Pathophys ch25 Endocrine Flashcards
Hyposecretion
deficit of hormone
Hypersecretion
excessive amounts of hormone
Adenoma
- Benign tumor in the gland - May be secretory - causing excess hormone - May be destructive - causing a deficit of hormone
Target cell involvement in disease?
may become resistant or insensitive to the hormone - creating the effect of a hormone deficit
Diabetes mellitus – What is it?
Disease caused by deficit of insulin secretion or lack of response by cells to insulin
Diabetes mellitus – S&S
- polyuria - polydipsia - polyphagia
- hyperglycemia - glucosuria - ketoacidosis - ketouria
Insulin deficit
results in abnormal carbohydrate - protein - and fat metabolism because the transport of glucose and amino acids into cells is impaired as well as the synthesis of protein and glycogen
Type 1 diabetes affect whom?
Occurs most frequently in children and young adults
Type 1 diabetes – pathophysiology
Insulin deficit results from destruction of cells from an autoimmune reaction
Type 1 diabetes – treatment
Insulin replacement is required
Type 2 diabetes affects whom?
Develops gradually in adults. Obesity and sedentary are factors.
Type 2 diabetes – pathophysiology
Decreased effectiveness of insulin or a relative deficit of insulin
Type 2 diabetes – treatment
Controlled by diet - exercise - oral medication - insulin replacement
Metabolic syndrome
a complex of several conditions marked by obesity - CV changes - and significant insulin resistance due to increased adipose tissue
Gestational diabetes
may develop during pregnancy and disappear after delivery of the child
(Acute complications of diabetes) Hypoglycemia
excess insulin causing a deficit of glucose in the blood
(Acute complications of diabetes) Hypoglycemia
Lack of glucose quickly affects the nervous system
(Acute complications of diabetes) Hypoglycemia
S&S - weakness - confusion - pallor - tremor - may lead to loss of consciousness - seizures - and death
(Acute complications of diabetes) Diabetic ketoacidosis
Insufficient insulin which leads to high blood glucose levels and mobilization of lipids
(Acute complications of diabetes) Diabetic ketoacidosis
S&S - thirst - dry skin - oliguria - acetone breath - nausea - vomiting - and can eventually lead to coma
(Acute complications of diabetes) Hyperosmolar hyperglycemic nonketotic coma
Infection or over indulge in carbohydrate using more insulin than anticipated
(Acute complications of diabetes) Hyperosmolar hyperglycemic nonketotic coma
Hyperglycemia and dehydration develops but sufficient insulin is available to prevent ketoacidosis
(Acute complications of diabetes) Hyperosmolar hyperglycemic nonketotic coma
S&S - neurologic deficits - muscle weakness - difficulty with speech
(Chronic complications of diabetes) Microangiopathy
capillary basement membrane becomes thick and hard - this causes obstruction or rupture of capillaries and small arteries and results in necrosis with loss of function
Retinopathy
the leading cause of blindness
Nephropathy
vascular degeneration in the glomeruli
(Chronic complications of diabetes) Macroangiopathy
Atherosclerosis leading to heart attacks - strokes - peripheral vascular disease
(Chronic complications of diabetes) Macroangiopathy
Obstruction of blood vessel in the legs results in ulcers on the feet and legs that are slow to heal
(Chronic complications of diabetes) Peripheral neuropathy
Results from ischemia and altered metabolic process in neurons
(Chronic complications of diabetes) Peripheral neuropathy
Leads to impaired sensations - numbness - tingling - and muscle wasting
(Chronic complications of diabetes) Infections
More common and more severe because of the vascular impairment - decreased tissue resistance - delayed healing
(Chronic complications of diabetes) Infections
Fungal infection occur frequently on the skin in body folds - oral cavity and vagina
(Chronic complications of diabetes) Cataracts
Related to abnormal metabolism of glucose
(Chronic complications of diabetes) Cataracts
Results in accumulated sorbitol and water in the lens
(Parathyroid hormone and calcium) Hypoparathyroidism
May be caused by lack of glands - surgery - radiation - or autoimmune
(Parathyroid hormone and calcium) Hypoparathyroidism
leads to hypocalcemia or low serum calcium levels
(Parathyroid hormone and calcium) Hypoparathyroidism
S&S - weak cardiac muscle contractions - increased excitability of nerves leading to spontaneous contraction of skeletal muscle
(Parathyroid hormone and calcium) Hyperparathyroidism
May be caused by an adenoma - hyperplasia - or secondary to renal failure
(Parathyroid hormone and calcium) Hyperparathyroidism
Leads to hypercalcemia or high serum calcium levels
(Parathyroid hormone and calcium) Hyperparathyroidism
S&S - forceful cardiac contractions - osteoporosis - kidney stones
(Pituitary hormones) Benign adenomas
are the most common cause of pituitary disorders
(Pituitary hormones) Benign adenomas
the mass causes increased ICP and associated signs
(Pituitary hormones) Benign adenomas
Tumor cells may secrete excessive amounts of hormones or may destroy cells causing a deficit of a hormone
(Growth hormone) Pituitary dwarfism
Deficit of growth hormone; Normal intelligence and normal body proportions
(Growth hormone) Gigantism
excess GH secretion before puberty
(Growth hormone) Acromegaly
Excess GH secretion in the adult; Bones become broader and heavier - resulting in enlarged hands and feet - a thicker skull - and changes in the facial features
(Antidiuretic hormone) Diabetes insipidus
Deficit of ADH; Polyuria with large volumes of dilute urine and thirst - eventually causing dehydration
(Antidiuretic hormone) Inappropriate ADH syndrome
Excess ADH; Causes retention of fluid - mental confusion and irritability
Thyroid disorders
May result from pituitary or thyroid gland dysfunction
(Thyroid disorders) Goiter
enlargement of the thyroid gland
Endemic goiter
i) Low iodine levels in soil and food; ii) Iodine deficiency leads to low T3 /T4 production and increased TSH producing hyperplasia and hypertrophy in the thyroid gland
Toxic goiter
hyperactivity of the thyroid gland
(Thyroid disorders) Hyperthyroidism/Grave’s disease
Related to an autoimmune factor - antibodies mimic TSH
(Thyroid disorders) Hyperthyroidism/Grave’s disease
S&S - hypermetabolism - toxic goiter - exophthalmos
Thyroid storm
uncontrolled hyperthyroidisms usually precipitated by infection or surgery
(Severe hypothyroidism) Hashimoto’s thyroiditis
destructive autoimmune disorder
(Severe hypothyroidism) Myxedema
i) Severe hypothyroidism in adults; ii) Myxedema coma results in hypotension - hypoglycemia - hypothermia - loss of consciousness
(Severe hypothyroidism) Cretinism
i) Untreated congenital hypothyroidism; ii) Results in severe impairment of all aspects of growth and development
(Adrenal medulla) Pheochromocytoma
benign tumor that secretes epinephrine - norepinephrine - etc.
(Adrenal medulla) Pheochromocytoma
Causes hypertension
(Adrenal medulla) Pheochromocytoma
S&S - headache - palpitations - sweating - anxiety
(Adrenal cortex) Cushing’s syndrome
Excessive amount of glucocorticoids (hydrocortisone - cortisol)
(Adrenal cortex) Cushing’s syndrome
Result from adrenal adenoma - pituitary adenoma - ectopic carcinoma - iatrogenic conditions (Fig. 25-17 - pg. 568)
(Adrenal cortex) Cushing’s syndrome
S&S - moon face - heavy trunk - fat on back of neck - wasting of muscles in the limbs - fragile skin - osteoporosis - delayed healing
(Adrenal cortex) Addison’s disease
deficit of glucocorticoids - mineral corticoids and androgens
(Adrenal cortex) Addison’s disease
Autoimmune reaction or destruction of glands
(Adrenal cortex) Addison’s disease
S&S - decreased blood volume - BP - weight - blood glucose - serum Na+ and stress responses with increased K+ and infection
