Patho & Pathophis week 10 (endocrine/enviromental)

Question 1

How does the endocrine system and the nervous system work together?

Answer 1

The hypothalamus links the two systems via the pituitary gland

Question 2

How does the anterior pituitary gland stimulate other endocrine glands to release their hormones

Answer 2

Regulatory hormones are released from the hypothalamus into the anterior pituitary gland from here different hormones are secreted and get sent to the target organs

Question 3

What hormones are released by the Posterior pituitary gland

Answer 3

ADH - Anti diuretic hormone
Oxy - Oxytocin
These have a dorect affect on the cells (not having an effect on the other glands)

Question 4

What is Hypopituitarism

Answer 4

This is the deficient secretion of hormones from the pituitary gland

This can be a complex syndrome involving metabolic dysfunction, sexual immaturity & growth retardation

Question 5

What does the Thyroid gland do

Answer 5

This is one of the largest endocrine glands

It secretes two hormones in response to hypothalamic pituitary secretion

The 2 main functions are:
Increase metabolism & protein synthesis
Necessary for growth & development in children (mental development & sexual maturity)

Question 6

What are the 2 main hormones of the pituitary

Answer 6

T4 is most abundant
T3 is actually made from T4

Question 7

Can disorders arise from hypothalamus dysfunction and pituitary dysfunction

Answer 7

YES
This is because the release of these hormones usually work on a negative feedback system involving both the hypothalamus and pituitary gland

Question 8

What is Goitre

Answer 8

This is enlargement of the thyroid gland.
May be caused by hypo & hyperthyroidism

Question 9

What is the different between Simple & Endemic Goitre

Answer 9

Simple Goitre - thyroid gland enlarged to compensate, & overcome mild/moderate impairment

Endemic goite - affect regional groups of people where soil & food iodine levels are low

Question 10

What can hyperthyroidism cause

Answer 10

This is an overactive thyroid causing metabolic imbalances due to increased secretion of T4 & T3. It stimulates protein, lipid & carbohydrate metabolism

Question 11

What is graves disease

Answer 11

This is the most common form of hyperthyroidism.
Autoimmune disorder leads to increase of T4

Question 12

What are some symptoms of Graves disease

Answer 12

Hypermetabolism
Toxic goitre
Exophthalmos - eye muscles swell, pushing globe outwards

People aged 20-40 years are at most risk for developing graves disease
Woman are 5x more likely to develop graves disease

Question 13

What is Thyroid storm (Thyrotoxic Crisis)

Answer 13

This is a extreme life threatening form of graves disease (rarely seen) Mortality is extremely high

Life threatening because of
Hyperthermia
Tachycardia
Heart failure
Delirium

Question 14

What is hypothyroidism

Answer 14

Under active insufficiency/resistance to thyroid hormone.
Common more prevalent in woman. Often treated with replacement thyroid hormone

Question 15

What does Severe hypothyroidism occur in

Answer 15

Chronic autoimmune thyroiditis (hashimoto’s thyroiditis) autoantibodies destroy thyroid gland tissue leading to goitre

Myxedema - severe adult hypothyroidism

Cretinism - untreated congenital hypothyroidism; non functional or absent

Question 16

What is Myxedema coma

Answer 16

This is ACUTE hypothroidism causing
Hypoglycemia
Hypotension
Hypothermia
LOC

Question 17

What are the 2 main parts of the adrenal glands

Answer 17

The adrenal medulla & adrenal cortex

Question 18

What parts of the adrenal glands secrete what

Answer 18

Medulla secrete - adrenaline/noradrenaline

Cortex secrete 3 types of hormones - Glucocorticoids (cortisol)
Mineralocorticoids (aldosterone)
Adrenal androgens (male sex hormones)

Question 19

What is cushing’s syndrome

Answer 19

This is where the body produces excess cortisol hormones. May be secondary to the body creating excess glucocorticoids

Question 20

What are some symptoms of cushing’s syndrome

Answer 20

Question 21

What is Addison’s disease

Answer 21

This is the insufficient adrenocortical secretions from adrenal glands.

Primary cause is autoimmune destruction with more than 90% of both adrenal glands
Secondary cause is impaired pituitary secretion of andrenocorticotropin ACTH and is categorized by decreased glucocorticoid secretion

Question 22

What are some concerns for a paramedic with Addison’s Disease

Answer 22

Fever
Syncope
Hypoglycemia
Severe vomiting/ diarrhea
hypoadrenal shock

Question 23

What are the 2 types of tissue in the Pancreas

Answer 23

Acini - secrete digestive enzymes

Islets of Langerhans -
Beta cells: secrete insulin & amylin
Alpha cells: Secrete glucagon

Question 24

Type 1 diabetes

Answer 24

This is Characterised by the destruction of the beta cells that produce insulin

Question 25

Type 2 diabetes

Answer 25

Major factor leading to type 2 diabetes is obesity.
No auto immune destruction of beta cells.

may require insulin treatment due to overuse of beta cells resulting in damage

Question 26

Why is type 2 diabetes a silent killer

Answer 26

Prolonged Hyperglycemia causes a inflammatory response which causes damage to the endothelial cells of the blood vessels

Question 27

What are some clinical manifestation of diabetes

Answer 27

Polyphagia - Excessive hunger (becuase the cells are constantly starved of glucose)

Polyuria - Excessive urination (high blood glucose causes water to move out of the cell via the osmotic pull)

Polydipsia - excessive thirst (the dehydration of cells causes thirst)

Question 28

What is DKA

Answer 28

Diabetic Keto acidosis occurs when there is insufficient insulin leading to increased lipolysis & proteolysis

Glycerol & amino acids convert to glucose (gluconeogenesis)

Fatty acids convert to ketons (Ketosis) THESE ARE ACIDIC

To try reverse the amount of acid in the body you can have higher respirations to blow off more CO2 (Kussmaul respirations)

Question 29

What is Hyperglycemia Hyperosmolar State (HHS)

Answer 29

HHS is mainly in T2 diabetic patients. There is enough insulin to drive Potassium into cells but not enough insulin to drive glucose into the cell.

Can often be secondary to an infection or an over indulgence of carbohydrate

No ketons produced

Question 30

What are some medications for diabetics

Answer 30

Question 30

What is Diabetes Insipidus

Answer 30

This is where there is deficient ADH secretion or renal resistance to ADH

There are 3 forms
Neurogenic: deficiency of ADH acute onset
Nephrogenic: Resistance of renal tubules to ADH
Psychogenic: Caused by excessive fluid intake Leading to Polyuria (weeing alot)

Question 30

What is Gestational Diabetes

Answer 30

This is where pregnant woman develop diabetes.

Pregnancy causes a increase in blood glucose and the beta cells can not compensate, therefore insulin resistance occurs

it usually resolves itself when pregnancy is over