Outcome 8 Endocrinology Flashcards
1
Q
Abnormal growth and stature
A
gigantism
2
Q
*5 pituitary gland diseases also
A
- gigantism
- acromegaly
- hypopituitarism
- dwarfism
- diabetes insipidus
3
Q
Gigantism is caused by the excessive production and secretion of ____ hormones
A
pituitary
4
Q
*Gigantism occurs when there is a hypersecretion of ____ from the anterior pituitary or adenoma before ____
A
growth hormone; puberty
5
Q
Child with gigantism experience abnormal growth because the ____ has not begun
A
epiphyseal closure
6
Q
Gigantism is treated by reducing the amount of ___ secreted
A
growth hormone
7
Q
How is surgery reducing the amount of growth hormone performed?
A
transsphenoidal approach
8
Q
Chronic metabolic condition of adults with overgrowth of soft tissue and the bones of face, hands and feet
A
acromegaly
9
Q
Which 3 bones are commonly affected by acromegaly?
A
bones of face, hands and feet
10
Q
*Acromegaly is caused by the hypersecretion of ____ from the anterior pituitary or adenoma after ___
A
growth hormone; after puberty
11
Q
Acromegaly is treated by reducing the amount of ___, ___ approach, and reverse or preventing ____ effects
A
growth hormone; transsphenoidal approach; tumor mass
12
Q
Condition caused by deficiency or absence of any pituitary hormones
A
hypopituitarism
13
Q
In hypopituitarism there is a deficiency or absence of hormones especially produced by the ____
A
anterior pituitary
14
Q
Hypopituitarism produces ____ in children
A
growth retardation
15
Q
Hypopituitarism can be genital or acquired ad may be caused by ___ tumor or tumor of the ___
A
pituitary; hypothalamus
16
Q
Hypopituitarism is also caused by damage to the pituitary gland caused by ____, ischemia of ____, tumor, or ____ fracture
A
radiation; gland; basilar skull
17
Q
*Destruction of entire anterior lobe and none of anterior pituitary hormones are secreted; occurs mostly in women
A
panhypopituitarism
18
Q
What 3 factors determine the treatment of hypopituitarism?
A
- age
- severity
- underlying cause
19
Q
Hypopituitarism is also treated with hormone relacement therapy with these 4 hormones
A
- thyroxine
- cortisone
- sex hormones
- somatropin (hGH)
20
Q
Abnormal underdevelopment occuring in children
A
dwarfism
21
Q
Dwarfism is ____ occurring in children
A
hypopituitarism
22
Q
Dwarfism can be congenital or can result from ____ after the birth process
A
cranial hemorrhage
23
Q
Dwarfism is treated by administering ____ until child reaches height of ____ feet
A
somatotropin (hGH); 5 feet
24
Q
Patients with dwarfism may need replacement of ___, ___, or ___ hormones
A
thyroid; adrenal; sex
25
* Disturbance of water metabolism resulting in polyuria and polydipsia
diabetes insipidus
26
Excessive amount of colorless and dilute urine
polyuria
27
Excessive thirst; deficiency in the release of vasopressin
polydipsia
28
Diabetes resulting from renal tubular resistance to action of vasopressin; more common in men
nephrogenic diabetes
29
Diabetes insipidus occurs when the ____ pituitary releases reduced amounts of ____
posterior; vasopressin
30
Diabetes inspidus may be hereditary, a result of insult to the ____ or ____ gland, head trauma, cerebral edema, or intracranial lesion
hypothalamus; pituitary
31
Diabetes insipidus is managed with ____ injections, ____ spray or ____ (DDAVP)
vasopressin; nasal; oral desmopressin acetate (DDAVP)
32
Nephrogenic diabetes is managed with ____
thiazide diuretics
33
Thiazide diuretics block the ability of kidneys to excrete ___ and increases excretion of ___ and ____
water; sodium chloride; water
34
2 types of hyperpituitarism
1. gigantism
| 2. acromegaly
35
*5 thyroid gland diseases
1. simple goiter
2. Hashimoto's thyroiditis
3. Hyperthyroidism
4. Cretinism
5. Myxedema
36
Enlargement or hyperplasia of thyroid gland usually with swelling in the neck area; asymptomatic in early stages
simple goiter
37
Simple goiter is also called ____
non-toxic goiter
38
Simple goiter can produce ___ or difficulty breathing
dyspnea
39
Simple goiter is caused by a shortage of ___ in diet
iodine
40
Simple goiter is treated with one drop per week of saturated solution of _____
potassium iodide
41
Unresponsive simple goiter is excised using what surgical procedure
subtotal thyroidectomy
42
Chronic disease of immune system that attacks the thyroid gland
Hashimoto's thyroiditis
43
Hashimoto's is also called ___
chronic thyroiditis
44
Hashimoto's is accompanied by gradual and painless lumpy enlargement of the ____ causing pressure in neck and difficulty swallowing
thyroid gland
45
Hashimoto's occurs in women __ times more than in men and is most common between ages 45-65
8 times
46
Hashimoto's has a hereditary pattern and may also be caused by ____
autoimmune disorders
47
Hashimoto's is treated with a lifelong replacement of _____ hormones; this treatment prevents further growth of goiter
thyroid hormones
48
Condition of primary hyperthyroidism where entire thyroid gland hypertrophies
Hyperthyroidism
49
Hyperthyroidism is also known as ____
Graves' disease
50
When the thyroid gland hypertrophies in hyperthyroidism, this results in ____ goiter and overproduction of ____ hormones
diffuse; thyroid
51
Sudden exacerbation of hyperthyroidism, also called ___ or ___, can be life-threatening
thyrotoxicosis; thyroid storm
52
Hyperthyroidism is believed to be an ______ response
autoimmune
53
The goal of treating hyperthyroidism is to reduce formation and secretion of ____ hormones
thyroid
54
Hyperthyroidism is treated with ____ drugs, ____ therapy or ____-ectomy
anti-thyroid drugs; radioactive iodine therapy; thyroidectomy
55
____ are given to treat tachycardia and hypertension associated with hyperthyroidism
B-Blockers
56
2 types of hypothyroidism
1. cretinism
| 2. myxedema
57
*Congenital hypothyroidism developing in infancy or early childhood where the thyroid gland is absent or thyroid hormone is not synthesized by thyroid gland
cretinism
58
Cretinism is caused by ____ in fetal development
error
59
Cretinism is caused by the congenital absence of ___ required for ___ and ___ synthesis
enzymes; T3; T4
60
Cretinism may also be caused by ____ deficient diets, ___ thyroid deficiency, or taking ____ drugs during pregnancy
iodine; maternal; anti-thyroid
61
Early treatment with thyroid hormone promotes normal physical growth for patients with cretinism, but this may not prevent _____
mental retardation
62
_____ therapy is required throughout the life of a patient with cretinism
hormone replacement therapy
63
*Severe acquired hypothyroidism with reduced levels of T4 developing in older child or adult
myxedema
64
Myxedema usually occurs in females, who experience ____
menorrhagia
65
Myxedema is caused by the impairment of the thyroid gland's ability to synthesize ___
T4
66
Myxedema may also be due to reduced amounts of _____, ____ of thyroid gland, surgical removal of gland without ____ surgery, or a tumor
thyrotropin; radiation destruction; T4 replacement surgery
67
Common cause for hypothyroidism in children is _____
Hashimoto's thyroiditis
68
The goal of treating myxedema is to achieve normal ____ function with the lowest possible ____
thyroid; dose
69
Myxedemia is treated with life-long replacement therapy and administering _____
Levothyroxine sodium (T4)
70
2 parathyroid gland diseases
1. hyperparathyroidism
| 2. hypoparathyroidism
71
Parathyroid hormones increase blood ____ level by stimulating bone ____ and increasing absorption of ____ in digestive tract/kidneys
calcium; demineraization; calcium
72
Overproduction of parathyroid hormones (PTH)
hyperparathyroidism
73
Increases breakdown of bone, resulting in hypercalcemia
hyperparathyroidism
74
Excessive reabsorption of calcium in blood
hypercalcemia
75
Hyperparathyroidism is twice as common in women and incidence rises sharply after age ___
40
76
Hyperparathyroidism is caused by overactivity of one or more of the four ____ glands
parathyroid
77
Overactivity of the parathyroid glands is usually a result of an excessive growth, or ____, or an ____ of the gland
adenoma; idiopathic hyperplasia
78
Hyperparathyroidism is also caused by an increased secretion of PTH induced by low level of ____ of ____
serum calcium; vitamin D
79
If hyperparathyroidisim is caused by an adenoma, the tumor is removed by ____ surgery
minimally invasive
80
*If hyperparathyroidism is caused by hyperplasia, ___ of 4 glands are usually removed
3.5
81
When hyperparathyroidism is secondary, the underlying cause is treated and ____ levels reduced
blood serum calcium
82
Secretion of parathyroid hormone by parathyroid glands is greatly reduced
hypoparathyroidism
83
In hypoparathyroidism, circulating ____ is reduced, resulting in hypocalcemia
calcium
84
In hypoparathyroidism, there are decreased deposits of ____ in tissue
calcium
85
Surgical reimplantation of ____ following ____ can help with postop hypoparathyroidism
parathyroid; thyroidectomy
86
The most common cause of hypoparathyroidism is surgical destruction of _____
parathyroid glands
87
Hypoparathyroidism may also be caused by raised ____ levels which by ____ causes decreased ____
blood calcium; negative feedback; PTH output
88
Acquired hypoparathyroidism results from these 5 things
1. injury
2. ischemia
3. radiation
4. neoplasia
5. various disease process
89
Presence of ____ is a sure indication of hypocalcemia
Trousseau's phenomenon
90
*Trousseau's phenomenon
--
91
Hypoparathyroidism is treated with ____ replacement therapy with Vitamin ___ to reduce hypocalcemia
calcium; D
92
In case of life threatening deficiency or tetany, hypoparathyroidism is treated with ____ administered ___ and followed by a ____ diet
calcium gluconate; intravenously; high-calcium diet
93
2 adrenal gland diseases
1. Cushing's syndrome
| 2. Addison's disease
94
Condition of chronic hypersecretion of the adrenal cortex, resulting in excessive circulating cortisol levels
Cushing's syndrome
95
4 key characteristics of Cushing's Syndrome
1. moon face
2. buffalo hump
3. gross obesity of trunk
4. specific patterns of fat deposits
96
Cushing's syndrome is caused by ____ of the ____ gland
hyperplasia; adrenal
97
Cushing's is also caused by excessive secretion of ____ from pituitary
corticotropin (ACTH)
98
Cushing's can also be caused by tumor of ____, production of _____ in another organ like cancer cells in lungs, and iatrogenic conditions (such as prolonged administration of large doses of _____)
adrenal cortex; corticotropin; glucocorticoids
99
Cushing's is treated with drug therapy to suppress ____ secretion, radiation or _____ when tumor is the cause
ACTH secretion; surgical removal
100
Partial or complete failure of adrenocortical function
Addison's disease
101
Addison's disease is also called ____ or ____
adrenal insufficiency; hypoadrenalism
102
The key physical characteristic of Addison's disease
bronze skin colour
103
Addison's is usually a gradual, progressive ____ of adrenal gland and reduction of important hormones
destruction
104
Destruction can result from the ____ process, tuberculosis, hemorrhage, fungal infections, neoplasms, or surgical resection of a gland
autoimmune
105
Addison's is secondary to ____
hypopituitarism
106
Addison's is treated by replacing natural hormones with ____ and ____ drugs
glucocorticoid; mineralocorticoid
107
Insuffiency or sudden decrease in adrenocortical hormone levels
Addisonian Crisis
108
Addisonian Crisis is a life-threatening emergency that can lead to ___, ___, and ___
shock, seizures, coma
109
*Chronic disorder of carbohydrate, fat and protein metabolism caused by inadequate production of insulin by pancreas of faulty use of insulin by cells
diabetes mellitus
110
How many types of diabetes mellitus?
2
111
Both forms of diabetes in most causes cause is unknown, but seems to be linked _____
genetically
112
Diabetes mellitus is an endocrine ____ of the ____
dysfunction; pancreas
113
Early, abrupt onset usually before age 30 with little or no insulin being secreted
DM I
114
DM I is formerly known as ___ or ___
juvenile-onset diabetes; insulin dependent diabetes mellitus (IDDM)
115
DM I: infection early in life may trigger _____ that produces antibodies, destroying ____ in pancreas
autoimmune process; B cells
116
DM I is also caused by insufficient ____ producing cells
insulin
117
DM I is treated with _____ replacement therapy with calculated ____ on a regular schedule
insulin; caloric intake
118
4 methods of insulin delivery
1. injection
2. insulin pump therapy
3. insulin inhalers
4. insulin pens
119
Most common form of DM; gradual onset in adults
DM II
120
DM II occurs in adults over __ and more often people over __
30; 55
121
DM II is formerly known as ___ or ___
adult-onset diabetes; non-insulin dependent DM (NIDDM)
122
In DM II, some ____ remain, permitting control of symptoms by dietary management
pancreatic functions
123
DM is caused by destruction of the ____, trauma to the ___ or other ____ disorders
pancreas; pituitary gland; endocrine disorders
124
4 other causes of DM II
1. obesity
2. tumor
3. drugs
4. familial patterns
125
DM II is managed through dietary management, exercise, and ___ medications
oral hypogylcemic
126
In DM II, ___ may be required if other treatments don't adequately control it
insulin
127
DM II doesn't usually require ____ injections to control ____ levels
insulin; glucose
128
2 endocrine dysfunctions of the pancreas
1. DM
| 2. hypoglycemia
129
Abnormally low glucose level in blood
hypoglycemia
130
Hypoglycemia occurs when insulin enters ____ or when ____ falls below tissue demands
bloodstream; glucose release rate
131
Hypoglycemia can be classified under what 2 types?
1. drug-induced
| 2. non-drug induced
132
What is the most common type of hypogylcemia, also known as reactive hypoglycemia?
Drug induced
133
Drug induced hypoglycemia is caused by ____ in a diabetic subject
insulin overdose
134
Drug induced hypoglycemia may also be triggered by significantly elevated ____ levels
blood alcohol
135
5 causes of non drug-induced hypoglycemia
1. fasting
2. delayed secretion of insulin by pancreas
3. excessive secretion of insulin by pancreas
4. gastrointestinal disorders
5. hereditary or endocrine disorders
136
The priority of treating hypoglycemia is restoring a normal ____ level through IV infusion of ____
glucose
137
The hormone ___ may also be given to counteract insulin in hypoglycemia
glucagon
138
2 types of precocious puberty
1. in boys
| 2. in girls
139
Onset of puberty in boys before age ___; normal puberty begins between 13-15 years
9
140
Early development of secondary sex characteristics, gonadal development, spermatogenesis, growth of pubic and facial hair, and sebaceous gland activity increases
precocious puberty in boys
141
Precocious puberty in boys may be genetic, but can be traced to ___ dysfunctions that secrete excessive ____ hormones
pituitary; gonadotropic
142
Precocious puberty in boys may also be induced by ____ tumors or other ____ disorders
testicular tumors; endocrine disorders
143
Precocious puberty in boys may also be caused by neoplasm in ____ gland or the ____
pituitary; hypothalamus
144
T or F. When p. puberty in boys is idiopathic, no specific treatment is required
T
145
P. puberty in boys is treated with hormones to suppress _____ until appropriate time
sexual maturation
146
When associated with tumors, p. puberty in boys is treated _____
invasively
147
Onset of puberty before age ___ in girls with increased growth rate, breast enlargement, growth of pubic and underarm hair
8
148
Girls with p. puberty have menarche before age __
10
149
T or F. P. puberty in girls is mostly idiopathic without associated abnormalities
T
150
P. puberty in girls may be caused by meningitis, ____ tumors, ingestion of ____
intracranial; oral contraceptives
151
P. puberty in girls is treated with _____ and may require ____ for emotional problems
hormone therapy; emotional
152
Levels of circulating calcium in blood ____ in hypoparathyroidism
decreases
153
Treatment for life-threatening cases of hypoparathyroidism
IV calcium gluconate
154
Cushing's Syndrome esults in excessive circulating levels of _____
cortisol
