Exam 3 pathopharm Flashcards
overactivity of thyroid (Excessive amounts of thyroid hormones are produced and released into the circulation)
Hyperthyroidism (thyrotoxicosis)
accompanied by opthalmopathy (or dermopathy) and diffuse goiter. Onset between 20-40 years more likely in women. Characterized by abnormal stimulation of thyroid gland by thyroid-stimulating antibodies that act through the normal TSH receptors.
Graves’ Disease
6 causes of hyperthyroidism
- Graves’ Disease
- Multinodular Goiter
- Adenoma of the thyroid
- Thyroiditis
- Iodine-containing agents
- Thyroid Crisis (thyroid storm)
acutely exaggerated manifestation of the thyrotoxic state. Life-threatening.
Thyroid Crisis (thyroid storm)
what are the s/sx of hyperthyroidism
Increased body temperature, tachycardia, thin skin, palpitations, hypertension, flushing, intolerance to heat, amenorrhea, weight loss, and goiter, lose weight, sweat, hot, red, increased metabolic rate
what are the treatments for hyperthyroidism?
Directed toward reducing the level of thyroid hormone. Accomplished with eradication of the thyroid gland with radioactive iodine, through surgical removal of part or all of the gland, or with the use of drugs that decrease thyroid function and thereby the effect of the thyroid hormone on the peripheral tissues.
administered to block effects of the hyperthyroid state on sympathetic nervous system.
They are given in conjunction with antithyroid drugs (propylthiouracil and methimazole) that act by inhibiting the thyroid gland from using iodine in thyroid hormone synthesis and by blocking the conversion of T4 to T3 in the tissues.
Beta-adrenergic blocking drug
underactivity of thyroid- can be congenital (from mom)
Hypothyroidism
Congenital causes of hypothyroidism
absence of the thyroid gland.
lack of suff iodine in the diet to produce the needed level of TH
Lack of suff fxning thyroid tissue due to tumor or autoimmune disorders
lack of TRH related to a tumor of disorder of the hypothalamus
Acquired causes of hypothyroidism
Hasimoto thryoiditis (MOST common cause)--> thyroid gland may be totally destroyed by immunologic process (women) Thyroidectomy
3 manifestations of hypothyroidism
Hypometabolic state
Myxedematous fluid
Myxedematous coma
characterized by gradual onstet of weakness and fatigue, tendency to gain weight despite loss of appetite, cold intolerance. Skin becomes dry and rough and hair becomes coarse and brittle. Increased blood levels of carotene give skin yellowish look.
Hypometabolic state
is most obvious in the face and can collect in interstitial spaces of almost any body structure. The tongue is enlarged and voice becomes hoarse and husky. Carpal tunnel and entrapment syndromes are common, impairment of muscle function with stiffness, cramps, and pain.
Myxedematous fluid
life-threatening, end-stage expression of hypothyroidism: coma, hypothermia, CV collapse, hypoventilation, severe metabolic disorders including hyponatremia, hypoglycemia, and lactic acidosis
Myxedematous coma
Tx of hypothyroidism: Levothyroxine Thyroid Desiccated Liothyronine Liotrix
- synthetic salt of T4
- prepared from dried animal thryoid galnds and contains both T3 and T4.
- Synthetic salt of T3
- Synthetic preparation of T4/T3 in a standard 4:1 ratio.
Disorder of the adrenal cortex;: Excessive anterior pituitary secretion of ACTH. Usually a tumor. something wrong with HPAxis (check CRH levels)
Cushing’s Disease/Syndrome
S/Sx of Cushing’s Disease
Excessive level of cortisol weight gain (truncal obsestiy, moon face) glucose intolerance/ DM Polyuria Muscle wasting/weakness Weak integumentary tissues
TX of Cushing’s Disease
CRH: stimulates release of ACTH from anterior pituitary- used to diagnose Cushing’s disease
- Primary adrenal cortical insufficiency
2. Severe hypotension and vascular collapse
- Addison Disease
2. Addison Crisis
Stimulate an increase in glucose levels for energy. used systemically in endocrine disorders.When produced as a part of stress response, these hormones aid in regulating the metabolic functions of the body and in controlling inflammatory response.
Glucocorticoids
What are the actions of Glucocorticoids
- Enter target cells and bind to cytoplasmic receptors
- initiate many complex runs respon. for anti-inflmm and immunosupp. effects
- Hydrocortisone, cortisone, prednisone have some mineralocorticoid activity.
3 Indications for the use of Glucocorticoids
- short-term tx of many inflm disorders
- to relieve discomfort
- give the body a chance to heal from the effects of inflm
Affect electrolyte levels and homeostasis. Play essential role in regulating potassium and sodium levels and water balance. Aldosterone secretion is regulated by rennin-angiotensin mechanism and by blood levels of potassium. Increased levels of aldosterone promote sodium retention by distal tubules of kidney while increasing urinary losses of potassium
Mineralcorticoids
Male and female sex hormones
Androgens
growth hormone excess in adulthood (called gigantism in childhood). Exaggerated growth of the ends of the extremities
Acromegaly
GH-secreting adenomas, most of which are benign. When the production of excessive GH occurs after the epiphyses of the long bones have closed, as in the adult, the person cannot grow taller, but the soft tissues continue to grow. This is the cause of what?
Acromegaly
CAN a father pass on an X linked disease to the son?
NO
graphic method for portraying a family history of an inherited trait. Constructed from a carefully obtained family hx and useful for tracing pattern of inheritance for a particular trait.
Pedigree
ordered display of chromosomes
Karyotype
A person’s physical characteristics
Phenotype
A person’s genetic material
Genotype
associated with the X chromosome, are those in which an unaffecyed mother carries one normal and one mutant allele on the X chromosome. She has a 50% chance of transmitting the defective gene to her sons who are affected, and her daughters have a 50% chance of being carriers of the mutant gene. Because of a normal paired gene, female heterozygotes rarely experience the effects of a defective gene.
Sex-linked disorders
single mutant allele from affected parent is transmitted to offspring regardless of sex. Affected parent has a 50% chance of transmitting the disorder to each offspring
Autosomal Dominant Disorders
manifested only when both members of the gene pair are affected. Usually, both parents are unaffected but are carriers of the defective gene. Their chances of having an affected child are 1/4; of having a carrier child, 2/4; and of having a noncarrier unaffected child ¼.
Autosomal Recessive Disorders
If two parents are both carriers of a genetic condition with a recessive inheritance pattern, there is a one-in-four chance that each child will be affected. So on average, one-quarter of their children will be affected. There is also a one-in-two chance that each child will be an unaffected carrier, like the parents. Examples of genetic conditions that show a recessive pattern of inheritance are cystic fibrosis, sickle-cell disease, Tay-Sachs disease and phenylketoneuria.
Recessive Inheritance
trait is seen much more often in males. bc a father can give a son only a Y chrome, trait is NEVER transmitted from a father to a son.The gene can be transmitted through a series of carrier females, causing the appearance of one or more “skipped generations.The gene is passed from an affected father to all his daughters
X linked Inheritance
the variation in a phenotype associated with a particular genotype. This can be caused by modifier genes
Expressivity
Examples of expressivity
Von Recklinghausen's disease. Neurofibromatosis 1 Autosomal dominant Long arm of chrom 17 disease varies from dark spots on the skin to malignantneurofibromas, scoliosis, gliomas, neuromas.
