II EXAM 1 Flashcards
A common way to see the cellular structure of a thyroid nodule is with:
Fine needle aspirate
The first test performed to assess thyroid function.
TSH
If the TSH is decreased and T4/FT4 is increased it would indicate what?
Hyperthyroidism
Positive thyroid peroxidase antibody and increased TSH could indicate what disease state?
Hashimoto’s thyroiditis
This is the major carrier of thyroid hormones.
TBG
Where is the adrenal gland located?
Top of kidney
What area of the adrenal cortex is responsible for androgens and sex hormones?
Zona reticularis
Produces steroid hormones
Outer portion
3 layers
Adrenal Cortex
Produces amine hormones
Inner portion
Adrenal Medulla
area of adrenal cortex secretes mineralocorticoids
Major hormone– aldosterone
Zona glomerulosa
area of adrenal cortex secretes glucocorticoids and cortisol?
Zona fasciculata
Steroid hormone that regulate salt balance
Mineralocorticoids
Steroid hormone that assist with carbohydrate metabolism
Glucocorticoids
What is the originating tissue of cortisol?
Adrenal cortex
Mineralocorticoid produced in the G- zone
Controls the amount of fluid in the body
increase salt and water conservation
Aldosterone
Hyperaldosteronism
Aldosterone-secreting adrenal adenoma—Conn syndrome
Adrenal disease
Hyperaldosteronism
Excess production of renin
Malignant hypertension
Renin-secreting renal tumor
Renin-angiotensin system disorder
atrophy of adrenal glands with depressed production of aldosterone and the glucocorticoids
decrease cortisol and increase ACTH and CRH
Hypoaldosteronism
Addison/s disease
Pigmentation of the skin
Muscle weakness
Weight loss
Decreased BP
Nausea
diarrhea
Hypoadrenalism
Released from the adrenal cortex, raises blood glucose levels, and raises blood pressure, but can also cause immunosuppression. It is a long-lived and slow-response hormone.
cortisol
Results from cortisol excess regardless of cause
Primary hypercortisolism
Cushing syndrome
results from pituitary ACTH excess, which stimulates excess cortisol production
Excessive production of ACTH due to pituitary tumor
Secondary hypercortisolism
Cushing disease
Converts glycogen to glucose—allows voluntary muscles to have greater work output
Released from the adrenal medulla to help sympathetic fight/flight responses. It is
a short-lived and fast-response hormone.
Epinephrine
Neurotransmitter affecting vascular smooth muscle and heart
Released primarily by the postganglionic sympathetic nerve
Norepinephrine
Neurotransmitter in the brain affecting the vascular system
Dopamine
Tumor of the adrenal medulla, usually benign
Increased levels of epinephrine and norepinephrine
Pheochromocytoma
Malignant tumor of the adrenal medulla that occurs in children
Produces epinephrine and norepinephrine along with dopamine
Neuroblastoma
an adrenal mass > 1 cm, which is discovered on imaging performed to evaluate a nonadrenal pathology.
Adrenal Incidentaloma
What three glands secrete testosterone?
Testes, ovaries, and adrenal glands
What hormone stimulates production of testosterone?
LH
What hormone is secreted by the placenta to maintain the uterus?
Progesterone
caused by an enzyme defect of 21-hydroxylase
Prevents cortisol production
CAH
Secreted by ovarian follicles and by the placenta(during pregnancy)
estrogen
ovarian tumor, hypothalamic tumor, adrenal tumors (rare); may be difficult to determine
Precocious puberty
polycystic ovaries, estrogen-producing ovarian tumors, disorders of the hypothalamus or pituitary
Infertility and irregular menses:
cervical or endometrial carcinoma, estrogen-producing ovarian tumors, exogenous estrogen consumption
Postmenopausal bleeding
Prevents menstrual cycle from occuring
Hyperprogesteronemia
What disorder is often associated with infertility and hirsutism?
Polycystic ovarian syndrome
This is a genetic defect in females that has a partial or complete loss of one of the X chromosomes.
turner syndrome
Are conjugated proteins bound to carbohydrates
Solubility and half life similar to protein hormones
Glycoprotein
What tissue does TRH act on?
Pituitary
What is the originating tissue of ACTH?
Anterior pituitary gland
Two predominant organs for eliminating hormones
Kidney and liver
hormone eliminated by inactivating metabolic pathways and excretion in urine or bile
steroid hormone
hormones inactivated by intracellular deiodinases
thyroid
substances rapidly degraded within the blood circulation
Catecholamines
which arises from the diencephalon, is responsible for the storage and release of oxytocin and arginine vasopressin (AVP
Posterior pituitary
prolactin secreting cells
Lactotrophs
growth hormone (GH) secreting cells
Somatotrophs
thyroid stimulating hormone (TSH) secreting cells
Thyrotrophs
adrenocorticotropin hormone (ACTH) secreting cells
Corticotrophs
luteinizing hormone (LH) and follicle stimulating hormone (FSH) secreting cells
Gonadotrophs
pituitary hormones that their actions are specific for another endocrine gland
tropic
pituitary hormones act directly on peripheral tissue.
direct effectors
What test is preferred for assessing growth hormone?
IGF-1
Structurally related to GH and human placental lactogen.
Considered a stress hormone, it has vital functions in relationship to reproduction.
Dopamine is the only neuroendocrine signal that inhibits them
prolactin
Usually seen in women who have been pregnant several times and has no pathological implication.
Lactation occurring in women with normal prolactin levels is defined
Idiopathic Galactorrhea
Complete loss of function of hypopituitarism is called:
Panhypopituitarism
consequence of vasopressin deficiency or resistance
Diabetes insipidus
In a pregnancy with Down’s syndrome, the hCG levels are how much higher typically?
2x
False negatives can be seen in immunoassays methodologies due to what?
hook effect
What hormone can be decreased during pregnancy due to structural similarities to hCG?
TSH
Pregnancy causes changes in respiration with a ___ in pO2 and ____ in pCO2.
pO2 increase
pCO2 decrease
cluster of 50-60 cells with a cavity to form the yolk sac—goal of implantation into uterine wall, approx. 5 days past fertilization
Blastocyst
create organs by embryo, takes 10 weeks
Organogenesis
what system activate during pregnancy—underfilling of arteries and release of relaxin
Hypothalamus releases AVP/ADH from posterior pituitary
Renin-Angiotensin-Aldosterone System
what hormone responsible for increase in plasma volume
Aldosterone secreted by adrenal glands to retain Na
Normal to have a mild, fully compensated respiratory alkalosis during pregnancy
true
Trig nad LHL level inc/decre during pregnancy
increase
hCG double very 24h until_____week of pregnancy and decrease at__________week and until______week then stable
8
10
16
what can cause false positive for pregnancy point of care test
Medications: aspirin, carbamazepine, methadone
Sitting too long, untrained eye
Produced by embryonic yolk sac first , then parenchymal cells in the fetal liver
Rise at end of first trimester and then fall after 32 weeks during preg
α-Fetoprotein (AFP)
When MS-AFP higher than expected and ultrasounds don’t provide an answer what test to use
amniotic fluid testing
MoM for open spina bifida
7
MoM for anencephaly is
20
Fluids available for amniotic fluid testing
serum, urine, amniotic fluid
Triple screen test includes
Quad includes
AFP, hCG, uE3
Quad has inhibin A
Cholinergic enzyme found in neuromuscular junctions in the muscle and nerves, preg
Acetylcholinesterase
Large glycoprotein produced in the placenta
Valuable 1st trimester screening test
PAPP-A
Extra copy of the long arm region q22.1 to q22.3 of chromosome 21 results in mental deficiency, hypotonia, congenital heart defects, and a flat facial profile.
down syndrome
Occurs when the fetus receives an extra copy of chromosome 18
trisomy 18 (edward)
2 layers of thyroid gland
Follicular and Parafollicular
thyroid cells secrete calcitonin—involved in calcium regulation
Parafollicular
chronic lymphocytic thyroiditis
Hashimoto’s thyroiditis
a drug used to treat cardiac arrhythmias, is a fat-soluble drug with a long half-life (50 days) that interferes with normal thyroid function
amiodarone
