Regulatory Disorders of glands Flashcards
List pituitary hormones:
Anterior (6)
Posterior (2)
ANTERIOR: Corticotropin (ACTH) Somatotropin (GH) growth hormone Thyrotropin (TSH) Follicle stimulating (FSH) Luteinizing hormone (LH) Prolactin
POSTERIOR:
Antidiuretic (ADH)
Oxytocin
Antidiuretic hormone (ADH) Also known as Vasopressin
Which gland secretes it?
What are it’s actions and effects?
Pituitary
Targets kidneys
ADH helps regulate fluids by regulating urine output.
When secretion of ADH is low, urinary output increases.
Trauma, pain, anxiety exposure to high temperature all increase ADH release, lowering urine output.
Corticotropin ACTH
Which gland secretes it?
What are it’s actions and effects?
Pituitary
Targets adrenal glands
ACTH stimulates adrenal gland to produce glucocorticoid and mineralcorticoid hormones.
Increased production of adrenal gland decreases ACTH production and vice versa
AdrenoCorticoTropic Hormone
Somatotropin- growth hormone (GH)
Which gland secretes it?
What is its target and effects?
Pituitary
Target: acts on all body cells
Increases bone and cartilage growth by increasing absorption of calcium in GI.
If GH is inhibited, growth will be stunted.
and if GH is overproduced, growth will be excessive.
Thyrotropin TSH
Which gland secretes it?
What are it’s actions and effects?
Pituitary
Targets thyroid gland
Stimulates thyroid to produce thyroxine and triiodothyronine.
Too little tsh leads to inactivity of thyroid.
Too much tsh causes hypertrophy(overgrowth) of thyroid.
Which gland regulates the pituitary?
Where is pituitary located?
Hypothalamus regulates pituitary.
Pituitary is located in sella turcica, a depression in sphenoid bone.
What must be ruled out as cause of decreased growth hormone?
Pituitary tumor
Sudden halted growth suggests a tumor.
Gradual failure suggests idiopathic involvement.
Signs symptoms of pituitary tumor:
Sudden halted growth. Vision loss Headache Increased head circumference Nausea vomiting
Management of GH deficiency
Hypopituitariantism
Treated by IM rhGH usually given at bedtime which is time of day that GH peaks.
Cause of Diabetes insipidus
Decreased release of ADH (antidiuretic hormone)
Causes less reabsorption of fluid by kidney tubules.
Urine becomes dilute and large amount of fluid is lost by urine.
May result from a lesion, tumor or injury to posterior pituitary.
Symptoms of diabetes insipidus
Polydipsia - excessive thirst
Polyuria
Very low specific gravity
Hypernatremia (fever, irritable, lethargic, headache, seizures)
Weight loss
Dehydration
Death
Treatment of diabetes insipidus
Desmopressin, an arginine vasopressin
Which hormones are secreted by thyroid? (3)
Thyroxine - T4
Triiodothyronine- T3
Calcitonin
Congenital hypothyroidism
(Screening is mandatory in US)
Cause and symptoms:
Born with absent or nonfunctional thyroid. sleeps excessively Enlarged tongue Cold, dry scaly extremities. No perspiration Short neck Constipation
If untreated, will result in irreversible cognitive delay
Corticosteroids
Hormones produced by adrenal cortex
Acromegaly
Over secretion of growth hormone
Cushing Syndrome symptoms
Weight gain and fatty tissue deposits, particularly around the midsection and upper back, in the face (moon face), and between the shoulders (buffalo hump)
Pink or purple stretch marks (striae) on the skin of the abdomen, thighs, breasts and arms
Thinning, fragile skin that bruises easily
Slow healing of cuts, insect bites and infections
Acne
Causes of Cushing syndrome
Oral corticosteroids
Over secretion of Adrenocorticotropic hormone.
Cushing syndrome
Sodium and potassium levels?
Can have hypernatremia And hypokalemia
Myxedema
Myxedema refers to a severe form of hypothyroidism than can occur when the condition is left untreated or is not treated sufficiently. The term also applies to the effects that hypothyroidism can have on the skin, making it appear swollen and puffy.
Hashimoto’s hypothyroidism
Anti-thyroid antibodies attack thyroid gland and it does not make T4.
The pituitary, working on negative feedback, keeps sending more tsh.
High TSH is hypothyroidism.
Types of hyperthyroidism
Hyperthyroidism has several causes, including Graves’ disease, thyroid nodules, and thyroiditis—inflammation of the thyroid.
Rarely, hyperthyroidism is caused by a noncancerous tumor of the pituitary gland located at the base of the brain.
Consuming too much iodine or taking too much thyroid hormone medicine also may raise your thyroid hormone levels.
Graves’ disease
Graves’ disease is the most common cause of hyperthyroidism. Graves’ disease is an autoimmune disorder. With this disease, your immune system attacks the thyroid and causes it to make too much thyroid hormone
syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Caused by excessive ADH secretion from Pituitary gland.
Retain fluids
accounts for approximately one-third of all cases of hyponatremia
If water intake exceeds the reduced urine output, the ensuing water retention leads to the development of hyponatremia
Treatment of SIADH
Fluid restrictions
Diuretics
Euthyroid
Normal thyroid production
Calcitonin
Secreted by thyroid gland.
Secreted in response to High plasma levels of calcium.
Reduces plasma level of calcium by increasing it deposit in bone.
Parathyroid hormone does what?
Regulates calcium and phosphorus metabolism. Increased Parathormone results in increased calcium absorption from the kidney, intestine, and bones which raises the serum calcium level.
Hyperparathyroidism
Overproduction of parathormone by parathyroid glands.
Characterized by bone decalcification and development of renal calculi containing calcium.
Elevated serum calcium levels
Hypercalcemic crisis
Calcium levels greater than 13 result in neurologic, cardiovascular, and kidney symptoms that can be life-threatening.
Requires Rapid rehydration and administration of calcitonin.
Hypoparathyroidism
Caused by abnormal parathyroid development, destruction of parathyroid glands and vitamin D deficiency.
Deficiency of parathormone results in increased blood phosphate and decreased blood calcium levels.
Sx: tetany, anxiety, delirium.
Symptoms of hypocalcemia or hypoparathyroidism.
Treatment of hypoparathyroidism
Tetany, positive chvostek’s sign or positive Trousseau’s sign.
Treatment increases calcium. Treatment may include combinations of Calcitrol, calcium, magnesium and vitamin D.
Diet high in calcium and low in phosphorus is recommended
Pheochromocytoma
Benign tumor of adrenal medulla.
Causes high blood pressure and is usually fatal if undetected. Can be cured by surgery.
Addison’s disease causes
Decreased cortisol.
Also known as adrenocortical insufficiency. Auto immune or idiopathic atrophy of adrenal glands accounts for many.
Other causes Are tuberculosis or surgical removal of both adrenal glands.
Therapeutic use of corticosteroids is the most common cause of adrenal cortical insufficiency.
Symptoms of Addison’s disease
Muscle weakness, anorexia, G.I. symptoms, dark pigmentation of mucous membranes in skin, hypotension,
low sodium, high potassium,
dehydration.
Difference between Cushing’s syndrome and Addison’s disease
Cushing’s : hyperproduction of adrenocortical hormone.
Hypernatremia and hypokalemia
Addison’s: hypoproduction of adrenocortical hormone
Hyponatremia and hyperkalemia
Aldosterone
Conserves body sodium. Kidneys excrete less sodium and more potassium and hydrogen.
Aldosteronism - overactive aldosterone
Symptoms and treatment
Universal sign of aldosteronism is hypertension.
Hypokalemia and alkalosis due to the excretion of potassium and hydrogen.
Treatment usually involves surgical removal of adrenal tumor.
What are the 3 types of corticosteroids that are secreted by adrenal cortex?
And what are their basic description and examples
Glucocorticoids - stress hormones- cortisol
Mineralocorticoids- regulate fluid and electrolytes—aldosterone
Sex hormones - androgens and estrogens
Name 2 catecholamine hormones that are excreted by adrenal medulla.
Epinephrine
Norepinephrine
Fight or flight
Sympathetic nervous system
“Master gland” of endocrine system
Pituitary
What illness/ disease is caused by high levels of corticosteroids?
Cushing’s syndrome
