18.5- 24.9
Overweight-25- 29.9
Obese>30
Obese class 1-30-34.9
Obese class 2- 35-39.9
Obese class 3- >40
BMI Percentages in children for overweight and obese?
Overweight- 85th-94th percentile
Obese- >95th percentile
What is diabetes mellitus?
A chronic systemic disorder characterized by hyperglycemia an disruption of the metabolism of carbs, fats, and proteins
What are the differences between type 1 (insulin dependent) and type 2 diabetes (non insulin dependent)?
What age?
Prevention?
Prevalence?
How many youth in 2014-2015?
They both can develop at any age
Type 1- no known way to prevent it
Type 2- most cases can be prevented
Type 1- 5-10% of cases
Type 2- 90-95% of cases
Type 1- just over 18K youth diagnosed 2014 and 2015
Type 2- nearly 6000 youth diagnosed 2014 and 2015
What is type 1.5 DM?
An autoimmune type of diabetes that begins in middle to late adulthood, referred to as latent autoimmune diabetes in adults
What is maturity onset diabetes of the young (MODY)?
What is Diabesity?
With increased obesity, type 2 DM being diagnosed in younger children
Obesity dependent diabetes in childhood
Considered an inflammatory metabolic condition
What is maturity onset diabetes of the young (MODY)?
With increased obesity, type 2 DM being diagnosed in younger children
Obesity dependent diabetes in childhood
Considered an inflammatory metabolic condition
What is Gestational DM?
Approx. how much in pregnancies?
Any degree of glucose intolerance recognized with the onset of pregnancy (24-28 weeks of gestation)
8% of all pregnancies
What is hemoglobin A1C (HbA1c)?
A measure of the % of blood sugar attached to Hh and is indicative of a person’s average blood sugar level for the previous 3 months
How many people have diabetes?
How many people have prediabetes?
37 million and about 1 in every 10 people
96 million American adults and 1 in every 3 people
How many people in late adulthood have prediabetes?
26.4 million people aged 65 years or older (48.8%) have pre diabetes
T1D is caused by?
Commonly occurs when?
What is needed throughout the day?
Cell medicated autoimmune destruction of beta cells of the pancreas and usually leads to absolute insulin deficiency
Childhood and adolescence
Check blood glucose frequently/ receive multiple insulin injections per day
What is type 2 diabetes?
What are the risk factors for T2D?
T2D insulin resistance?
Adult onset ( non insulin dependent ) diabetes
Age, obesity, and sedentary lifestyle
Insulin resistance to Beta cell stress to decrease in beta cell mass
50% become insulin dependent
Polyuria?
Polydipsia?
Polyphagia?
Polyuria- excessive urination (water not reabsorbed from renal tubes)
Polydipsia- excessive thirst (dehydration from polyuria)
Polyphagia- excessive hunger (starvation secondary to tissue breakdown)
Macrovascular?
Microvascular?
Affecting arteries that supply the heart, brain, and lower extremities
Retina, renal glomerulus, and peripheral nerve
What is diabetic ketoacidosis?
Most commonly seen in?
Characterized by the triad of…
An insufficient or absent level of circulating insulin
T1D
hyperglycemia, acidosis, and ketosis
You can prevent or delay type 2 diabetes by…
Eating healthy
Being more active
Losing weight
T2D diagnosis delayed or not?
What is not prominent in the early stages?
Often delayed for several years because hyperglycemia develops gradually
Polyuria and Polydipsia
When is T2D commonly diagnosed?
While the client is hospitalized or receiving medical care for another problem
Is there a cure for diabetes?
How can diabetes be treated?
There is no cure
The goal is to manage blood glucose and the risk of vascular complications
What does controlling the ABC’s mean?
A. A1c less than 7%
B. Blood pressure less than 130/80 mmHg
C. Cholesterol: LDL<100 mg/dL, HDL>50 mg/dL, triglycerides<150 mg/dL
Treatment for long term complications of Diabetes?
- Prophylactic Aspirin or statin therapy
- Diabetic ulcers
- Transplantation
T2D raises a person’s risk of dying from heart disease by…
About ___ % of heart attacks and ____ % of strokes are attributed to diabetes…
Diabetes is the leading cause of _____ and is a contributary cause to _____ and ________
2 to 3 times
50% and 75%
New blindness, renal failure and peripheral vascular disease
