Patho & Pathophis week 10 (endocrine/enviromental) Flashcards
How does the endocrine system and the nervous system work together?
The hypothalamus links the two systems via the pituitary gland
How does the anterior pituitary gland stimulate other endocrine glands to release their hormones
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
What hormones are released by the Posterior pituitary gland
ADH - Anti diuretic hormone
Oxy - Oxytocin
These have a dorect affect on the cells (not having an effect on the other glands)
What is Hypopituitarism
This is the deficient secretion of hormones from the pituitary gland
This can be a complex syndrome involving metabolic dysfunction, sexual immaturity & growth retardation
What does the Thyroid gland do
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)
What are the 2 main hormones of the pituitary
T4 is most abundant
T3 is actually made from T4
Can disorders arise from hypothalamus dysfunction and pituitary dysfunction
YES
This is because the release of these hormones usually work on a negative feedback system involving both the hypothalamus and pituitary gland
What is Goitre
This is enlargement of the thyroid gland.
May be caused by hypo & hyperthyroidism
What is the different between Simple & Endemic Goitre
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
What can hyperthyroidism cause
This is an overactive thyroid causing metabolic imbalances due to increased secretion of T4 & T3. It stimulates protein, lipid & carbohydrate metabolism
What is graves disease
This is the most common form of hyperthyroidism.
Autoimmune disorder leads to increase of T4
What are some symptoms of Graves disease
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
What is Thyroid storm (Thyrotoxic Crisis)
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
What is hypothyroidism
Under active insufficiency/resistance to thyroid hormone.
Common more prevalent in woman. Often treated with replacement thyroid hormone
What does Severe hypothyroidism occur in
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
What is Myxedema coma
This is ACUTE hypothroidism causing
Hypoglycemia
Hypotension
Hypothermia
LOC
What are the 2 main parts of the adrenal glands
The adrenal medulla & adrenal cortex
What parts of the adrenal glands secrete what
Medulla secrete - adrenaline/noradrenaline
Cortex secrete 3 types of hormones - Glucocorticoids (cortisol)
Mineralocorticoids (aldosterone)
Adrenal androgens (male sex hormones)
What is cushing’s syndrome
This is where the body produces excess cortisol hormones. May be secondary to the body creating excess glucocorticoids
What are some symptoms of cushing’s syndrome
What is Addison’s disease
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
What are some concerns for a paramedic with Addison’s Disease
Fever
Syncope
Hypoglycemia
Severe vomiting/ diarrhea
hypoadrenal shock
What are the 2 types of tissue in the Pancreas
Acini - secrete digestive enzymes
Islets of Langerhans -
Beta cells: secrete insulin & amylin
Alpha cells: Secrete glucagon
Type 1 diabetes
This is Characterised by the destruction of the beta cells that produce insulin
Type 2 diabetes
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
Why is type 2 diabetes a silent killer
Prolonged Hyperglycemia causes a inflammatory response which causes damage to the endothelial cells of the blood vessels
What are some clinical manifestation of diabetes
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)
What is DKA
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)
What is Hyperglycemia Hyperosmolar State (HHS)
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
What are some medications for diabetics
What is Diabetes Insipidus
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)
What is Gestational Diabetes
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
