The Endocrine System Flashcards
What are the main functions of the endocrine system?
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
What are the key endocrine glands?
Hypothalamus
Pituitary gland
Thyroid gland
Parathyroid glands
Adrenal glands
Pancreas
Pineal gland
Gonads
What is the function of the hypothalamus?
Controls other endocrine glands and regulates fxns like hunger, thirst, sleep, and emotions
What is the fxn of the pituitary gland?
It regulates hormones that influence growth, reproductive health, and other glands
Which endocrine gland is the “master gland”?
The pituitary gland
What is the fxn of the thyroid gland?
It produces hormones (T3 and T4) that control metabolism and affect growth and brain development
What is the function the parathyroid glands?
To regulate calcium levels in the blood
What is the fxn of the adrenal glands?
To produce hormones like cortisol and adrenaline, which manage stress and metabolism
What does cortisol and adrenaline do?
Manage stress and metabolism
What is the fxn of the pancreas?
To release insulin and glucagon to control blood sugar levels
What is the fxn of the pineal gland?
To produce melatonin to regulate the sleep cycle
What are the gonads?
Testes and ovaries
What is the fxn of the gonads?
To produce sex hormones (testosterone, estrogen, and progesterone) that influence sexual development and reproduction
What are the s/s of endocrine system struggles?
Joint pain
Muscle pain
Parasthesias
Dry, scaly skin
Constipation
Fatigue
Dyspnea
Brittle nails/hair
Weight change
Periorbital edema
Hoarseness
Polydipsia/polyuria
How can we get glucose?
Gliconeogenesis (made by our body), consumed in food, or released from our body’s glycogen stores
What hormone do we need to use glucose?
Insulin
Where is insulin made?
In the pancreas
Bc glucose can’t enter cells w/o the help of insulin, any impairment of the fxn of insulin results in what?
Excess glucose in the bloodstream
Why do people with DM tend to be fatigued?
Bc their cells aren’t getting energy from glucose
What is the only fuel the brain can use?
Glucose
What is type 1 DM?
An autoimmune condition where the immune system attacks and destroys insulin-producing cells in the pancreas
Why do people with type 1 DM need to take insulin for life?
Bc their bodies can no longer produce it
What percent of people with DM have type 1?
About 5-10%
When does type 1 DM often develop?
In childhood or adolescence
T/f: there is high levels of sugar in the blood and urine of those with type 1 DM
True
Why is frequent urination a common symptom with DM?
Bc the kidneys are trying to flush the excess glucose from the body
Why is frequent thirst a common symptom of DM?
Bc the body is trying to replace lost fluids
What are the symptoms of type 1 DM?
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
Why is fatigue, irritability, and mood changes a common symptom of DM?
Bc there is no glucose for energy
Why do people with DM sometimes have fruity smelling breath?
Bc of a buildup of ketones
Does type 1 or 2 DM have a sudden onset of symptoms?
Type 1
Does type 1 or 2 DM have gradual onset of symptoms?
Type 2
What is the average age of onset of type 2 DM?
About 45
What is type 2 DM?
The body has the physical ability to make insulin but doesn’t make enough or use insulin effectively
Which type of DM is more common, type1 or type 2?
Type 2
Which type of DM is often linked to family hx of DM and lifestyle factors such as obesity, physical inactivity, and poor diet
Type 2 DM
Which type of DM is typically found in adults, but is increasingly seen in younger people due to lifestyle factors?
Type 2 DM
How is type 2 DM managed?
Through diet, exercise, oral meds, and sometimes insulin
What is gestational DM?
Diabetes that can develop during pregnancy and often resolves after giving birth
Gestational DM can increase the risk of what?
Developing type 2 DM later in life
T/f: gestational DM increases the risk of other complications during birth and pregnancy
True
T/f: gestational DM has symptoms that pregnant women should look for
False there are no symptoms
Why is it important for pregnant people to undergo glucose testing by weeks 24-28 of pregnancy.
Bc of the risks of gestational DM which has no symptoms otherwise
How can we reduce the risk of gestational DM?
With regular exercise activity and maintaining a healthy weight
What are the glucose testing procedures?
Oral glucose tolerance test (OGTT)
Glucated hemoglobin (A1C) test
What is the glucose testing procedure to test for gestational DM?
Oral glucose tolerance test (OGTT)
What does the oral glucose tolerance test (OGTT) do?
It measures blood sugar b4 and 1-2 hours after consuming a sweet drink with 75g of glucose
What are normal results of an OGTT?
<140 mg/dL after 2 hours
What OGTT results indicate pre-diabetes?
140-199 mg/dL or higher after 2 hours
What OGTT results indicate diabetes?
200 mg/dL or higher after 2 hours
T/f: one OGTT is good to draw conclusions on diabetes risk
False, we usually want a few tests done
What does the glycated hemoglobin (A1C) test measure?
The average level of blood sugar in hemoglobin over 2-3 months
What is hemoglobin?
The protein in RBCs that are responsible for carrying oxygen
When glucose is in the bloodstream, some attaches to _____ and it becomes ______ ________
Hemoglobin, glycated hemoglobin
The higher your blood glucose levels are the ______ hemoglobin that has sugar attached
More
What are normal A1C results?
<5.7%
What A1C results point towards prediabetes?
5.7-6.4%
What A1C results point towards diabetes?
> 6.5% on separate tests
What do continuous glucose monitors (glucometers) do?
They more accurately and conveniently track glucose levels at home to help follow glucose levels over time and measure response to exercise and foods
What population may especially benefit from CGM?
Children with type 1 DM
What are the ways to manage type 1 DM?
Insulin therapy
Blood sugar monitoring
Diet and exercise
Why is insulin therapy used to manage type 1 DM?
Bc the body can no longer produce insulin so they need to take daily insulin through pump or injections
T/f: blood sugar needs to be monitored multiple times a day in type 1 DM
True
How can we monitor blood sugar throughout the day?
Blood testing or CGM
T/f: following a balanced diet and regular physical activity helps maintain stable blood sugar levels
True
What are ways to manage type 2 DM?
Lifestyle changes
Oral meds
Insulin therapy
Blood sugar monitoring
What lifestyle changes can be made to manage type 2 DM?
Balanced diet low in processed sugars and refined carbs
Regular physical activity
How do oral meds help manage type 2 DM?
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
T/f: insulin therapy may or may not be needed to manage type 2 DM
True
What are important PT concerns surrounding DM?
Monitoring A1C
BP
Skin/footwear
What are some fast acting glucose sources to manage emergency hypoglycemia?
Juice boxes, regular soda, hard candies, glucose tablets/gels
What is an important consideration with fast acting glucose sources?
We have to make sure that they don’t go bad b4 using them
What are possible systemic complications of DM?
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)
What does the thyroid do?
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
What hormones are produced by the thyroid?
Thyroxine (T3)
Triiodothyronine (T4)
What thyroid hormone gets converted?
T4 gets converted to T3
How does the thyroid regulate metabolism?
Energy use and calorie burning
Body temp
Weight management
When the thyroid produces more hormone, is there an increase or decrease in metabolism?
An increase in metabolism
What heart and muscle fxns is the thyroid responsible for?
HR, force of contraction
What are the causes of hypothyroidism?
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
Why would iodine deficiency lead to hypothyroidism?
Bc iodine is required for thyroid hormone production
What meds would cause hypothyroidism?
Lithium and some heart meds
What meds would cause hypothyroidism?
Lithium and some heart meds
T/f: clinical manifestations of hypothyroidism may manifest so slowly that a clinician may fail to notice them
True
T/f: there is a genetic link to hypothyroidism
True
Hypothyroidism may be a risk if a family member had what factors?
Hypothyroidism or hyperthyroidism
Hair that turned gray in their 20s
An immune problem or juvenile DM
What is Hashimotos disease?
Hypothyroidism
What are possible s/s of Hashimotos disease?
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
What is the trifecta of endocrine symptoms?
Hair, skin, and nails
What things can cause hyperthyroidism?
Graves’ disease
Thyroid nodules
Thyroiditis
Excess iodine
Excessive thyroid hormone intake
Pituitary tumors
Thyroid cancer
Struma ovarii
What is the most common autoimmune cause of hyperthyroidism?
Graves’ disease
What are the two types of thyroid nodules that can cause hyperthyroidism?
Toxic adenoma
Toxic multinodular goiter
What is toxic adenoma?
A single benign (noncancerous) nodule that produces excess thyroid hormone
What is toxic multinodular goiter (Plummers disease)?
Multiple nodules in the thyroid that overproduces hormones
What is thyroiditis and why does it cause hyperthyroidism?
It is inflammation of the thyroid gland that can lead to temporary release of stored thyroid hormones into the blood
What is struma ovarii and why does it cause hyperthyroidism?
It is a rare condition in which an ovarian tumor produces thyroid hormones
What are some s/s of Graves’ disease (hyperthyroidism)?
Tachycardia
Hyperactive reflexes
Increased sweating
Heat intolerance
Fatigue
Tremor
Nervousness
Polydisia
Weakness
Increased appetite
Dyspnea
Weight loss
Are more males or females affected by hyperthyroidism (Graves’ disease)?
More females
When is the peak of hyperthyroidism?
In the 3rd and 4th decade of life
What are the PT goals when treating thyroid diseases?
Strengthening
Flexibility
Balance
Endurance (breathing)
What meds are used to treat hypothyroidism?
Levothyroxine
What meds are used to treat hyperthyroidism?
Anti-thyroid meds
What complications should we be aware of in PT with a pt with thyroid diseases?
CV issues
Osteoporosis
T/f: We may need to adjust our PT session for pts with thyroid diseases based in their energy tolerance
True
What vitals should we monitor with thyroid diseases?
HR, BP, RR, RPE
What is thyroid storm?
Hyperthyroidism where there is a sudden symptoms onset like rapid HR, fever, and confusion that requires IMMEDIATE MEDICAL ATTENTION
How many parathyroid glands are there?
4 glands the size of a grain of rice each
Are all or one parathyroid glands usually damaged in parathyroid diseases?
One
What is the one job of the parathyroid glands?
To make and release parathyroid hormone to control all calcium levels in the body (move calcium in and out of the bloodstream)
When someone presents with intermittent normal calcium levels, should we be concerned?
YES VERY, something is wrong and needs to be dealt with
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
True
What are the symptoms of hypoparathyroidism?
Irritability
Cardiac arrhythmias
Skeletal muscle cramping
Tingling in the fingers
Dry/scaly skin
Pigment changes
Thin hair and brittle nails
(+) Chvostek’s sign
What are the clinical tests for hypoparathyroidism?
(+) Trosseau’s sign
(+) Chvostek’s sign
What is a positive Trosseau’s sign?
Carpal spasm (hand positioning) when inflated BP cuff is maintained above the SBP for 3 min
What is a positive Chvostek’s sign?
Hyperirritability (twitch of the face) of the facial nerve when tapped just below the zygomatic arch
In 91% of cases of hyperparathyroidism, how many of the glands “go bad”?
Just one
T/f: it is a mistake to say a “mild” elevation in blood calcium means you have “mild” hyperparathyroidism
True
What are some signs of high calcium levels?
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
What are some s/s of hyperparathyroidism?
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
What is gout?
A problem with increased purine leading to increased uric acid
What proportion of purine in produced in the body?
2/3
What portion of purine is in foods?
1/3
What are some foods high in purines?
Shellfish, organ meats, dried beans, peas, anchovies, high fructose corn syrup
T/f: alcohol especially beer decreases the ability to get rid of purines
True
What are some s/s of gout?
Rapid onset of sudden severe pain
Inflammation of the first MTP, knee, wrist, or elbow
Redness, swelling
Tenderness, hypersensitivity
Fever, chills
Why is the great toe mostly affected in gout?
Bc uric acid crystals are sensitive to temp (cooler temps) and the toes are the coolest part of the body
What is the treatment for gout?
NSAIDS
Colchicine within 12 hours of an attack
Corticosteroids if NSAIDS and colchicine are contraindicated
Meds that decrease uric acid levels
T/f: colchicine has analgesic effects to treat gout
False
Why do premenopausal women have a lower prevalence of gout?
Bc female sex hormones increase urinary excretion of uric acid
