FINAL Flashcards
What is the endocrine system
Complex communication network composed of glands and glandular tissue that make, store and secrete chemical messengers called hormones.
What does endocrine system do?
Reproduction
Growth and development
Fluid and electrolyte balance
Energy metabolism
Host defense
Respond to stress and injury
What is hypothalamus
Organ in the brain that secretes factors that can directly inhibit or stimulate the pituitary
What are hormones of anterior pituitary?
Growth hormone
Adrenocorticotropic hormone (ACTH)
Thyroid stimulating hormone
Follicle stimulating hormone
Luteinizing hormone
Prolactin
Melanocyte
What are hormones of post pit?
Antidiuretic hormone (ADH)
Oxytocin
What does Growth hormone and Adrenocorticotropic hormone do?
GH –stimulates development of bones, muscles and organs
ACTH – Controls growth/devep and function of cortex of adrenal glands – regulates secretion of adrenal hormones - increased in response to stress
What does Thyroid stimulating hormone and Follicle stimulating hormone do?
TSH – Controls secretion of thyroid gland
FSH = Stimulates develop of eggs
What does Luteinizing hormone
Prolactin
Melanocyte
LH – Stim breast milk
Prolaction – stimulate breast milk
Melanoxyte – skin pigment
What does Antidiuretic hormone (ADH) and
Oxytocin do?
ADH – Causes reabsorption of water
Oxytocin – contraction in labor and breast milk
What are diseases of Anterior Pit?
Hypersecretion of ACTH= Cushing’s Disease (neoplasm of gland)
Hypersecretion of Growth Hormone = Giantism
Hypersecretion of Growth Hormone = Acromegaly
What are diseases of Post Pit?
Hypersecretion of ADH=SIADH
Hyposecretion of ADH= DI
What are diseases of Adrenal cortex?
Insufficient secretion= Addison’s Disease
Acute adrenal insufficiency=Adrenal Crisis
Hyperfunction= Cushing’s Syndrome
What are diseases of Adrenal medulla?
Hyperfunction=Pheochromocytoma
Pituitary adenoma
Tumor
More common in women, teens to 30’s
-Amenorrhea, abnormal milk and hypothyroidism
Gigantism
-Define
-Tx
Secretion of GH in children before fusion of epiphyseal growth plates. Can be 7-8ft tall
TX - drug therapy, radiation, surgery
DI - Post pit disorder
Define
S/S
24 urine output?
Excessive output of dilute urine
ADH deficiency or inability of kidneys to respond to ADH
Massive diuresis, dehydration, thirst, malaise, lethargy, irritability
24 hr urine greater than 4 L
Adrenal glands
Medulla?
Cortex?
Medulla – surrounded by adrenal cortex
Secretes norepinephrine, epinephrine - Stimulate sympathetic nervous system
Function to adapt to stress (fight or flight) and maintain hemostasis
Cortex - Essential for maintaining many life-sustaining physiological activities
What steroids does the cortex produce?
Mineral corticoids / sugar
Aldostorone - promotes reabsorbtion of sodium & secretion of potassium
Glucocorticoids / salt
Cortisol - needs to be present for other processes, control metabolism, reg antiinflamm and immune, emotional states
Androgens or estrogens
What are signs of adrenal crisis?
LIFE THREATENING EMERGENCY
Profound fatigue
Hypotension, tachycardia, confusion
Dehydration
Vascular collapse
Renal shut down
Serum NA derease - hyponatremia
Serum K increase - hyperkalemia
Hypercalcemia
Hypoglycemia
What is most common cause of anterior pit disorder?
TUMORS
S/S - headache, visual disturbances
What can cause adrenal crisis?
Sudden decrease in available adrenal hormones
Adrenal surgery, pit destruction, abrupt withdrawl from steorids, stress
Pheochromocytoma
S/S
Continually in fight or flight state
PRIMARY S/S Arterial HTN
Excessive sweating
Palpitations
Headhache
Hyperventilation
Flushing
Cardiomegaly
CHF
Vent failure
Pheochromocytoma-
Pre-op
Post-op
Pre-op
Stimulant free diet
Bedrest
Regitine (alpha adrenergic blocker) and/or Minipress
Inderal
Post op
Monitor for Hypovolemic shock caused by rapid relaxation of constricted blood vessels!
Monitor for transient hypertensive episodes
What are the organs of the urinary system
Kidneys
Ureters
Urinary Bladder
Urethra
Function of kidneys (6)
- Remove liquid waste from blood in form of urine
- Stable balance of salts and other substances in blood
- produce erthopoietin
- Remove nitrogenous waste
- Blood filter
- Homeostatic organ
What enters the renal artery?
Blood waste and water
What enters renal vein?
Blood without waste or excess water
What diuretics work at the proximal tubule?
MOA
Used for?
Osmotics and Carbonic anhydrase inhibitors
(Mannitol)
-Increase osmolality and sodium reabsorbtion
-Used to prevent kidney failure and decrease intrcranial and intraocular pressure
What diuretics work at the loop of henle?
Loop diuretics (Furosemide)
Used to get water off quickly
What diuretics work at the distal tubule?
MOA
Used for?
Thiazides (Hydrochlorothiazide)
* Promote sodium, water and chloride excretion
* Used HTN and peripheral edema
* Immediate diuresis
What diuretics work at the Collecting tubule?
MOA
Used for
Potassium sparing (triamterene)
* Promote sodium and water excretion and potassium retention
* Cardiac patients
Prerenal failure
Decreased blood flow to glomeruli / HTN
SPB 70mmHg needed for glomerular filtration
Intrarenal failure
INSIDE KIDNEY
Nephrotoxic agents
Infections
HTN, DM, trauma
Postrenal failure
Causes urine to back up
Obstructions
What are phosphorus and calcium used for?
Maintain strong bones, teeth
What does excess phosphate in the blood do?
Bone damage, heart disease
May need vit D supplement
What is dialysis
Passage of molecules through semipermeable membrane into special solution called dialysate solution
To restore acid base balance, remove toxins
Dialysis is based on what 3 principles?
Diffusion - mvmt of particles across semi permeable membrane from higher to lower concentration
Osmosis - mvmt of particles from areas of lesser solute to area of greater solute concentration
Ultrafiltration - mvmt of fluid as a result of pressure gradient
Who needs dialysis?
A
E
I
O
U
Acid base problems
Electrolyte problems
Intoxications
Overload of fluids
Uremic symptoms
Goals of dialysis?
Remove products of protein metabolism
Maintain safe serum electrolye concentrations
Correct acidosis, replenish bicarb buffer system
Remove excess fluid from blood
Complications of hemodialysis?
Hypovolemic shock
Blood loss
Electrolyte imbalance
Air embolus
Peritoneal dialysis
Define
MOA
Temporary
Long term
- Uses the patient’s own peritoneum as a semipermeable dialyzing membrane
- Fluid instilled into peritoneal cavity
- Waste products drawn into the fluid, which is then drained from the peritoneal cavity
- May be temporary or permanent
Temporary: catheter inserted into the peritoneal cavity through the abdominal wall
Long-term: catheter is implanted into the peritoneal cavity
What are post kidney transplant rejection signs
Hyperacute - w/in48hrs, High fever, organ must be removed
Acute - 1wk to 2years, Oliguria, ^temp and bp, lethargy, ^ bun, K, creatinine, fluid retention
Chronic - Gradual , ^ in BUN, creatinine, proteinuria, fatigue
