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pathophysiology > patho exam endocrine > Flashcards

patho exam endocrine Flashcards

1
Q

hormones produced by anterior pituitary

A

TSH, ACTH, GH

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2
Q

hormones produced by posterior pituitary

A

vasopressin/ADH

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3
Q

ACTH function

A

stimulates release of cortisol

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4
Q

TSH

A

stimulates production/secretion of thyroid hormones

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5
Q

patho acromegaly

A

hormonal disorder resulting from overproduction of GH – frequently misdiagnosed d/t slow onset – most common in middle age, can cause premature death

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6
Q

dx acromegaly

A

serum GH > 10 ng/mL, CT, MRI

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7
Q

causes acromegaly

A

benign tumors on pituitary gland (most common) or lungs

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8
Q

s/s acromegaly

A

swelling of hands/feet, coarsening of facial features d/t bone growth, coarsening of hair/skin, barrel chest d/t thickened ribs, joint pain, cardiomegaly

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9
Q

patho diabetes insipidus

A

decreased secretion of ADH causes polyuria & polydipsia

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10
Q

dx diabetes insipidus

A

urine specific gravity < 1.005, osmolality < 200 mOsm/kg – hypernatremia – Miller-Moses water deprivation test

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11
Q

s/s diabetes insipidus

A

dehydration, enlarged bladder, weight loss, muscle weakness, polyuria, polydipsia

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12
Q

causes diabetes insipidus

A

idiopathic/autoimmune, damage from surgery, tumors, cancer, anorexia nervosa

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13
Q

patho SIADH

A

inappropriate release of ADH

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14
Q

dx SIADH

A

serum electrolytes, BUN, creatinine, glucose low; hyponatremia; serum osmolality < 280 mOsm/kg; urinary sodium elevated (>20 mmol/L)

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15
Q

causes SIADH

A

cancer: lung, pancreas, lymphoma, leukemia; pulmonary disease: pneumonia, TB, COPD; CNS: head trauma, stroke, brain tumor; IDIOPATHIC MOST COMMON

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16
Q

s/s SIADH

A

headache, muscle cramp, anorexia, nausea/vom, confusion, coma, convulsions – first sign usually decreased urine output w/increased specific gravity – serum hyponatremia & hypoosmolarity

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17
Q

diet for hypoparathyroidism

A

high Ca: almonds, legumes, dark leafy greens, molasses, oats, sardines, prunes, apricots – low P, avoid oxalic acid (spinach, rhubarb), phytic acid (bran, whole grains) – avoid carbonated beverages, dairy, caffeine

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18
Q

glucocorticoids

A

cortisol – help regulate blood sugar, increase burning of protein/fat, respond to stressors

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19
Q

mineralcorticoids

A

aldosterone – regulate blood volume/pressure by acting on kidneys

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20
Q

patho Cushing’s

A

hormonal disorder caused by prolonged exposure of tissues to high levels of cortisol – most common age 20-50

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21
Q

dx Cushing’s

A

24-hr urinary free cortisol levels > 50-100 mcg, dexamathasone suppresion test, CT, MRI

22
Q

s/s Cushing’s

A

upper body obesity, round face, fat neck, thin limbs, thin skin, striae, bone fracture, fatigue, muscle weakness, high BP, hyperglycemia, irritability, anxiety, depression, hair loss

23
Q

patho Addison’s disease

A

hormone deficiency caused by damage to outer layer of adrenal gland – decreased production of cortisol & aldosterone

24
Q

primary Addison’s

A

adrenal gland damaged

25
Q

secondary Addison’s

A

damage outside adrenal gland – aldosterone may not be affected

26
Q

dx Addison’s

A

ACTH/CRH stimulation tests, CT, MRI

27
Q

causes Addison’s

A

autoimmune, infection (TB, HIV), hypovolemia, tumors, anticoagulant use

28
Q

s/s Addison’s

A

increased HR, mouth lesions, hyperpigmentation, low BP, hyponatremia

29
Q

patho pheochromocytoma

A

tumor in core of adrenal gland – most common age 40-60 – often benign tumor, but causes adrenal gland to over-secrete catecholamines, raising BP & HR

30
Q

s/s pheo

A

headache, palpitations, rapid HR, diaphoresis, flushing, chest/ab pain, anxiety, irritability, increased appetite, loss of weight, HYPERTENSION

31
Q

normal function thyroid

A

uses iodine to produce hormones: thyroxine (T4) & triiodothyronine (T3)

32
Q

function T3

A

affects metabolism of cells

33
Q

patho Grave’s disease (thyrotoxicosis)

A

autoimmune disease causing overproduction of thyroid hormones – most common cause of hyperthyroidism

34
Q

s/s Grave’s

A

exophthalmos, anxiety, restlessness, insomnia, weight loss

35
Q

exophthalmos

A

protrusion of eyeballs, may cause irritation & tearing

36
Q

dx all thyroid disorders

A

T3, T4, TSH levels

37
Q

mechanisms of thyroid hormone release

A

hypothalamus releases thyrotropin releasing hormone (TRH), which signals pituitary to release TSH, which signals thyroid to release T3/T4

38
Q

patho hypothyroidism

A

very common – 3-5% of population – more common in women, increases w/age

39
Q

causes hypothyroidism

A

Hashimoto’s, lymphocytic (after hyperthyroidism), thyroid destruction from radiation/surgery), pituitary/hypothalamic disease, medication s/e, iodine deficiency

40
Q

Hashimoto’s thyroiditis

A

most common cause of hypothyroidism in US – genetic, autoimmune – thyroid enlarged (goiter) w/decreased ability to produce hormones – 10-15x more common in women

41
Q

dx Hashimoto’s

A

low T3, high TSH & TRH

42
Q

s/s Hashimoto’s/hypothyroid

A

fatigue, cold intolerance, constipation, dry flaky skin

43
Q

patho diabetes mellitus type 1

A

pancreatic atrophy & loss of beta cells – does not produce insulin

44
Q

causes DM type 1

A

combo genetic & environmental factors

45
Q

s/s DM type 1

A

hyperglycemia, polydipsia, polyuria, polyphagia, weight loss, fatigue

46
Q

patho DM type 2

A

insulin resistance

47
Q

dx DM

A

serum glucose > 130; glucose tolerance test; glycated hemoglobin test (measures glucose utilization over 6-12 wks)

48
Q

complications DM

A

hypoglycemia, DKA (type 1), HHNKS (type 2)

49
Q

hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

A

complication of DM type 2 in which high blood sugars cause severe dehydration, increases in osmolarity (relative concentration of solute) and a high risk of complications, coma and death

50
Q

diabetic ketoacidosis (DKA)

A

body burns fatty acids in absence of insulin, which produces ketone bodies

51
Q

dx DKA

A

hyperglycemia, acidosis, ketones in blood/urine

52
Q

dx HHNKS

A

MRI, hyperglycemia

pathophysiology (7 decks)

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