Pathophysiology - Metabolic/Endocrine Flashcards
test 2
What is the endocrine system made up of?
Glands, clusters of specialized cells, hormones, target tissues
What system is working with the endocrine system to maintain homeostasis and metabolic activity?
Nervous System
What is the endocrine responsible for?
hormone secretion, chemical transmission to the NS
What are the affected body functions of the endocrine system?
growth, development, energy metabolism, mm and adipose tissue, distribution, sexual development, fluid balance, inflammation, immune response
What is hormone secretion supported by?
hypothalamus
T or F?
Endocrine system is a negative feedback mechanism
True
What is hyperpituitarism?
Abnormal increase of pituitary hormone affecting ones growth
What are the two types of hyperpituitarism?
Gigantism (before puberty)
Acromegaly (after puberty)
Hormones secreted in hyperpituitarism…
prolactin, adrenocorticotropic hormone, and growth hormone
What is the etiology of hyperpituitarism?
pituitary adenomas from the anterior lobe
What is the clinical manifestation of gigantism and acromegaly?
Gigantism - increased growth rate w/ slow mental & sexual development
Acromegaly - enlargement of small bones and soft tissues
How is hyperpituitarism diagnosed?
Physical examination, blood test w/high GH, TH, prolactin, tumor (MRI)
Treatment of hyperpituitarism?
Surgical removal of tumor if present
T or F?
Hyperpituitarism prognosis is good for both giantism and acromegaly
False, acromegaly differs - often shortens life span and can lead to other diseases
What is HYPOpituitarism (dwarfism)?
Decrease in pituitary activity
How does hyppituitarism affect ones development?
Abnormal or absence of secondary sexual characteristics, underdeveloped sexually and mentally
What are the two types of hypopituitarism caused by?
Complete loss of anterior lobe pituitary function
Primary: caused by pituitary disorders
Secondary: caused by hypothalamus disorders
What is the main etiology of hypopituitarism?
Benign pituitary tumor
What is the clinical manifestation of hypopituitarism?
- Growth hormone deficiencies
- Women: amenorrhea or infertility
- Men: lower testosterone levels
- Short stature
Treatment of hypopituitarism
Hormone replacement
What is diabetes insipidus?
Disturbance of water metabolism
What can diabetes insipidus lead to?
Excessive thirst, frequent urination, constipation, hypotension
What is the cause of diabetes inspidus?
Deficiency of ADH(vasopressin) release
What is the treatment of diabetes insipidus?
Vasopressin tablet or nasal spray; nephrogenic via increase of fluid intake
What is a simple goiter?
Enlarged thyroid gland
What is the clinical manifestation of a simple goiter?
neck bulge
What is the diagnosis of a simple goiter?
physical examination, T3 and T4 blood test, ultrasound, fine needle biopsy
T or F?
Simple goiters prognosis is poor and progressive
FALSE. Prognosis is good as long as the goiter does not restrict breathing/swallowing
What is Hashimoto’s thyroiditis?
Chronic immune thyroiditis and lymphocytic thyroiditis where antibodies destroy the thyroid gland tissues
T or F?
Hashimoto’s is believed to be genetic
True
What is the tx of Hashimotos?
Thyroid hormone replacement, surgical excision, chemotherapy, radiation
What is the clinical manifestation of Hashimotos?
Hypothyroidisms, weight gain, fatigue, mental apathy, cold sensitivity
T or F?
All Hashimotos has a good prognosis
False, mild has a good prognosis
What is hyperthyroidism?
Excess T4 secretion of the thyroid gland
What is graves disease?
In hyperthyroidism and occurs when thyroid gland is hypertrophied resulting in diffuse goiter
T or F?
Graves Disease is autoimmune and genetically linked
True
What is hyperthyroidisms clinical manifestation?
Increase in metabolic changes that lead to:
- tachycardia
- hypertension
- weight loss
- heat intolerance
- hair loss
- excessive thirst
- nervousness
How do you diagnose hyperthyroidism?
Elevated T3 and T4 levels
T or F?
Tx of hyperthyroidism is the reduction of thyroid hormones being secreted with beta blockers. If severe - radioactive iodine therapy
True
What is HYPOthyroidism?
Not enough TSH that leads to low thyroid hormone levels
Two types of hypothyroidism?
cretinism - infancy or early childhood
myxedema - older children and adults
What is the cause of hypothyroidism?
Absence of T3 and T4, destruction of thyroid gland
What is the clinical manifestation of hypothyroidism?
Cretinism - mental and growth deficiencies, protruding abdomen
Myxedema - heavy periods, weight gain, cold intolerance, hair los, slurred speech, thick tongue
How is hypothyroidism diagnosed and treated?
- dx blood test, thyroid scan
- tx thyroid hormone therapy
What is thyroid storm?
Life threatening thyrotoxicosis
What is the etiology of thyroid storm/cancer?
uncommon, genetical, radiation exposure
What is the clinical manifestation of thyroid storm/cancer?
Hoarseness, Cushing syndrome, vocal cord paralysis, difficulty swallowing, cervical lymph adenopathy
What is the thyroid storm/cancer tx?
removal of thyroid and nearby lymph nodes, T4 therapy
T or F?
Thyroid cancer/storms prognosis depends on the size and age
True
What is hyperparathyroidism?
overproduction of parathyroid hormone
What is hypothyroidism?
Decrease in PTH that leads to low blood calcium levels
What is Cushing disease?
Pituitary form - excessive ACTH production
What is the etiology of Cushing syndrome?
Pituitary or adrenal tumors developed after prolonged doses of cortisone
How is cushing syndrome presented?
“Moon face”, “buffalo hump” on the upper back, poor wood healing, thin arms and legs w/ rounded abdomen, osteoporosis, hypertension
What is the dx of cushing syndrome?
Dx: hypersecretion of cortisol, plasma levels of ACTH, tumor MRI
What is the tx of cushing syndrome?
Surgical removal of tumor
What is Addisons disease?
Adrenal hypofunction w/ deficiencies of mineralocorticoids, glucocorticoids, and androgens
What is the clinical manifestation of Addisons Disease?
Fatigue, anorexia, GI complications, bronze skin, CV abnormalities, emotional distress
How to diagnoses Addisons disease?
Low blood and urine cortisol levels
Tx of Addisons Disease
Medication, increased fluid intake, hormone replacement
What is diabetes mellitus?
Chronic metabolic disorder from hyperglycemia that is a result from lack of insulin
Type 1 diabetes mellitus -
Absolute insulin insufficiency
Type 2 diabetes mellitus -
Insulin resistance
What are normal glucose levels?
60-100 mg/dl
Who is effected the most by type 1 diabetes?
Children and young adults
Who is effected the most by type 2 diabetes?
Pts typically obese and over 40 yo
What is the risk factor in gestational diabetes?
Future occurrence of Type 2 diabetes mellitus for mother and infant
What is the clinical manifestation of diabetes mellitus?
Polyuria, polydipsia, hyperglycemia, ketone formation in blood and urine, fatigue, neural tissue damage
How is type 1 diabetes presented?
Slower breathing, fruity breath, sweating, light headed
How is type 2 diabetes conrolled?
Through diet and exercise
How to dx diabetes mellitus
fasting glucose, glucose tolerance test, hemoglobin A1c test
How many times a day should type 1 diabetes be monitored?
4-5x
How is type 1 diabetes treated?
Insulin therapy/injections
T or F?
Both types of diabetes mellitus prognosis are good
False - type 1 is poor because of the many complications that can happen
What is hypoglycemia?
Blood sugar level below 60 mg/dL
T or F?
Hypoglycemia is more dangerous than hyperglycemia because the brain cannot store glucose but is needed to function
True
What is the cause of hypoclycemia?
Excessive exercise, fasting, over administration of insulin, pancreatic ademona, GI disorder
How is hypoglycemia presented?
Light headed, disphoresis (sweating)
How to dx hypoglycemia?
Testing of glucose levels
Tx of hypoglycemia
glucose tablets, orange juice, candy
