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Cassandra's Advanced Pathophysiology > Module 6: Endocrine System > Flashcards

Module 6: Endocrine System Flashcards

1
Q

What is the condition:
Occurs after a woman gives birth, develops low blood pressure and reduced blood flow to the pituitary gland and can result in severe depression with SI?

A

Sheehan’s syndrome

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2
Q

In Sheehan’s syndrome, what gland is under perfused?

A

The pituitary gland

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3
Q

which 3 are hormones and neurotransmitters?

A

Serotonin, norepinephrine, and epinephrine

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4
Q

What three glands in the brain are where the nervous and endocrine system comes together?

A

The hypothalamus, the pituitary gland, and the pineal gland.

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5
Q

what are hormones?

A

secreted circulating chemical mediators

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6
Q

what do autocrine mediators do?

A

they help regulate the cell that secreted it

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7
Q

what do paracrine mediators do?

A

influence cells nearby

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8
Q

Name the 4 steroid hormones

A

aldosterone, cortisol, estrogen, and testosterone

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9
Q

Name 3 amino acid hormones

A

insulin, adrenocorticotropic hormone (ATH), and prolactin

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10
Q

Name 3 amine hormones

A

thyroid hormone, epinephrine, and norepinephrine

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11
Q

what are amine hormones derived from?

A

built/derived from the amino acid tyrosine

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12
Q

what are steroids made out of?

A

made of cholesterol (fat) and are lipid soluble

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13
Q

where do steroids bind to?

A

they bind to receptors inside the cytosol or the nucleus

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14
Q

what is the “interface” between the nervous and endocrine system/

A

the hypothalamus

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15
Q

what 3 endocrine glands does the hypothalamus communicate with?

A

adrenal medulla (gland), anterior pituitary (adenohypophysis), and the posterior pituitary (neurohypophysis).

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16
Q

what is another name for the anterior pituitary?

A

adenohypophysis

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17
Q

how does the hypothalamus communicate with the adenohypophysis?

A

the hypothalamus communicates with the anterior pituitary with chemical signals via the blood stream.

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18
Q

what is another name for the posterior pituitary?

A

neurohypophysis

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19
Q

how does the hypothalamus communicate with the posterior pituitary?

A

the hypothalamus communicates with the posterior pituitary via a nerve track

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20
Q

what kind of hormones are released from the hypothalamus?

A

releasing-factor hormones

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21
Q

how many hormones are released from the anterior pituitary ?

A

5 hormones

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22
Q

what are the 5 hormones secreted by the anterior pituitary?

A
  • adrenocorticotropic hormone
  • growth hormone
  • prolactin
  • follicle stimulating hormone/luteinizing hormone
  • thyroid stimulating hormone
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23
Q

what is the ACTH?

A

adrenocorticotrophic hormone

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24
Q

what is TSH?

A

thyroid stimulating hormone

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25
Q

what is GH?

A

growth hormone

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26
Q

what is FSH/LH ?

A

follicle stimulating hormone/ luteinizing hormone

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27
Q

what is PRL?

A

Prolactin hormone

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28
Q

what does the adrenal cortex describe?

A

it means outside of the organ

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29
Q

what does the adrenal medulla describe?

A

inside the organ

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30
Q

what does the adrenal cortex secrete?

A

corticosteroids

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31
Q

what is the primary corticosteroid the adrenal cortex releases?

A

cortisol

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32
Q

what is a mineralocorticoid released from the adrenal cortex?

A

aldosterone

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33
Q

what is the function of aldosterone?

A

retain sodium, excrete potassium

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34
Q

what is the 3 glucocorticoids?

A

cortisol, cortisone, and corticosterone

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35
Q

what is the most abundant glucocorticoid?

A

cortisol

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36
Q

Emotional and physical stress is communicates to the hypothalamus via what system of the CNS?

A

the limbic system

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37
Q

what is cholesterol a component of and where does it come from?

A

it is a component of glucocorticoids and comes from the liver.

**it is delivered to the adrenal cortex where it its used to produce glucocorticoids

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38
Q

When is cortisol level the highest throughout the day?

A

In the morning, when waking up

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39
Q

what pattern does cortisol have?

A

It has a diurnal or circadian pattern

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40
Q

what is muscle protein catabolism?

A

breakdown of muscle protein which leads to loss of functional muscle

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41
Q

what is lipolysis?

A

breakdown of fat

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42
Q

what is gluconeogenesis?

A

making new glucose out of amino acids and lactate

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43
Q

what is anabolism?

A

building up or synthesizing of complex chemical structures

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44
Q

what is catabolism?

A

the breakdown of complex chemicals into simple chemical products

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45
Q

What is Cushing’s disease associated with?

A

Too much or excess cortisol

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46
Q

what type of cancer is a frequent cause of ectopic excess of ACTH?

A

small cell lung cancer

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47
Q

what are the s/s of Cushing’s disease?

A

muscle wasting, hyperglycemia, increased infection, hypertension, bruising, central redistribution of fat

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48
Q

What is Addison’s disease associated with?

A

A deficit or too little cortisol

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49
Q

what are the s/s of Addison’s disease?

A

hypoglycemia, weakness, weight loss, hypotension, lethargy, mental confusion, possible seizures

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50
Q

aldosterone is under partial influence of what hormone?

A

adrenocorticotropic hormone (ACTH)

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51
Q

aldosterone secretion is under dual control by?

A

the hypothalamus and the renin-angiotensin system

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52
Q

Describe the Renin-angiotensin-aldosterone system:

A

The liver produces angiotensinogen which is secreted when the renal artery pressure is low, there is increased sympathetic activity. the juxtaglomerular cells of the kidneys secrete renin into the circulation. Renin breaks down angiotensinogen to angiotensin 1. the angiotensin 1 circulates to the lung in which the enzyme ACE converts angiotensin 1 to angiotensin 2.

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53
Q

what is renin?

A

an enzyme that breaks down angiotensinogen to angiotensin 1.

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54
Q

what cells of the kidneys secrete renin?

A

the juxtaglomerular cells

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55
Q

what does ACE stand for?

A

angiotensin converting enzyme

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56
Q

where in the body does the ACE enzyme convert angiotensin 1 to angiotensin 2?

A

the lungs

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57
Q

aldosterone is regulated by: (2)

A

adrenocorticotrophic hormone (ACTH) and angiotensin II

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58
Q

what happens in hyperaldosteronism?

think fluid and electrolyte imbalance

A

hypernatremia and hypokalemia

HTN, cardiac hypertrophy, and HF occur

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59
Q

what is the function of the thyroid gland?

A

Helps control growth and maintain energy (metabolism) homeostasis

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60
Q

what two hormones does the thyroid gland secrete?

A

T3 and T4

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61
Q

what is another name for T4?

A

thyroxine

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62
Q

what is another name for t3?

A

triiodothyronine

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63
Q

how many iodines does thyroxine have?

A

4 iodines

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64
Q

how many iodines does triiodothyronine have?

A

3 iodines

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65
Q

T3 and T4: which is more abundant and more potent?

A

T3 is more potent but less abundant.

T4 is less potent but more abundant.

66
Q

what are the thyroid hormone functions?

A

increase carbohydrate and lipid catabolism (breakdown), increased protein synthesis, thermogenesis, stimulate growth and development with GH, and increases reactivity of the nervous system

67
Q

what are the symptoms of hypothyroidism?

A

myxedema, lethargy, memory impairment, slow deep tendon reflexes, anovulation, menstrual irregularities, infertility, constipation, depression, hypercholesterolemia, high LDL, goiter.

68
Q

what is grave’s disease associated with?

A

hyperthyrodisim

69
Q

what are the s/s of hyperthyroidsim?

A

exophthalmos, goiter, weight loss, tachycardia, hypertension, hyperreflexia, and diarrhea

70
Q

what is a normal TSH range?

A

0.30–3.0

71
Q

In hypothyroidism, what labs are expected for TSH and T4?

A

TSH is high and T4 is low

72
Q

in hyperthyroidism, what labs are expected for TSH and T4?

A

TSH is low and T4 is high

73
Q

what is the ratio for T4 to T3?

A

20 to 1

74
Q

what is another name for the growth hormone?

A

Somatotropin

75
Q

At what part in life is somatotropin the most secreted?

A

During puberty or adolescence

76
Q

growth hormone targets what organ?

A

the liver

77
Q

what does hormone does the liver secrete?

A

somatomedin

78
Q

Deficiency of the growth hormone in neonates can result in what?

A

Hypoglycemia

why: somatotropin is not available to tell the liver to release glucose from glycogen

79
Q

Deficiency of the growth hormone in infants and children can result in what?

A

slow growth, delayed puberty and bone growth or maturity, dwarfism, slow muscle development and delayed motor skills

80
Q

deficiency of the growth hormone in adults results in what?

A

muscle wasting and weakness, reduced bone density–osteoporosis, increased insulin resistance, increased central obesity, dyslipidemia

81
Q

Excess growth hormone in children can result in what?

A

accelerated growth and gigantism

82
Q

Excess growth hormone in adults can result in what ?

A

Acromegaly and type 2 diabetes

83
Q

what is acromegaly?

A

enlargement or increased bone thickening particularly in the hands, feet, jaw.

84
Q

Growth hormone targets what tissues?

A

The skeleton, skeletal muscle, adipose tissue

85
Q

Follicle stimulating hormone and lutenizing hormone targets what gland?

A

Ovary and testes

86
Q

prolactin targets what glands?

A

the mammary glands

87
Q

what type of connection does the posterior pituitary have with the hypothalamus?

A

Neural connection, does so by nerve transmission

88
Q

what 2 hormones does the posterior pituitary secrete?

A

Oxytocin and anti-diuretic hormone (also called vasopressin)

89
Q

what does ADH (anti-diuretic hormone) target?

A

the kidneys

90
Q

what does oxytocin help control (2)?

A

the uterus and mammary glands

91
Q

After ADH is transported to the kidney, where is water reabsorbed?

A

distal tubule and the collecting duct

92
Q

what are the 4 functions of ADH?

A

Increase water reabsorption, decrease perspiration (inhibit sweat glands), conserve fluid volume, and raises blood pressure.

93
Q

what is the deficiency of ADH called?

A

Diabetes Insipidus

94
Q

what are the 3 main symptoms of diabetes insipidus?

A

Polydipsia (increased thirst), dehydration, and increased/excessive urination

95
Q

what does the adrenal medulla secrete?

A

catecholamines: epinephrine and norepinephrine

96
Q

what is the communication between the hypothalamus and the adrenal medulla?

A

it has a direct (neural integration) relationship/communication

97
Q

of the two catecholamines which is more potent?

A

epinephrine (it is more abundant and potent)

98
Q

where on the adrenal gland are the glucocorticoids and the catecholamines produced?

A

adrenal cortex: glucocorticoids

adrenal medulla: medulla

99
Q

Describe the effects of the catecholamines on:

  • blood vessels
  • airway
  • respiratory rate
  • digestion
  • blood sugar
A

The effects are sympathomimetic
Constricts blood vessels–increases blood pressure
increased HR, RR, slowed digestion, increased blood sugar, and airway dilation

100
Q

What is an agoinst?

A

something that binds to receptors and activates it

101
Q

what is pheochromocytoma ?

A

it is a tumor of the adrenal gland–usually benign

102
Q

what can pheochromocytoma cause?

A

malignant hypertension (due to excess catecholamine)

103
Q

what are s/s pheochromocytoma?

A

systemic vasoconstriction, HTN, elevated HR, nervousness, anxiety, tremors, excessive sweating, weight loss, volume depletion

104
Q

What system relays emotional stress to the hypothalamus?

A

the limbic system

105
Q

what system relays physiological stress to the hypothalamus?

A

the reticular system

106
Q

when the hypothalamus sends out the corticotropin releasing hormone/factor what cells does it activate?

A

mast cells

107
Q

what role does mast cells have?

A

they are a major line of defense against invading pathogens, they can eat microbes and release cytokines to destroy foreign invades, helps mediate inflammation.

108
Q

what gland is affected by light and dark cycles?

A

the pineal gland

109
Q

the pineal gland secretes which 5 hormones?

A

melatonin, adrenoglomerulotropic hormone (aldosterone stimulating), norepinephrine, serotonin, gonadotropin releasing factor

110
Q

when does the thymus stop increasing?

A

It stops after puberty

111
Q

what is the thymus made out of ?

A

lymphoid tissue

112
Q

The release of what hormone inhibits the production of immunoglobulin production and the maturation of NK T lymphocytes?

A

Somatostatin or Growth Hormone

113
Q

what does VIP stand for?

A

Vasoactive intestinal peptide

114
Q

what is an exocrine gland?

A

an exocrine gland produces a substance which is secreted into a duct

115
Q

what is an endocrine gland?

A

an endocrine gland produces a substance which is secreted into circulation

116
Q

what gland/organ has both endocrine and exocrine properities?

A

the pancreas

117
Q

Name the endocrine and exocrine properties of the pancreas?

A

endocrine properties is the islets of Langerhans

exocrine properties are the digestive enzymes from the pancreatic duct

118
Q

where are the alpha and beta cells secreted from?

A

the Islets of Langerhans

119
Q

what do the alpha cells of the pancreas secrete?

A

the alpha cells secrete glucagon

120
Q

When do the alpha cell secrete?

A

they begin secreting when glucose levels are low which helps increase blood glucose levels

121
Q

what process is used for alpha cells to increase glucose?

A

Hepatic gluconeogenesis (liver helps make new glucose which is made out of lactate (a metabolite of glucose) and amino acids

122
Q

what is glycogenolysis?

A

it is the breakdown of glucose–catabolism of glycogen that has been stored in the liver

123
Q

what is lipolysis?

A

the breakdown of fat.

124
Q

what is the released from lipolysis?

A

fatty acids are released from fat breakdown into circulation.

125
Q

what do beta cells secrete (2)?

A

insulin and amylin

126
Q

what do delta cells of the pancreas secrete?

A

somatostatin

127
Q

what is one of the main determinants of blood glucose levels?

A

muscle uptake of glucose

128
Q

what are the functions of insulin?

A

increase muscle uptake of glucose, promote glucose storage as glycogen, increase lipogenesis, and protein synthesis

129
Q

the main organs for converting glucose to fatty acids are:

A

the liver and adipose tissue

130
Q

The rise in ATP to ADP ratio closes the potassium ATP channel into the cell and it opens what?

A

the calcium channel, calcium influx stimulates the release and synthesis of insulin.

131
Q

what are the 3 functions of amylin?

A

decrease hepatic glucose release, regulate gastric emptying into duodenum, and may suppress feeding by signaling leptin to the hypothalamus

132
Q

what is leptin?

A

a hormone secreted by fat cells that is an integral part of energy regulation in signaling satiety to the hypothalamus. (amylin helps increase the hypothalamic sensitivity to leptin.

133
Q

what is the drug pramlintide (simillnitide)?

A

it is a synthetic form of amylin and it can be used as an adjuvant therapy at mealtime with insulin–given subcutaneously for Type 1 or 2 DM. Can’t be mixed in the same syringe as insulin.

134
Q

what is the function of the delta cell hormone, somatostatin?

A

it counterbalances the growth hormone by curbing or slowing down growth

135
Q

what is aldosterone deficiency?

A

diabetes insipidus

136
Q

what is the cause of type 1 diabetes mellitus?

A

damaged pancreatic insulin secretion, insulin deficient

137
Q

what is the cause of type 2 diabetes mellitus?

A

insulin resistance, increased insensitivity to insulin

138
Q

what is gestational diabetes?

A

diabetes type 2 (insulin resistance) that develops during pregnancy

139
Q

when does gestational diabetes usually occur?

A

usually occurs in the 2nd half of pregnancy

140
Q

what is the diagnostic criteria for diabetes?

A
  • Hemoglobin A1C greater 6.5%
  • a fasting plasma glucose greater than 126mg/dL (with no caloric intake for at least 8hrs)
  • oral glucose tolerance test that has a b.g. greater than 200mg (after 2 hours on ingestion)
  • random plasma glucose greater than 200 with s/s: polyuria, polydipsia, and polyphagia with weight loss
141
Q

what 3 tests for diabetes needs to be confirmed with a 2nd test?

A

Hemoglobin A1C, fasting blood glucose, oral glucose tolerance test

142
Q

what is hyperinsulinemia and what is it characterized with?

A

increased insulin in the blood
it is associated with early on in diabetes because the body wants glucose to be taken up by the muscles to turn off gluconeogenesis in the liver

143
Q

what cell is associated with destroying beta cells in type 1 diabetes?

A

T cells

144
Q

glycosuria leads to what?

A

Polyuria due to the sugar in the urine acting as an osmotic diuretic

145
Q

what process make a hemoglobin A1C result possible?

A

Glycosylation of RBCs, it tests over the lifespan of a RBC which is 3 months (120 days)

146
Q

what a ketones?

A

they are the byproduct of lipid breakdown

147
Q

what is ketosis?

A

lipid breakdown resulting in small fatty acids in the blood

148
Q

what is ketoacidosis, hyperkalemia, and hyperglycemia associated with?

A

Type 1 diabetes mellitus

149
Q

what are long term complications associated with diabetes?

A

microvascular and macrovascular changes, nephropathy, neuropathy, hyperglycemia/hypoglycemia, blindness, atherosclerosis

150
Q

retinopathy is associated with what type of complication in diabetes?

A

it is a microvascular change that can lead to blindness

151
Q

atherosclerosis is associated with what type of complication in diabetes ?

A

it is a macrovascular change that can lead to blindness

152
Q

In type 2 diabetes, amylin will activate what system to increase vasoconstriction and makes patients prone to hypertension?

A

the renin-angiotensin aldosterone system

153
Q

what medications are given to inhibit the renin-angiotensin aldosterone system?

A

Angiotensin converting enzyme (ACE) inhibitors

154
Q

what do ACE inhibitors specifcially act on?

A

They block the end stages of the RAAS by preventing conversion of angiotensin 1 to angiotensin 2

155
Q

what are the 5 reactive oxygen species (ROS) –free radicals that cause damage in type 2 diabetes?

A

superoxide, hydrogen peroxide, hydroxyl radical, and peroxynitrite

156
Q

what causes oxidative stress in type 2 diabetes?

A

altered glucose and fat metabolism with chronic inflammation

157
Q

what are 2 signs of chronic inflammation in type 2 diabetes?

A

increased fibrinogen and C-reactive protein

158
Q

what effects does chronic inflammation have on the lipid profile?

A

elevated triglycerides
low density lipoproteins (LDL)
low levels of high density lipoprotein (HDL)

159
Q

what is the good cholesterol (lipoprotein)?

A

HDL (high density lipoprotein)

160
Q

what is visceral obesity?

A

the deposition of adipose tissue in the abdomen (apple shaped body)

161
Q

what are complications associated with type 2 diabetes?

A

macrovascular and microvascular disease, neuropathy, nephropathy, nonalcoholic steatohepatitis (fatty liver), and hyperglycemia, hyperosmolar nonketotic condition

162
Q

what is hyperosmolar nonketotic condition ?

A

extremely high hyperglycemia which leads to serious dehydration and hyperosmolar condition

Cassandra's Advanced Pathophysiology (9 decks)

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