Brainscape's Knowledge GenomeTM

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


See full index

NR507 - Advanced Pathophysiology > Week 6 - Endocrine System > Flashcards

Week 6 - Endocrine System Flashcards

1
Q

Hypothyroidism

A

Deficient production of TH by the thyroid gland.

Most common thyroid disorder. More prevalent in women and the elderly.

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

Treatment for hypothyroidism

A

Levothyroxine

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

Secondary hypothyroidism

A

Caused by pituitary or hypothalamic failure to stimulate thyroid to produce TH

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

What causes hypothyroidism?

A

1.Usually caused by autoimmune thyroiditis (Hashimoto’s disease)
2. Loss of thyroid tissue after surgery
3. chemo/radiation
5. Medications
6. Iodine deficiency

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

Symptoms of hypothyroidism

A

Affects all body systems and occurs insidiously over months/years

Symptoms dependent on degree of deficiency
1. Low energy levels
2. Low basal metabolic rate
3. Cold intolerance
4. Lethargy
5. Tiredness
6. Lowered body temp
7. Diastolic hypertension
8. Goiter
9. weight gain

Myxedema

Myxedema coma – low level of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Evaluation for hypothyroidism

A
  1. clinical symptoms
  2. increase in TSH levels and decrease in TH levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thyroid stimulating hormone

A

Synthesized and stored in the anterior pituitary gland, circulates to bind with the TSH receptor. Effects include:
i. Immediate increase in release of stored thyroid hormones
ii. Increase in iodine uptake and oxidation
iii. Increases TH synthesis
iv. Increase in synthesis and secretion of prostaglandins by the thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Function of the thyroid

A

Controls the body’s metabolic processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Secondary hypothyroidism

A

Caused by the pituitary’s failure to synthesize adequate amounts of TSH or a lack of TRH.

Pituitary tumors that compress surrounding pituitary cells or the consequences of their treatment are the most common causes
- TBI
- subarachnoid hemorrhage
- pituitary infection

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

Feedback loop for primary thyroid malfunction

A
  1. thyroid doesn’t produce enough TH
  2. no negative feedback to pituitary and hypothalamus
  3. .Low TH and high TSH, TRH levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Feedback loop for pituitary malfunction

A
  1. lack of negative feedback to hypothalamic release of TRH by TSH and TH
  2. low levels of TSH and TH and high levels of TRH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Feedback loop for hypothalamic function

A
  1. Decreased TRH due to defect in hypothalamic function
  2. Low levels of TRH, TSH, and TH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hyperthyroidism

A

Excess amounts of TH from the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of hyperthyroidism

A
  1. Graves’ disease (an immune system disorder that results in the overproduction of thyroid hormones)
  2. Toxic multinodular goiter
  3. Solitary toxic adenoma
  4. Follicular thyroid carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Central (secondary) hyperthyroidism

A

caused by TSH secreting pituitary adenomas

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

Clinical manifestations of hyperthyroidism

A

Attributable to the metabolic effects of increased circulating levels of TH

a. Increased metabolic rate
b. Heat intolerance
c. Sensitivity to stimulation by the sympathetic division of the ANS

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

Diagnostic criteria for primary hyperthyroidism

A

Diagnosed with elevated T3 and T4 levels and decreased serum TSH

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

Diagnostic criteria for secondary hyperthyroidism

A

Normal TSH levels despite increase TH concentrations

(TSH secreting pituitary tumor)

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

Treatment for hyperthyroidism

A

Aimed at controlling TH production, secretion or action

Includes radioactive iodine therapy (drug is absorbed by the thyroid tissue causing cell death - goal to kill overactive thyroid tissue), antithyroid drug therapy (methimazole or propylthiouracil) and surgery

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

What are the two most distinguishing factors of hyperthyroidism?

A

Pretibial myxedema (a waxy, discolored induration of the skin—classically described as having an orange peel appearance—on the anterior aspect of the lower legs, spreading to the dorsum of the feet, or as a non-localised, non-pitting edema of the skin in the same areas)

Exophthalmos (he protrusion of one or both eyes anteriorly out of the orbit)

21
Q

Functional abnormalities of hyperthyroidism

A

Result from hyperactivity of the sympathetic division of the ANS
1. lag of the globe on upward gaze 2. lag of the upper lid on downward gaze

22
Q

Grave’s Disease

A

An immune system disorder that results in the overproduction of thyroid hormones

23
Q

Infiltrative abnormalities of hyperthyroidism

A

Involving the orbital contents with enlargement of the ocular muscles. Affect more than ½ of individuals with the disease.
- Increased secretion of hyaluronic acid, adipogenesis, inflammation, and edema of the orbital contents result in
- exophthalmos (protrusion of the eyeball)
- periorbital edema
- extraocular muscle weakness leading to strabismus (crossed eyes) and diplopia (double vision)

24
Q

Environmental Risk Factors for Type 1 Diabetes

A
  • Viral infections (enterovirus), coxsackievirus, other infectious microorganisms
  • H pylori
  • Exposure to cow’s milk proteins
  • Lack of Vitamin D
25
Q

How is diabetes diagnosed?

A

An A1c greater than 6.5%

26
Q

What are the actions of insulin?

A

Promotes glucose uptake in the liver, muscle, and adipose tissue

27
Q

What are the autonomic neuropathic complications of diabetes?

A

Slows everything down
- decreased esophageal motility
- gastroparesis
- delayed gastric emptying

28
Q

Hypoglycemia

A

Blood sugar less than 60

29
Q

Symptoms of hypoglycemia

A
  • Tachycardia
  • Palpitations
  • Diaphoresis
  • Tremors
  • Pallor
30
Q

Cause of primary hyperparathyroidism

A

Caused by parathyroid gland tumor (something wrong with the gland itself)

31
Q

Primary hyperparathyroidism

A

Characterized by inappropriate and excess secretion of parathyroid hormone (PTH) and no feedback loop to control secretion. Usually caused by a parathyroid tumor –> something with the gland itself

32
Q

Primary hyperparathyroidism results in…

A
  1. Increased level of calcium in the blood
  2. Higher threshold for calcium level feedback is set
  3. Results in hypercalcemia and hypophosphatemia
33
Q

Secondary hyperparathyroidism

A

A compensatory response of the parathyroid glands to chronic hypocalcemia, which is a common complication of chronic kidney disease or vitamin D deficiency.

34
Q

Symptoms of hypercalcemia

A

May be asymptomatic or may have
- paresthesias (numbness and tingling)
- muscle cramps

35
Q

Patients with hypercalcemia may have low bone density (osteoporosis) where is this mostly noted?

A

The distal third of the radius.

36
Q

Complications of hypercalcemia

A
  • Kidney stones
  • fractures
  • Ventricular hypertrophy
  • Depression
  • Gastric issues
37
Q

Causes of hypoparathyroidism

A
  • damage to Parathyroid gland during surgery
  • genetic syndromes
  • idiopathic
  • autoimmune causes
  • DiGeorge syndrome
38
Q

Hypoparathyroidism

A

A lack of circulating PTH causes depressed serum calcium levels and increased serum phosphate levels. In the absence of PTH, resorption of calcium from bone and regulation of calcium reabsorption from the renal tubules are impaired. Therefore phosphate reabsorption by the renal tubules is increased, causing decreased renal phosphate excretion and hyperphosphatemia.

39
Q

Symptoms of hypocalcemia

A
  • Dry skin
  • Loss of body and scalp hair
  • Hypoplasia of developing teeth
  • Horizontal ridges in nails
  • Cataracts
  • Basal ganglia calcification
  • Bone deformities
  • Bowing of long bones
40
Q

Causes of hypomagnesemia

A
  • Chronic alcoholism
  • Malnutrition
  • Malabsorption
  • Increased renal clearance of MG caused by the use of aminoglycoside antibiotics or certain chemotherapeutic agents, or prolonged Mg deficiency parenteral nutritional therapy
41
Q

What does hypomagenesemia do?

A

Inhibits PTH secretion

  • if Mg is low, then Ca is high, so don’t want the PTH to increase Ca levels any more
42
Q

Hypercortisolism

A

AKA Cushing’s Syndrome
Glucose intolerance because of cortisol-induced insulin resistance and increased gluconeogenesis and glycogen storage by the liver.

Overproduction of ACTH by pituitary adenoma or ectopic secreting nonpituitary tumor.

Happens when there’s extra cortisol in your body. Cortisol, the “stress hormone,” is vital to regulating your blood sugar and turning food into energy. Unfortunately, too much of it caused by a medication or a tumor can cause weight gain, muscle weakness and more.

Characterized by patterns of fat deposition “truncal obesity”, “moon face” and “buffalo hump”

43
Q

What is the cause of Cushing’s syndrome?

A

From overproduction of cortisol by the adrenal glands or steroid use.

44
Q

Adrenocorticotropic Hormone (ACTH)

A

Hormone produced by the pituitary gland that controls the production of cortisol by the adrenal gland.

45
Q

Function of cortisol

A
  1. Respond to stress
  2. Fight infection
  3. Regulate blood sugar
  4. Maintain blood pressure
  5. Regulate metabolism, the process of how your body uses food and energy
46
Q

Adrenal crisis

A

Onset signified by severe hypotension which can progress to complete vascular collapse and shock .

“adrenal crisis” or “Addisonian crisis” and develops when:
- Undiagnosed disease
- Withdrawal of glucocorticoid therapy
- Infection
- Multiple stressor

This is why we wean steroids.

47
Q

What hormones do the adrenal glands produce?

A

Aldosterone and cortisol

48
Q

Primary Adrenal insufficiency

A

AKA Addison’s disease

Adrenal gland is unable to produce enough cortisol and aldosterone.

Lab work shows:
- Serum and urine cortisol levels depressed
- ACTH levels are increased

Symptoms may not present until 90% of adrenal cortex is destroyed

When prescribing cortisol remember:
o More cortisol is needed with acute stressors (infection, surgery, trauma) to approximate the amount that would be secreted if normal adrenal function were present

49
Q

Most common cause of Addison’s disease

A

Autoimmune destruction of adrenal cortex.

NR507 - Advanced Pathophysiology (9 decks)

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