objective 9 Flashcards
Affects almost every cell, organ, and function of the
body
is closely linked with the nervous system and the immune system
endocrine system
most commonly
involves adrenocorticotropic hormone (ACTH) or growth
hormone (GH) and results in Cushing’s Syndrome or
acromegaly
over secretion of the anterior pituitary gland
large volumes of dilute urine as a result of deficient production of vasopressin
characterized by deficiency of ADH
excessive thirst,
fluid restriction can cause hypernatremia and severe dehydration
diabetes insipidus
excessive ADH secretion from the pituitary
concentrated urine, fluid retention, sodium deficiency known as dilutional hyponatremia
caused by head injury, brain surgery or tumour
SIADH
autoimmune thyroiditis and hashimotos disease which causes atrophy of the thyroid
hyporthyroidism
what are the manifestations of hypothyroidism?
fatigue; hair, skin and nail changes; weight gain; personality and cognitive changes; and cardiac and respiratory complications
The second most prevalent endocrine disorder
Excessive output of thyroid hormone
Disease of unknown etiology marked by diffuse
thyroid enlargement and excessive thyroid
hormone secretion.
Graves’ disease accounts for 90% of the cases of
hyperthyroidism and is more common in women,
particularly between the ages of 20 to 40 years
hyperthyroidism
what are the manifestations of hyperthyroidism?
nervousness; palpitations;
rapid pulse;; tremors; skin is flushed; exophthalmos;
increased appetite and dietary intake; restlessness
and weight loss; may progress to cardiac
dysrhythmias and heart failure
Inflammation of the thyroid gland
thyroiditis
hought to be caused by a viral
infection (e.g., mumps, measles, adenovirus) or post–viral
inflammatory processes resulting from prior upper respiratory
infections
subacute granulomatous thyroiditis
be caused by a bacterial or fungal
infection. The thyroid gland is tender and enlarged, and the patient
often experiences neck pain and fatigue
acute thryoiditis
most
common in women, can lead to hypothyroidism and goitre formation
chronic autoimmune thyroiditis
is a chronic autoimmune disease in
which thyroid tissue is replaced by lymphocytes and fibrous
tissue
If untreated, the disease runs a slow, progressive course,
leading to hypothyroidism
Treatment: reduce the size of the thyroid gland and prevent
hypothyroidism. Surgery may be required.
hashimoto’s thyroiditis
Found in regions where the natural supply of iodine is
deficient
Usually cause no symptoms , except for swelling in the neck
which may result in tracheal compression
endemic goitre
compensatory hypertrophy of the thyroid gland
simple goitre
Areas of hyperplasia (overgrowth)
Nodules slowly increase in size, with some descending into
the thorax
Some are malignant and some are associated with a
hyperthyroid state. May require surgery.
nodular goitre
More than 95% of all thyroid nodules are benign
Thyroid cancer is the most common endocrine-related
carcinoma
The primary sign of thyroid cancer is the presence of a
painless, palpable nodule or nodules in an enlarged thyroid
gland.
Needle biopsy used to diagnose
MRI, CT and thyroid scans
thyroid cancer
Occurs when the adrenal cortex function is inadequate in
making cortical hormones
Autoimmune destruction of adrenal glands is responsible for
majority of cases
Therapeutic use of corticosteroids is most common cause of
adrenocortical insufficiency
addisons disease
what are the manifestations of addisons disease?
Muscle weakness, anorexia, fatigue, hypotension, low blood
glucose, low serum sodium, high serum potassium, mental
changes, confusion
happens with disease progression.
Characterized by cyanosis, rapid and weak pulse, rapid
respirations, abdominal pain, diarrhea, confusion
addisonian crisis
Caused by excessive adrenocortical activity or
corticosteroid medications
cushings syndrome
what are the manifestations of cushings syndrome?
Hyperglycemia that may develop into diabetes, weight gain,
central type obesity with “buffalo hump,” heavy trunk and thin
extremities, fragile thin skin, ecchymosis, striae, weakness,
sleep disturbances, osteoporosis, muscle wasting,
hypertension, “moon-face,” acne, increased susceptibility to
infection, slow healing, loss of libido, mood changes,
increased serum sodium, and decreased serum potassium
multisystem disease related to abnormal insulin
production, impaired insulin utilization, or both
diabetes mellitus
what are the functions of insulin?
Transports and metabolizes glucose for
energy
Stimulates storage of glucose in the liver and
muscle as glycogen
Signals the liver to stop the release of glucose
Enhances the storage of dietary fat in adipose
tissue
Accelerates transport of amino acids into cells
Inhibits the breakdown of stored glucose,
protein, and fat
Insulin-producing beta cells in the pancreas are
destroyed by an autoimmune process
Characterized by a stop in insulin production
Usually occurs in younger people but can occur
at any age
type 1 diabetes
Decreased sensitivity to insulin (insulin
resistance) and impaired beta cell function results
in decreased insulin production
90% of person with diabetes
More common in persons older than 35 years of
age and in the obese
Slow, progressive glucose intolerance
Treated initially with diet and exercise
Oral hypoglycemic agents and insulin may be
used
type 2 diabetes
what are the manifestations of type 1 diabetes?
“Three Ps”
Polyuria
Polydipsia
Polyphagia
Fatigue, weakness, vision changes, tingling or
numbness in hands or feet, dry skin, skin lesions
or wounds that are slow to heal, and recurrent
infections
Type 1 may have sudden weight loss, nausea,
vomiting, and abdominal pain if DKA has
developed
what are the manifestations of type 2 diabetes>
Possible that an individual with type 2 DM will experience
some of the classic symptoms associated with type 1.
Some of the more common manifestations associated with
type 2 DM include fatigue, recurrent infections, prolonged
wound healing, visual acuity changes, and painful peripheral
neuropathy in the feet.
Unfortunately, the clinical manifestations appear so gradually
that, before the person knows it, they may have
complications
Describes how much a food increases blood
glucose
Combining starchy food with protein- and fat-
containing food slows absorption and glycemic
response
Raw or whole foods tend to have lower response
than cooked, chopped, or pureed foods
glycemic index
Abnormally low blood glucose level (less
4.0mmol/L)
Causes include too much insulin or oral
hypoglycemic agents, too little food, and
excessive physical activity
Manifestations
Hypoglycemic symptoms: sweating, tremors,
tachycardia, palpitations, nervousness, and
hunger
hypoglycemia
Caused by an absence of or inadequate amount of
insulin resulting in abnormal metabolism of
carbohydrate, protein, and fat
Clinical features
Hyperglycemia
Dehydration
Acidosis
Manifestations include polyuria, polydipsia, blurred
vision, weakness, headache, anorexia, abdominal
pain, nausea, vomiting, acetone breath,
diabetic ketoacidosis
is a life-threatening syndrome
that can occur in the patient with DM who is able to produce enough
insulin to prevent DKA but not enough to prevent severe hyperglycemia,
osmotic diuresis, and extracellular fluid depletion
The main difference between HHS and DKA is that the patient with HHS
usually has enough circulating insulin so that ketoacidosis does not occur.
HHS produces fewer symptoms in the earlier stages, blood glucose levels
can climb quite high before the condition is recognized. The higher blood
glucose levels increase the more-severe neurological manifestations, such
as somnolence, coma, seizures, hemiparesis, and aphasia
hyperosmolar hyperglycemic state
