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DPT 631 > The Endocrine System > Flashcards

The Endocrine System Flashcards

1
Q

What are the main functions of the endocrine system?

A

Regulating metabolism and energy levels
Controlling growth and development
Managing stress responses
Regulating sexual fxn and reproduction
Maintaining fluid and electrolyte balance
Controlling mood, emotions, and sleep
Immune system regulation

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2
Q

What are the key endocrine glands?

A

Hypothalamus
Pituitary gland
Thyroid gland
Parathyroid glands
Adrenal glands
Pancreas
Pineal gland
Gonads

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3
Q

What is the function of the hypothalamus?

A

Controls other endocrine glands and regulates fxns like hunger, thirst, sleep, and emotions

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4
Q

What is the fxn of the pituitary gland?

A

It regulates hormones that influence growth, reproductive health, and other glands

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5
Q

Which endocrine gland is the “master gland”?

A

The pituitary gland

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6
Q

Hat is the fxn of the thyroid gland?

A

It produces hormones (T3 and T4) that control metabolism and affect growth and brain development

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7
Q

What is the function the parathyroid glands?

A

To regulate calcium levels in the blood

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8
Q

What is the fxn of the adrenal glands?

A

To produce hormones like cortisol and adrenaline, which manage stress and metabolism

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9
Q

What does cortisol and adrenaline do?

A

Manage stress and metabolism

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10
Q

What is the fxn of the pancreas?

A

To release insulin and glucagon to control blood sugar levels

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11
Q

What is the fxn of the pineal gland?

A

To produce melatonin to regulate the sleep cycle

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12
Q

What are the gonads?

A

Testes and ovaries

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13
Q

What is the fxn of the gonads?

A

To produce sex hormones (testosterone, estrogen, and progesterone) that influence sexual development and reproduction

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14
Q

What are the s/s of endocrine system struggles?

A

Joint pain
Muscle pain
Parasthesias
Dry, scaly skin
Constipation
Fatigue
Dyspnea
Brittle nails/hair
Weight change
Periorbital edema
Hoarseness
Polydipsia/polyuria

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15
Q

How can we get glucose?

A

Gliconeogenesis (made by our body), consumed in food, or released from our body’s glycogen stores

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16
Q

What hormone do we need to use glucose?

A

Insulin

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17
Q

Where is insulin made?

A

In the pancreas

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18
Q

Bc glucose can’t enter cells w/o the help of insulin, any impairment of the fxn of insulin results in what?

A

Excess glucose in the bloodstream

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19
Q

Why do people with DM tend to be fatigued?

A

Bc their cells aren’t getting energy from glucose

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20
Q

What is the only fuel the brain can use?

A

Glucose

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21
Q

What is type 1 DM?

A

An autoimmune condition where the immune system attacks and destroys insulin-producing cells in the pancreas

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22
Q

Why do people with type 1 DM need to take insulin for life?

A

Bc their bodies can no longer produce it

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23
Q

What percent of people with DM have type 1?

A

About 5-10%

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24
Q

When does type 1 DM often develop?

A

In childhood or adolescence

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25
Q

T/f: there is high levels of sugar in the blood and urine of those with type 1 DM

A

True

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26
Q

Why is frequent urination a common symptom with DM?

A

Bc the kidneys are trying to flush the excess glucose from the body

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27
Q

Why is frequent thirst a common symptom of DM?

A

Bc the body is trying to replace lost fluids

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28
Q

What are the symptoms of type 1 DM?

A

Frequent urination

Abnormally thirsty

Extreme hunger but loses weight

Blurred vision

Fatigue, irritability, and mood changes

Abdominal pain, nausea, vomiting, and fruity smelling breath

Onset of bedwetting in a child with no prior px

Vaginal yeast infection prior to puberty in girls

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29
Q

Why is fatigue, irritability, and mood changes a common symptom of DM?

A

Bc there is no glucose for energy

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30
Q

Why do people with DM sometimes have fruity smelling breath?

A

Bc of a buildup of ketones

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31
Q

Does type 1 or 2 DM have a sudden onset of symptoms?

A

Type 1

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32
Q

Does type 1 or 2 DM have gradual onset of symptoms?

A

Type 2

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33
Q

What is the average age of onset of type 2 DM?

A

About 45

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34
Q

What is type 2 DM?

A

The body has the physical ability to make insulin but doesn’t make enough or use insulin effectively

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35
Q

Which type of DM is more common, type1 or tyoe 2?

A

Type 2

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36
Q

Which type of DM is often linked to family hx of DM and lifestyle factors such as obesity, physical inactivity, and poor diet

A

Type 2 DM

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37
Q

Which type of DM is typically found in adults, but is increasingly seen in younger people due to lifestyle factors?

A

Type 2 DM

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38
Q

How is type 2 DM managed?

A

Through diet, exercise, oral meds, and sometimes insulin

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39
Q

What is gestational DM?

A

Diabetes that can develop during pregnancy and often resolves after giving birth

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40
Q

Gestational DM can increase the risk of what?

A

Developing type 2 DM later in life

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41
Q

T/f: gestational DM increases the risk of other complications during birth and pregnancy

A

True

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42
Q

T/f: gestational DM has symptoms that pregnant women should look for

A

False there are no symptoms

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43
Q

Why is it important for pregnant people to undergo glucose testing by weeks 24-28 of pregnancy.

A

Bc of the risks of gestational DM which has no symptoms otherwise

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44
Q

How can we reduce the risk of gestational DM?

A

With regular exercise activity and maintaining a healthy weight

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45
Q

What are the glucose testing procedures?

A

Oral glucose tolerance test (OGTT)
Glucated hemoglobin (A1C) test

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46
Q

What is the glucose testing procedure to test for gestational DM?

A

Oral glucose tolerance test (OGTT)

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47
Q

What does the oral glucose tolerance test (OGTT) do?

A

It measures blood sugar b4 and 1-2 hours after consuming a sweet drink with 75g of glucose

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48
Q

What are normal results of an OGTT?

A

<140 mg/dL after 2 hours

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49
Q

What OGTT results indicate pre-diabetes?

A

140-199 mg/dL or higher after 2 hours

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50
Q

What OGTT results indicate diabetes?

A

200 mg/dL or higher after 2 hours

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51
Q

T/f: one OGTT is good to draw conclusions on diabetes risk

A

False, we usually want a few tests done

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52
Q

What does the glycated hemoglobin (A1C) test measure?

A

The average level of blood sugar in hemoglobin over 2-3 months

53
Q

What is hemoglobin?

A

The protein in RBCs that are responsible for carrying oxygen

54
Q

When glucose is in the bloodstream, some attaches to _____ and it becomes ______ ________

A

Hemoglobin, glycated hemoglobin

55
Q

The higher your blood glucose levels are the ______ hemoglobin that has sugar attached

A

More

56
Q

What are normal A1C results?

A

<5.7%

57
Q

What A1C results point towards prediabetes?

A

5.7-6.4%

58
Q

What A1C results point towards diabetes?

A

> 6.5% on separate tests

59
Q

What do continuous glucose monitors (glucometers) do?

A

They more accurately and conveniently track glucose levels at home to help follow glucose levels over time and measure response to exercise and foods

60
Q

What population may especially benefit from CGM?

A

Children with type 1 DM

61
Q

What are the ways to manage tyoe 1 DM?

A

Insulin therapy
Blood sugar monitoring
Diet and exercise

62
Q

Why is insulin therapy used to manage type 1 DM?

A

Bc the body can no longer produce insulin so they need to take daily insulin through pump or injections

63
Q

T/f: blood sugar needs to be monitored multiple times a day in type 1 DM

A

True

64
Q

How can we monitor blood sugar throughout the day?

A

Blood testing or CGM

65
Q

T/f: following a balanced diet and regular physical activity helps maintain stable blood sugar levels

A

True

66
Q

What are ways to manage type 2 DM?

A

Lifestyle changes
Oral meds
Insulin therapy
Blood sugar monitoring

67
Q

What lifestyle changes can be made to manage type 2 DM?

A

Balanced diet low in processed sugars and refined carbs
Regular physical activity

68
Q

How do oral meds help manage type 2 DM?

A

Drugs like metformin help lower blood sugar levels
Other meds may help the body use insulin more effectively or stimulate the pancreas to produce more insulin

69
Q

T/f: insulin therapy may or may not be need to manage type 2 DM

A

True

70
Q

What are important PT concerns surrounding DM?

A

Monitoring A1C
BP
Skin/footwear

71
Q

What are some fast acting glucose sources to manage emergency hypoglycemia?

A

Juice boxes, regular soda, hard candies, glucose tablets/gels

72
Q

What is an important consideration with fast acting glucose sources?

A

We have to make sure that they don’t go bad b4 using them

73
Q

What are possible systemic complications of DM?

A

CV disease
Nerve damage (neuropathy)
Kidney damage (nephropathy)
Eye damage (retinopathy)
Foot complications
Skin conditions
Hearing impairments
Alzheimer’s disease and dementia
Mental health although issues
Diabetic ketoacidosis (DKA)

74
Q

What does the thyroid do?

A

Hormone production
Regulation of metabolism
Growth and development in children
Regulation of heart and muscle fxns
NS regulation
Reproductive health
Regulating cholesterol levels
Influences skin hydration and hair growth
Supports digestion by regulating GI motility

75
Q

What hormones are produced by the thyroid?

A

Thyroxine (T3)
Triiodothyronine (T4)

76
Q

What thyroid hormone gets converted?

A

T4 gets converted to T3

77
Q

How does the thyroid regulate metabolism?

A

Energy use and calorie burning
Body temp
Weight management

78
Q

When the thyroid produces more hormone, is there an increase or decrease in metabolism?

A

An increase in metabolism

79
Q

What heart and muscle fxns is the thyroid responsible for?

A

HR, force of contraction

80
Q

What are the causes of hypothyroidism?

A

Autoimmune disease
Iodine deficiency
Thyroid surgical removal
Congenital hypothyroidism
Radiation therapy to the head neck or thyroid
Meds
Pituitary or hypothalamic dysfunction
Postpartum thyroiditis
Chronic illness
Aging

81
Q

Why would iodine deficiency lead to hypothyroidism?

A

Bc iodine is required for thyroid hormone production

82
Q

What meds would cause hypothyroidism?

A

Lithium and some heart meds

83
Q

What meds would cause hypothyroidism?

A

Lithium and some heart meds

84
Q

T/f: clinical manifestations of hypothyroidism may manifest so slowly that a clinician may fail to notice them

A

True

85
Q

T/f: there is a genetic link to hypothyroidism

A

True

86
Q

Hypothyroidism may be a risk if a family member had what factors?

A

Hypothyroidism or hyperthyroidism
Hair that turned gray in their 20s
An immune problem or juvenile DM

87
Q

What is Hashimotos disease?

A

Hypothyroidism

88
Q

What are possible s/s of Hashimotos disease?

A

Decreased basal metabolic rate
Dry skin
Muscle/joint pain
Proximal weakness
Lethargy, depression, apathy
Confusion
Weight gain
Edema around the eyes
Loss of lateral eyebrow
Cardiomegaly
Constipation
Cold intolerance
Brittle nails
Sparse/course hair
Peripheral edema
Joint effusion with calcium deposits
CTS (carpal tunnel syndrome)
Slow healing
Hoarseness
HR<60 in untrained person

89
Q

What is the trifecta of endocrine symptoms?

A

Hair, skin, and nails

90
Q

What things can cause hyperthyroidism?

A

Graves’ disease
Thyroid nodules
Thyroiditis
Excess iodine
Excessive thyroid hormone intake
Pituitary tumors
Thyroid cancer
Struma ovarii

91
Q

What is the most common autoimmune cause of hyperthyroidism?

A

Graves’ disease

92
Q

What are the two types of thyroid nodules that can cause hyperthyroidism?

A

Toxic adenoma
Toxic multinodular goiter

93
Q

What is toxic adenoma?

A

A single benign (noncancerous) nodule that produces excess thyroid hormone

94
Q

What is toxic multinodular goiter (Plummers disease)?

A

Multiple nodules in the thyroid that overproduces hormones

95
Q

What is thyroiditis and why does it cause hyperthyroidism?

A

It is inflammation of the thyroid gland that can lead to temporary release of stored thyroid hormones into the blood

96
Q

What is struma ovarii and why does it cause hyperthyroidism?

A

It is a rare condition in which an ovarian tumor produces thyroid hormones

97
Q

What are some s/s of Graves’ disease (hyperthyroidism)?

A

Tachycardia
Hyperactive reflexes
Increased sweating
Heat intolerance
Fatigue
Tremor
Nervousness
Polydisia
Weakness
Increased appetite
Dyspnea
Weight loss

98
Q

Are more males or females affected by hyperthyroidism (Graves’ disease)?

A

More females

99
Q

When is the peak of hyperthyroidism?

A

In the 3rd and 4th decade of life

100
Q

What are the PT goals when treating thyroid diseases?

A

Strengthening
Flexibility
Balance
Endurance (breathing)

101
Q

What meds are used to treat hypothyroidism?

A

Levothyroxine

102
Q

What meds are used to treat hyperthyroidism?

A

Anti-thyroid meds

103
Q

What complications should we be aware of in PT with a pt with thyroid diseases?

A

CV issues
Osteoporosis

104
Q

We may need to adjust our PT session for pts with thyroid diseases based in their energy tolerance

A

True

105
Q

What vitals should we monitor with thyroid diseases?

A

HR, BP, RR, RPE

106
Q

What is thyroid storm?

A

Hyperthyroidism where there is a sudden symptoms onset like rapid HR, fever, and confusion that requires IMMEDIATE MEDICAL ATTENTION

107
Q

How many parathyroid glands are there?

A

4 glands the size of a grain of rice each

108
Q

Are all or one parathyroid glands usually damaged in parathyroid diseases?

A

One

109
Q

What is the one job of the parathyroid glands?

A

To make and release parathyroid hormone to control all calcium levels in the body (move calcium in and out of the bloodstream)

110
Q

When someone presents with intermittent normal calcium levels, should we be concerned?

A

YES VERY, something is wrong and needs to be dealt with

111
Q

T/f: the vast majority of pts with hyperparathyroidism have calcium levels that bounce around in the intermittent normal range and is not uncommon for those with parathyroid tumors

A

True

112
Q

What are the symptoms of hypoparathyroidism?

A

Irritability
Cardiac arrhythmias
Skeletal muscle cramping
Tingling in the fingers
Dry/scaly skin
Pigment changes
Thin hair and brittle nails
(+) Chvostek’s sign

113
Q

What are the clinical tests for hypoparathyroidism?

A

(+) Trosseau’s sign
(+) Chvostek’s sign

114
Q

What is a positive Trosseau’s sign?

A

Carpal spasm (hand positioning) when inflated BP cuff is maintained >SBP for 3 min

115
Q

What is a positive Chvostek’s sign?

A

Hyperirritability (twitch of the face) of the facial nerve when tapped just below the zygomatic arch

116
Q

In 91% of cases of hyperparathyroidism, how many of the glands “go bad”?

A

Just one

117
Q

T/f: it is a mistake to “mild” elevation in blood calcium means you have “mild” hyperparathyroidism

A

True

118
Q

What are some signs of high calcium levels?

A

You just feel bad
Ruins the kidneys, liver, and arteries
Causes strokes and cardiac rhythm problems
Kidney stones and osteoporosis
Increased chance of breast, kidneys and prostrate cancers

119
Q

What are some s/s of hyperparathyroidism?

A

Increased DTRs
Fatigue, drowsiness
Proximal weakness
Arthralgia/myalgia
Reflux/peptic ulcer
Kidney stones
Increased BP
heart palpitations
Pancreatitis, gout
Thinning hair
Mental slowing/memory problems
Emotional irritability
Hypercalcemia
Difficulty sleeping
Headaches

120
Q

What is gout?

A

A problem with increased purine leading to increased uric acid

121
Q

What proportion of purine in produced in the body?

A

2/3

122
Q

What portion of purine is in foods?

A

1/3

123
Q

What are some foods high in purines?

A

Shellfish, organ meats, dried beans, peas, anchovies, high fructose corn syrup

124
Q

T/f: alcohol especially beer decreases the ability to get rid of purines

A

True

125
Q

What are some s/s of gout?

A

Rapid onset of sudden severe pain
Inflammation of the first MTP, knee, wrist, or elbow
Redness, swelling
Tenderness, hypersensitivity
Fever, chills

126
Q

Why is the great toe mostly affected in gout?

A

Bc uric acid crystals are sensitive to temp (cooler temps) and the toes are the coolest part of the body

127
Q

What is the treatment for gout?

A

NSAIDS
Colchicine with 12 hours of an attack
Corticosteroids of NSAIDS and colchicine are contraindicated
Meds that decrease uric acid levels

128
Q

T/f: colchicine has analgesic effects to treat gout

A

False

129
Q

Why do premenopausal women have a lower prevalence of gout?

A

Bc female sex hormones increase urinary excretion of uric acid

DPT 631 (5 decks)

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