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Summer AP II > SG 3 endocrine Mo > Flashcards

SG 3 endocrine Mo Flashcards

1
Q

How do you treat excessive GH?

A

Octreoid

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2
Q

what hormone decreases glucose uptake into the cells?

A

GH (diabetogenic)

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3
Q

Hormone responsible for lactogenesis and breast development

A

prolactin

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4
Q

what inhibits prolactin secretion?

A

dopamine and dopamine agonists.

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5
Q

is prolactin regulated by positive or negative feedback and how?

A

Prolactin inhibit its own secretion by stimulating the hypothalamic release of dopamine

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6
Q

What hormone inhibits ovulation, spermatogenesis, and causes impotence and loss of libido in men?

A

Prolactin

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7
Q

what two things can cause you to have an excess of prolactin?

A

prolactinomas and hypothalamic destruction

destruction of the AP would cause deficiency of prolactin

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8
Q

why do antipsychotic meds increase prolactin secretion?

A

dopamine antagoinist thus prolactin can be in excess

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9
Q

ADH and oxytocin are sythesized where?

A

hypothalamic nuclei; supraoptic and parventricular

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10
Q

What does secretion of ADH cause?

A

You do not urinate.

Increases water reabsorption from late distal tubules and collecting ducts, potent vasoconstirctor.

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11
Q

What increases or decreases ADH?

A

Increased serum osmolarity increases ADH (high sodium, holding onto water to try and dilute it)

decreased serum osmolarity decreases ADH

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12
Q

Is DI an overproduction or underproduction of ADH?

A

underproduction

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13
Q

You can NOT concentrate your urine if you do not have?

A

ADH

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14
Q

What does it mean to have SIADH and what does it look like?

A

overproduction of ADH

low sodium (<120)
signs of brain swelling, lethargy, weakness, seizures, coma, death.
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15
Q

what three things can increase the secretion of oxytocin?

A

suckling, dilation of Cx and orgasim.

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16
Q

oxytocin can be used for what two purposes?

A

induce labor and reduce PPH

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17
Q

Synthesis of thyroid horomone?

A

transport of iodide from blood stream into cells.
oxidation of iodide to iodine (1-2) which is catalyzed by peroxidase enzyme.
organification of I2 resulting in the formation of MIT and DIT.
Coupling of MIT and DIT to produce T4 and T3.
Binding of T3 and T4.
Conversion of T4 to T3

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18
Q

Is graves dz high or low thyroid hormone?

A

high

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19
Q

What is the best screening test to find out if someone has hyper or hypo thyroidism?

A

TSH level

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20
Q

Is TSH high or low in hyperthyroidism?

A

low

21
Q

Is TSH high or low in hypothyroidism?

A

high

22
Q

Treatment for hypothyroidism

A

levothyroxine which is T4 replacement

23
Q

Treatment for hyperthyroidism?

A

beta blockers

radioactive iodine

thyroidectomy

propylthiouracil which is a medication that blocks peroxidase thus no synthesis of thyroid hormone.

24
Q

is cretinism a baby with low or high thyroid?

A

low= hypothyroidism

25
Q

pre-op for a person with hyperthyroidism?

A

No surgery until the patient is Euthyroid with medical treatment
Antithyroid medication (PTU, methimazole)
High dose of sodium iodide (decrease size of gland and decrease risk of bleeding)
Beta blockers (esmolol )
Benzodiazepine for sedation

26
Q

drugs you DO NOT want to use with someone who is having surgery has hyperthyroid?

A

Ketamine , pancuronium , indirect-acting adrenergic agonist and other drugs that stimulates sympathetic nervous system are avoided because risk of elevation of blood pressure and heart rate

27
Q

What nerve typically becomes palsy with subtotal thyroidectomy and what is the sign of that?

A

RLN palsy= stridor

28
Q

low blood calcium (such as from removal of the Parathyroid gland by accident with Thyroid surgery) would result in what signs?

A

increases neural excitability thus you will see muscle spasms and tetany.

29
Q

with hypothyroidism what is one thing you have to worry about with intubation?

A

difficult intubation due to enlarged tongue

30
Q

post op if someone has hypothyroid you do not want to give them?

A

opioids for post op pain

31
Q

what are the three zones of the adrenal cortex and what does it produce?

A

Zona Glomerulosa - Aldosterone (outer layer)
Zona Fasiculata - Cortisol (middle layer)
Zona Reticularis - Androgen (inner layer)

corresponds with salt (Na+)
sugar (glucocorticoids), and sex (androgen)

32
Q

what hormone is the fight or flight hormone?

A

cortisol

33
Q

if you increase cortisol levels then what else will you increase? (also if you decrease cortisol then it will decrease)

A

BP

34
Q

What does this describe?

Is controlled by ACTH, but is separately regulated by the renin-angiotensin system.

A

Mineralocorticoids (Aldosterone)

35
Q

Action of Aldosterone: it increases and decreases what renal electrolytes?

A

Aldosterone has the renal system secrete K and H and reabsorb sodium!

36
Q

What disease is a primary adrenal insufficiency with increased ACTH?

A

addison’s dz

37
Q

What are some of the symptoms of addison’s dz?

A

LOW- aldosterone, and all the steroids produced (hormones) by the adrenal gland.
hypotension
hypoglycemia due to low cortisol
hyperpigmintation
hyperkalemia and hyponatremia (no aldosterone)
metabolic acidosis

38
Q

anesthesia consideration with Addison’s dz?

A

steroid coverage during perioperative period

39
Q

What can chronic treatment with steroids cause?

A

atrophy of adrenal cortex, look like addison’s dz some.

DOES NOT have high K, hyperpigmentation, metabolic acidosis, or volume contraction like addisons tho

40
Q

Excess of glucocorticoids describes with what syndrome?

A

Cushings syndrome

due to prolonged intake of steroids

41
Q

What is Cushings dz caused by?

A

when it is caused by pituitary adenoma that release excessive ACTH

42
Q

How do you test to see if someone has cushings dz?

A

HIGH dose dex test (8mg), will suppress secretion of cortisol.

43
Q

If you have too much aldosterone from a tumor what syndrome is that?

A

Conn’s

44
Q

symptoms of Conn’s syndrome?

A 
because it is too much aldosterone you will see
hypertension
hypernatremia
hypokalemia
low plasma renin 
and met. alk.

(low plasma renin is due to neg. feedback due to high BP and ECF)

45
Q

High plasma renin would be associated with what issue?

A

2ndary hyperaldosteronism caused by CHF

46
Q

treatment for too much aldosterone?

A

spironolactone (aldosterone antagonist)

47
Q

What is CAH?

A

Enzymatic deficiency in cortisol…

48
Q

what is the most common type of CAH? and what does it cause?

A

21B hydroxylase deficiency

masculinization in women and

49
Q

Vit D deficiency has what effect on Ca absorption?

A

causes low intestinal absorption of calcium

Summer AP II (3 decks)

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