Unit 5 Patho Flashcards
What is Graves’ Disease? (Hyperthyroidism)
An autoimmune disease leading to the over production of thyroid hormone.
(Thyroid hormone T3-T4)
How might a patient present in the clinic with Graves’ Disease?
Goiters, heat sensitivity, exophthalmos (bulging eyes[excessive deposits of mucopolysaccharides in BONEY ORBIT]), muscle weakness, unexplained weight-loss, tremors, irregular or rapid heartbeat and hyper-excitable reflexes
What are some treatment options for Graves’ disease?
Surgical removal of thyroid gland, destroy with radioactive iodine, medications to block hormone production
What is Cushing Disease (Hypercortisolism)?
A disease caused by an adrenal gland tumor, (Primary) which causes the over production of cortisol, (Secondary) a tumor in the pituitary gland which causes the over production of ACTH
How might a patient present in the clinic with Cushing Disease?
Moon face, Striations of abdominal fat, muscle weakness and fatigue.
How might hypercortisolism affect the body? What are the red flags?
May cause hypertension, hyperglycemia, hypokalemia (low potassium levels) and poor wound healing.
What is the pathway control for cortisol?
Secretion in hypothalamus ➡️then acts on the ACTH in the anterior pituitary ➡️ to release cortisol from the adrenal cortex
What is the pathway for the release of thyroid hormone?
The hypothalamus activates the secretion of TRH ➡️that then travels to the anterior pituitary to activate TSH ➡️ it then travels to the thyroid to secrete and release thyroid hormone (T3 and T4)
Where does the synthesis of the thyroid hormone take place?
1) Thyroid Follicles
2) Adrenal Cortex
3) Hypothalamus
4) pituitary gland
1) Thyroid Follicles
What is the primary cause of Hypothyroidism?
Lack of Iodine (Iodine deficiency)
What are some treatments for hypothyroidism?
-Oral thyroid hormone (Medication)
-Removal or destruction of gland or block hormone synthesis.
How might hypothyroidism affect the body? Possible Red flags.
-Slows metabolic rate and oxygen consumption
-Slows reflex, speech and thought process
-Decreases protein synthesis
-Bradycardia
How might a patient present in the clinic with hypothyroidism?
A patient may present with myxedema (mucoploysaccharides deposits under skin may cause baggy eyes)
The patient may be intolerable to cold
The patient may have slow speech
What is Addison’s Disease ( Hypocortisolism)?
Hyposectretion of all adrenal steroid hormone
Autoimmune destruction of adrenal cortex
What are the affects of hypocortisolism (Addison’s disease) in the body?
Hypoglycemia
Metabolic disturbances
Weakness in stress response
How may a patient present in the clinic with Addisons disease?
Easily irritable (mild neurotic) or depressed
Weak and fatigued
Hypotensive
Nausea, vomiting and abdominal pain
What role does cortisol have on the body?
It’s the primary stress hormone
Provides a negative feedback system to decrease the amount of CRH released from the hypothalamus
Protects against hypoglycemia
Promotes gluconeogenesis
Suppresses the immune system
A patient comes to the clinic with a moon face, excess adipose tissue, and acne. Which of the following diagnosis should the tested for?
1) Cushing’s Disease
2) Addison’s Disease
3) Diabetes
4) Hyperthyroidism
1) Cushing’s Disease
The release of hormones from glands is most often controlled by:
1) Nephrogenic mechanisms
2) Negative feedback mechanisms
3) Active Transport
4) Ectopic Hormone Production
2) Negative Feedback Mechanism
A patient is experiencing cold intolerance, slow speech and weight gain. Which condition is the patient most likely experiencing?
1) Hyperthyroidism
2) Addison’s Disease
3) Cushing’s Disease
4) Hypothyroidism
4) Hypothyroidism
With complete absence of ACTH, which symptoms will be present in the patient?
1) Nausea, vomiting, Anorexia (weight loss), fatigue, hypoglycemia and weakness
2) Cold tolerance, dry skin, mild myxedema, lethargy (lack of energy), and decreased metabolic rate
3) Amenorrhea, atrophic vagina, uterus, breast, decrease in body hair, and diminished libido
1) Nausea, vomiting, anorexia (weight loss), fatigue, hypoglycemia and weakness
Explanation: when you think of ACTH you have to think of the pathways associated with it. So the hypothalamus activates/secretes Corticotrophin-Releasing hormone (CRH) ➡️then it goes the the anterior pituitary and that secrets ACTH ➡️ that the goes to the adrenal cortex to secrete cortisol.
So the question is asking for the absence of ACTH. If we know that ACTH is associated with cortisol and there is absence, this is talking about Addison’s disease or Hypocortisolism and those are the symptoms present with it.
In metabolism , what is the difference between Fed state and Fasted state
Fed state in an anabolism, and is insulin’s dominant, required input of energy, and synthesizes large molecules FROM smaller ones
Fasted state is a catabolism, and is glucagon dominant, releases energy, and breaks down large molecules INTO smaller ones
What is the role of the pancreas in metabolism?
The pancreas secretes glucagon and insulin.
What is the Islets of Langerhans?
Beta cells in the pancreas secrete insulin
Alpha cells in the pancreas secrete glucagon
In metabolism what is the role of insulin?
Insulin increase plasma glucose and plasma amino acids
Also affects feedforward affect of gastrointestinal (GI) hormones
It is a parasympathetic activity (rest and digest)
(Reduces blood glucose levels)
In metabolism what is the role of glucagon?
Glucagon prevents hypoglycemia by stimulating glyconeogenesis and glycogenolysis
The release of glucagon is stimulated by low blood glucose and plasma amino acids
(Increases blood glucose levels)
Define Diabetes Mellitus.
Abnormal elevated plasma glucose concentrations or hyperglycemia
(When your body has trouble moving glucose from your blood into your cells, causes high blood sugar)
When diagnosing for blood glucose, what is the difference between fasting blood glucose and glucose tolerance test?
Fasting blood glucose (8hrs after fasting) | Glucose Tolerance Test (After 2hrs)
Normal: 100 mg/dl | Normal: <140 mg/dl
Pre-diabetes: 100-125 mg/dl | Pre-diabetes: 140-199 mg/dl
Diabetes: >125 mg/dl | Diabetes: >199 mg/dl
(Idk if we need to know this)
What is the difference between Type 1 and Type 2 diabetes mellitus.
Type 1 DM is a genetic predisposition sometimes preceded by viral infection often in childhood.
(The pancreas does not produce insulin and the body’s immune system (T-cells) attacks the islet cells (beta cells) in the pancreas that make insulin).
Type 2 DM is the pancreas makes less insulin than it used to, and the body become resistant to insulin.
True or False. Without insulin the cells of the body go into a fasted-state metabolism. Why? state reason.
True
Since there is no insulin, this is type 1 diabetes.
—This will increase protein metabolism, fat metabolism, glucose metabolism (hyperglycemia) and brain metabolism (polyphagia- excessive eating).
—Will also increase glucose in urine (glucosuria)and will increase urine (polyuria) due to the increase of thirst (polydipsia)
—Lastly there will be a breakdown of fat so ketones can be used for energy. However ketones are acidic and may lead to ketoacidosis. Which can cause deep or labored breathing and an increase of potassium in the blood (hyperkalemia)
Insulin is a natural hormone secreted by which organ or gland?
1) The kidneys
2) The liver
3) The pancreas
4) The spleen
3) The pancreas
What are some treatment options for type 1 diabetes mellitus?
Taking insulin injections
Monitoring blood sugar often
Eating healthier and exercising regularly
True or False. Type 1 diabetes accounts for 90% of all cases for diabetes,
False
— Type 2 Diabetes accounts for 90% of all cases
When the body does not respond to the insulin it makes , this is called…
1) Type 1 diabetes
2) Type 2 diabetes
3) Both Type 1 and Type 2
4) Gestational diabetes
Type 2 diabetes
What are some treatment options for type 2 diabetes?
—Exercise and a balanced diet
—Medications
