Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced clinical practice: examining the complex patient > Week 5 > Flashcards

Week 5 Flashcards

1
Q

What are the general health effects that can be caused by the endocrine system?

A
  • Fatigue
  • Unexplained weight change
  • Weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the psychological/ cognitive effects that can be caused by the endocrine system?

A
  • Personality changes
  • Memory loss
  • Confusion
  • Irritability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the gastrointestinal effects that can be caused by the endocrine system?

A
  • Nausea
  • Vomiting
  • Anorexia
  • Dysphagia
  • Diarrhea
  • Constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the urogenital effects that can be caused by the endocrine system?

A
  • Impotence
  • Intermittent urine stream
  • Dribbling
  • Straining to void
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the MSK effects that can be caused by the endocrine system?

A
  • Muscle weakness and cramps, • Arthralgias
  • Myalgias
  • Stiffness
  • Bone pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the sensory effects that can be caused by the endocrine system?

A
  • Paresthesia

* Numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the dermatologic effects that can be caused by the endocrine system?

A
  • Foot ulcerations
  • Edema
  • Dry, coarse skin
  • Impaired wound healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some miscellaneous effects that can be caused by the endocrine system?

A
  • Temperature intolerance
  • Visual changes
  • Orthostatic hypotension
  • Increased bruising
  • Increased thirst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main function of the endocrine system?

A

Maintain body homeostasis through the coordination of chemical messages called hormones, which relay information instruction between cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do hormone signaling pathways do?

A

They regulate cellular activity and target organs throughout the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The endocrine system work in coordination with the nervous system to regulate what? metabolism, water and salt balance, BP, res

A

Metabolism, water and salt balance, BP, response to stress, and sexual reproduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

___ is the largest endocrine gland in the body

A

Adipose tissue is the largest endocrine gland in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the endocrine glands of the body?

A
  • Hypothalamus
  • Adrenals
  • Pancreas (islets of langerhans)
  • Ovaries
  • Testes
  • Thyroid
  • Parathyroids
  • Pituitary anterior and posterior lobe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is psychoneuroimmunology (PNI)?

A

The study of the complex series of interactions where the endocrine system meets the nervous system that links behavioral, neural, endocrine and immunologic responses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does the hypothalamus exert control over the anterior(adrenal hypophysis) and posterior (neurohypophysis) portions of the pituitary gland?

A

By either hormonal or nervous signals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What controls the secretions by the posterior pituitary?

A

Nerve signals that originate in the hypothalamus and terminate in the posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What controls the secretions by the anterior pituitary?

A

Hormones called hypothalamic releasing and hypothalamic inhibitory hormones/factors secreted within the hypothalamus and conducted to the anterior pituitary through the hypothalamic hypophysial portal vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The _____ receives signals from many sources in the nervous system and is considered the center for . maintaining the body’s homeostasis

A

The hypothalamus receives signals from many sources in the nervous system and is considered the center for . maintaining the body’s homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When can an endocrine disorder be considered as primary?

A

When excess or deficiency of secretions affects the gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When can an endocrine disorder be considered as secondary?

A

When excess or deficiency of secretions affects the pituitary gland with altered secretion. This can also occur as a result of chemotherapy, surgical removal of glands, therapy of a non-endocrine disorder like in the case of cushing syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When can an endocrine disorder be considered as tertiary?

A

When excess or deficiency of secretions affects the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is diabetes insipidus?

A

An endocrine pathophysiology
affecting the pituitary gland, which is caused by a lack of secretion or action of vasopressin, and ADH all of which normally stimulates the distal tubules of the kidneys to reabsorb water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens to the body without ADH?

A

Water moving through the kidneys is not reabsorbed and is lost in the urine, resulting in severe water loss, and dehydration through diuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the types of diabetes insipidus?

A

Central diabetes insipidus (CDI)

Nephrogenic diabetes insipidus (NDI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes the most common type of CDI?

A

The inability to synthesize and release vasopressin, which can be idiopathic or primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What causes secondary central diabetes insipidus (CDI)?

A
  • Pituitary trauma, neurosurgery, or head trauma
  • Infections such as meningitis or encephalitis
  • Tumors including cranopharyngioma, pituitary adenoma, suprasellar meningioma, pineal gland, and metastasis
  • Anorexia
  • Vascular lesions such as aneeurysms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is nephrogenic diabetes insipidus (NDI)?

A

A defective hormone or receptor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the medications that can cause nephrogenic diabetes insipidus (NDI)?

A
  • Lithium, 20% of chronic users

* Demeclocycline, amphotericin, colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the alcohol imbalances that can cause nephrogenic diabetes insipidus (NDI)?

A
  • Hyperkalemia

* Hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the renal diseases that can cause nephrogenic diabetes insipidus (NDI)?

A
  • Sacoidosis
  • Multiple myeloma
  • Pyelonephritis
  • SLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the clinical signs and symptoms of diabetes insipidus?

A
  • Polyuria
  • Nocturia
  • Polydipsia
  • Dehydration
  • Decreased urine specific gravity
  • Increased serum sodium, if more than 145mEQ/dsL resulting from concentration of serum from water loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is polyuria?

A

Increased urination more than 3L/day in adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is nocturia?

A

Waking up at night to urinate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is polydipsia?

A

Increased thirst, which occurs subsequent to polyuria in response to the loss of fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the manifestation of dehydration in patients with diabetes insipidus?

A
  • Dry, cracked lips or skin
  • Fever
  • Orthostatic hypotension
  • Weakness
  • Dizziness
  • Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the range of the decreased urine specific gravity that is seen in diabetes insipidus?

A

1.001-1.005

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH)?

A

An excess or inappropriate secretion of vasopressin that results in marked retention of water, resulting in hyponatremia(low blood sodium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does hyponatremia as a result of Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) result in?

A

Results in dramatic decreased urine output as the body retains large amounts of water, which is almost all distributed within body cells. causing intracellular water gain and cellular swelling(water intoxication)

39
Q

What are the risk factors for the development of Secretion of Antidiuretic Hormone (SIADH)?

A

• Pituitary damage due to
infection, trauma or neoplasma
• Secretion of vasopressin-like
substances from some type of malignant tumors
• Thoracic pressure changes
from compression of pulmonary or cardiac pressure receptors or both

40
Q

What are the clinical signs and symptoms of SIADH?

A
  • Headache, confusion, lethargy (most significant early indicators)
  • Decreased urine output
  • Weight gain without visible edema
  • Seizure
  • Muscle cramping
  • Vomiting, diarrhea
  • Increased urine specific gravity (greater than 1.03)
  • Decreased serum sodium (less than 135 mEq/dL; caused by dilution of serum from water
41
Q

True or False

The symptoms of SIADH are the opposite of the symptoms of DI

A

True, the symptoms of SIADH are the opposite of the symptoms of DI

42
Q

The clinical signs and symptoms of SIADH are a result of…?

A

Water retention and the subsequent dilution of sodium in blood serum and body cells

43
Q

What is acromegaly?

A

The abnormal enlargement of extremities of the skeleton, resulting from hyper-secretion of growth hormone from the pituitary gland and consequently, insulin like growth factor 1(IGF1). This condition is rare and occurs in adults, most often due to a tumor of the pituitary gland

44
Q

What are the bones most affected by acromegaly and why?

A

Bones of the face, jaw, hands, and feet due to the long bone already being developed.

45
Q

What are the signs and symptoms of acromegaly?

A 
• Amenorrhea in women
• DM
• Profuse sweating
• HTN
• Bony enlargement (face, jaw,
hands, feet)
• Carpal tunnel syndrome (CTS)
• Hand pain and stiffness
• Back pain (thoracic and/or lumbar)
• Proximal myopathy and poor
exercise tolerance
• Fibromyalgia
46
Q

What causes acromegaly in children?

A

The over-production of growth hormones which stimulates the growth of long bones and results in gigantism

47
Q

What is the typical clinical presentation of acromegaly?

A

• Degenerative Arthropathy most frequently attacking the large joints
• Hand stiffness of both hands that is associated with a broad enlargement of the fingers from bony growth and thickening of the soft tissue
• Carpal Tunnel Syndrome seen in up to 50% of people
• Proximal Myopathy and
Fribromyalgia
• Back Pain

48
Q

What are the endocrine pathophysiology that

affects the pituitary gland?

A
  • Acromegaly
  • SIADH
  • Diabetes insipidus
49
Q

What are the endocrine pathophysiology that

affects the adrenal glands?

A

• Adrenal Insufficiency

50
Q

What is the outer cortex of the adrenal gland responsible for?

A

The secretion of mineral corticosteroid hormones that regulate fluid and mineral balance

51
Q

What are glucocorticiods?

A

Steroid hormones that re responsible for controlling the metabolism of glucose, and adregins(sex hormones)

52
Q

What is the centrally located adrenal medulla derived from and what does it secrete?

A

Derived from neural tissue and secretes epinephrine and norepinephrine

53
Q

___ and __ are major factors in the body’s response to stress

A

The adrenal cortex and medulla are major factors in the body’s response to stress

54
Q

What are the types of adrenal insufficiency?

A

• Primary adrenal insufficiency
(Addison’s Disease)
• Secondary adrenal insufficiency

55
Q

What are the signs and symptoms of adrenal insufficiency?

A

Dark pigmentation of the skin, especially mouth and scars (occurs only with primary disease; Addison’s disease)
• Hypotension (low blood pressure causing orthostatic symptoms)
• Progressive fatigue (improves with rest)
• Hyperkalemia (generalized weakness and muscle flaccidity)
• Gastrointestinal (GI) disturbances
• Anorexia and weight loss
• Nausea and vomiting
• Arthralgias, myalgias (secondary only)
• Tendon calcification
• Hypoglycemia

56
Q

What are the clinical manifestations of adrenal insufficiency?

A
  • “Moonface” appearance
  • Buffalo hump at the neck (fatty deposits)
  • Protuberant abdomen with accumulation of fatty tissue and stretch marks
  • Muscle wasting and weakness
  • Decreased density of bones (especially spine)
  • Hypertension
  • Kyphosis and back pain (secondary to bone loss)
  • Easy bruising
  • Psychiatric or emotional disturbances
  • Impaired reproductive function (e.g., decreased libido and changes in menstrual cycle)
  • Diabetes mellitus (DM)
  • Slow wound healing
  • For women: masculinizing effects (e.g., hair growth, breast atrophy, voice changes)
57
Q

Where is the thyroid gland located?

A

In the anterior portion of the lower neck, below the larynx on both sides of and anterior to the trachea

58
Q

What are the chief hormones produced by the thyroid?

A
  • Tyrosine (T4)
  • Triiodothyronine (T3)
  • Calcitonin
59
Q

What are the functions of tyrosine (T4) and triiodothyronine (T3)?

A

Regulate the metabolic rate of the body and increase protein synthesis

60
Q

What are the functions of Calcitonin?

A

It has a weak physiologic effect on calcium and phosphorus balance in the body

61
Q

What are the risk factors for thyroid disease?

A
  • Genetics: family history
  • Age: >50 years of age
  • Gender: Women > Men
62
Q

What is goiter?

A

An enlargement of the thyroid gland, which occurs in areas of the world where iodine which is necessary for the production of thyroid hormone is deficient in a person’s diet

63
Q

What is the mechanism of goiter?

A

When factors inhibit normal thyroid hormone production, hyper-secretion of TSH occurs, because of the lack of negative feedback loop, which results in an increase of thyroid mass

64
Q

What are the clinical signs and symptoms of goiter?

A
  • Increased neck size
  • Pressure on adjacent tissue (e.g., trachea and esophagus)
  • Difficulty in breathing
  • Dysphagia
  • Hoarseness
65
Q

What is thyroiditis?

A

An inflammation of the thyroid gland

66
Q

What are the causes of thyroiditis?

A

Infection or autoimmune processes

67
Q

What is the most common form of thyroiditis?

A

Hashimoto’s thyroiditis

68
Q

What are the risk factors of thyroiditis?

A
  • Women more than men

* 30-50 y/o age group

69
Q

What can cause hypothyroidism?

A

Distraction of the thyroid gland from thyroiditis

70
Q

What does the early symptoms of thyroiditis cause?

A

Mild hyperthyroidism

71
Q

What does the late symptoms of thyroiditis cause?

A

Hypothyroidism

72
Q

What are the clinical signs and symptoms of thyroiditis?

A
  • Painless thyroid enlargement
  • Dysphagia, “tight” sensation when swallowing, or choking
  • Anterior neck, shoulder, or rib cage pain without biomechanical changes
  • Gland sometimes easily palpable over anterior neck (warm, tender, swollen)
  • Fatigue, weight gain, dry hair and skin, constipation (these are later symptoms associated with hypothyroidism)
73
Q

____ is a common type of hyperthyroidism

A

Graves disease is a common type of hyperthyroidism

74
Q

What are the manifestations of hyperthyroidism?

A
  • Thin hair
  • Exophthalmos: a bulging of the eye anteriorly out of the orbit.
  • Enlarged thyroid: diffuse/warm on palpation, nodular, solitary toxic nodule
  • Heart failure (tachycardia)
  • Weight loss
  • Diarrhea
  • Warm skin, and sweaty palms
  • Hyperreflexia
  • Pretibial edema
75
Q

What are the manifestations of hypothyroidism?

A
  • Loss of hair/ coarse, brittle hair
  • Periorbital edema
  • Puffy face
  • Normal or small thyroid
  • Heart failure (bradycardia)
  • Constipation
  • Cold intolerance
  • Muscle weakness
  • Edema of extremities
76
Q

What are the major functions of the liver?

A
  • Produce albumin & other other plasma proteins
  • Bile production
  • Conversion and excretion of bilirubin
  • Produce clotting factor
  • Store vitamins
  • Immune system for the gut
77
Q

What is the primary pain pattern for the liver and gallbladder?

A
  • Mid-epigastrium or

* Right upper quadrant of the abdomen.

78
Q

What is the secondary referral pain pattern for the liver?

A

T7 to T10

• Right shoulder

79
Q

What is the secondary referral pain pattern for the gallbladder?

A
  • Right shoulder,
  • Right interscapular (T4 or T5 to T8)
  • Right subscapular area
80
Q

What are the signs and symptoms of hepatic disease?

A
  • Gastrointestinal symptoms –nausea, vomiting, diarrhea, constipation, heartburn
  • Edema/ascites
  • Dark urine
  • Light- or clay-colored stools
  • Right upper quadrant abdominal pain
  • Skin changes
  • Neurologic involvement
  • Musculoskeletal pain
  • Hepatic osteodystrophy
81
Q

What are the skin changes that are seen in hepatic disease?

A
  • Jaundice, often identified by looking at the yellowish tint of the skin in lighter individuals, may not be present on dark skin
  • Bruising
  • Spider angioma
  • Palmar erythema
82
Q

What are the neurologic involvements that are seen in hepatic disease?

A
  • Confusion
  • Sleep disturbances
  • Muscle tremors
  • Hyperreactive reflexes
  • Asterixis: myoclonus of the wrist
83
Q

What are the combination of symptoms that indicate an increase in serum bilirubin levels?

A
  • Dark urine
  • Light- or clay-colored stools
  • Skin changes

This is due to the liver’s inability to breakdown and excrete bilirubin properly

84
Q

How is asterixis tested?

A

Extending the arm, dorsiflexing the wrist, and spreading the fingers to observe for the flap at the wrist

85
Q

What is hepatic osteodystrophy?

A

The abnormal formation of the bone, which can occur with any disruption of bile flow

86
Q

What is the typical progression of hepatic disease?

A

Liver inflammation –> liver necrosis —> liver fibrosis and scarring

87
Q

What are the risk factors for hepatitis A?

A
  • Household contacts or sexual contacts of infected persons
  • Unprotected homosexual/bisexual activity
  • Injection/non-injection illegal drug users
  • Living in areas with increased rates of HAV (children at greatest risk)
  • Travel in areas where HAVis epidemic
  • Tattoo inscription or removal
  • Piercings with shared or unsterile needles
88
Q

What are the risk factors for hepatitis B, D, and E?

A
  • Injection drug use
  • Unprotected homosexual/bisexual activity
  • Incarcerated in correctional facilities
  • Certain ethnic groups including Asia, South America, South Africa, Mexico, Eastern and mediterranean Europe
  • Travel to high risk areas
  • Occupational risk: morticians, dental workers, emergency medical technicians, firefighters, health care workers in contact with body fluid or blood
  • Liver transplant recipient
  • Infant born to mothers with the condition
  • Immunocompromised individuals
89
Q

What are the risk factors for hepatitis C?

A
  • Current or previously used injected illegal drugs
  • Intranasal cocaine use with shared equipment
  • Tattoos
  • Evidence of liver disease, liver transplant recipient
  • Infants born to HCV
  • Long term kidney dialysis
90
Q

What are the things that may lead to portal HTN?

A

Progressing from a chronic inflammatory state into destruction and damage of the liver and scarring of the sclerosis

91
Q

What is cirrhosis?

A

Progressive loss of normal tissue replaced with fibrosis

and nodular regeneration

92
Q

What are the signs and symptoms of cirrhosis?

A
  • Fatigue,
  • Weight loss
  • Jaundice
  • Coagulopathies
  • Loss of ability to metabolize drugs
  • Hypoalbuminemia
93
Q

What are the characteristic of portal HTN?

A

• Increased venous blood
pressure in the portal vein
• Pressure > 6mmhg
• Most common in cirrhosis

94
Q

What is the mechanism of portal HTN?

A

An increased pressure in the portal vein combines with an intra-hepatic vasoconstriction that is due to a reduction of nitric oxide release, combined with alterations in the mechanical architecture of the liver, which will all increase the pressure in the vein and cause a back up of venous flow back to the originating organs

Advanced clinical practice: examining the complex patient (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions