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Pathophysiology > Hormonal Regulation > Flashcards

Hormonal Regulation Flashcards

1
Q

Insulin, amylin, and glucagon are produced by

A

pancreas

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2
Q

i. Promotes utilization of glucose

ii. Lowers serum glucose by transporting glucose to the cell to be utilized or stored as glycogen

A

Insulin

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3
Q

i. Delays nutrient uptake and suppresses glucagon after meals

A

Amylin

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4
Q

i. Promotes glycogenolysis (the breakdown of glycogen, which is the storage form of glucose)&raquo_space; raises serum glucose

A

Glucagon

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5
Q

is a state of insufficient blood glucose levels

< __

A

Hypoglycemia

70

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6
Q

is the maintenance of blood glucose in a normal range

a. 70 – ___ mg/dl at all times
b. Fasting blood glucose should be less than 100mg/dl

A

Euglycemia

70 - 140

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7
Q

_________ hemoglobin (HgbA1C) indicates glucose control over a longer period of time. The goal for normal glucose control would be ≤ 6%

A

Glycosylated

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8
Q

is a state of elevated blood glucose levels

a. > 100 mg/dl when fasting
b. > 140 mg/dl postprandial

A

Hyperglycemia

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9
Q

c. Hyperglycemia causes:
i. _____________
&raquo_space; binding of glucose to collagen/proteins of blood vessels/tissues
» thickening basement membranes,
^^ cytokines,
^^ lipid oxidation,
^^ O2 free radicals
» tissue injury

ii. Excess glucose gets broken down into _______ and fructose that enters cells&raquo_space; ^^H20
» cell injury

iii. ^^ PKC (Protein Kinase Inhibitor)
»^^ insulin resistance, cytokines & permeability

iv. Insulin _________
» ^^triglycerides & ^^ apoB lipoproteins & decreased HDL&raquo_space; atherosclerosis

A

Glycosylation

sorbitol

resistance

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10
Q

(Hyperglycemia)

poly____ - ^ urination
poly_____ - ^ thirst
poly______ - ^ hunger

A

polyuria - ^ urination
polydipsia - ^ thirst
polyphagia - ^ hunger

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11
Q

(Hyperglycemia)

Risk Factors for Imbalanced Glucose

a. Infants (small or large for gestational age)
b. Older adults
c. _____ history of diabetes
d. _______
e. decreased HDL levels
f. ^^ _________ fat
g. ^^ trans fatty acids
h. decreased fiber intake
i. Lack of physical exercise/sedentary lifestyle
j. Infection
k. High ______

A

Family

Obesity

saturated

stress

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12
Q

Intra-abdominal obesity is the greatest risk factor in ____ _ diabetes. Excess nutrients
»^^ adipocytokines (IL-1, IL-6, TNFa)
» insulin resistance and beta cell death
» ______ serum glucose

A

Type 2

Excess

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13
Q

_________ Syndrome is a syndrome characterized by a combination of any 3 or more of the following

Abdominal obesity
≥ 40 in waist men; ≥ 35 in waist women

_____________ ≥150 mg/dl

_ _ _ ≤ 40 male; ≤ 50 female

Blood Pressure ≥ 130/ ≥ 85 mmHg or on meds

Fasting Glucose ≥___ mg/dl

A

Metabolic

Triglycerides ≥150 mg/dl

HDL ≤ 40 male; ≤ 50 female

Fasting Glucose ≥100 mg/dl

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14
Q

Diagnostic Numbers for Diabetes

Diabetes Mellitus

_______ ≥ 126mg/dl

2 hourpostprandial or random hyperglycemia ≥ 200mg/dl

Tests must be abnormal on 2 separate days unless extremely high

HgbA1C ≥ 6._%

___ Diabetes
Fasting Blood Sugar of 100-125mg/dl

2 hour postprandial of 140- 199mg/dl

A

Fasting

pre

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15
Q

________ ________ is characterized by hyperglycemia resulting from defects in insulin secretion and/or action.

A

Diabetes mellitus

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16
Q

Types of diabetes mellitus include:

a. Type 1: ________ insulin deficiency due to beta cell destruction; autoimmune cause
b. Type 2: insulin _________ with inadequate secretion due to decreased or abnormal beta cell function
c. Type 3: related to _______ defects
d. Type 4: ___________; glucose intolerance related to demands of *pregnancy

A

Type 1: absolute

Type 2: resistance

Type 3: genetic

Type 4: gestational

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17
Q

These are what type of complications for diabetes?

a. Infections (fungal, bacterial)
b. Hypoglycemia
c. Hyperglycemia
d. Diabetic Ketoacidosis
e. Somogyi Phenomenon
ii. Dawn Phenomenon

A

ACUTE

18
Q

(Acute)
Diabetic ____________
i. More common in type _ as a result of profound insulin deficiency

ii. Specific to DKA:
1. Lipolysis&raquo_space; formation of acetoacetic acids&raquo_space; ______ in urine and
Kussmaul respirations

iii. Hyperosmolar Hyperglycemic NonKetotic Coma (HHNK)Only seen in type _ (there is still insulin to avoid lipolysis)

A

Diabetic Ketoacidosis (DKA)

1

ketones (chemicals that your liver makes)

2

19
Q

_______ Phenomenon

i. There is SO much insulin given in the morning
» blood sugar drops (hypoglycemic) in the night
&raquo_space; hyperglycemic rebound in the morning
» need ____ insulin

A

Somogyi Phenomenon

LESS

20
Q

(Acute)
_______ Phenomenon

i. There is SO much insulin given in the morning
» blood sugar drops (hypoglycemic) in the night
&raquo_space; hyperglycemic rebound in the morning
» need ____ insulin

A

Somogyi Phenomenon

LESS

21
Q 
(Acute)
\_\_\_\_ Phenomenon
Insulin given in morning 
>> only slight drop in glucose overnight (not hypoglycemic) + normal release of cortisol and growth hormone in the morning 
>> hyperglycemia in the morning 
>> need \_\_\_\_ insulin
A

Dawn Phenomenon

MORE

22
Q

_______ complications of diabetes include:

Microvascular effects

  • Neuropathy
  • Ocular
  • Nephropathy
  • Dermopathy

Macrovascular

A

CHRONIC

23
Q

MICROvascular effects:

____pathy
1. Nerve degeneration from poor perfusion and ischemia

______ Damage

  1. Retinal detachments
  2. Cataracts from sorbitol deposits in the lens&raquo_space; opacity of lens
  3. Glaucoma from neovascularization that blocks outflow of aqueous humor

iii. _______pathy (kidney failure due to microalbuminuria and hypertension)
iv. _____pathy (non-healing skin and foot lesions)

A

Neuropathy

Ocular Damage

Nephropathy

Dermopathy

24
Q

MACROvascular = increased _________, ________ wound healing, amputations

Due to:

  1. *Decreased sensory perception of pain&raquo_space; risk for injury
  2. *Decreased visual perception&raquo_space; risk for injury
  3. *Decreased vascular flow and increased HgbA1C&raquo_space; hypoxia&raquo_space; ineffective cell function (like WBCs)
  4. Hyperglycemia&raquo_space; food for bacteria
A

infections

impaired

25
Q

The _______ is responsible for production of:

a. Thyroid hormones (T_ & T_) that increase the rate of cellular metabolism
b. _________ that lowers serum calcium (osteoblastic)

A

thyroid

T3 & T4

Calcitonin

26
Q

The parathyroid is responsible for the production of parathyroid hormone, which raises the serum _________ levels (osteoclastic)

A

calcium

27
Q

is a thyroid dysfunction in which there is decreased production of T3 and T4. Consequently, when associated with primary loss (congenital loss, lack of iodine, treatment for hyperthyroidism), this leads to increased thyroid stimulating hormone (TSH).

Secondary loss (hypothalamic disease or a pituitary disease) results in normal or decreased TSH levels despite low T3 and T4 due to dysfunction or disease of the hypothalamus and/or pituitary gland that suppresses the negative feedback system.

A

Hypothyroidism

28
Q

__________ disease is an autoimmune disease that leads to the destruction of thyroid tissue; it is the most common form of hypothyroidism.

A

Hashiomoto

29
Q

Hashiomoto
Signs/Symptoms

i. __ TSH (Thyroid Stimulating hormone)
ii. Confusion
iii. ________ memory
iv. Lethargy/fatigue
v. Decreased DTRs (Deep Tendon Reflex)
vi. ^^ cholesterol
vii. Weight ____
viii. ____ intolerance
ix. Edema
x. Dry skin
xi. ______ (Kidney production of erythropoietin is slowed in hypothyroidism leading to a decrease in RBCs)

A

Increased

Decreased

Gain

Cold

Anemia

30
Q

c. Hypothyroidism in its severest form presents as ________

i. May lead to ________ coma
1. Hypothermia without shivering
2. Hypoventilation
3. Hypotension
4. Hypoglycemia
5. Lactic acidosis

A

Myxedema

31
Q

is a thyroid dysfunction in which there is increased production of T3 and T4, which leads to decreased thyroid stimulating hormone (TSH). This could be due to a primary thyrotoxicosis (Graves Disease, goiter, toxic adenoma, treatment of hypothyroidism) or a secondary thyrotoxicosis (pituitary adenoma).

A

Hyperthyroidism

32
Q

______ disease is an autoimmune hyperplasia of the thyroid tissue that presents as a *goiter; it is the most common form of hyperthyroidism.

A

Graves

33
Q

Hyperthyroidism

Signs/Symptoms

i. *Exophthalmos (protrusion of the eyes)
ii. *Goiter (enlargement of thyroid gland)
iii. __ TSH
iv. ____________
v. Insomnia
vi. Hyperreflexia - overactive reflexes
vii. Hypertension - High BP
viii. Heart failure
ix. Weight ____
x. ____ intolerance
xi. Increased blood sugar
xii. Diaphoresis (sweaty)
xiii. Increased appetite

A

Decrease

Restlessness

loss

heat

34
Q

c. Extreme levels of thyroid hormone can lead to thyroid _____; may be triggered by excessive stress

i. Hyperthermia (103-105)
ii. Tachycardia
iii. Heart _______
iv. _______
v. Cardiac collapse and _____

A

thyroid storm

failure

delirium

death

35
Q

The posterior pituitary is responsible for the production of

A

antidiuretic hormone (ADH)

36
Q

i. ↑ ADH&raquo_space; water retention → water intoxication, hyponatremia (b/c high water dilutes), ↑ specific gravity of urine (highly concentrated urine)
ii. May be due to posterior pituitary neoplasm, surgery, pulmonary disease, brain trauma/tumor

Signs/Symptoms

  1. Thirst
  2. Dulled consciousness (if sodium <130)
  3. Muscle twitching and convulsions (if sodium <115)
A

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

37
Q

i. ↓ ADH&raquo_space; inability to concentrate urine due to low ADH, extreme polyuria
leading to ↓ specific gravity
ii. May be due to neurogenic causes or nephrogenic causes

Signs/Symptoms:

  1. Polyuria
  2. Nocturia
  3. Polydipsia
  4. hydronephrosis - excess fluid in kidney
A

Diabetes Insipidus (DI)

38
Q

__________ Disease is a primary hypocortisolism; it occurs when there is decreased
production of cortisol and aldosterone.
a. Destruction of adrenal cortex&raquo_space; decreased cortisol & decreased aldosterone with
^^ ACTH
b. Addison’s ______ occurs may occur during a time of increased stress
i. Severe hyponatremia (low sodium in blood)» dehydration & hypovolemia&raquo_space; decreased CO&raquo_space; decreased BP&raquo_space; reflexic tachycardia&raquo_space; _____
ii. Severe hypoglycemia

A

Addison’s

crisis

shock

39
Q

____________ (such as in Addison’s and Secondary ____________) leads to:

a. Hypotension (decreased Na, more pronounced in Addison’s)
b. Dysrhythmia (^^ K, more pronounced in Addison’s)
c. Hypoglycemia (because cortisol normally antagonizes insulin)
d. Virilism (secondary male sex characteristics in the female)
e. Weakness

A

HYPOcortisolism

40
Q

______________ can be classified as Cushing’s Syndrome or Cushing’s Disease.
a. Cushing’s Syndrome occurs when there is increased exposure to cortisol

b. Cushing’s Disease is hypercortisolism due to increased endogenous secretion of ACTH
(usually due to a pituitary tumor in adults or adrenal tumor in children)

A

Hypercortisolism

41
Q

________

Signs/Symptoms:

a. Facial flush
b. ____ face
c. Purple striae
d. Pendulous abdomen
e. Easy bruising
f. Acne and increased body/facial hair (increased androgen levels)
g. Hyperpigmentation
h. Truncal obesity with thin extremities
i. Increased glucose levels (high sugar)
j. Impaired healing

A

Cushing’s

Moon

42
Q

The adrenal medulla produces __________ and _____________ (catecholamines).
a. These catecholamines regulate blood pressure by effecting vascular smooth muscle and the heart

A

epinephrine & norepinephrine

Pathophysiology (11 decks)

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