Exam 3 Study Guide Flashcards
These are chemical messengers from the various glands in the endocrine system
Hormones
How many cells in the body can hormones affect?
thousands
How long does it take for an optimal response to be produced for hormones?
several days
What kind of changes occur when too little or too much of a hormones is produced?
physiological changes
This part of the brain secretes releasing hormones that travel to the pituitary.
hypothalamus
What hormones does the anterior pituitary secrete?
- adrenocorticotropic hormone
- thyroid stimulating hormone
- growth hormone
- prolactin
- follicle stimulating hormone
- luteinizing hormone
What kind of tissue is in the posterior pituitary?
nervous tissue
When is ADH and oxytocin released?
in response to nerve impulses from the hypothalamus
Hypersecretion of corticosteroids can cause?
Cushing syndrome
Hyposecretion of the adrenal cortex can cause?
Addison disease
Hyposecretion of the parathyroid hormone can cause?
hypoparathyroidism
Hypersecretion of the parathyroid can cause?
hyperparathyroidism
Ketoconazole and mitotane is used for what disorder?
Cushing syndrome
What medication(s) are used for Cushing syndrome?
ketoconazole and mitotane
What medications are used for Addison disease?
hydrocortisone, prednisone
What medication is used for hyperparathyroidism?
no medication, surgery is done
What medication is used for hypoparathyroidism?
human parathyroid hormone (natpara), vitamin D and calcium supplements
Natpara is used for what disorder?
hypoparathyroidism
Hyposecretion of the pituitary causes what disorder?
diabetes insipidus
What medication is used for diabetes insipidus?
desmopressin (DDAVP, Noctiva, Stimate) and vasopressin
What disorder is caused by hypersecretion of the pituitary?
SIADH
What is medication is used for acromegaly?
octreotide
Octreotide is used for what disorder?
acromegaly
Hypersecretion of the thyroid causes?
Gaves disease
Hyposecretion of the thyroid causes?
myxedema (adults), cretinism (children)
How is graves disease treated?
propylthiouracil (PTU) and I-131
How is myxedema and cretinism treated?
thyroid hormone and levothyroxine (T4)
This hormone stimulates growth and metabolism in nearly all cells in body.
growth hormone
Sumatotropin is also known as
growth hormone
Growth hormone is also known as
somatotropin
The deficiency that results in short stature is
dwarfism
What should you monitor with growth hormone agents?
glucose tolerance and thyroid function
Glucose tolerance and thyroid function are monitored when _______ are administered.
Growth hormone agents
This has the same actions as GH (growth hormone).
Mecasermin (increlex)
This type of excess secretion results in deformed bones and enlarged small bones of hands, feet, face, and skull.
acromegaly
Octreotide is a synthetic GH (antagonist, agonist)
antagonist
ADH is secreted from the
posterior pituitary
When is ADH secreted?
when the hypothalamus senses that the plasma volume has decreased or blood osmolality is too high
ADH is also known as
vasopressin
This has the ability to constrict blood vessels and RAISE blood pressure
ADH (vasopressin)
ADH deficiency results in which type of diabetes?
diabetes insipidus
What does ADH act on?
the collecting ducts
This is the most common drug for treating diabetes insipidus.
desmopressin
ADH (increases, decreases) serum osmolality.
decreases
Does thyroid hormone increase or decrease basal metabolic rate?
increase
Parifollicular cells secrete
calitonin
Thyroid hormone consists of T__ and T___
T4, T3
Is T4 converted to T3 or is T3 converted to T4?
T4 is converted to T3
Is T3 or T4 more biologically active?
T3
This is a carrier protein in the plasma that attaches to thyroid hormone
TBG (thyroxine-binding globulin)
This part of the brain tells the posterior pituitary what to do.
hypothalamus
What are some adverse effects of desmopressin?
headache, nasal congestion, water intoxication, hyponatremia
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
Water intoxication, headache, nausea, mild abdominal pain, and hypotension are adverse effects of what medication?
Desmopressin
True or False. The thyroid affects every cell in the body.
TRUE
Abnormal thyroid levels can occur due to the disease within the _______, ________, or _________
thyroid gland, pituitary, or hypothalamus
This disorder is due to a poorly function thyroid.
hypothyroidism
This disorder is due to decreased TSH production by the pituitary
hypothyroidism
What is the etiology of hypothyroidism?
it is an autoimmune disease, surgical removal of the thyroid, and aggressive treatment with antithyroid drugs
This is the most common cause of hypothyroidism in the US.
Hashimotos
What are some early symptoms of hypothyroidism?
weakness, muscle cramps, dry skin
Slurred speech, bradycardia, weight gain, decreased sense of taste and smell, and cold intolerance are severe symptoms of
hypothyroidism
In labs, what would show hypothyroidism regarding TSH, T3, and T4?
elevated TSH, decreased T3 and T4
True or False. Goiter must be present in hypothyroidism.
False. it can be present or absent
What is the standard medication to treat hypothyroidism?
levothyroxine
What is the most common form of hyperthyroidism?
grave’s disease
The body develops antibodies against its own thyroid gland in which disorder?
hyperthyroidism
Increased metabolism, tachycardia, weight loss, elevated body temperature, and anxiety are symptoms of what disorder?
hyperthyroidism
This is very high levels of circulating thyroid hormone.
thyroid storm
What is the treatment for thyroid storm?
remove all or part of the thyroid
What is monitored to evaluate progress of of therapy for hypothyroidism?
serum TSH level
This medication is contraindicated in pregnant patients, crosses placenta more readily for hyperthyroidism.
Methimazole
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
What percentage of epinephrine does the adrenal medulla secrete?
75%-80%
75%-80% of _____________ is secreted by the adrenal medulla
Epinephrine
What percentage of norepinephrine does the adrenal medulla secrete?
20%-25%
20%-25% of ______________ is secreted by the adrenal medulla.
Norepinephrine
What are the three classes of steroid hormones?
- Gonadocorticoids
- Mineralocorticoids
- Glucocorticoids
Mineralocorticoids regulate plasma volume by promoting
sodium reabsorption and potassium excretion by renal tubules.
When plasma volume falls, kidney secretes _________, which results in production of Angiotensin II.
renin
When plasma volume falls, kidney secretes renin, which results in production of Angiotensin (I, II)
Angiotensin II
Angiotensin II causes Aldosterone secretion, promoting ______________ retention.
sodium and water
What steroid hormone class includes cortisol, corticosterone, and cortisone?
Glucocorticoids
Corticosteroids = __________corticoids and ___________corticoids
mineralocorticoids and glucocorticoids
Glucocorticoids suppress __________________________ responses
inflammatory and immune responses
Glucocorticoids Increase the sensitivity of
vascular smooth muscle to norepinephrine and angiotensin II.
This glucocorticoid effect promotes
bronchodilation
Glucocorticoids promote bronchodilation by making bronchial muscle more responsive to
sympathetic nervous system activation.
Glucocorticoids increase the breakdown of the _________
bony matrix
Glucocorticoids increase the breakdown of bony matrix which results in
bone demineralization
Which part of the brain releases secretes corticotropin-releasing factor (CRF).
hypothalamus
CRF travels to the pituitary where it causes the release of
adrenocorticotropic hormone (ACTH).
ACTH travels through blood to reach
adrenal cortex
Cortisol levels in the blood rise, providing (positive, negative) feedback to the hypothalamus and pituitary
negative
Cortisol levels in blood rise, providing negative feedback to the
hypothalamus and pituitary
Adrenocortical insufficiency is the lack of adequate
corticosteroid production
Adrenocortical insufficiency is the lack of adequate corticosteroid production, caused by Hyposecretion of _____________ and inadequate secretion of
adrenal cortex, ACTH
Hyposecretion of the adrenal cortex is (primary, secondary) insufficiency?
primary insufficiency
Inadequate secretion of ACTH from the pituitary is (primary, secondary) insufficiency?
secondary insufficiency
This closely resembles ACTH and is used to diagnose the cause of the adrenocortical insufficiency.
Cosyntropin (Cortrosyn)
Cosyntropin (Cortrosyn) closely resembles ACTH and is used to diagnose the cause of the
adrenocortical insufficiency.
Hypoglycemia, fatigue, hypotension, increased skin pigmentation, and GI disturbances are symptoms of
adrenocortical insufficiency
____________ are used as replacement therapy for adrenocortical insufficiency
Corticosteroids
Corticosteroids are used as replacement therapy for
adrenocortical insufficiency
(Low, high) plasma cortisol and high plasma ACTH indicate that adrenal gland is not responding to ACTH stimulation.
low
Which adrenocortical insufficiency is more common?
secondary
Which adrenocortical insufficiency is rare?
primary (Addisons)
Without ACTH stimulation, the adrenal cortex shrinks and stops secreting endogenous corticosteroids which is called
adrenal atrophy
What are the symptoms of abrupt stopping of corticosteroid medication?
Nausea, Vomiting
, Lethargy, Confusion, Coma
(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
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
This disorder is commonly caused by long-term therapy with high-dose corticosteroids.
Cushing syndrome
Cushing’s Disease caused by pituitary tumor producing excess
ACTH
This blocks synthesis of corticosteroids, lowering serum levels.
Ketoconazole (Nizoral)
Should ketoconazole be used during pregnancy?
No
This inhibits ACTH secretion by pituitary, which reduces corticosteroid secretion from the adrenals.
Pasireotide (Signifor)
This is the leading cause of death in the US
Diabetes
What serious complications can be caused by diabetes?
stroke, heart disease, blindness, kidney failure, amputations
This organ is Located behind the stomach, between duodenum and spleen, essential to digestive and endocrine systems.
Pancreas
The (endocrine, exocrine) function is Responsible for secretion of several enzymes that assist with digestion
exocrine
In the (endocrine, exocrine) function Cell clusters called Islets of Langerhans secrete insulin and glucagon
endocrine function
Insulin (increases, decreases) blood glucose levels.
decreases
Glucagon (increases, decreases) blood glucose levels
increases
Without ______ glucose remains in the bloodstream and can not enter cells
insulin
Insulin has a (hypoglycemic, hyperglycemic) effect
hypoglycemic
Insulin has a hypoglycemic effect: as glucose leaves the blood serum glucose levels (fall, rise)
fall
Insulin provides storge of glucose as glycogen in the
skeletal muscle and liver
Insulin inhibits the breakdown of
fat and glycogen
This is the production of new glucose from non-carbohydrate molecules
Gluconeogenesis
Glucagon: Maintains adequate levels of
serum glucose between meals.
When blood glucose levels fall, ________ is secreted.
glucagon
Hyperglycemic hormones include:
Epinephrine, Thyroid hormone, Growth hormone, Glucocorticoids
Hyperglycemic drugs include:
Corticosteroids, NSAIDs, Diuretics
Hypoglycemic drugs include:
Alcohol, Lithium, Angiotensin-converting enzyme (ACE) inhibitors, Beta-adrenergic blockers
Etiology of diabetes mellitus
combination of genetic and environmental factors. Sedentary lifestyles, stress, consumption of high calorie foods.
This type of diabetes is often diagnosed in childhood.
type 1 diabetes
Type 1 diabetes was also called
juvenile diabetes
What percentage of type 1 diabetes is diagnosed in childhood?
5-10%
What percentage of Type 1 diabetes is diagnosed in adulthood
25%
excessive urination is called
polyuria
increased hunger is called
Polyphagia
increased thirst is called
Polydipsia
Hyperglycemia—fasting glucose >
126 mg/dL
high levels of glucose in the urine is called
Glucosuria
What percentage of HbA1c indicates diabetes?
6.5%
Untreated DM produces long-term damage to arteries, leading to
heart disease, stroke, kidney disease, and blindness.
What symptom is common in untreated DM?
nerve degeneration
DKA primarily occurs in what type diabetes
Type I DM
Goal of insulin therapy is to strictly
maintain blood glucose levels within normal range
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
In diabetes, this is abdominally anchored, release small SQ doses at predetermined intervals, manual boluses if necessary.
Insulin pumps
Sudden onset of symptoms for hypoglycemia are
Pale, cool, moist skin, Confusion, Lightheadedness, Weakness, Anxiety, Blood glucose <50 mg/dL
Mild to moderate hypoglycemia can be reversed by
consuming foods that contain glucose.
The quickest way to reverse severe hypoglycemia it to give
iv glucose in a dextrose solution.
Glucagon can be given by what route
IV, SQ, or IM.
Waning insulin is when glucose levels rise in response to
declining insulin during night
What is the dawn phenomenon?
between 0400 and 0800, the body produces cortisol and growth hormone, which cause glucose level to rise
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
This is an antiphyperglycemic drug used along with insulin
Pramlinitide (Symlin)
Synthetic form of amylin, hormone release by beta cells of
pancreas with insulin
In this type of diabetes Target cells become unresponsive to insulin, although pancreas produces sufficient amount.
Type 2 DM
Activity of insulin receptors can be increased by
physical exercise and lowering the amount of circulating insulin.
Type 2 dm is usually controlled with
non-insulin antidiabetic drugs (after exercise and diet have failed).
These stimulate release of insulin and increase receptor sensitivity.
Sulfonylureas
This decreases hepatic production of glucose (gluconeogenesis), and reduce insulin resistance.
Biguanides
This blocks enzymes in the small intestine that break down complex carbs to monosaccharides
Alpha-glucosidase inhibitors
These decrease insulin resistance and block gluconeogenesis
Thiazolidinediones or glitazones
Meglitinides stimulate
insulin release
Incretin enhancers—mimic the actions of
incretins or reduce their breakdown
These are hormones released by the small intestine to signal the pancreas to increase insulin secretion, and the liver to stop producing glucagon.
Incretins
Why are autonomic drugs important?
, because they mimic involuntary bodily functions.
What are the four fundamental classes of autonomic drugs?
- Cholinergic drugs
- Adrenergic drugs
- Cholinergic blocking drugs (anticholinergics)
- Adrenergic blocking drugs (adrenergic antagonists)
The brain and spinal cord are located in which system?
central nervous system
all nervous tissue all nervous tissue are located in which system?
peripheral nervous system
Name the actions of teh nervous system.
- Recognizing changes in the internal and external environments
- Processing and integrating the environmental changes that are perceived
- Reacting to the environmental changes by producing an action or response
What organs and tissues does the ANS regulate?
Heart, Digestive tract
, Respiratory tract, Reproductive tracts, Arteries, Salivary glands, Portions of the eye
