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Pathophysiology > Week 10: Endocrine > Flashcards

Week 10: Endocrine Flashcards

1
Q

failure of feedback systems

A

may fail to funciton properly, may respond to inappropriate signals

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2
Q

dysfunction of an endocrine gland

A

Inability to produce or obtain an adequate quantity of required hormone precursors
Inability to convert precursors to the active hormone
Excessive or inadequate hormone production

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3
Q

target cell dysfunction

A

failure of target cell to respond to its hormone

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4
Q

thyroid synthesizes and releases

A

calcitonin, thyroxine, and triiodothyronine

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5
Q

hyperthyroidism clinical manifestations

A

increased metabolic rate with heat intolerance and increased tissue sensitivity to stimulation by the sympathetic nervous system, enlargement of thyroid gland

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6
Q

hyperthyroidism tx

A

methimazole or propylthiouracil
radioactive iodine therapy
surgery

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7
Q

causes of hyperthyroidism

A 
graves disease
toxic multinodular goiter
toxic adenoma
follicular thyroid carcinoma
TSH secreting pituitary adenomas
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8
Q

hyperthyroidism endocrine effects

A

goiter, bruit, diminished sensitivity to endogenous insulin

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9
Q

hyperthyroidism reproductive effects

A

oligomenorrhea, erectile dysfunction

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10
Q

hyperthyroidism GI effects

A

weight loss, anorexia, increased peristalsis, changes in vitamin metabolism

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11
Q

hyperthyroidism integumentary effects

A

excessive sweating, flushing, heat intolerance, hair and nail changes

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12
Q

hyperthyroidism cardiovascular effects

A

increased cardio output, decreased peripheral resistance, tachycardia at rest

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13
Q

hyperthyroidism pulmonary effects

A

dyspnea & reduced vital capacity

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14
Q

what is found in 95% of grave’s pts

A

thyroid antibodies, IgG

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15
Q

clinical s&s of thyrotoxic crisis

A

Hyperthermia; tachycardia, especially atrial tachydysrhythmias; high-output heart failure; agitation or delirium; and nausea, vomiting, or diarrhea

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16
Q

primary hypothyroidism types

A 
Iodine deficiency
Autoimmune thyroiditis (Hashimoto disease)
Subacute thyroiditis
Painless thyroiditis
Iatrogenic thyroiditis
Postpartum thyroiditis
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17
Q

hypothyroidism clinical manifestations

A

Low basal metabolic rate, cold intolerance, lethargy, tiredness, and slightly lowered basal body temperature; also possible diastolic hypertension
Myxedema

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18
Q

all hormones released from the adrenal cortex are synthesized by

A

cholesterol

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19
Q

disorders of the adrenal cortex

A

cushings disease
virilization
hyperaldosteronism
addison disease

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20
Q

addisons disease marked by

A

hyperpigmentation, weight loss, fatigue, low blood pressure, poor appetite

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21
Q

thyrotoxicosis

A

condition caused by excessive TH

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22
Q

grave’s disease

A

the most common form of hyperthyroidism; caused by an autoimmune defect that creates antibodies (95% of pt) that stimulate the overproduction of TH, causing TSH and TrH suppression

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23
Q

grave’s clinical manifestation

A

exophthalmos (dt ^ hyaluronic acid)
orbital fat accumulation
diplopia
pretibial myxedema (swelling

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24
Q

grave’s tx

A

rad I-
sx
doesn’t remove leg edema or eye conditions

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25
Q

1º hypothyroidism

A 
I- deficiency
hashimoto's disease (autoimmune)
subacute thyroiditis (nonbacterial inflammation)
painless thyroiditis
Iatrogenic thyroiditis
postpartum thyroiditis
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26
Q

congenital hypothyroidism

A

TH deficiency at birth, can cause cretinism if not tx
neonatal screening
T4 for tx

27
Q

thyroid carcinoma

A

most common thyroid malignancy from rad
∆ in voice and swallowing
dyspnea dt tumor growth
may have normal T3/T4 lvls

28
Q

myxedema

A

non-pitting, boggy edema of the skin in hypothyroidism, esp around eyes, hands, feet, tongue

29
Q

adrenal hyperfunction cm

A 
dt hypercortisolism
wt gain
glucose intolerance
muscle wasting/weakness
v bone density
easily damaged skin
vasoconstriction/HTN
i.s suppression
neuro ∆
30
Q

adrenal hyperfunction dx

A

urinary free cortisol < 100 ug/day
pit MRI
inf petrosal sinus sample

31
Q

cushing’s disease

A

excessive ACTH secretion
most common in 30-50 women
most have pit microadenoma w hypercortisolism

32
Q

addison’s disease cm

A 
hypocortisolism, hypoaldosteronism
weakness, fatigue
hyperpigmentation
wt loss, poor appetite
hypoTN
33
Q

2º hypocortisolism

A

addisonian crisis
prolonged admin of exogenous glucocorticoids (pred) inhibits ACTH secretion
CM: similar to Addison’s, no hyperpigmentation

34
Q

DM

A

dysfunction of endocrine pancreas
affects metabolism
characterized by hyperglycemia

35
Q

DM dx

A

1+ NFG > 7 mmol/L
2hrPG > 11.1 mmol/L, confirmed next day
3 Ps (polydipsia/phagia/uria)
HgBA1C

36
Q

hyperglycemia

A

high blood sugar, 80-90% of B-cells must be lost before it occurs, alongside abnormal glucagon

37
Q

type 1 DM

A

IDDM
unknown cause, rt genetic and environment
can be immune/non-immune

38
Q

non-immune T1DM

A

occurs 2º to other diseases (ex pancreatitis)

39
Q

immune t1dm

A

cell-mediated destruction of B-cells, w antibodies found in 85-90%
HLA-DR4 strongly associated

40
Q

4 characteristics of t1dm

A

genetic susceptibility
long preclinical period
immunologically mediated destruction of B-cells
hyperglycemia

41
Q

t1dm clinical manifestations

A

3 Ps
wt loss
fatigue
dradual insulin deficiency and hyperglycemia

42
Q

t1dm tx

A 
insulin
meal planning
exercise
self-monitoring
transplant (temporary)
43
Q

ketoacidosis

A

excessive production of ketones, making the blood acid, body compensates by blowing off acetone, giving breath a fruity scent
diabetic coma may be 1st manifestation

44
Q

t2dm

A

more common than T1
genetic and environmental interaction, obesity and sedentary
major factor is insulin resist

45
Q

t2dm patho

A

gradual ^ in insulin resist dt lifestyle factors, many years of hyperinsulinemia, eventually B-cell responsiveness drops, hypoglycemia occurs

46
Q

t2dm cm

A

often nonspecific, over 30
oft overwt, dyslipidemic, hyperinsulinemic, HTN
PCOS x7 risk
onset 7+ yrs before dx

47
Q

t2dm tx

A

restoration of euglycemia
wt loss, exercise
insulin, antihyperglycemics

48
Q

hypoglycemia

A

low blood sugar (<3.5 mmol/L)
oft when tx w insulin (insulin shock)
dt hypothalamus sensing low glucose

49
Q

hypoglycemia cm

A

tachycardia, palpitations
diaphoresis, pallor
tremors, anxiety
coma, death

50
Q

hypoglycemia tx

A

glucagon/glucose

51
Q

dka

A

absolute deficiency of insulin and ^ in insulin counterregulatory H
common fx incl: illness, interruption of insulin tx
most common in IDDM

52
Q

dka patho

A

increased production of glucose ketones for fuel
hyperketonemia dt peripheral ketone impairment
cir of strong acids w/out bicarb buffer
metabolic acidosis

53
Q

dka cm

A 
kussmaul resp
postural hypoTN
CNS depression
Anorexia
Nausea, abd pain
polyuria, thirst
glucosuria, ketonuria
54
Q

dka dx

A

serum glucose > 250 mg/dL
serum bicarb < 18 mg/dL
pH < 7.3
anion gap

55
Q

dka tx

A

serum glucose > 250 mg/dL
serum bicarb < 18 mg/dL
pH < 7.3
anion gap

56
Q

HHNS

A

hyperosmolar hyperglycemic nonketotic syndrome
life threatening, in NIDDM
dt infection, rx, nonadherence, coexisting disease

57
Q

hhns patho

A

far more fluid deficiency in HHNS

higher glucose and glucose in HHNS

58
Q

hhns cm

A 
Glycosuria, polyuria
dehydration
neuro ∆
glucose > 600 mg/dL
absent/low urine ketones
59
Q

diabetic neuropathy

A

nerve damage that occurs because of the metabolic derangements associated with DM

60
Q

diabetic retinopathy

A

retinal ischemia dt bv ∆ and RBC aggregation

61
Q

diabetic nephropathy

A

Most common cause of ESRD

damage to glomeruli dt ^ P and glucose lvls

62
Q

diabetic cad and pvd

A

Most common cause of ESRD

damage to glomeruli dt ^ P and glucose lvls

63
Q

diabetic infection risk

A 
impaired senses
hypoxemia/low bld supply
suppressed i.s and delayed healing
rapid pathogen replication dt ^ glucose
hypoxia
glycosylated HgB impaires O2 release

Pathophysiology (12 decks)

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