Midterm 3 Endocrine Flashcards

1
Q

What is Addison’s disease

A

Usually caused by adrenal destruction (adrenocortical hypo function)
Results from deficient aldosterone and cortisol

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2
Q

Symptoms of Addison’s disease

A

↓ Aldosterone: fluid & electrolyte imbalances, ↑ Na excretion, Dehydration, ↓ BP, ↓ CO, Weakened CV activity, Circulatory collapse, Shock, Arrhythmias & possible cardiac arrest (K retention)
↓ Cortisol: ↓ gluconeogenesis, Hypoglycemia, Deficient glycogen in liver, Weakness, Exhaustion, Low BP,freq syncope fainting, Anorexia, Wt. loss, Nausea/vomiting, Low mood/depression, Fatigue, Susceptible to infections, Cannot tolerate stress, Hyper-pigmentation of mucous membranes & skin – ‘tanned’ appearance, ACTH cannot stim the secretion of corticosteroids (used for dx)

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3
Q

What is conn’s disease

A

Hyperaldosteronism (hypersecretion of mineralocorticoids (aldosterone))

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4
Q

Conn’s disease risk factors

A

Adenoma and hyperplasia of the zona glomerulosa

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5
Q

Conn’s disease pathology

A

aldosterone ↑, the reabsorption of sodium (water follows) and excretion of potassium

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6
Q

Conn’s disease symptoms

A
  • hypertension (hypernatremic hypokalemic hypertension)
  • hypernatremia
  • hypopotassemia or hypokalemia (low level of potassium)
  • feeling tired
  • H.A.
  • mm weakness
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7
Q

What is Hashimoto’s thyroiditis

A

Autoimmune disease. most common type of hypothyroidism. 10x more common in women (middle aged) than men. Temporary thyroid hyperfunctioning

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8
Q

Hashimoto’s thyroiditis pathology

A

Thyroid gland is attacked by various autoantibodies

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9
Q

Hashimoto’s thyroiditis symptoms

A

underactive thyroid (i.e. hypothyroidism sx); goiter (due to constant stimulation of the thyroid to release more hormones)

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10
Q

What is cretinism

A

Retarded mental development
A condition characterized by physical deformity & learning disabilities that is caused by congenital thyroid deficiency.

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11
Q

Cushing disease

A

Hypersecretion of ACTH from pituitary adenomas (70%)
Most common adrenal cortex disease
Pituitary HYPERfunction

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12
Q

Cushing syndrome

A

Hypercortisolism (ie. Too much of the hormone cortisol in the body) of any cause
HYPERcortisolism – hypersecretion of glucocorticoids (Cortisol).
Most common adrenal cortex disease
Hypersecretion of ACTH from pituitary adenomas

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13
Q

Cushing disease/syndrome symptoms

A
  • central obesity - face, trunk (moon face, buffalo hump)
  • red face
  • thinning hair
  • extremities with mm wasting
  • fatigue, weakness
  • glucose intolerance/diabetes
  • purple striations on the skin of the abdomen, thighs, breasts
  • mentally unstable
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14
Q

Graves’ disease

A

Autoimmune disorder (thyroid components become autoantigenic)
10x more in women than men.

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15
Q

Grave’s disease pathology

A

Antibodies to TSH receptors on the surface of follicular cells -> stimulate the production of thyroid hormone. Thyroid growth stimulating immunoglobulins -> proliferation of thyroid follicular cells

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16
Q

Grave’s disease symptoms

A
  • diffusely enlarged thyroid
  • exophthalmos (i.e. bulging eyes)
  • restlessness, nervousness, emotional lability, anxiety
  • sweating, tachycardia, cardiac palpation
  • weight loss with increased appetite
  • muscular tremor, diarrhea
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17
Q

What are causes for gigantism and acromegaly?

A

Pituitary hyperfunction: somatotropic adenomas (large, benign tumors (i.e.macroadenomas >10mm)).

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18
Q

What’s the difference between gigantism and acromegaly?

A

Gigantism is prepuberty, longitudinal skeletal growth; 7-9ft tall.
Acromegaly is in adults, enlargement of extremities, tongue, jaws, and nose. enlarged internal organs (e.g cardiomegaly). Metabolic disturbances (e.g. hyperglycemia, hypercalcemia)

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19
Q

Hypothyroidism

A

Functional failure of the thyroid gland & its inability to meet the body’s demands for thyroid hormones (T3 and T4)

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20
Q

Hypothyroidism symptoms

A

Children: ↓ growth and development of CNS
Thyroid dwarfism - stunted child growth
Cretinism - retarded mental development
Adults: Myxedema - skin appears puffy and dough-like sleepy, gets tired easily lack of endurance
constipation
bradycardia
weak, stiff and achy mm
lowered body temperature
slowing the function of all organs

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21
Q

Hyperthyroidism

A

excess of thyroid hormones (T3 and T4) in the blood -> hypermetabolic state.

22
Q

Hyperthyroidism symptoms

A

AI – Grave’s Disease
Idiopathic nodular hyperplasia – Toxic Goiter
Tumor – Thyroid Adenoma
Rare: Temporary thyroid hyperfunctioning – Hashimoto’s Disease, Uncontrolled intake of thyroid hormone pills – self-tx of obesity

23
Q

Hyperparathyroidism

A

↑ levels of PTH circulating in the blood

24
Q

Primary hyperparathyroidism

A

Tumor, hyperplasia

25
Q

Secondary hyperparathyroidism

A

chronic renal failure (or any conditions with chronic hypocalcemia), hypovitaminosis D, hereditary

26
Q

Most common causes of hyperparathyroidism

A

benign parathyroid adenoma, hyperplasia of parathyroid gland, parathyroid carcinoma

27
Q

Hyperparathyroidism pathology

A

excess PTH in circulation that acts primarily on bones and kidneys
- bones: stimulates osteoclasts -> release calcium
- kidneys: promotes resorption of calcium -> reducing excretion of calcium in urine
- intestines: promotes the formation of active vit D3 -> facilitating the uptake of calcium from food
in the intestine

28
Q

Hyperparathyroidism symptoms

A

“moans, groans, stones, and bones with psychic overtones”
Decalcification of bones -> fractures (osteopenia/osteoporosis)
Nephrocalcinosis (deposition of calcium salts in the kidney) & urolithiasis (formation of urinary stones)
Conduction defects in the heart
Mm weakness; lethargic
Abdominal pain; polyuria
Depression, irritability

29
Q

Diabetes mellitus

A

The body’s inability to produce or respond to the hormone insulin is impaired, resulting in abnormal metabolism of carbs, prots, fats and elevated levels of glucose in the blood and urine

30
Q

Diabetes mellitus type 1

A

1: 5 – 10% of pt.
- Insulin dependent, juvenile onset
- Absolute deficiency of insulin production & secretion
- Can develop from viral infections

31
Q

Diabetes mellitus type 1 symptoms

A
  • Polydipsia/polyuria/glycosuria
  • Polyphagia, weight loss
  • Ketonuria
  • Weakness, fatigue, dizziness
32
Q

Diabetes type 2

A

90 – 95% of pt.

  • Non-insulin dependent, adult onset - Cellular resistance to insulin
  • Can develop from obesity
  • Is reversible
33
Q

Diabetes type 2 symptoms

A
  • Polydipsia/polyuria/glycosuria - Polyphagia
  • Recurrent blurred vision
  • Weakness, fatigue, dizziness
34
Q

Diabetes insipidus

A

Posterior pituitary -> lack of antidiuretic hormone (ADH) or vasopressin

35
Q

Diabetes insipidus risk factors

A

destructive lesions of the hypothalamus or pituitary stalk. Tumors of the posterior pituitary

36
Q

Diabetes insipidus pathology

A

kidney tubules fail to reabsorb water -> increased excretion of urine

37
Q

Diabetes insipidus symptoms

A

polydipsia (extreme thirst), polyuria (body makes more pee than normal, no glucose in the urine), nocturia (waking up at night to pee);dehydration (poor turgor, dry membranes, fatigue, weakness, dizziness, constipation, ↓ BP)

38
Q

What do diabetes mellitus and insipidus have in common

A

Diabetes Insipidus – Not related to diabetes, but does share some of the same signs and symptoms o 2 main symptoms of diabetes insipidus are: Extreme thirst (polydipsia), Excessive urination, even at night (polyuria)

39
Q

What does “iatrogenic etiology” mean?

A

Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence

40
Q

Which endocrine pathology has an iatrogenic etiology?

A

exogenous cushings, hypoparathyroidism

41
Q

Myxedema

A

Severely advanced hypothyroidism

42
Q

Goiter

A

Enlarged thyroid

43
Q

Cretinism

A

Developmental disability

44
Q

Pheochromocytoma

A

Most common tumor involving adrenal medulla

45
Q

pheochromocytoma pathology

A

benign, solitary tumor. Vascular tumor of chromaffin cells in the adrenal medulla. ↑ production of norepinephrine & epinephrine

46
Q

pheochromocytoma symptoms

A

common manifestation: attacks of paroxysmal hypertension also: tachycardia, diaphoresis, postural hypotension, tachypnea

47
Q

What overall hormones are produced by the hypothalamus?

A

Corticotropin-releasing hormone (CRH)
Growth hormone-releasing hormone (GHRH) aka somatocrinin Growth hormone-inhibiting hormone (GHIH) aka somatostatin Thyrotropin-releasing hormone (TRH)
Gonadotropin-releasing hormone (GnRH)
Prolactin releasing hormone (PRH)
Prolactin inhibiting hormone (PIH) aka dopamine

48
Q

Two hormones are made in the hypothalamus and stored in the posterior pituitary gland; which ones?

A

Oxytocin
Antidiuretic hormone (ADH)

49
Q

Oxytocin

A

stimulates the contraction of the gravid uterus (i.e. role in the childbirth process)

50
Q

Antidiuretic hormone (ADH)

A

promotes the reabsorption of water from the renal tubules