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Pathophysiology - MW > Immune system, Renal system, Hematologic System, Endocrine System > Flashcards

Immune system, Renal system, Hematologic System, Endocrine System Flashcards

Up to cut off of Quiz 2

1
Q

Immunity definition

A

process by which body recognizes foreign substances and neutralizes them to prevent damage

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2
Q

Immunology

A

study of structure and function of immune system

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3
Q

Antigens

A

any foreign substance that does not have the characteristic cell surface markers of an individual and is capable of eliciting an immune response
- antigens are recognized by specific receptors present on them by lymphocytes/antibodies

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4
Q

Antibody

A

produced in response to an antigen, are protein molecules structured in such a way that they only interact with the antigen that induce their synthesis

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5
Q

what are the 2 types of immunity

A
  • innate immunity (natural/native)
  • acquired/adaptive immunity
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6
Q

innate immunity (natural/native)

A
  • first responders to insult
  • response is rapid and same at all times
  • Nonspecific: does not distinguish between different types of invaders (bacteria, virus)
  • Nonadaptive: does not remember the previous encounter
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7
Q

acquired/adaptive immunity

A
  • body knows what to do but also thinks slowly
  • slower response: when reintroduced then rapid and intense immune response
  • Diversity, specificity, memory, self and non-self recognition
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8
Q

Diversity define

A

recognize and destroy foreign material like bacteria, fungi

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9
Q

Specificity define

A

targeted response to a distinct antigen

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10
Q

Memory define

A

when same organism enters again, body respond’s more rapidly to it and with a stronger reaction

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11
Q

Neutrophils are ______ to respond

A

fast to respond

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12
Q

Dendritic cells do what

A

take bacteria with them and take to adaptive immunity

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13
Q

Cytotoxic T cell (CD8) is what to an antigen

A

toxic

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14
Q

Helper T cells (CD4) help with what

A

help B cells make antibodies

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15
Q

Active acquired immunity is…

A
  • development of antibodies in response to an antigen
  • introduction of antigen by either naturally from environmental exposure or artificially by vaccination
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16
Q

passive acquired immunity

A
  • when antibodies produced by one person are transferred to another person either naturally (mother to fetus) or inoculation of antibody
  • breast milk
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17
Q

two types of cells in Adaptive/Acquired Immunity

A
  • humoral-B cells
  • cell mediated-T cells
  • response from these two types of immunity overlap and interact considerably
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18
Q

how do T and B cells migrate throughout the body

A

through blood, lymph, and lymph nodes
- circulate throughout body to find antigen

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19
Q

humoral

A

involving antibodies/immunoglobulins

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20
Q

B lymphocytes originate and mature in

A

bone marrow
- free floating in the body

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21
Q

B lymphocyte-plasma cell can produce 5 types of antibodies; what are they

A

IgG, IgM, IgA, IgD, IgE

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22
Q

Cell mediated immunity from T cell can …

A

NOT be transferred passively to another person

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23
Q

T lymphocytes originate in _______ and mature in _______

A
  1. bone marrow
  2. Thymus
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24
Q

T cells job

A

recognize the hidden organisms, search them out and destroy on a cell-to-cell basis

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25
Q

helper T cells do what

A

assist B cells to mature and produce antibodies
-activating macrophages and helping them destroy large bacteria
- helping other T lymphocytes recognize and destroy virally infected cells
- HIV destroys these helper T cells and leaves the body at risk of infections

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26
Q

suppressor T cells

A

suppresses the activation of immune system
- may be overactive (keeps body in check)
- stops autoimmune

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27
Q

Factors altering the immune system

A
  • aging
  • nutrition
  • burns
  • sleep disturbances
  • concurrent illness and disease
  • drugs
  • surgery anesthesia
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28
Q

how does nutrition alter immune system

A
  • deficits in cal, protein intake or vitamins like A and E can cause deficiency in T cell function and numbers
  • zinc deficiency impairs T and B cell function
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29
Q

how do burns alter immune system

A

decrease external defense, decrease neutrophil function, decrease cell mediated and humoral responses

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30
Q

what does surgery/anesthesia do to immune system

A

suppresses T and B cell function up to 1 month post op

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31
Q

moderate intensity exercise does what to immune system?

A

enhances (50-70% of max heart rate)

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32
Q

strenuous/intense/long duration exercise ____ immune system

A

impairs

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33
Q

amount of exercise for adults

A

30 minutes a day 3-5 days/week

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34
Q

if sick/cancer what type of exercise should they do

A

moderate intensity exercise

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35
Q

Neutrophils with Exercise immunology

A
  • Exercise: rise in blood levels of neutrophils
  • after brief gentle exercise - count returns to baseline
  • after strenuous exercise - return to normal may take 6-24 hrs
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36
Q

NK cells with exercise immunology

A
  • once the person is accustomed to a given exercise level, the NK enhancement falls off
  • after intense exercise, # and activity of NK cells decline, maximum reduction occurs 2-4 hours after the exercise, return to baseline soon
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37
Q

lymphocytes with exercise immunology

A

Increase but decrease below normal for several hours after intense exercise

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38
Q

immunodeficiency disorders

A

immune response is absent/depressed

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39
Q

immune system disorders: primary

A

defect involving the cells
- GENETIC

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40
Q

immune system disorders: secondary

A

results from an underlying disease/factor
- malnutrition/alcoholism, ageing, autoimmune, MS, MG, RA, Addison’s, IBD, cancer, steroids, chemo, radiation, leukemia, lymphomas
- HIV/AIDS
- MUST follow guidelines with this

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41
Q

AIDS

A
  • infection of immune system
  • human immunodeficiency virus (HIV)
  • infects CD4 helper T lymphocytes, dendritic cells, and macrophages
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42
Q

resultant immunodeficiency

A

opportunistic infections including unusual cancers, tuberculosis

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43
Q

Pathophysiology of AIDS

A
  • transmitted through blood-blood contact, sexual contact, perinatally
  • infection can occur across mucosal surfaces including vagina, cervix, and anus
  • unprotected anal/oral/vaginal sex
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44
Q

risk factors of AIDS

A

poverty, illegal drug use, not good access to health care system

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45
Q

HIV is what type of virus

A

retrovirus (genetic material in RNA)

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46
Q

transcription is

A

DNA to mRNA

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47
Q

translation is

A

mRNA to protein

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48
Q

HIV has a ______ mutation rate even within a single individual, to fight for survival

A

high

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49
Q

pathogenesis process

A
  1. binding
  2. fusion
  3. reverse transcription
  4. integrated
  5. transcription
  6. translation
  7. assembly
  8. budding and release
  9. HIV replication
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50
Q

binding in pathogenesis is

A

binding of virus to CD4+ cells after it enters the blood stream

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51
Q

fusion in pathogenesis is

A

fusion and contents of the viral core enter host cells

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52
Q

reverse transcription is what

A

when the genetic information of the virus from viral RNA to double stranded DNA, reverse transciptase

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53
Q

integrated with pathogenesis is

A

integrated into host DNA and replicated many times

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54
Q

transcription is what

A

double stranded DNA to single stranded RNA

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55
Q

assembly is what with pathogenesis

A

new HIV proteins and RNA assemble and move to the surface of the cells

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56
Q

HIV replication is what in pathogenesis

A

killing of CD4+ cells release of HIV copies into the bloodstream- viral particles invade other CD4+ cells- infection progresses

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57
Q

True or False: all people with HIV have AIDS

A

false

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58
Q

asymptomatic HIV seropositive characteristics

A

positive for HIV antibodies; CD4 count >500 cells/mm3)
no symptoms
positive for antibodies
can be asymptomatic for 1-20 yrs
- clinically healthy, normal ADLs, unrestricted level and duration of exercise

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59
Q

symptomatic HIV characteristics

A

CD4 count between 200-500 cells/mm3
has symptoms
left untreated - eventually progress to advanced HIV disease

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60
Q

HIV advanced disease (AIDS) characteristics

A

<200 cells/mm3
- Neurologic involvement
- opportunistic infections

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61
Q

HIV encephalopathy is

A

gait disturbances, intension tremors

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62
Q

HIV associated dementia

A

apathy, lethargy, social withdrawal, depression, memory impairment

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63
Q

Peripheral neuropathies

A

pain, sensory loss, motor deficits, gait disturbances

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64
Q

P. carinii pneumonia

A

fungal infection of lungs, risk for pneumonia, cough, shortness of breath, fever

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65
Q

malignancies

A

Kaposi sarcoma, lymphoma

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66
Q

dermatologic conditions of AIDS

A

hair loss, rash, delayed wound healing, bacterial, viral infection, fungal infections, dry flaking skin, thinning of skin/hair, kaposi sarcoma

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67
Q

neuro-musculoskeletal diseases are

A

osteomyelitis, myositis, arthritis, myopathy

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68
Q

Treatment of HIV

A

no cure, current medications decrease the amount of virus in the body
- HAART: highly active antiretroviral therapy - recommended
- according to the symptoms use NSAIDS

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69
Q

HIV and Rehabilitative Therapy

A
  • HIV is considered a chronic illness rather than terminal illness
  • neuro: stroke, peripheral neuropathy, gait, balance training
  • musculoskeletal: soft tissue/joint mobilization, stretching/strengthening (bands/weights), posture
  • cardiopulmonary
    -integumentary
  • exercises at all stages
  • early stage HIV
  • advanced stage/chronic HIV
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70
Q

hypersensitivity disorders are

A

abnormal and excessive response of the activated immune system that causes injury and damage to the tissues
- hypersensitivity reactions/allergy
- allergens
mild>severe>life threatening

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71
Q

what are the 4 types of hypersensitivity disorders

A

type 1: IgE mediated; most common; immediate
type 2: IgG, IgM mediated
type 3: IgG, IgM mediated; complement-mediated
type 4: T cell mediated

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72
Q

autoimmune disorders type 2…

A
  • Addison’s disease
  • Crohn’s disease
  • type 1 diabetes mellitus
  • polymyositis/dermatomyositis
  • thyroiditis
  • ulcerative colitis
  • MS
  • MG
  • RA
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73
Q

Systemic Lupus Erythematosus (SLE)

A

type 3 systemic reaction, autoimmune disease
- antigen antibody complex deposition and inflammation
common in women
- chronic system disease
- wherever they go is where the rash is
- commonly: skin, kidneys, MSK

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74
Q

treatment of Lupus is

A
  • anti-inflammatory: NSAIDS
  • immunosuppressive: corticosteroids
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75
Q

why immunocompromised patients are at great risk for cancer?

A

less weapons to fight the war

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76
Q

people can suffer from the same illness as a cold, many times. what is a possible explanation for this?

A

don’t have antibodies, different strains, immunocompromised

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77
Q

Why is there less chance of rejection when a transplant occurs between identical twins? is the chance of rejection the same if the twins are fraternal (not identical)?

A
  • genetically the same with identical twins, so that means less chance of rejection
  • different for fraternal twins
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78
Q

what is a part of the urinary system

A
  • two kidneys
  • two ureters
  • urinary bladder
  • urethra
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79
Q

what is the function of kidneys

A
  • filter the blood and produce urine
  • regulation of plasma ionic composition
  • regulation of plasma volume
  • regulation of plasma osmolarity
  • regulation of plasma hydrogen ion concentration (pH)
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80
Q

what are the secondary functions of the kidneys

A
  • secrete erythropoietin
  • secrete renin
  • activate vitamin D3
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81
Q

erythropoietin function

A

stimulates erythrocytes production by bone marrow

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82
Q

renin function

A

necessary for production of angiotensin 2, a hormone which regulates salt and water balance - control of blood pressure

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83
Q

what does vitamin D3 do?

A

regulates calcium and phosphate levels

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84
Q

parts of the kidney

A
  • cortex (outer)
  • medulla (inner or pyramids)
  • papilla (innermost tip of inner medulla)
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85
Q

kidneys have how many nephrons

A

1 Million +

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86
Q

what forms urine?

A

nephrons

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87
Q

anatomy of nephron

A
  • functional unit of kidney
  • consist of renal corpuscles and renal tubule
  • renal corpuscles
  • renal tubule
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88
Q

what are the two classes of nephrons

A

superficial/cortical nephron
Juxtamedullary nephron

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89
Q

glomerular filtration is

A

first step in the formation of urine

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90
Q

fluid that is filtered in nephron is

A

filtrate/glomerular filtrate/ultrafiltrate

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91
Q

ultrafiltrate contains what

A

water and all of the small solutes of the blood

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92
Q

oncotic pressure is

A

pressure due to presence of proteins in the blood

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93
Q

how much plasma flows through kidneys each minute

A

~625 mL

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94
Q

normal Glomerular Filtration Rate (GFR) ranges from ______ in young adults

A

120-130 ml/min/1.73 m2
- declines with age

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95
Q

Stage 1 of Chronic kidney disease

A

90+ GFR
90-100% function
kidney damage with normal kidney function

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96
Q

Stage 2 of Chronic kidney disease

A

89 to 60 GFR
89-60% function
kidney damage with mild loss of kidney function

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97
Q

Stage 3a of Chronic kidney disease

A

59 to 45 GFR and % function
mild to moderate loss of kidney function

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98
Q

Stage 3b of Chronic kidney disease

A

44 to 30 GFR and % function
moderate to severe loss of kidney function

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99
Q

Stage 4 of Chronic kidney disease

A

29 to 15 GFR and % function
severe loss of kidney function

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100
Q

Stage 5 of Chronic kidney disease

A

less than 15 GFR and % function
kidney failure

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101
Q

Flitration process

A
  • across glomerular capillaries into Bowman’s space
  • the bulk flow of protein-free plasma from the glomerular capillaries into the Bowman’s capsule
    -filtered load
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102
Q

reabsorption process

A
  • water and many solutes (sodium, chloride, bicarbonate, lactate, citrate) are reabsorbed from the glomerular filtrate into the peritubular capillary
  • transporters in the membrane of epithelial cells
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103
Q

Secretion process

A
  • few substances like organic acids, bases, potassium are secreted from pertubular capillary blood to tubular fluid. mechanism of excreting substances in the urine involves transporters in the membrane of epithelial cells lining the nephron
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104
Q

excretion process

A

is the net result or sum of processes of filtration, reabsorption and secretion
- excretion: (filtration - reabsorption) + secretion

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105
Q

Normal values for routine urinalysis

A

Color: yellow amber
appearance: clear to slightly hazy
Volume: 600-2500ml/24hr
Glucose: negative
ketones: negative
Protein: negative
RBC: negative
WBC: negative

106
Q

Renal Function Tests

A

GFR
Serum creatinine (creatinine levels in the blood)
blood urea nitrogen (normal: 7-20 mg/dl)
ultrasonography
radiologic examination (CT, MRI, Xray films)

107
Q

proteinuria

A

protein in urine

108
Q

glucosuria

A

glucose in urine

109
Q

ketonuria

A

ketones in urine

110
Q

hematuria

A

red blood cells in urine

111
Q

pyuria

A

WBC in urine

112
Q

bacteruria

A

bacteria in urine

113
Q

cystic kidney disease

A

fluid filled sacs or segments that have their origin in the tubular structures of the kidney
- single/multiple; cysts of varying size- replace functional tissue- progressive nature- loss of renal function- renal failure
- inherited or acquired
- autosomal dominant (most common)

114
Q

Autosomal dominant polycystic kidney disease (ADPKD)

A

account for 10% of the cases of end stage renal disease (ESRD)
4th leading cause of ESRD
- progression is slow
- kidneys enlarged and contours of the kidney distorted

115
Q

manifestations of ADPKD include

A
  • pain from enlarged cysts, lumbar pain, flank pain, infected cysts from UTIs, swollen tender abdomen
  • hemturia
  • enlarged kidneys
  • hypertension from compression of intra-renal blood vessels with activation of renin-angiotensin mechanism
  • headaches, nausea, anorexia
  • continued disease is extra-renal manifestations
116
Q

what mutation causes ARPKD

A

PKHD1 gene

117
Q

glomerular disease

A

group of conditions that damage kidney filtering units (glomeruli)
includes: glomerulonephritis (inflammation) and glomerulonephritis (scarring)

118
Q

glomerulonephritis

A

group of disease that affect both kidneys, inflammation of glomeruli
- men more than women
- acute/chronic
- forms: nephritic syndrome and nephrotic syndrome

119
Q

common causes of Chronic Kidney disease

A
  • diabetes mellitus
  • hypertension
  • glomerulonephritis
  • cystic kidney disease
  • urine obstructions
120
Q

in stage 1 of chronic kidney disease

A
  • no overt symptoms
  • unaffected nephrons undergo structural and physiologic hypertrophy to make up for the lost ones
  • early manifestations include hypertension and anemia
  • increase in BUN and creatinine
121
Q

in stage 2 of chronic kidney disease

A
  • small amount of albumin is excreted in the urine
  • with proper control of hypertension and blood glucose levels- might not progress
122
Q

in stage 3 of chronic kidney disease

A
  • albumin levels increase in urine and decrease in blood - edema
  • levels of BUN and creatinine increase, accumulation of waste products in the blood called azotemia
123
Q

in stage 4 and 5 of chronic kidney disease

A
  • complication appear
  • proteinuria
  • progressive increase of BUN and creatinine levels, patients are hypertensive
124
Q

Stage 5 of chronic kidney disease

A
  • kidneys cannot excrete toxins, maintain pH, fluid electrolyte function, secrete important hormones (renin, vit D, erythropoietin)
  • uremia (toxins not removed from blood): no treatment would lead to coma/death
125
Q

clinical manifestations of CKD

A

tired, weak, pale skin color due to anemia and toxins
itching, dryness, decreased sweating
metallic taste in mouth, fishy breathe
cardiopulmonary: hypertension
platelet dysfunction
anorexia, nausea, vomiting, ulcerations
electrolyte imbalances
pleuritis, pleural effusion, pulmonary edema
recurrent infections

126
Q

peritoneal dialysis

A

can be done at home
- continuous ambulatory peritoneal dialysis
- continuous cycle assisted peritoneal dialysis

127
Q

blood composition

A
  • plasma (55%)
  • RBC: 4.8-5.4 billion/ul
  • platelets: 150000-400000/ul
  • WBCs: 5000-10000/ul
128
Q

neutrophils do what

A

acute inflammation
- kills bacteria
- first ones there
* majority

129
Q

lymphocytes are what

A

T & B cells

130
Q

monocytes

A

baby macrophages

131
Q

eosinophils

A

allergic response

132
Q

plasma function

A
  • transport vehicles for nutrients, chemical messengers, metabolites
  • maintain electrolytes and acid/base balance
133
Q

plasma proteins

A
  • albumin
  • globulins
  • fibrinogen
134
Q

albumin

A
  • most common
  • pulls water back into blood
  • maintains plasma oncotic pressure and maintain blood volume
    0 serves as a carrier
    ^ in water = decrease in pressure
135
Q

globulins

A
  • alpha - transports bilirubin = liver
  • beta - transports iron
  • gamma - antibodies of immune system
136
Q

fibrinogen

A

helps form fibrin for blood clotting
- blood clot with platelets

137
Q

is plasma anticoagulated or clotted

A

anticoagulated

138
Q

plasma is what

A

liquid, cell-free part of blood, that has been treated with anti-coagulants

139
Q

anticoagulated is what?

A

make clotting factors not work

140
Q

is serum anticoagulated or clotted

141
Q

what is serum

A

liquid part of blood AFTER coagulation, therfore devoid of clotting factors as fibrinogen

142
Q

RBCs are…

A

most common type of blood cell, nonnucleated biconcave disk

143
Q

each molecule of hemoglobin carries ____ molecule of oxygen

A

4 molecules

144
Q

production of red blood cells is called as _______

A

erythropoiesis

145
Q

hematocrit is what

A

volume of cells in 100 ml of blood
- height of erythrocyte column/height of whole blood column x 100

146
Q

high hematocrit =

A

polycythemia

147
Q

hematopoiesis =

A

production of blood cells
- derived from hematopoietic stem cells

148
Q

anemia

A

common acquired/inherited disorder of erythrocytes
- abnormally low number of RBCs or levels of hemoglobin

149
Q

Anemia clinical features

A
  • weakness
  • fatigue
  • dyspnea
  • hypoxia of brain tissue
  • pallor
  • tachycardia and palpitations
  • severe cases: ventricular hypertrophy and heart failure
  • increase respirator rate
  • diffuse bone pain
150
Q
A

iron deficiency anemia

151
Q
A

megaloblastic anemia

152
Q
A

sickle cell disease

153
Q
154
Q

Iron deficiency anemia is

A
  • iron is needed for hemoglobin production and formation of erythrocytes
  • cause: decreased iron consumption, decreased iron absorption, increased bleeding, increased iron demand
155
Q

groups @ risk of iron deficiency anemia

A
  • pregnant women
  • women with heavy menstrual bleeding
  • infants and younger children
  • frequent blood donor
  • people with cancer, GI diseases/surgery- who report of chronic blood loss
  • vegetarian diet
156
Q

clinical features of IDA

A
  • brittle nails in spoon shaped
  • headache
  • delayed healing
  • palpitations
  • decreased appetite
157
Q

IDA diagnosis

A

low hemoglobin and hematocrit
RBCs microcytic and hypochromic
serum ferritin
serum iron

158
Q

IDA treatment

A

treating the cause of iron deficiency
consuming iron rich foods
iron supplements
foods/supplements with high vit C (promotes absorption of iron)

159
Q

what causes megaloblastic anemia

A

B12 deficiency
folic acid deficiency

160
Q

clinical features of Megaloblastic Anemia

A
  • bleeding gums
  • diarrhea
  • anorexia
  • demyelination
  • impaired sense of smell
  • personality/memory changes
  • mild jaundice
161
Q

Hemolytic Anemia is the result of

A

excessive/premature destruction or hemolysis of erythrocytes; an increase in erythropoiesis

162
Q

causes of Hemolytic anemia

A

idiopathic
autoimmunity
infections
genetics
blood transfusion reactions

163
Q

types of hemolytic anemia

A

sickle cell anemia
thalassemia

164
Q

Sickle cell anemia

A

genetic type
crescent or sickle shaped cells
S Hemoglobin
RBCs lifespan is reduced to 16 days

165
Q

what is point mutation

A

when is transitioned from HbA to HbS

166
Q

What is thalassemia?

A

genetic, results in abnormal Hb absence of alpha or beta globin

167
Q

normal range of platelets

A

150,000 - 350,000 cells/ml

168
Q

thrombocytosis is

A

increased platelets

169
Q

thrombocytopenia is

A

decreased platelets levels, increased risk of bleeding and infection

170
Q

what is melena

A

blood in the stool

171
Q

Disorders of WBCs

A
  • Leukocytosis
  • Leukocytopenia
  • neutropenia
  • neutrophilia
  • lymphocytosis
  • lymphocytopenia
  • leukemia
172
Q

leukocytosis

A

increased WBCs

173
Q

leukocytopenia

A

decreased WBCs

174
Q

neutropenia

A

decrease number of circulating neutrophils

175
Q

neutrophilia

A

increase in number of circulating neutrophils

176
Q

lymphocytosis

A

increased lymphocytes

177
Q

lymophocytopenia

A

decreased lymphocytes

178
Q

leukemia

A

cancer of leukocytes

179
Q

what is responsible for homeostasis

A

endocrine system + nervous system

180
Q

dose-response relationship

A

magnitude of response is correlated with hormone concentration

181
Q

down-regulation

A

mechanism in which a hormone decreases the number or affinity of its receptors in a target tissue

182
Q

up-regulation

A

number or affinity of the receptors for the hormone has increased
- increasing the synthesis of new receptors

183
Q

hypothalamus does

A

sleep wake cycles

184
Q

adrenal gland does

A

blood pressure regulation

185
Q

pituitary gland does

A

growth, metabolism, and reproduction

186
Q

thyroid gland does

A

regulates the body’s metabolism

187
Q

parathyroid gland does

A

regulates calcium levels in the blood

188
Q

pancreas does

A

digestion and blood sugar regulation

189
Q

pineal gland does

A

melatonin, sleep cycles

190
Q

thymus gland does

A

T cell maturation

191
Q

negative feedback loop in regulation of hormone secretion

A

when hormone levels are judged to be adequate or high
- self limiting

192
Q

positive feedback loop in regulation of hormone secretion

A

‘rare’ or special circumstance
- breastfeeding
- contractions started = increased hormone

193
Q

hypothalamus releases what hormones

A

TRH, CRH, GnRH, GHRH, somatostatin, dopamine

194
Q

anterior pituitary releases what hormones

A

TSH, FSH, LH, ACTH, MSH, growth hormone, prolactin

195
Q

Posterior pituitary releases what hormones

A

Oxytocin, ADH

196
Q

Thyroid releases what

A

T3,T4, calcitonin

197
Q

parathyroid releases

198
Q

pancreas releases

A

insulin, glucagon

199
Q

adrenal medulla releases

A

norepinephrine, epinephrine

200
Q

adrenal cortex releases

A

cortisol, aldosterone, adrenal androgens

201
Q

testes releases

A

testosterone

202
Q

ovaries release

A

estradiol, progesterone

203
Q

what is the infundibulum

A

where the hypothalamus and pituitary gland are connected

204
Q

somatotropin (growth hormone)

A

stimulates growth synthesis and overall growth

205
Q

what hormones in the pituitary are trophic hormones

A

TSH, FSH, LH, ACTH, ADH, and oxytocin

206
Q

What hormones in the pituitary are non trophic hormones

A

somatotropin (growth hormone) and prolactin

207
Q

which hormones are stimulants from hypothalamus

A

thyrotropin-releasing hormone
corticotrophin-releasing hormone
gonadotrophin-releasing hormone
growth hormone-releasing hormone

208
Q

which hormones are inhibitors released by hypothalamus

A

somatotropin-release inhibiting hormone
dopamine or prolactin-inhibiting hormones

209
Q

primary altered endocrine function

A

dysfunction of the target gland
specific gland

210
Q

secondary altered endocrine function

A

gland not receiving appropriate stimulation
- pituitary gland

211
Q

tertiary altered endocrine function

A

defect in the hypothalamus

212
Q

hypopituitarism

A

decreased secretion of pituitary hormones
- congenital or acquired causes: pituitary surgery/radiation, infections, infarction, hemorrhage, hypothalamic disorder, genetic disease

213
Q

what is the typical sequence of anterior pituitary hypofunction

A

“Go Look For The Adenoma”
-GH
- LH
- FSH
- TSH
- ACTH

214
Q

what therapy is most common for anterior pituitary hypofunction

A

hormone replacement therapy

215
Q

hormones essential for normal growth and maturation

A

GH
insulin
thyroid hormone
androgens: testosterone and dihydrotestosterone

216
Q

GHRH does what

A

increase GH release

217
Q

what does somatostatin do

A

inhibits GH release

218
Q

direct effect of growth-promoting actions of growth hormone are

A

increased linear growth, increased size and function, increased lean muscle

219
Q

anti-insulin effects from growth hormone are

A

decrease in adiposity
increased blood glucose

220
Q

Growth hormone deficiency in children presents as

A

short stature (height less than 3rd percentile); pituitary dwarfism
increased subcutaneous fat in the abdominal area
immature facial features like underdeveloped nasal bridge, delayed dentition
short stature

221
Q

growth hormone excess in children is

A

Gigantism
rare
before puberty and fusion epiphysis of the long bones
high levels of IGF-1 stimulate excessive skeletal growth
complications because of body mass and excessive secretion of other hormones

222
Q

growth hormone excess in ADULTS is known as

A

acromegaly
occurs after the epiphysis of long bones have fused
annual incidence: 3-4 cases/million people
increased blood levels of GH and IGF-1

223
Q

clinical manifestations of Acromegaly

A

bones cannot grow tall, but get thicker, soft tissues continues to grow
enlargement of small bones of hand/feet and bones of face and skull

224
Q

antidiuretic hormone is the …

A

major hormone concerned with regulation of body fluid osmolarity

225
Q

antidiuretic hormone helps with

A

reabsorption

226
Q

factors that stimulate the secretion of ADH by the posterior pituitary:

A

increased plasma osmolarity
hypovolemia

227
Q

diabetes insipidus is

A

inability of body to properly regulate water balance
- excessive thirst (polydipsia) & dilute urine (polyuria)
- excess amount of ADH

228
Q

polyuria is

A

excessive urination

229
Q

polydipsia is

A

excessive thirst and water consumption can lead to polyuria

230
Q

when there is less water in the body, there would be _____ of the other solutes

A

more concentrated

231
Q

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A

excessive release of ADH - water intoxication due to fluid retention

232
Q

hyponatremia is

A

sodium levels in blood is too low

233
Q

severe hyponatremia can result in what

A

lethargy, nausea, weakness, muscle cramps, headache, irritability, seizures, coma

234
Q

plasma osmolarity is only a problem with

A

water NOT sodium (sodium is diluted)

235
Q

what helps diagnosis hyponatremia

A

hyponatremia (serum sodium < 135mEq/L)
plasma osmolality < 280 mOsm/kg
decreased urine output
concentrated urine (dark yellow to amber color

236
Q

what is the treatment of hyponatremia

A

medications (vasopressin receptor)
fluid restrictions
hypertonic IV solution

237
Q

diabetes insipidus, if left untreated, will rapidly develop into:

A

dehydration

238
Q

Adrenal gland location

A

above the kidneys (suprarenal glands)

239
Q

adrenal medulla secretes

A

catecholamines (epinephrine and norepinephrine)

240
Q

adrenal cortex secretes

A

adrenocorticoids

241
Q

types of adrenocorticoids

A

glucocorticoids, mineralocorticoids, androgens

242
Q

glucocorticoids key hormones

243
Q

mineralocorticoids key hormones

A

aldosterone

244
Q

androgens key hormones

A

DHEA, androstenedione

245
Q

Mineralocorticoids does what

A

regulate reabsorption of Na+ and secretion of K+ by kidneys, water balance, blood pressure

246
Q

glucocorticoids does what

A

regulate body’s response to stress, protein, lipid and carbohydrate metabolism, blood glucose levels, immune/inflammatory response

247
Q

adrenal androgens does what

A

regulate reproductive function, and pubic and axillary hair growth

248
Q

all adrenocortical steroids are made up of

A

cholesterol

249
Q

actions of Mineralocorticoids

A

increase sodium reabsorption, potassium excretion, and hydrogen excretion
blood pressure regulation

250
Q

increase in aldosterone =

A

increased BP

251
Q

what does the kidney release?

252
Q

function of glucocorticoids

A

cortisol is essential for life!
- contribute to effective stress response
- stimulates glucose production, decreases tissue glucose utilization
- increases breakdown of proteins
- decrease capillary permeability and inhibit edema formation
- inhibit bone formation

253
Q

in males, adrenal androgens play a ________ role

254
Q

in females, adrenal androgens are a ________ role

255
Q

Adrenal cortical insufficiency primary, secondary, and tertiary levels

A

primary: destruction of adrenal gland
secondary: disorder of pituitary gland
tertiary: hypothalamic defects

256
Q

what is addison’s disease?

A

primary adrenal insufficiency, rare disorder, most serious endocrine disorder, can lead hypotension, shock and death

257
Q

Adrenal Crisis: red flags

A

it is a potentially life-threatening medical emergency that requires management in a hospital or ER
should wear a medical alert ID

258
Q

what is cushing syndrome

A

high levels of cortisol due to different reasons

259
Q

endogenous excess glucocorticoid

A

caused by excessive production of ACTH
- cushing’s

260
Q

exogenous excess glucocorticoid

A

caused by taking glucocorticoid drugs

261
Q

excessive glucocorticoid hormone presents as

A

“moon face”
steroid diabetes

262
Q

lupus is an autoimmune type _____

Pathophysiology - MW (3 decks)

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