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Internal Medicine > Week 8- Endocrine and Metabolic System *didn't finish > Flashcards

Week 8- Endocrine and Metabolic System *didn't finish Flashcards

1
Q

The endocrine system and the nervous system control and integrate body function to maintain ______________

A

Homeostasis

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2
Q

The endocrine system sends its messages in the form of hormones via the ____________

A

Bloodstream

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3
Q

Five general functions of the endocrine system

A

-Differentiation of the reproductive and central nervous system of the developing fetus
-Stimulation of sequential growth and development during childhood and adolescence
-Coordination of the male and female reproductive systems
-Maintenance of optimal internal environment throughout the life span
-Initiation of corrective and adaptive responses when emergency demands occur

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4
Q

______________ , the main integrative center for the endocrine and autonomic nervous systems, controls the function of endocrine organs by neural and hormonal pathways

A

Hypothalamus

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5
Q

In addition to hormonal and neural controls, a ________________ system (simple or complex) regulates the endocrine system

A

Negative feedback

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6
Q

SLIDE 7, 8, 9

A
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7
Q

_____________ can be classified as an endocrine gland, because it secretes several hormones responsible for metabolism, hunger, vasoconstriction, and cellular growth and development

A

Adipose tissue

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8
Q

Hormones released by adipose tissue

A

Adiponectin
Leptin

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9
Q

Dysfunctions of the endocrine system are classified as _____________or ____________

A

HYPOfunction
HYPERfunction

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10
Q

Endocrine system, together with the immune system and the nervous system, mounts an integrated response to stressors

A

Psychoneuroimmunology

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11
Q

Catecholamines

A

Epinephrine
Norepinephrine
Dopamine

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12
Q

Catecholamines produce a _____________ response

A

Fight-or-flight

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13
Q

SLIDE 11- cortisol (look at table 11.2)

A
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14
Q

Other hormones produced through neuroendocrine response to stress

A

Endorphins
GH
Prolactin
Testosterone

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15
Q

True or false: Exact effects of aging on the endocrine system are clear

A

False

(not clear)

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16
Q

Failure of homeostasis basis of age-associated ___________ in physiologic performance on the endocrine system

A

Declines

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17
Q

Equilibrium concentrations of the principal hormones necessary to maintain homeostasis are not necessarily altered with age, but what may differ as we get older is ______________ , which points to changes in regulatory control

A

The way we achieve equilibrium hormone levels

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18
Q

True or false: Only subtle changes occur in the pituitary, adrenal, and thyroid function

A

True

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19
Q

True or false: Changes in glucose homeostasis, reproductive function, and calcium metabolism are less apparent

A

False

(more apparent)

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20
Q

Suggests that cells are programmed to function only for a given time

A

Neuroendocrine theory of aging

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21
Q

Example of neuroendocrine theory of aging

A

Menopause (result of programmed changes in reproductive system)

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22
Q

Clients with a variety of endocrine and metabolic disorders report symptoms of ___________, _________, and occasionally ____________

A

Fatigue
Muscle weakness
Muscle or bone pain

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23
Q

The lack of progress in therapy should signal to the therapist the possibility of a ____________ of musculoskeletal symptoms

A

Systemic origin

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24
Q

SLIDE 16

A
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25
Q

________________ can be an indicator of an underlying endocrine disease

A

Rheumatoid arthritis

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26
Q

True or false: Muscle weakness, atrophy, myalgia, and fatigue that persist despite rest may be early manifestations of thyroid or parathyroid disease, acromegaly, diabetes, Cushing syndrome, or osteomalacia

A

True

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27
Q

_____________ resulting from __________ nerve impairment at the wrist is a common finding in people with certain endocrine and metabolic conditions such as acromegaly, diabetes, pregnancy, and hypothyroidism

A

Carpal tunnel syndrome (CTS)
Median

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28
Q

In endocrine disorders, CTS is frequently _________ , which is one characteristic that may distinguish it from overuse syndromes and other causes of CTS

A

Bilateral

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29
Q

___________ , __________ , and ___________ (joint stiffness) of the small joints of the hand may occur with endocrine and metabolic diseases

A

Hand stiffness
Hand pain
Arthralgias

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30
Q

Flexor tenosynovitis with stiffness is a common finding in persons with _______________

A

Hypothyroidism

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31
Q

Anterior lobe disorders of pituitary gland

A

HYPERpituitarism
HYPOpituitarism

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32
Q

Hyperpituitarism

A

Orthopedic considerations
Acromegaly

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33
Q

Skeletal manifestations, such as __________ of the hands and _____________ of the spine, may develop with hyperpituitarism

A

Arthritis
Osteoarthritis

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34
Q

CTS is seen in up to ____% of people with acromegaly

A

50

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35
Q

About _________ of individuals with acromegaly have thoracic or lumbar back pain

A

Half

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36
Q

True or false: Therapist may be called on to provide a program that promotes maximum joint mobility, muscle strength, and functional skills

A

True

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37
Q

Excessive secretion of growth hormone after normal completion of body growth

A

Acromegaly

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38
Q

Anyone with acromegaly should be screened for __________, ____________, and ____________

A

Weakness
Changes in joint mobility
Poor exercise tolerance

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39
Q

Primary hormones produced by the thyroid

A

Thyroxine (T4)
Triiodothyronine (T3)
Calcitonin

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40
Q

Both _____ and ______ regulate the metabolic rate of the body and increase protein synthesis

A

T3
T4

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41
Q

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

A

Calcitonin

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42
Q

Thyroid function is regulated by…

A

-Hypothalamus
-Pituitary feedback controls
-Intrinsic regulator mechanism within the gland

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43
Q

True or false: Disorders of the thyroid gland may be functional abnormalities leading to hyperfunction or hypofunction of the gland or anatomic abnormalities such as thyroiditis, goiter, and tumor

A

True

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44
Q

Alterations in thyroid function produce changes in…

A

Nails
Hair
Skin
Eyes
GI tract
Respiratory tract
Heart and blood vessels
Nervous tissue
Bone
Muscle

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45
Q

True or false: Women do not notice disturbances in mood and menstrual cycles

A

False

(they do notice lol)

46
Q

Both hyperthyroidism and hypothyroidism can adversely affect _____________

A

Cardiac funciton

47
Q

SLIDE 28- Table 40.19

A
48
Q

Creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system

A

Hyperthyroidism

49
Q

The most common for (85% of cases) of hyperthyroidism

A

Graves disease

50
Q

Regarding Graves disease, the autoimmune condition increases ______ production

A

T4

51
Q

True or false: Hyperthyroidism affects women more than men (4:1)

A

True

52
Q

Acute episode of thyroid over activity

A

Thyroid storm

53
Q

Functional abnormalities of thyroid gland

A

Hyperthyroidism
Hypothyroidism

54
Q

Anatomic abnormalities of thyroid gland

A

Goiter
Thyroiditis
Thyroid cancer

55
Q

About _____ % of people with Graves disease have circulating autoantibodies called __________ that react against thyroglobulin (precursor for thyroid hormones)

A

-95
-Thyroid-stimulating immunoglobulins (TSIs)

56
Q

TSIs react against a component of the thyroid cell membranes, _________ enlargement of the thyroid gland and secretion of __________ thyroid hormone

A

Stimulating
Excess

57
Q

Hyperthyroidism results with increased __________ nervous system activity and __________ deficiency

A

Sympathetic
Nutritional

58
Q

Mild symmetric enlargement of the thyroid (goiter), nervousness, heat intolerance, weight loss despite increased appetite, sweating, diarrhea, tremor, and palpitations

A

Hyperthyroidism

59
Q

Hyperthyroidism may induce…

A

-Atrial fibrillation
-Precipitate congestive heart failure
-Increase the risk of underlying CAD for myocardial infarction

60
Q

Forward displacement of the eyeballs associated with thyroid disease

A

Exophthalmos

61
Q

True or false: PT is recommended for someone with exophthalmos

A

False

(not recommended until after endocrine system is solved)

62
Q

Inflammation that involves the peri-articular structures, including the tendons, ligaments, and joint capsule

A

Peri-arthritis

63
Q

True or false: Peri-arthritis can be be unilateral or bilateral

A

True

64
Q

Proximal muscle weakness (most marked in the pelvic girdle and thigh muscles) accompanied by muscle atrophy

A

Myopathy

65
Q

Respiratory muscle weakness can present as _________

A

Dyspnea

66
Q

True or false: There is a way to prevent Graves disease

A

False

(no way)

67
Q

Lab tests for hyperthyroidism

A

TSH and antithyroid antibodies

68
Q

_______ is positive in almost all people with Graves disease

A

TSI

69
Q

Three major forms of therapy for hyperthyroidism

A

-Antithyroid medication
-Radioactive iodine (RAI)
-Surgery

70
Q

True or false: Lifelong follow-up for patients with hyperthyroidism is recommended because many remissions are not permanent

A

True

71
Q

True or false: If PT sees unusual swelling, enlargement with or without symptoms of pain, tenderness, hoarseness, or dysphagia (difficulty swallowing), a medical referral is required

A

True

72
Q

True or false: Hyperthyroidism is associated with exercise tolerance and increased exercise capacity, although the exact relationship is unknown

A

False

(intolerance, decreased exercise capacity)

73
Q

Results in a generalized slowed body metabolism (basal metabolic rate)

A

Hypothyroidism

74
Q

These types are involved in hypothyroidism

A

-Type I / primary (hormone deficient)

-Type II / secondary (hormones resistant)

75
Q

True or false: Hypothyroidism is more prevalent in men than women

A

False

(more prevalent in women than in med)

76
Q

SLIDE 37-44

A
77
Q

______ parathyroid glands are located on the posterior surface of each lobe of the thyroid gland

A

Two

78
Q

Parathyroid glands secrete _____, which regulates _______ and ________ metabolism

A

PTH
Calcium
Phosphorus

79
Q

PTC exerts its effect by the following…

A

-Increasing the release of calcium and phosphate from the bone (bone demineralization)
-Increasing the absorption of calcium and excretion of phosphate by the kidneys
-Promoting calcium absorption in the GI tract

80
Q

SLIDE 48 ,49

A
81
Q

Over-activity of one or more of the four parathyroid glands that disrupts calcium, phosphate, and bone metabolism

A

Hyperparathyroidism

82
Q

True or false: Regarding hyperparathyroidism, women are affected more than men (2:1), usually after age 60 years (postmenopausal)

A

True

83
Q

SLIDES 51-57

A
84
Q

______________ are two small glands located on the upper part of each kidney

A

Adrenals

85
Q

Two relatively discrete parts of each adrenal gland

A

-Outer cortex
-Inner medulla

86
Q

The outer cortex of the adrenal gland is responsible for the secretion of…

A

-Mineralocorticoids (steroid hormones that regulate fluid and mineral balance)
-Glucocorticoids (steroid hormones responsible for controlling the metabolism of glucose)
-Androgens (sex hormones)

87
Q

The centrally located adrenal medulla is derived from neural tissue and secretes __________and ___________, which exert widespread effects on vascular tone, the heart, and the nervous system and affect glucose metabolism

A

Epinephrine
Norepinephrine

88
Q

Together, the adrenal _______ and ________ are major factors in the body’s response to ________

A

Cortex
Medulla
Stress

89
Q

SLIDE 61-62

A
90
Q

Disorders of the adrenal gland

A

-Primary Adrenal Insufficiency (Addison Disease)
-Secondary Adrenal Insufficiency
-Adrenocortical Hyperfunction (Cushing syndrome and Conn syndrome)

91
Q

Insufficient cortisol release from the adrenal glands causing a wide range of problems

A

Primary adrenal insufficiency (Addison Disease)

92
Q

Regarding Addison Disease, most causes occurred as a complication of tuberculosis, but now most cases are considered ___________ or ____________

A

Idiopathic
Autoimmune

93
Q

True or false: Other causes of Addison Disease include bilateral adrenalectomy, adrenal hemorrhage or infarction, radiation to the adrenal glands, malignant adrenal neoplasm, infections, and medications

A

True

94
Q

SLIDE 65-71

A
95
Q

Examples of adrenocortical hyperfunction

A

-Cushing syndrome
-Conn syndrome or aldosteronism

96
Q

An excess of cortisol in the body

A

Hypercorticolism

97
Q

REST OF SLIDE 73

A
98
Q

__________ has a key role in glucose metabolism and a lesser part in protein, carbohydrate, and fat metabolism

A

Cortisol

99
Q

True or false: Cortisol also helps maintain blood pressure and cardiovascular function while reducing the body’s inflammatory responses

A

True

100
Q

Hypercortisolism resulting from adrenal gland oversecretion or from hyperphysiologic doses of corticosteroid medications

A

Cushing syndrome

101
Q

When the hypercortisolism results from oversecretion of ACTH from the pituitary (usually due to an anterior pituitary tumor)

A

Cushing disease

102
Q

Occurs when conditions such as depression, alcoholism, estrogen therapy, or eating disorders cause changes like those of Cushing syndrome

A

Pseudo-Cushing syndrome

103
Q

SLIDE 76-77

A
104
Q

Therapists are more likely to treat people who have developed medication-induced ______________ (exogenous steroid administration)

A

Cushing syndrome

105
Q

Cushing syndrome occurs after individuals have received large doses of _________ (also known as hydrocortisone) or _________

A

Cortisol
Cortisol derivatives

106
Q

Occurs when an adrenal lesion results in hypersecretion of aldosterone

A

Conn syndrome

107
Q

The major cause of primary aldosteronism is a benign, aldosterone-secreting tumor called ______________

A

Aldosteronoma

108
Q

________________ also can occur as a consequence of pathologic lesions that stimulate the adrenal gland to increase production of aldosterone

A

Secondary hyperadolsteronism

109
Q

Aldosterone affects the tubular reabsorption of ________ and _________ and the excretion of _________ and _________ ions in the renal tubular epithelial cells

A

Sodium
Water
Potassium
Hydrogen

110
Q

An excess of aldosterone enhances ________ reabsorption by the _________

A

Sodium
Kidneys

Internal Medicine (25 decks)

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