Exam 2 Endocrine Flashcards
1
Q
The anterior pituitary gland is responsible for what hormone?
A
LH/regulates sex hormones
ACTH/stress hormone
GH/growth hormone
PRL/Milk production
FSH/sperm& egg production
2
Q
True or false?
Negative feedback results in slowing down or inhibiting a hormone.
It can help maintain homeostasis?
A
True
3
Q
Number of receptors increases in response to rising hormone levels, making the cell more sensitive to the hormone and allowing for more cellular activity.
This called?
A
Up-regulation
4
Q
Number of receptors decreases in response to rising hormone levels
This called?
A
down-regulation
5
Q
Most hormones work via a ______________ feedback loop.
A
Negative
6
Q
What are the products of the posterior pituitary?
A
- Antidiuretic hormone ADH
- Oxytocin
7
Q
What are the products of the adrenal cortex?
A
- Epinephrine
- Noreponephrine
- Aldosterone
- Cortisol
- Sex hormones
8
Q
What are the products of the thyroid gland?
A
T3 and T4
- Supports brain function
- heart function, digestion
- Metabolic rate and bone health
9
Q
What happens when your T3 and T4 are low?
A
Hypothyroidism
Autoimmune disease
Thyroid surgery
10
Q
What are the products of the Parathyroid?
A
PTH
Raises Ca levels by releasing Ca from bones
Increasing Ca absorbed from small intestine
11
Q
What are the products of the pancreas?
A
Insulin
Glucagon
12
Q
Your patient has high levels of blood calcium. This result indicates that they might have ____________.
A
hyperparathyroidism
13
Q
What are hormones?
A
Chemical messengers that are released by glands
14
Q
What is autocrine communication?
A
“Self “Communication of cells.
15
Q
What is paracrine communication?
A
Communication between local cells
16
Q
What is endocrine communication?
A
chemical signaling via the straight into the bloodstream then to the target
17
Q
Lipid-soluble hormones are primarily transported bound to a carrier or transport _______.
A
protein
18
Q
Name a water soluble hormone.
A
Insulin
19
Q
What is the function of the Hypothalamic-Pituitary Axis (HPA)?
A
- *HYPOTHALAMUS**
- Produces Corticotropin-Releasing Hormone (CRH)
- *Anterior PITUITARY GLAND**
- –> stimulates anterior PITUITARY GLAND
- –> produce ACTH (AdrenoCorticoTropic Hormone)
- *ADRENAL GLANDS**
- –> produce/release CORTISOL
20
Q
Neurohypophysis aka _________ ?
A
posterior pituitary
21
Q
Adenohypophysis aka __________
A
anterior pituitary
22
Q
_______ is necessary for the function of the thyroid gland. Patients deficient in this might develop goiter.
A
Iodine
23
Q
Which is more numerous T4 or T3?
A
T4 90%
T3 10%
24
Q
Where are the parathyroid glands located?
What do the parathyroid glands secrete?
A
parathyroid hormone (PTH)
Behind the thyroid gland
25
What is the endocrine function of the pancreas?
- produces glucagon and insulin
- responsible for carbohydrate, protein, and fat metabolism
26
\_\_\_\_\_\_\_ cells within the Islets of Langerhans produce glucagon
Alpha
27
\_\_\_\_\_\_\_\_ cells within the Islets of Langerhans produce insulin and amylin
Beta
28
Delta cells within the Islets of Langerhans produce _________ and \_\_\_\_\_\_\_\_\_\_
Somatostatin (not hypothalamic) and gastrin
Somatostatin (not hypothalamic)
gastrin
29
What pancreas cells get destroyed when a patient has diabetes?
Beta cells
30
In addition to shuttling glucose, insulin helps __________ get into cells
potassium
31
Your diabetic patient has extremely high glucose. You are going to administer insulin. Her potassium is 5.8 (normal range is 3.5-5.0). You get an additional order to add potassium to her IV. Why?
The insulin being given is going to drive that potassium into cells leading to a rapid decrease in extracellular potassium.
32
What is the function of glucagon?
acts in liver to increase glycogenolysis and gluconeogenesis
glycogenolysis/glycogen breaks down into glucose
33
Your morning shift just started. You have a diabetic patient who hasn't eaten breakfast yet. Why might she have high blood glucose?
Glucagon naturally spikes in the morning to release glucose for energy.
34
Adrenal cortex is \_\_\_\_\_% of an adrenal gland's total weight
80%
35
The adrenal cortex is stimulated by ______________ hormone
adrenocorticotropic (ACTH)
36
What mineralocorticoid hormone produced by the adrenal cortex effects kidney function?
Aldosterone
37
What does the adrenal medulla release?
Release of catecholamines has been characterized as a "fight or flight" response. Epi and norepi
38
You are being chased by a bear outside the nursing school. Your SNS will stimulate your adrenal medulla to release...
epinephrin and norepinephrine
epinephrin and norepinephrinev
39
Angiotensin II is primary stimulant of __________ synthesis and secretion.
aldosterone
aldosterone
40
1) ____________ maintains extracellular volume to increase sodium reabsorption and potassium and hydrogen excretion. Regulated by 2) _________ system
1) Aldosterone
2) Renin Angiotensin Aldosterone system (RAAS)
41
What does acromegaly look like?
The body produces too much growth hormone, causing body tissues and bones to grow more quickly.
This comes from anterior pituitary
Usually die from heart enlargement
42
You patient is recovering form surgery after a traumatic brain injury. You notice that they are constantly thirsty, drinking alot, and urinating alot. You might suspect....
That their posterior pituitary was damaged and is hypofunctioning leading to too little antidiuretic hormone effect.
43
You patient has increased TSH but decreased T4 and T3. You suspect that they might have....
hypothyroidism
44
Your patient has cancer and is undergoing chemo. You notice she is developing hypothyroidism. This is __________ hypothyroidism.
secondary
45
elevated \_\_1\_\_ and suppressed \_\_2\_\_\_.
1) TH
2) TSH
46
What is hyperthyroidism?
Production of too much thyroxine hormone
It can increase metabolism
47
What is the main cause of hyperthyroidism?
**Graves' disease**
Most common cause of hyperthyroidism, is an autoimmune disorder
48
What is the Graves' disease?
An immune system disorder that results in the overproduction of thyroid hormones
include bulging eyes, redness and retracting eyelids
49
What are some causes of primary hypothyroidism?
- Iodine deficiency (endemic goiter): Most common worldwide
- Autoimmune thyroiditis (Hashimoto disease): Most common hypothyroidism in the United States
50
What is secondary hypothyroidism?
Conditions that cause either pituitary or hypothalamic failure with deficiency of thyrotropin-releasing hormone (TRH) and TSH
51
What is the goiter?
Abnormal enlargement of the butterfly-shaped gland below the Adam's apple (thyroid).
A goiter commonly develops as a result of iodine deficiency or inflammation of the thyroid gland
52
What is the Hashimoto's disease?
An autoimmune disorder affecting the thyroid gland
When body makes antibodies that attack the cells in your thyroid
**hypothyroidism**
53
The hypothalamus produces TRH which causes the release of ______ from the pituitary which then travels down to the thyroid gland
TSH
tells the thyroid gland how much thyroid hormone to make
54
What is the difference between Primary and Secondary Hypothyroidism
* *Primary**
- the thyroid itself is not secreting t3 and t4
* *Secondary**
- the pituitary is not secreting sufficient TSH, which causes low T3 or T4 synthesis
55
If TSH were low, what condition is that?
Secondary thyroidism
56
What is the most common cause of hypothyroidism
Hashimoto's thyroiditis
57
If you have a high TSH level with low T3 and T4. What is the diagnosis?
Primary Hypothyroidism
58
If you have low TSH and T4 levels. What is the diagnosis?
Secondary Hypothyroidism
59
What is the cause of Cushing syndrome?
60
what is the ACTH hormone do?
controls the production of another hormone called cortisol
61
What is the symptoms of Cushing disease?
62
What condition is to have high cortisol levels?
**Cushing's syndrome**
Too much cortisol over a prolonged period of time can lead to a condition called Cushing's syndrome.
Weight gain and fatty tissue deposits
Pink or purple stretch marks (striae) on the skin of the abdomen
Fragile skin that bruises easily
63
What is cause of Addison's disease?
Immune system attacks the adrenal glands and severely damages your adrenal cortex
64
What is the symptoms of Addison's disease?
65
What is the SIADH?
the body retains water instead of excreting it normally in urine
66
A 54-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?
a. Hyponatremia
b. Hyperkalemia
c. Hypernatremia
d. Hypokalemia
a. Hyponatremia
Rationale: Hyponatremia occurs due to increased water reabsorption by kidneys.
67
A 44-year-old patient with pulmonary tuberculosis (lung infection) is evaluated for SIADH. Which of the following assessment findings would be expected in this patient?
a. Peripheral edema
b. Tachycardia
c. Low blood pressure
d. Concentrated urine
d. Concentrated urine
Rationale: Clinical manifestations of SIADH include urine that is inappropriately concentrated with respect to serum osmolarity.
68
A nurse is caring for a patient with SIADH. What severe complication should the nurse assess for?
a. Stroke
b. Diabetes insipidus
c. Neurologic damage
d. Renal failure
c. Neurologic damage
Rationale: When the hyponatremia of SIADH becomes severe, 110 mEq/L to 115 mEq/L, confusion, lethargy, muscle twitching, convulsions, and severe and sometimes irreversible neurologic damage may occur.
69
Diabetes insipidus, diabetes mellitus (DM), and SIADH share which of the following assessment manifestations?
a. Polyuria
b. Edema
c. Vomiting and abdominal cramping
d. Thirst
d. Thirst
70
A 22-year-old male is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate?
a. Dilutional hyponatremia
b. Dehydration from polyuria
c. Cardiac arrest from hyperkalemia
d. Metabolic acidosis
b. Dehydration from polyuria
Rationale: Diabetes insipidus is a well-recognized complication of closed head injury and is manifested by polyuria leading to dehydration.
71
While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is _____ diabetes insipidus.
a. Neurogenic
b. Nephrogenic
c. Psychogenic
d. Allogenic
b. Nephrogenic
72
SIDAH or DI?
## Footnote
Diagnosed by the finding of a low urine osmolality with associated evaluatedserum sodium
DI
73
SIADH or DI?
## Footnote
The symptoms of the disorder result from hyponatremia
SIADH
74
SIADH or DI?
## Footnote
The clinical manifestations include water retention, weight gain, low urine output, nausea, mental change?
SIADH
75
SIADH or DI?
Partial to total inability to concentrate urine
DI
76
SIADH or DI?
## Footnote
The clinical manifestations include polyuria, nocturia and polydipsia?
DI
77
SIADH or DI?
Enhanced renal free water retention
SIADH
78
SIADH or DI?
## Footnote
The loss of too much free water into the urine
DI
79
SIADH or DI?
you can treat with fluid replacement
DI
80
SIADH or DI?
## Footnote
You can treat with vasopressin receptor antagonists.
SIADH
81
What is the vasoconstriction?
The narrowing (constriction) of blood vessels by small muscles in their walls
Increase BP, HR
82
Type 2 diabetes mellitus causes up or down regulation?
**Down-regulation**
Involves insulin resistance: decreased target cell sensitivity to insulin due to down-regulation of insulin receptors
Cells cannot bind enough insulin to allow a sufficient amount of glucose to enter the cell.
83
Low blood levels of a hormone result in an increase in the number of receptors per cell?
UP or down regulation?
Up regulation of receptors
84
High blood levels of a hormone result in a decrease in the number of receptors per cell
UP or down regulation?
Down-regulation of receptors
85
Examples of why hormone receptors are altered
Antibodies may destroy or block receptor proteins
Up-regulation: decreased hormone levels result in an increase in receptor site.
Down-regulation: increased hormone levels may cause a decrease in receptor sites; can regulate up & down to adjust to the bodies needs
86
What is the major cause of hyponatremia?
An excess of water relative to solute
**Na is too low, extra water goes into the cells and makes them swell.**
Dangerous especially in the bran since the brain cannot expand past the skull.
87
Relationship with water and sodium?
Water LOVES sodium
Water always move wherever sodium are
88
What is polyuria means?
A medical term that describes **excessive urination**.
89
What is in a general anesthetic?
A combination of medications that put you in a sleep-like state before a surgery or other medical procedure
