Unit 5 Patho

Question 1

What is Graves’ Disease? (Hyperthyroidism)

Answer 1

An autoimmune disease leading to the over production of thyroid hormone.
(Thyroid hormone T3-T4)

Question 2

How might a patient present in the clinic with Graves’ Disease?

Answer 2

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

Question 3

What are some treatment options for Graves’ disease?

Answer 3

Surgical removal of thyroid gland, destroy with radioactive iodine, medications to block hormone production

Question 4

What is Cushing Disease (Hypercortisolism)?

Answer 4

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

Question 5

How might a patient present in the clinic with Cushing Disease?

Answer 5

Moon face, Striations of abdominal fat, muscle weakness and fatigue.

Question 6

How might hypercortisolism affect the body? What are the red flags?

Answer 6

May cause hypertension, hyperglycemia, hypokalemia (low potassium levels) and poor wound healing.

Question 7

What is the pathway control for cortisol?

Answer 7

Secretion in hypothalamus ➡️then acts on the ACTH in the anterior pituitary ➡️ to release cortisol from the adrenal cortex

Question 8

What is the pathway for the release of thyroid hormone?

Answer 8

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)

Question 9

Where does the synthesis of the thyroid hormone take place?

1) Thyroid Follicles
2) Adrenal Cortex
3) Hypothalamus
4) pituitary gland

Answer 9

1) Thyroid Follicles

Question 10

What is the primary cause of Hypothyroidism?

Answer 10

Lack of Iodine (Iodine deficiency)

Question 11

What are some treatments for hypothyroidism?

Answer 11

-Oral thyroid hormone (Medication)

-Removal or destruction of gland or block hormone synthesis.

Question 12

How might hypothyroidism affect the body? Possible Red flags.

Answer 12

-Slows metabolic rate and oxygen consumption

-Slows reflex, speech and thought process

-Decreases protein synthesis

-Bradycardia

Question 13

How might a patient present in the clinic with hypothyroidism?

Answer 13

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

Question 14

What is Addison’s Disease ( Hypocortisolism)?

Answer 14

Hyposectretion of all adrenal steroid hormone

Autoimmune destruction of adrenal cortex

Question 15

What are the affects of hypocortisolism (Addison’s disease) in the body?

Answer 15

Hypoglycemia

Metabolic disturbances

Weakness in stress response

Question 16

How may a patient present in the clinic with Addisons disease?

Answer 16

Easily irritable (mild neurotic) or depressed

Weak and fatigued

Hypotensive

Nausea, vomiting and abdominal pain

Question 17

What role does cortisol have on the body?

Answer 17

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

Question 18

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

Answer 18

1) Cushing’s Disease

Question 19

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

Answer 19

2) Negative Feedback Mechanism

Question 20

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

Answer 20

4) Hypothyroidism

Question 21

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

Answer 21

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.

Question 22

In metabolism , what is the difference between Fed state and Fasted state

Answer 22

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

Question 23

What is the role of the pancreas in metabolism?

Answer 23

The pancreas secretes glucagon and insulin.

Question 24

What is the Islets of Langerhans?

Answer 24

Beta cells in the pancreas secrete insulin

Alpha cells in the pancreas secrete glucagon

Question 25

In metabolism what is the role of insulin?

Answer 25

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)

Question 26

In metabolism what is the role of glucagon?

Answer 26

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)

Question 27

Define Diabetes Mellitus.

Answer 27

Abnormal elevated plasma glucose concentrations or hyperglycemia

(When your body has trouble moving glucose from your blood into your cells, causes high blood sugar)

Question 28

When diagnosing for blood glucose, what is the difference between fasting blood glucose and glucose tolerance test?

Answer 28

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)

Question 29

What is the difference between Type 1 and Type 2 diabetes mellitus.

Answer 29

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.

Question 30

True or False. Without insulin the cells of the body go into a fasted-state metabolism. Why? state reason.

Answer 30

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)

Question 31

Insulin is a natural hormone secreted by which organ or gland?

1) The kidneys
2) The liver
3) The pancreas
4) The spleen

Answer 31

3) The pancreas

Question 32

What are some treatment options for type 1 diabetes mellitus?

Answer 32

Taking insulin injections
Monitoring blood sugar often
Eating healthier and exercising regularly

Question 33

True or False. Type 1 diabetes accounts for 90% of all cases for diabetes,

Answer 33

False

— Type 2 Diabetes accounts for 90% of all cases

Question 34

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

Answer 34

Type 2 diabetes

Question 35

What are some treatment options for type 2 diabetes?

Answer 35

—Exercise and a balanced diet
—Medications