Chapter 22 Flashcards by Desiree Namou

disorders of the adrenal medulla

hyperfunction
_____ of adrenal medulla
-_________

tumor

pheochromocytoma

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If there is pressure exerted by a pituitary tumor

If the tumor exerts sufficient pressure, then ______ and _______ hypofunction may occur because of lack of _____ and _____

These result in the symptoms of _______ and _______

thyroid, adrenal
TSH, ACTH
hypothyroidism
hypocortisolism

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Diabetes insipidus (cont’d)
Treatment
______: This form of diabetes insipidus (DI) is ______ with exogenous antidiuretic hormone ADH Administration of the synthetic vasopressin analog desmopressin acetate (DDAVP)

________: this form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate _______

neurogenic
treatable
nephrogenic
insensitivity

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diabetic nephropathy

Most common cause of end-stage kidney disease in the Western world

________- The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy

microalbuinuria

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posterior pit
clinical manifestations lab values:
\_\_\_\_\_\_\_\_:  Sodium <135 mEq/L
\_\_\_\_\_\_\_\_\_\_: <280 mOsm/kg
\_\_\_\_\_\_\_\_\_: Higher than serum osmolality
-\_\_\_\_\_\_\_\_\_
-\_\_\_\_\_\_\_\_\_\_
Serum sodium levels below \_\_\_ to \_\_\_ mEq/L: Can cause severe and sometimes irreversible \_\_\_\_\_\_\_ damage

hyponatremia
hypoosmolality
urine hyperosmolality
hypervolemia
weight gain
110, 115
neurologic

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diabetes insipidus and SIADH both present with

excessive thirst

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diseases of anterior pit

_________
Commonly from benign, slow-growing pituitary adenoma

Clinical manifestations

Headache and fatigue
Visual changes-pressure of the tumor on the _______
______ of pituitary from tumor
______ of neighboring anterior pituitary hormones

hyperpituitarism
optic chiasm
hypersecretion
hyposecretion

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alterations of thyroid function
Rare but life threatening within 48 hours if not treated.
Results from excessive stress

clinical manifestations:
1
2 \_\_\_\_\_ especially \_\_\_\_\_\_\_
3
4 \_\_\_\_\_\_ or \_\_\_\_\_\_
5
6

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

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hyponatremia:

_______ is under hyponatremia

SIADH

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type 2 diabetes
Insulin resistance
-Response of insulin-sensitive tissues (especially ____, _____, and ______ tissue ) to insulin is suboptimal.
-______ makes one prone to insulin resistance.

treatment:

liver, muscle, adipose tissue
obesity
hypoglycemics

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chronic complications of diabetes

microvascular disease
1
2
3

macrovascular disease
1
2
3

diabetic retinopathy
diabetic nephropathy
diabetic neuropathies
coronary artery disease
stroke
peripheral arterial disease

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diseases of the anterior pit

Hypopituitarism (cont’d)
_________- a lack of all hormones associated with the anterior pituitary is:
-Adrenocorticotropic hormone (ACTH) deficiency
Cortisol deficiency

-Thyroid-stimulating hormone (TSH) deficiency
Altered metabolism

-Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) deficiency
Lack of secondary sex characteristics

-Growth hormone (GH) deficiency
Lack of growth in children

Panhypopituitarism

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gestational diabetes

if the gestational diabetes melliitus develops, then the risk for type __ diabetes increases

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Visual disturbances are a result of ________

Due to the pressure of the tumor on the _________!!!!

pituitary adenoma

optic chiasm

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diseases of post pit
Diabetes insipidus-Sodium levels are _____..
-Insufficiency of _____
-_____and _____
-Partial or total inability to concentrate the ______

Neurogenic
-Insufficient amounts of ____

Nephrogenic
-Insensitivity of the _____________s to ADH

Dipsogenic
-_______ fluid intake ________ plasma osmolarity to the point that it falls below the threshold for ADH secretion

high
ADH
polyuria, polydipsia
urine
ADH
renal collective tubules
excessive
lowering
excessive
lowering

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alterations of thyroid function

Primary hypothyroidism
-A deficiency of chemical: ______ deficiency ( ______): Most common worldwide

iodine

endemic goiter

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CHART for diseases of post pit
functioning: hypofunction
antidiuretic hormone effects:
examples of diseases:

too little
Diabetes insipidus
Neurogenic
Nephrogenic
Dipsogenic

posterior pit
clinical manifestations
1
2
3
4 decreased \_\_\_\_\_\_\_\_\_
5 concentrated \_\_\_\_\_\_

lethargy
hyponatremia
seizure
plasma osmolarity
concentrated urine

diseases of post pit
Diabetes insipidus (cont’d)

Lab Clinical manifestations

_____, _____ continual ______
Low _______ gravity: <1.010
Low urine ______ (<200 mOsml/kg)
________

Clinical manifestations
-_______, _____, _____, _____increased ________, large volume of _____ urine

The basic criteria for diagnosing DI include a ___ urine-specific gravity while sodium levels are ____

polyuria, nocturia, thirst
urine specific
osmolality
hypernatremia

polydipsia, nocturia, polyuria, hypernatremia, plasma osmlality
dilute
low
high

Microvascular Disease is a result
characteristics
-Microvascular complications are a result of capillary basement membranes ____ and _____cell _____

thickening
endothelial
hyperplasia

CHART for diseases of post pit
functioning: hyperfunction
antidieuretic hormone effects:
examples of diseases:

too much

Syndrome of inappropriate antidiuretic hormone (SIADH) secretion

cushing disease and cushing syndrome
Cushing disease
Hypersecretion of ____ by a pituitary adenoma

ACTH

alterations of parathyroid function
Secondary hyperparathyroidism
-Increase in ___, secondary to a chronic ______
Chronic _______

PTH
disease
renal failure

cushing disease or and c ushing syndrome clinical manifestations
1
2
3
4

acne
easy bruising
thin extremities
truncal obesity

addison disease hypersecretion of ________ hormones

adrenal cortex

type 1 diabetes mellitus why polyuria??? ______ accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic _____ and the symptoms of ____and ____

glucose dieuresis polyuria thirst

hypoglycemia - lowered _____ level - newborns: less than _ - children and adults: less than __ to __ clinical manifestations _______, ______, _____, ______, _______, decreased level of ______, perhaps ______

``` plasm glucose 35 45, 60 tachycardia diaphoresis tremor pallor confusion consciousness seizure ```

diseases of the anterior pit Hypersecretion of GH _______ -GH hypersecretion in children and adolescents because the the ________ have not yet closed. _______- Hypersecretion of growth hormone - Hypersecretion of GH during adulthood - Slowly progressive __________ 1. Co-morbid conditions: Cardiac _______; _______; _______; type _ diabetes mellitus, leading to __________ 2. Other malignancies: Common

``` giantism epiphyseal plates acromegaly pituitary adenoma hypertrophy hypertension atherosclerosis 2 coronary artery disease ```

diabetic rietinopathy is the leading cause of blindness Retinopathy develops in patients with diabetes mellitus because of progressive process that accompanies retinal capillary ______, vessel _____, rential ______ and red blood cell _______occurs.

permeability occlusion ischemia aggregation

alterations of thyroid function Hyperthyroid condition: Hypersecretion of thyroid hormone- ______ disease Cause is an ________disease; develops autoantibodies. Thyroid-stimulating immunoglobulin that causes _______ of thyroid hormones.

graves disease autoimmune overproduction

Syndrome of inappropriate antidiuretic hormone (SIADH) secretion Levels of antidiuretic hormone (ADH) are abnormally high. _______ secretion of ADH is the most common cause; is also common after _____ and some ______ Water ______ and ________: Action of ADH on renal collecting ducts increases their _______ to water, thus increasing water _______ by the kidneys.

``` ectopic surgery cancers retention dilutional hyponatremia permeability reabsorption ```

diabetic ketoacidosis clinical manifestations ______, decreased level of _______, ______ breathing, ______ smell breath, ________, decreased __, ______, _______

``` polyuria conscious kussmaul acetone hyperglycemia pH ketonuria glycosuria ```

Graves disease The level of ___ in individuals with Graves disease is usually ___ _____ of the neck of a person diagnosed with Graves disease would detect a thyroid that is diffusely ____

TSH low palpation enlarged

Hypoglycemia caused by ______ exercise ______, _______, ______, ____, ______, and _______. The most probable cause of these symptoms is hypoglycemia, which is often caused by a lack of ______glucose as a result of muscular activity.

``` increased hunger lightheadedness tachycardia pallor headache confusion systemic ```

``` hyperaldosteronism Primary (____ disease, primary aldosteronism)-Hypersecretion of aldoestrone ```

conn

diseases of post pit Diabetes insipidus Is characterized by the inability of the kidney to increase ______ to water. - Excretion of large volumes of ____ urine - Increase in plasma osmolality: ____ mOsm or more, depending on adequate water intake - Urine output: _ to _L/day; normal output: _ to _ L/day

``` permeability dilute 300 8, 12 1,2 ```

alterations in thyroid function hypothyroidism diagnosis is with _____ - _____________ clinical manifestations: -___ basal metabolic rate , decreased ____, ___intolerance,_____, ______, _____, and slightly lowered ___body temperature; also possible ______ hypertension -________- Hyposecretion of thyroid hormone

``` fine-need aspiration biopsy low heart rate cold constipation lethargy tiredness basal diastolic myxedema ```

hypoparathyroidism usual cause - MCC is parathyroid damage in thyroid ______ Clinical manifestations: - ______ spasms; _________; ________ seizures; ______ spasms; death from _________ - _______ and ______ signs

``` surgery muscle spasms hyperreflexia tonic-clonic asphyxiation chvostek trousseau ```

``` diseases of the anterior pit Hypersecretion of prolactin Caused by ________ Most common ______ active pituitary tumor In women: 1 2 3 4 ``` In men: 1 2

``` prolactinomas hormonally amenorrhea galactorrhea hirsutism osteoporosis hypogonadism erectile dysfunction ```

hypoglycemics medications: I. Biguanide (metformin)- decreases _____ glucose production and increases _____ sensitivity and _______glucose uptake II. Meglitinides (glinides)- increase _____from the pancreas III. Sulfonylureas (glyburide)-increase ____ from the pancreas IV. a-Glycosidase inhibitor (miglitol)- ____ the glucose in the ______ lining.

``` hepatic insulin peripheral insulin insulin block intestinal ```