Alterations of Endocrine Function I

Question 1

Syndrome of Inappropriate ADH (SIADH)

-what is it?

Answer 1

When the kidneys are exposed to excessive amounts of ADH

Question 2

Syndrome of Inappropriate ADH (SIADH)

-causes

Answer 2

• post surgery: see increased ADH secretion for 5 to 7 days following general anesthesia
• Ectopic production by cancers
• Pulmonary infections: TB
• CNS disorders (stroke)

Question 3

What is nephrogenic diabetes insidious?

Answer 3

Decreased renal response to normal ADH levels

Question 4

What is Neurogenic diabetes insidious?

Answer 4

Decreased ADH secretion from the posterior pituitary or hypothalamus

Question 5

A patient presents with hyponatremia following surgery. What disorder is a likely cause?

Answer 5

SIADH

Question 6

What is a common cause of SIADH?

Answer 6

Lung cancer

Question 7

Common cause of nephrogenic diabetes insipidus is?

Answer 7

Taking lithium for bipolar disorder

Question 8

Patient is diagnosed wit SIADH. Which lab values would be most important to monitor?

Answer 8

Sodium

Question 9

SIADH manifests (displays)with all of the following changes EXCEPT:

Answer 9

High volume urine output

Question 10

A patient is diagnosed with secondary hyperthyroidism manifested by elevated T3/T4 and elevated TSH. Which are the following are possible causes of this condition?

Answer 10

Pituitary gland adenoma

Question 11

In primary hyperthyroidism, both T3/T4 and TSH levels are low? T or F

Answer 11

False

Question 12

Describes pathophysiology of Graves Disease?

Answer 12

Production of antibodies that mimic TSH function

Question 13

Which of the following metabolic changes are indicative of hyperthyroidism?

Answer 13

Weight loss

Question 14

All of the following clinical consequences are associated with long term, untreated hypothyroidism except:

Answer 14

Hypertension

Question 15

Which of the following thyroid diseases would result in goiter?

Answer 15

Grave’s disease
Secondary hyperthyroidism
Iodine deficiency

Question 16

Which of the following problems is a consequence of Hashimoto’s disease?

Answer 16

Hypothyroidism

Question 17

Patho of SIADH?

Answer 17

Increased secretion of ADH
Increased permeability of renal tubules to water
Excretion of concentrated urine
Results in hyponatremia 
Increased blood volume/blood pressure

Question 18

Types of diabetes insipidus?

Answer 18

Nephrogenic

Neurogenic

Question 19

Patho of neurogenic DI?

Answer 19

• Acute damage to hypothalamus
• Decreased permeability of renal tubules to water
• excretion of large volumes of dilute urine
• High plasma osmolarity and hypernatremia
• Hypovolemia and hypotension

Question 20

Patho of Nephrogenic DI?

Answer 20

• Damage to renal tubules lead to decreased response to ADH
• excretion of large volumes of dilute urine
• High plasma osmolarity and hypernatremia
• Hypovolemia and hypotension

Question 21

Thyroid hormone (overview)

Answer 21

• produced by follicle cells of the thyroid gland

- hormones produced are T4 and T3

Question 22

Thyroid hormone (psychological effects)

Answer 22

• Stimulates metabolism (main function)
• Normal maturation of the nervous system and promotes effects of growth hormone (have to have thyroid)
• Increases target cell responsiveness to catecholamines*
• raise blood pressure and heart rate

Question 23

What is Hyperthyroidism?

Answer 23

When the tissues are exposed to excessive amount of thyroid hormone (T3/T4)

Question 24

Causes of primary hyperthyroidism?

Answer 24

• Genetic predisposition (causes a variety of familial hyperthyroid disorders)
• Thyroidotis (gets inflamed)
• Toxic nodular or multinodular goiter (Plummer disease) solid begin tumor
• Thyroid cancer

Question 25

Causes of secondary hyperthyroidism?

Answer 25

- TSH secreting pituitary adenomas (begin tumors) - Graves disease (70%) - Overdose of thyroid medicine

Question 26

Patho of primary hyperthyroidism and secondary hyperthyroidism?

Answer 26

- Primary: increase T3/T4 secretion from thyroid gland leads to thyroid stimulating hormone (TSH) suppression - Secondary: increased TSH secretion from anterior pituitary gland leads to increased T3/T4 secretion

Question 27

Due to increased TSH...

Answer 27

Goiter possible with secondary hyperthyroidism (elevated TSH causing hyperthyroidism)

Question 28

What is Graves' disease?

Answer 28

An autoimmune disease causing hyperthyroidism (unique)

Question 29

Patho of Graves Disease?

Answer 29

- Overproduction of thyroid autoantibodies called thyroid stimulating immunoglobulins (TSI) - TSIs mimic effect of TSH - Elevated plasma levels of T3/T4 cause TSH suppression

Question 30

Primary Hypothyroidism (etiologies)

Answer 30

- Iodine deficiency *** - Congenital lack of thyroid tissue - Hashimotos thyroiditis: production of autoantibodies that block TSH receptors

Question 31

Secondary hypothyroidism (etiologies)

Answer 31

- Stroke to hypothalamus or pituitary*** - Pituitary tumor - Postpartum pituitary necrosis

Question 32

Primary hypothyroidism (patho)

Answer 32

Decreased T3/T4 secretion from thyroid gland leads to increased TSH secretion

Question 33

Secondary hypothyroidism (patho)

Answer 33

Decreased TSH secretion from anterior pituitary gland leads to decreased T3/T4 secretion

Question 34

Clinical consequences (due to decreased T3/T4)

Answer 34

- going to feel really tired - decreased neuromuscular activity - decreased SNS activity