Exam 3 Study Guide Flashcards
1
Q
These are chemical messengers from the various glands in the endocrine system
A
Hormones
2
Q
How many cells in the body can hormones affect?
A
thousands
3
Q
How long does it take for an optimal response to be produced for hormones?
A
several days
4
Q
What kind of changes occur when too little or too much of a hormones is produced?
A
physiological changes
5
Q
This part of the brain secretes releasing hormones that travel to the pituitary.
A
hypothalamus
6
Q
What hormones does the anterior pituitary secrete?
A
- adrenocorticotropic hormone
- thyroid stimulating hormone
- growth hormone
- prolactin
- follicle stimulating hormone
- luteinizing hormone
7
Q
What kind of tissue is in the posterior pituitary?
A
nervous tissue
8
Q
When is ADH and oxytocin released?
A
in response to nerve impulses from the hypothalamus
9
Q
Hypersecretion of corticosteroids can cause?
A
Cushing syndrome
10
Q
Hyposecretion of the adrenal cortex can cause?
A
Addison disease
11
Q
Hyposecretion of the parathyroid hormone can cause?
A
hypoparathyroidism
12
Q
Hypersecretion of the parathyroid can cause?
A
hyperparathyroidism
13
Q
Ketoconazole and mitotane is used for what disorder?
A
Cushing syndrome
14
Q
What medication(s) are used for Cushing syndrome?
A
ketoconazole and mitotane
15
Q
What medications are used for Addison disease?
A
hydrocortisone, prednisone
16
Q
What medication is used for hyperparathyroidism?
A
no medication, surgery is done
17
Q
What medication is used for hypoparathyroidism?
A
human parathyroid hormone (natpara), vitamin D and calcium supplements
18
Q
Natpara is used for what disorder?
A
hypoparathyroidism
19
Q
Hyposecretion of the pituitary causes what disorder?
A
diabetes insipidus
20
Q
What medication is used for diabetes insipidus?
A
desmopressin (DDAVP, Noctiva, Stimate) and vasopressin
21
Q
What disorder is caused by hypersecretion of the pituitary?
A
SIADH
22
Q
What is medication is used for acromegaly?
A
octreotide
23
Q
Octreotide is used for what disorder?
A
acromegaly
24
Q
Hypersecretion of the thyroid causes?
A
Gaves disease
25
Hyposecretion of the thyroid causes?
myxedema (adults), cretinism (children)
26
How is graves disease treated?
propylthiouracil (PTU) and I-131
27
How is myxedema and cretinism treated?
thyroid hormone and levothyroxine (T4)
28
This hormone stimulates growth and metabolism in nearly all cells in body.
growth hormone
29
Sumatotropin is also known as
growth hormone
30
Growth hormone is also known as
somatotropin
31
The deficiency that results in short stature is
dwarfism
32
What should you monitor with growth hormone agents?
glucose tolerance and thyroid function
33
Glucose tolerance and thyroid function are monitored when _______ are administered.
Growth hormone agents
34
This has the same actions as GH (growth hormone).
Mecasermin (increlex)
35
This type of excess secretion results in deformed bones and enlarged small bones of hands, feet, face, and skull.
acromegaly
36
Octreotide is a synthetic GH (antagonist, agonist)
antagonist
37
ADH is secreted from the
posterior pituitary
38
When is ADH secreted?
when the hypothalamus senses that the plasma volume has decreased or blood osmolality is too high
39
ADH is also known as
vasopressin
40
This has the ability to constrict blood vessels and RAISE blood pressure
ADH (vasopressin)
41
ADH deficiency results in which type of diabetes?
diabetes insipidus
42
What does ADH act on?
the collecting ducts
43
This is the most common drug for treating diabetes insipidus.
desmopressin
44
ADH (increases, decreases) serum osmolality.
decreases
45
Does thyroid hormone increase or decrease basal metabolic rate?
increase
46
Parifollicular cells secrete
calitonin
47
Thyroid hormone consists of T__ and T___
T4, T3
48
Is T4 converted to T3 or is T3 converted to T4?
T4 is converted to T3
49
Is T3 or T4 more biologically active?
T3
50
This is a carrier protein in the plasma that attaches to thyroid hormone
TBG (thyroxine-binding globulin)
51
This part of the brain tells the posterior pituitary what to do.
hypothalamus
52
What are some adverse effects of desmopressin?
headache, nasal congestion, water intoxication, hyponatremia
53
What is the mechanism of action for Desmopressin?
a synthetic analog of human ADH acts on the kidneys to increase water reabsorption, contracts smooth muscle of the vascular system, uterus, and GI tract
54
Water intoxication, headache, nausea, mild abdominal pain, and hypotension are adverse effects of what medication?
Desmopressin
55
True or False. The thyroid affects every cell in the body.
TRUE
56
Abnormal thyroid levels can occur due to the disease within the _______, ________, or _________
thyroid gland, pituitary, or hypothalamus
57
This disorder is due to a poorly function thyroid.
hypothyroidism
58
This disorder is due to decreased TSH production by the pituitary
hypothyroidism
59
What is the etiology of hypothyroidism?
it is an autoimmune disease, surgical removal of the thyroid, and aggressive treatment with antithyroid drugs
60
This is the most common cause of hypothyroidism in the US.
Hashimotos
61
What are some early symptoms of hypothyroidism?
weakness, muscle cramps, dry skin
62
Slurred speech, bradycardia, weight gain, decreased sense of taste and smell, and cold intolerance are severe symptoms of
hypothyroidism
63
In labs, what would show hypothyroidism regarding TSH, T3, and T4?
elevated TSH, decreased T3 and T4
64
True or False. Goiter must be present in hypothyroidism.
False. it can be present or absent
65
What is the standard medication to treat hypothyroidism?
levothyroxine
66
What is the most common form of hyperthyroidism?
grave's disease
67
The body develops antibodies against its own thyroid gland in which disorder?
hyperthyroidism
68
Increased metabolism, tachycardia, weight loss, elevated body temperature, and anxiety are symptoms of what disorder?
hyperthyroidism
69
This is very high levels of circulating thyroid hormone.
thyroid storm
70
What is the treatment for thyroid storm?
remove all or part of the thyroid
71
What is monitored to evaluate progress of of therapy for hypothyroidism?
serum TSH level
72
This medication is contraindicated in pregnant patients, crosses placenta more readily for hyperthyroidism.
Methimazole
73
This is used to suppress thyroid function prior to thyroidectomy, to treat thyroid storm, to reduce thyroid vascularity prior to surgery, or to protect the thyroid after radiation exposure.
Non-radioactive iodine
74
What percentage of epinephrine does the adrenal medulla secrete?
75%-80%
75
75%-80% of _____________ is secreted by the adrenal medulla
Epinephrine
76
What percentage of norepinephrine does the adrenal medulla secrete?
20%-25%
77
20%-25% of ______________ is secreted by the adrenal medulla.
Norepinephrine
78
What are the three classes of steroid hormones?
1. Gonadocorticoids
2. Mineralocorticoids
3. Glucocorticoids
79
Mineralocorticoids regulate plasma volume by promoting
sodium reabsorption and potassium excretion by renal tubules.
80
When plasma volume falls, kidney secretes _________, which results in production of Angiotensin II.
renin
81
When plasma volume falls, kidney secretes renin, which results in production of Angiotensin (I, II)
Angiotensin II
82
Angiotensin II causes Aldosterone secretion, promoting ______________ retention.
sodium and water
83
What steroid hormone class includes cortisol, corticosterone, and cortisone?
Glucocorticoids
84
Corticosteroids = __________corticoids and ___________corticoids
mineralocorticoids and glucocorticoids
85
Glucocorticoids suppress __________________________ responses
inflammatory and immune responses
86
Glucocorticoids Increase the sensitivity of
vascular smooth muscle to norepinephrine and angiotensin II.
87
This glucocorticoid effect promotes
bronchodilation
88
Glucocorticoids promote bronchodilation by making bronchial muscle more responsive to
sympathetic nervous system activation.
89
Glucocorticoids increase the breakdown of the _________
bony matrix
90
Glucocorticoids increase the breakdown of bony matrix which results in
bone demineralization
91
Which part of the brain releases secretes corticotropin-releasing factor (CRF).
hypothalamus
92
CRF travels to the pituitary where it causes the release of
adrenocorticotropic hormone (ACTH).
93
ACTH travels through blood to reach
adrenal cortex
94
Cortisol levels in the blood rise, providing (positive, negative) feedback to the hypothalamus and pituitary
negative
95
Cortisol levels in blood rise, providing negative feedback to the
hypothalamus and pituitary
96
Adrenocortical insufficiency is the lack of adequate
corticosteroid production
97
Adrenocortical insufficiency is the lack of adequate corticosteroid production, caused by Hyposecretion of _____________ and inadequate secretion of
adrenal cortex, ACTH
98
Hyposecretion of the adrenal cortex is (primary, secondary) insufficiency?
primary insufficiency
99
Inadequate secretion of ACTH from the pituitary is (primary, secondary) insufficiency?
secondary insufficiency
100
This closely resembles ACTH and is used to diagnose the cause of the adrenocortical insufficiency.
Cosyntropin (Cortrosyn)
101
Cosyntropin (Cortrosyn) closely resembles ACTH and is used to diagnose the cause of the
adrenocortical insufficiency.
102
Hypoglycemia, fatigue, hypotension, increased skin pigmentation, and GI disturbances are symptoms of
adrenocortical insufficiency
103
____________ are used as replacement therapy for adrenocortical insufficiency
Corticosteroids
104
Corticosteroids are used as replacement therapy for
adrenocortical insufficiency
105
(Low, high) plasma cortisol and high plasma ACTH indicate that adrenal gland is not responding to ACTH stimulation.
low
106
Which adrenocortical insufficiency is more common?
secondary
107
Which adrenocortical insufficiency is rare?
primary (Addisons)
108
Without ACTH stimulation, the adrenal cortex shrinks and stops secreting endogenous corticosteroids which is called
adrenal atrophy
109
What are the symptoms of abrupt stopping of corticosteroid medication?
Nausea, Vomiting
, Lethargy, Confusion, Coma
110
(Acute, chronic) adrenocortical insufficiency requires replacement therapy, to achieve the same physiological level of hormones in the blood seen with normal adrenal function.
Chronic adrenocortical insufficiency
111
What are non-endocrine disorders that corticosteroids are used for?
allergies, asthma, cancer, edema, inflammatory bowel disease, rheumatic disorders, shock, skin disorders, and transplant rejection prophylaxis
112
This disorder is commonly caused by long-term therapy with high-dose corticosteroids.
Cushing syndrome
113
Cushing’s Disease caused by pituitary tumor producing excess
ACTH
114
This blocks synthesis of corticosteroids, lowering serum levels.
Ketoconazole (Nizoral)
115
Should ketoconazole be used during pregnancy?
No
116
This inhibits ACTH secretion by pituitary, which reduces corticosteroid secretion from the adrenals.
Pasireotide (Signifor)
117
This is the leading cause of death in the US
Diabetes
118
What serious complications can be caused by diabetes?
stroke, heart disease, blindness, kidney failure, amputations
119
This organ is Located behind the stomach, between duodenum and spleen, essential to digestive and endocrine systems.
Pancreas
120
The (endocrine, exocrine) function is Responsible for secretion of several enzymes that assist with digestion
exocrine
121
In the (endocrine, exocrine) function Cell clusters called Islets of Langerhans secrete insulin and glucagon
endocrine function
122
Insulin (increases, decreases) blood glucose levels.
decreases
123
Glucagon (increases, decreases) blood glucose levels
increases
124
Without ______ glucose remains in the bloodstream and can not enter cells
insulin
125
Insulin has a (hypoglycemic, hyperglycemic) effect
hypoglycemic
126
Insulin has a hypoglycemic effect: as glucose leaves the blood serum glucose levels (fall, rise)
fall
127
Insulin provides storge of glucose as glycogen in the
skeletal muscle and liver
128
Insulin inhibits the breakdown of
fat and glycogen
129
This is the production of new glucose from non-carbohydrate molecules
Gluconeogenesis
130
Glucagon: Maintains adequate levels of
serum glucose between meals.
131
When blood glucose levels fall, ________ is secreted.
glucagon
132
Hyperglycemic hormones include:
Epinephrine, Thyroid hormone, Growth hormone, Glucocorticoids
133
Hyperglycemic drugs include:
Corticosteroids, NSAIDs, Diuretics
134
Hypoglycemic drugs include:
Alcohol, Lithium, Angiotensin-converting enzyme (ACE) inhibitors, Beta-adrenergic blockers
135
Etiology of diabetes mellitus
combination of genetic and environmental factors. Sedentary lifestyles, stress, consumption of high calorie foods.
136
This type of diabetes is often diagnosed in childhood.
type 1 diabetes
137
Type 1 diabetes was also called
juvenile diabetes
138
What percentage of type 1 diabetes is diagnosed in childhood?
5-10%
139
What percentage of Type 1 diabetes is diagnosed in adulthood
25%
140
excessive urination is called
polyuria
141
increased hunger is called
Polyphagia
142
increased thirst is called
Polydipsia
143
Hyperglycemia—fasting glucose >
126 mg/dL
144
high levels of glucose in the urine is called
Glucosuria
145
What percentage of HbA1c indicates diabetes?
6.5%
146
Untreated DM produces long-term damage to arteries, leading to
heart disease, stroke, kidney disease, and blindness.
147
What symptom is common in untreated DM?
nerve degeneration
148
DKA primarily occurs in what type diabetes
Type I DM
149
Goal of insulin therapy is to strictly
maintain blood glucose levels within normal range
150
Administering insulin when not enough glucose is present in the blood can lead to serious hypoglycemia and coma. This can happen when:
a meal is skipped after proper insulin administration
with heavy exercise
151
In diabetes, this is abdominally anchored, release small SQ doses at predetermined intervals, manual boluses if necessary.
Insulin pumps
152
Sudden onset of symptoms for hypoglycemia are
Pale, cool, moist skin, Confusion, Lightheadedness, Weakness, Anxiety, Blood glucose <50 mg/dL
153
Mild to moderate hypoglycemia can be reversed by
consuming foods that contain glucose.
154
The quickest way to reverse severe hypoglycemia it to give
iv glucose in a dextrose solution.
155
Glucagon can be given by what route
IV, SQ, or IM.
156
Waning insulin is when glucose levels rise in response to
declining insulin during night
157
What is the dawn phenomenon?
between 0400 and 0800, the body produces cortisol and growth hormone, which cause glucose level to rise
158
This is a rebound drop in glucose (related to excessive insulin dose, alcohol intake, or a missed meal), followed by nighttime release of hormones that elevate glucose (epinephrine, cortisol, glucagon).
Somogyi phenomenon
159
This is an antiphyperglycemic drug used along with insulin
Pramlinitide (Symlin)
160
Synthetic form of amylin, hormone release by beta cells of
pancreas with insulin
161
In this type of diabetes Target cells become unresponsive to insulin, although pancreas produces sufficient amount.
Type 2 DM
162
Activity of insulin receptors can be increased by
physical exercise and lowering the amount of circulating insulin.
163
Type 2 dm is usually controlled with
non-insulin antidiabetic drugs (after exercise and diet have failed).
164
These stimulate release of insulin and increase receptor sensitivity.
Sulfonylureas
165
This decreases hepatic production of glucose (gluconeogenesis), and reduce insulin resistance.
Biguanides
166
This blocks enzymes in the small intestine that break down complex carbs to monosaccharides
Alpha-glucosidase inhibitors
167
These decrease insulin resistance and block gluconeogenesis
Thiazolidinediones or glitazones
168
Meglitinides stimulate
insulin release
169
Incretin enhancers—mimic the actions of
incretins or reduce their breakdown
170
These are hormones released by the small intestine to signal the pancreas to increase insulin secretion, and the liver to stop producing glucagon.
Incretins
171
Why are autonomic drugs important?
, because they mimic involuntary bodily functions.
172
What are the four fundamental classes of autonomic drugs?
1. Cholinergic drugs
2. Adrenergic drugs
3. Cholinergic blocking drugs (anticholinergics)
4. Adrenergic blocking drugs (adrenergic antagonists)
173
The brain and spinal cord are located in which system?
central nervous system
174
all nervous tissue all nervous tissue are located in which system?
peripheral nervous system
175
Name the actions of teh nervous system.
1. Recognizing changes in the internal and external environments
2. Processing and integrating the environmental changes that are perceived
3. Reacting to the environmental changes by producing an action or response
176
What organs and tissues does the ANS regulate?
Heart, Digestive tract
, Respiratory tract, Reproductive tracts, Arteries, Salivary glands, Portions of the eye
