HLTH 2501: other hormonal disorders Flashcards
most common cause of pituitary disorders
benign adenomas
two groups of manifestations of pituitary disorders
the effect of the mass as it enlarges and causes pressure in the skull and the effect of the tumor on hormone secretion
effects of the mass as it enlarges and causes pressure in the skull
aka increased intracranial pressure; signs of this include headaches, seizures, visual defects and drowsiness
the effect of the tumor on hormone secretion
depends on which specific cells are involved and their location, causing the hormone to secrete excessive amounts or a deficit
what may develop along with tumors in the pituitary gland?
hemorrhage or infarction, causing even more intracranial pressure and part of the pituitary can be destroyed
pituitary apoplexy
when part of the pituitary is destroyed by a tumor
panhypopituitarism
diminution or cessation of pituitary function resulting in loss of gonadal function and the degrading of thyroidal and adrenal function
treatment for pituitary tumors
surgery or radiation to remove the tumor, followed by hormone replacement therapy
what besides tumors can damage the pituitary?
vascular thrombosis and infarction associated with obstetric delivery; this can cause hypopituitarism
what do hypothalamic disorders include?
tumors or infection
dwarfism
is caused by a number of factors such as a deficit in growth hormone; intelligence and body proportions are normal, but there is a delay in skeletal maturation and puperty
gigantism
results from excess GH before puberty and fusion of the epiphyses
acromegaly
refers to the effects of excess GH in the adult, usually by an adenoma; this causes the bones to become broader and heavier, and the soft tissues grow, resulting in enlarged hands and feet, a thicker skull, and changes in the facial features
what are the results of acromegaly?
thickening and growth of the bones may compress nerves and cause carpal tunnel or arthritis; the effectiveness of insulin decreasing and diabetes may develop; and hypertension and cardiovascular disease may develop as well
where does diabetes insipidus originate from?
a deficit in the neurohypophysis
another name for ADH
vasopressin
signs of diabetes insipidus
polyuria (large volumes of dilute urine), and thirst that causes severe dehydration
treatment for diabetes insipidus
replacement therapy for ADH
inappropriate ADH syndrome
is an excess of ADH, which causes retention of fluid; can be temporary via stress or secreted by an ectopic source like a bronchogenic carcinoma
signs of inappropriate ADH syndrome
severe hyponatremia, which causes mental confusion and irritability
treatment for inappropriate ADH syndrome
diuretics and sodium supplements
two thyroid hormones
thyroxine and triiodothyronine
what are thyroid hormones released in response to?
hypothalamic-pituitary secretion of TSH (thyroid stimulating hormone)
what do disorders of the thyroid gland result from?
pituitary or thyroid gland dysfunction
goiter
refers to an enlargement of the thyroid gland, which is often visible on the anterior neck
what are goiters caused by?
various hypothyroid and hyperthyroid conditions
what are the risks of a goiter?
it can compress the esophagus and interfere with swallowing and can cause pressure on the trachea
endemic goiter
is a hypothyroid conditions that occurs in regions where there are low iodine levels in the soil and food ex. mountains or great lakes
role of iodine for thyroid
iodine is normally ‘trapped’ by the thyroid gland and used to synthesize triiodothyronine (T3) and thyroxine (T4)
T3
triiodothyronine
T4
thyroxine
what does an iodine deficiency cause?
low thyroid hormone production and a compensatory increase in TSH from the pituitary; this results in hyperplasia and hypertrophy of the thyroid gland
treatment for endemic goiter
iodized salt
goitrogens
are foods that contain elements that block synthesis of T3 and T4, but increase TSH secretion
what does TSH cause when iodine is deficent?
hyperplasia of the gland and promote goiter formation
examples of goitrogens
cabbage, turnips, and other related vegetables; lithium and fluoride may also be goitrogenic
toxic goiter
is a hyperthyroid conditions resulting from excess activity of the gland which may be caused by TSH
treatment for goiters
medications such as levothyroxine (Levothroid, Synthroid), surgery to remove or partially remove the the thyroid, radioactive iodine, and hormone replacement therpay
example of hyperthyroidism disorder
graves disease
risk population for graves disease
women over 30 and is related to an autoimmune factor
signs of graves disease
hypermetabolism, toxic goiter, and exophthalmos
exophthalamous
symptom of graves disease and is protruding, staring eyes and decreased blinking movements
why do exophthalmos form?
increased tissue mass in the orbit pushing the eyeball forward and increase SNS
what may occur is exophthalmos is untreated?
visual impairment due to optic nerve damage and corneal ulceration
thyrotoxic crisis
is an acute situation with uncontrolled hyperthyroidism, usually by infection or surgery; can be dangerous due to hyperthermia, tachycardia, and heart failure
treatment for graves disease
radioactive iodine, surgical removal of the thyroid gland, and the use of antithyroid drugs
how is mild hypothyroidism treated?
replacement doses of thyroid hormone
hashimoto thyroiditis
is a severe hypothyroidism disorder that results from a destructure autoimmune disorder
functions of the thyroid gland
metabolism, growth and development, and homeostasis
myxedema
is severe hypothyroidism in adults that results in non pitting edema manifesting as facial puffiness and a thick tongue
myxedema coma
refers to acute hypothyroidism resulting in hypotension, hypoglycemia, hypothermia, and loss of consciousness
cretinism
is untreated congenital hypothyroidism and may be related to iodine deficiency during pregnancy; causes a nonfunctional or absent thyroid gland that can result in severe impairment of growth and development, ex. difficulty feeding or delayed tooth eruption
tests for thyroid disorders
tests blood levels of T3 and T4, as well as TSH and the uptake of radioactive iodine
general symptoms of hypothyroidism
low metabolic rate, pale, cool skin, edema, cold intolerance, bradycardia, enlarged heart, decreased appetite, and lethargic
general symptoms of hyperthyroidism
high metabolic rate, flushed and warm skin, heat intolerance, exophthalmos in graves disease, tachycardia, increased BP, restless, nervous, tremor, and increased appetite
pheochromocytoma
is a benign tumor of the adrenal medulla that secretes epinephrine, norepinephrine, and sometimes other substances
what does pheochromocytoma cause?
hypertension, manifesting itself through headache, heart palpitations, sweating, and anxiety
cushing syndrome
is caused by an excess of glucocorticoids (hydrocortisone or cortisol)
what may cause cushing syndrome
adrenal adenoma, pituitary adenoma, an ectopic carcinoma that causes paraneoplastic syndrome, or large amounts of glucocorticoids for inflammation
what are glucocorticoids essential for?
the stress response
typical changes associated with cushing syndrome
changes in appearance, fragile skin with red streaks, increased hair growth, catabolic effects such as osteoporosis, insulin resistance, edema, suppression of the immune system, stimulation of RBC production, and emotional lability
how might one’s appearance change with cushing syndrome
a moon face (round and puffy), heavy trunk with fat at the back of the neck, and wasting of muscle
concerns of those with cushing’s syndrome
risks of infection and a decreased stress response, therefore, doses of medication may have to be increased before and during a stressful event
addison disease
refers to a deficiency of adrenocortical secretions, the glucocorticoids, mineralocorticoids, and androgens
cause of addison disease
an autoimmune reaction in which the gland is destroyed by a hemorrhage and infection
signs of addison disease
decreased blood glucose levels, poor stress response, fatigue, low BP, weight loss, hyperpigmentation, and frequent infections
risks of addison disease
increased risk for cardiac arrhythmias and failure
treatment for addison disease
replacement therapy of the necessary hormones