Diseases and disorders of Endocrine system Flashcards

Question

What is the endocrine pancreas?

Answer 1

fish shaped organ in middle of abd cavity, below stomach divided into head, body, and tail w/ head neartest to duodenum and opening of pancreatic duct

Answer 2

synthesis, storage, release of insulin (secreted by beta cells located in patches of tissue called islets of langerhans aka pancreatic islets), glucagon (secreted by alpha cells of islets) and somatostatin (delta cells, inhibits secretion of glucagon and insulin)

Answer 3

antagonistic to each other to maintian normal blood glucose of 80-120 mg/dl insulin lower blood glucose, glucagon elevates it by stimulating liver to release glycogen in form of glucose after meal blood sugar increases = insulin which moves sugar into blood and tissues to be converted to glycogen which is converted into glucagon when blood sugar levels drop

Answer 4

overies and testes function is endocrine gland + source of ova and sperm ova secretes estrogen and progesterone (sexual development, secondary sex characterisitcs and reproductive cycle) testes secerte testosterone (sexual development, secondary sex characterisitcs)

Answer 5

thyroid and testes

Answer 6

in blood or urine samples via enzyme-linked immunosorbant assay (ELISA), and radioimmunoassay (RIA) in these tests labeled hormone (antigen) competes with unlabed hrmone for binding sites on an antibody if v. high concentration of hormone in blood or urine sample most of resulting antigen-antibody complexes will be unlabeled v. low concentration of hormone in blood or urine sample, most of the antigened-antibody complexes will be labled

Answer 7

is result of inherited disorders, malignant tumors, inadequate secretion of hormones, inflammation, and vascular changes of pituary gland

Answer 8

due to inadequate secretion of growth hormone by pitaury gland (adult height reachign only 4 ft 10) only known risk factor is injury or trauma to pituitary gland cause is mostly idiopathic, other causes may include genetics, congenital, cranial tumor in pituary gland interfering with hormone production, trauma to the gland or radiation treatment to the head

Answer 9

1 in 14,000 to 1 in 27,000 200,000

Answer 10

children w/ pituitary dwarfism r proportionately small - slowed growth before age of 5 years - absent or delay sexual development - short stature and height for age

Answer 11

diagnose - physical exam, secondary tooth eruption is delayed, fat deposits in lower trunk area blood test confirming low GH and imaging tests treat - GH replacement therapy until child reaches 5 ft, replacement thyroid and adrena hormones when multiple hormone deficines r found (as they approach puberty, sex hormoens r adminstered if needed)

Answer 12

result of hypersecretion of GH (somatotropin) in children = abn and accelerated growth, typically of long bones bc epiphyseal closure has not begun 100 cases of gigantism reported to date no known risk factors for gigantism most common cause is benign tumor of the pituary gland that leads to excessive secretion of GH

Answer 13

- facial features may thicken - hands & ft may be disproportionately enlarged, - headaches may develop along with excess sweating - late onset of puberty - joint problems - CV weakness and myoptahy - shorter life expenctancy

Answer 14

diagnose - physical exam, imaging tests, biopsy, elevated levels of GH, age-reference norms for insulin-like growth factor 1 (IGF-1) r best indicators of endogeounous secretion of GH), pituary MRI or CT, bone radiographs show thickening of cranium, enlargement of jaws and elongation of long bones, and blood test treat - depends on etiology (if well-defined tumors then surgery), radiation therapy, med to reduce growth hormone secretion, if surgery than transsphenodial apprach

Answer 15

result of excess GH secretion in adulthood 4,676 cases per million people no known risk factors for acromegaly slow but harmful onset, s/s are usually present for a number of yr before diagnosis caused by benign tumor of pituitary gland or adenoma that leads to excessive seretion of GH

Answer 16

grwith plates of long bones r clsoed to long bones dont increase in length - enlargemetn of hands, feet and head - soft-tissue thickening of palms of head and soles of ft - enlargemetn of forehead - enlargement of the jaw to cause teeth to spread - enlargement of tongue - arthritis

Answer 17

diagnose - med history, physical exam, blood test for high GH and IGF-1, glucose tolerance tests bc increased glucose levels = failure of suppression of GH levels, MRI and CT, and biopsy treatment - focuses on correcting metabolic abn, improving cliical features and correcting underlying cause (surgical removal of tumors through transsphenoidal approach), med to decrease GH secretion prior to surgery or when surgery isn't possible, radiation

Answer 18

distrurbance of water metabolism, resulting in extreme thrist and excessive secretion of dilute urine due to results from decreased secretion or action of ADH (vasopressin) (may be hereditary, head trauma, cerebral eema, intracranial lesion, renal tubular resistance, more common in men, childhood or early adulthood) occur in 3 in 100,000

Answer 19

head injury, brain surgery, kidney disease, pregnancy, taking certain meds (lithium, amphotercin B, demeclocycline)

Answer 20

polyuria polydipsia disturbed sleep due to bedwetting daytime fatigue fever, headaches wt loss low bp dry mucous membranes hypotension dizziness poor skin turgor

Answer 21

Central DI - damage to pituary gland from surgery, tumor, illness (ex: meningitis), inflammation or head injury Nephrogenic DI - defect in kidney tubules, making kidneys unable to properly respond to ADH (can be bc genetic disorder, chronic kidney disorder, drugs like lithium and emecloycline)

Answer 22

diagnose - med history, physical exam, urinalysis (shows colorless urine w/ low specific gravity (<1.005)) and water restriction test (when urine concentration is stable on consecutive measurements or blood osmolality is above normal, vasopressin is administered) treat - removing the primary cause and treating symptoms to prevent dehydration, may be controlled with vasopressin (nasal spray or tablet), vasopressin is ineffective for nephrogenic DI so treatment is compensatory fluid intake with effort to correct underlying etiology, thiazide dieuretic by inducing mild volume depletion (kidney transplant may be needed)

Answer 23

used to treat DI urine of DI pt is colorless and has v. low specific gravity (diluted urine) limits pt water intake for few hours while measuring urine output, bp, and urine concentration, after several hrs pt is given vasopressin meds (med decrease urine output and increase urine concentration)

Answer 24

below-normal production of T4 by thyroid gland is in 1-2% of population caused by autoimmune diseases (hashimotos's disease), family tendecy, surgery to remove all or part of thyroid, radiation treatment, treatment for hyperthyroidism, certain meds (lithium, interferon)

Answer 25

being female over 50 having autoimmune disorder having close relative with thyroid disease or an autoimmune disease use of radioactive iodine surgical removal of thyroid gland radiation to head or neck antithyroid med pregnancy some meds (lithium, interferon)

Answer 26

vary and depend on severity of deficiency unexplained wt gain dry skin hair loss swollen face, hands legs, ankles or ft increased sensitivity to cold aches and pains in muscles or joints hoarse or raspy voice constipation heavy or irregular periods fatigue slower thinking trouble remembering things slower speech depression enlarged thyroid changes in blood cholesterol levels slow heart rate infertility

Answer 27

diagnose - med history, s/s, blood test confirming low T4 and T3 and high TSH, autoantibody testing, and imaging tests treat - thyroid hormone replacement therapy

Answer 28

aka cretinism, occurs in 1 in 4,000 newborns no known risk factors most often result of hypoplasia (underdevelopment), aplasia (absence of development) and failure of thyroid gland to migrate to its normal anatomical position maternal factors like iodine deficiency and ingestion of antithyroid meds during pregnancy can cause hypothyroidism in both mother and fetus

Answer 29

intellectual development disorder umbilical hernia protruding abd reduced level of activity and generalized lethargy continuous wt gain even with physical feeding habits small stature retardation of physical growth developmental delay swelling in eyelids, enlarged tongue and coarse facial features

Answer 30

diagnose - blood test confirming low levels of T3 and T4 and high TSH usually within first 10 days of birth, thyroid scan confirming absence of thyroid tissue treat - adequate treatment with thyroid hormone supplements as soon as possible

Answer 31

excess thyroid hormone graves' disease is most common form of hyperthyroidism (occurs in 0.4% of the population) (entire thyroid gland hypertrophies, resulting in diffuse goither and overproduction of thyroid hormones) more common in women than men onset is btwn 20 and 40 yrs associated with autoimmune disease such as diabetes mellitus and rheumatoid arthritis

Answer 32

being female family history stress smoking

Answer 33

increased metabolism multisystem changes exitability profuse perspiration and war, moist skin muscle weakness nail change (onycholysis) enlargement of thyroid nervousness irritability heat intolerance increased sweating insomnia rapid or irregular heartbeat fatigue diarrhea wt loss 1/2 of ppl with Graves' disease have Graves' ophthalmopathy (bulging eyes) sudden increase in severity may signal thyrotoxicosis (thyroid storm) from v high levels of thyroid hormone levels

Answer 34

diagnose - family history, physical exam, s/s, blood test confirming high T3 and T4, and low TSH, and imaging

Answer 35

depends on severity, etiology, presence of complication, goal is to bring metabolic rate to normal with minimal complications administration of antithyroid drugs such as propylthiouracil and methimaole (tapazxole) to block synthesis of thyroid hormone b-blockers such as propranolol hydrochloride (inderal) and atenolol (Tenormin) r given to treat tachycardia radioactive iodine therapy or surgery (thyroidectomy)

Answer 36

abnormal immune system response that causes the thyroid gland to produce too much thyroid hormone (immune system releases abn antibodies that mimic TSH, and thereby thyroid hormone is increased

Answer 37

enlargement of thyroid gland usually evident by swelling in neck may be caused by iodine deficiency (iodine is needed to produce T3 and T4 which = thyroid hormone, and inadequate blood thyroid hormone levels = increased secretion of TSH = thyroid gland increasing in size), eating large amt of goiter-producing foods (soy, peanuts, peaches, spinach, turnips, brussel sprouts, seaweed, cabbage) that inhibit TH production, certain meds (immunosuppressants, antiretrovirals, lithium) or may be idiopathic

Answer 38

being female, over 40, family history of goiter

Answer 39

thryoid gland can compress trachea or esophagus, causing diff breathing or swallowing, dizziness and syncope - wt loss despite hearty appetite - heat intolerance - tachycardia - anxiety - increased sweating may be reported by pt when there is excessive production of thyroid hormones

Answer 40

diagnose - medical history, physical exam, blood test to measure levels of decreased TH and increased TSH, measurement of radioactive iodine uptake by thyroid, thyroid ultrasonography and imaging tests treatment - administer 1 drop per wk of saturated solution of potassium iodide,thyroid hormone replacement pills if goiter is bc underactive thyroid, small doses of iodine if goiter is bc lack of iodine, radiation therapy to shrink gland if bc thyroid is producing too much TH, surgery to remove all or part of gland

Answer 41

adequate intake of dietary iodine (150-300 ug) and monitoring intake of goiter-producing foods and medication

Answer 42

priamry cancer that starts in the thyroid glands secondary metastases from breast, colon, kidney, skin cancer to thyroid gland commonly diagnosed at a younger age than most other adult cancers women 3x r more likely

Answer 43

60,220 1,850 two out of three 55

Answer 44

being female diet low in iodine exposure to radiation (esp in early childhod0

Answer 45

no s/s early in disease as tumor grows s/s like lump in neck, voice hoarseness, difficulty swallowing, pain in neck and throat, swollen lymph nodes in neck, dysphagia, hoarseness resulting from compression of upper aerodigestive tract,

Answer 46

diagnose - medical history, physical exam, blood tests to measure levels of TSH and TH, imaging tests and biopsy, fine needle aspiration and histologic exam, check for carcinoembryonic antigen (CEA) which can serve as tumor marker as they r secreted by medullary carcinomas along w/ calcitonin treat - surgery, radioactive iodine treatment, thyroid hormone therapy, radiation therapy, chemo, and targeted therapy

Answer 47

results from excessive secretion of parathyroid hormone by parathyroid glands caused by benign tumors of parathyroid, causing oversecretion of pTH (size of tumor is often correlated with amt of parathyroid hormone secreted in blood) most frequently in ppl over 40, at 2x more common in women secondary is caused by low levels of serum calcium or serum vitamin D from renal disease

Answer 48

postmenopausal chronic vitamin D deficiency neck area radiation lithium therapy

Answer 49

excess parathyroid hormone = increased levels of circulating calcium (hypercalcemia) which comes from bone reabsorption so as calcium levels rise phosopate levels fall, bones weaken, bend, and fracture giant cell tumor, cysts of the bone, kidney stones made of calcium, and calcium deposits in stomach, lungs and walls of blood vessels (making them hard) may form

Answer 50

- pain in bones sometimes confused with arthritis - increased breakdown of bone from skeletal system (demineralization) - hypercalcemia - nervous system is depressed - muscles lose their tone and weaken - heart muscle is affected - pulse slow GI disturbance (from deposition of calcium in mucosa in GI tract) - abd pain - vomiting - constipation calcium deposit in eyes can cause irritation and excessive tearing

Answer 51

diagnose - blood tests to confirm high PTH and calcium and low phosphorous, urinalysis to confirm increased calcium, alkaline phosphatase elves tend to be icnreased, urine calcium is high, low bone mineral density, esp in sites richer in cortical bone, and imaging tests treat - depends on etiology, surgery to remove tumor if adenoma or parathyroid glands, if hyperlasia then 3 out of 4 parathroid glands r removed, diuerteics to increase urine output (increase calcium exertion) and limiting intake of calcium, treatment is aimed at lowing serum calcium levels)

Answer 52

result of decrease in secretion of parathyroid hormone by parathyroid glands commonly caused by surgical removal of thyroid gland prevalence in US in 4 in 1000

Answer 53

damage to glands from heavy metals (copper or iron) immune disorders (Addison's disease) a family history of hyperparathyroidism some infections

Answer 54

principal manifestation is tetany (sustained muscular contraction) muscles of hands and feet contract in a characteristic fashion - circulating levels of calcium r reduced = hypocalcemia w/ occasional possibilty of excessive deposits of calcium into tissue = hyperexcitable nervous system - overstimulation of skeletal muscle - numbness and tingling of fingertips, toes, ears, or nose - emotional changes, confusion, irritabilty - laryngospasm - arrhythmias - respiratory paralysis

Answer 55

diagnose - physical exam, neuromuscular hyperexcitability aong w/ hisotry of possible insult to parathyroid glands, presence of Trousseau phenomenon is sure indication of hypocalcemia, blood test confirming low PTH and calcium and high phosphate, ECG, and imaging test treat - calcium and vitamin D

Answer 56

aka primary adrenal insufficiency or Addison's disease partial or complete failure of adrenocortical function result of undersecretion of hormones by adrenal cortex first described in 1855 by THomas Addison (described symptoms associated with destruction of adrenal glands) occurs in 1 in 1000 ppl more common in female (female to male ratio is 2:1) usually diagnosed in 30s-50s

Answer 57

having other autoimmune problems such as Graves' disease, hypopituitarism. and vitilgo

Answer 58

lack of cortisol, aldosterone and adrenal androgens wt loss, fatigue, and anorexia from deficiency in cortisol bronze skin color cardiovascular difficulties such as irregular pulse, reduced cardiac output, orthostatic hypotension depression, anxiety and emotional distress most distinctive sign is hyperpigmentation in non-sun-exposed areas like gingvia tissue and creases of hands GI signs r anorexia or loss of appetite, and discomfort, vomiting and diarrhea fluid loss from these symptoms is associated with hypotension, dizziness, lack of blood sodium and syncope (fainting )

Answer 59

any disease that damages the entire adrenal cortex 75-80% of all cases are due to autoimmune other causes are infectious diseases like tuberculosis, fungal disease, opportunistic infection associated with AIDS, certain cancers, and hemorrhage of adrenal gland after anticoagulation med

Answer 60

diagnose - med history, physical exam, blod test confirming low cortisol and high ACTH, ACTH stimulation tests that measure level of crtisol before and after injection of synthetic ACTH, and imaging tests treat - lifelong replacement of both glucocorticoids and mineralocorticods, may need additional meds like hydrocortisone during stress

Answer 61

cane cause acute adrenal insufficiency (life-threatening, esp in pt with chronic adrenal insufficiency who a;also have another acute illness like infection, trauma or severe physical stress like surgery) s/s r rapid and include N&V, and pain and severe hypotension, death from shock and CV collapse treated with immediate rehydration with salt solutions and IV glucocorticoid replacement

Answer 62

can be due to overproduction of cortisol (Cushing's syndrome) or overproduction of aldosterone (Conn's sudnrome)

Answer 63

condition of chronic hypersecretion of adrenal cortex = excessive circulating cortisol levels prevalence is 1 in 500,000 ppl etiology is most often benign pituitary tumor, adrenal tumor resutling in excessive secretion of cortisol (prolonged admin of large doseses of cortisone will also cause Cushing's syndrome), excessive secretion of corticotropin from pituariy gland, production of corticotropin in another organ, iatrogenic factors such as prolonged administration or large doses of glucocorticoids risk factors r having adrenal tumor or corticosteroid therapy

Answer 64

fat accumulation behind the shoulders (buffalo hump) and in trunk = protruding abd round "moon-shaped" face salt and water retention hyperlipidemia hyperglycemia osteoprosis atherosclerosos changes in mood and cognition and decerased short-term memory fatigue weakness impaired wound healing hypertension wt gain stretch marks on skin excessive hair growth amenorrhea and impotence

Answer 65

diagnose - physical appearance, blood and urine test to confirm high levels of cortisol and imaging tests treatment - goal is to correct hypersecretion of adrenal hormones (removal of pituary tumors through surgery or radiation, med to block synthesis of corticosteroids r useful in pt who cant have surgery)

Answer 66

etiology is benign tumor of adrenal cortex prevalence of Conn's syndrome is 0.05-2.0% women r 2x moe likely to suffer from Conn's sudrome incidence increases with age no known risk factors

Answer 67

only symptom is hypertension which may cause headaches, blurred vision and dizziness some pt with hyperaldosteronism have normal K levels, others have low K levels, leading to fatigue, numbness, increased urination, increased thirst, muscle crampls and muscle weakness

Answer 68

diagnose - blood test to confirm high level of aldosterone and low or undetectable level of rennin which is produced by kidney and imaging tests treat - surgery, antihypertensive meds and aldosterone blockers

Answer 69

endocrine disease of impaired glucose regulation and hyperglycemia caused by genetics, environ factors, and lifestyle choices chronic disorder of carb, fat and protein metabolism caused by inadequate production of insulin by pancrease or faulty use of insulin by cells factors that contribute is absolute insulin deficiency, reduction in insulin secretion, decreased glucose utilization and increased glucose production prevalence of DM is 8.3%

Answer 70

little or no insulin production 5-10% of all diabetes causes formerly known as juvenile-onset diabetes bc peak is 10-14 risk factors r genetics, family history of T1DM, certain viral infections, being Caucasian, living in a northern climate and having other autoimmune diseases

Answer 71

polyuria, polydipsia, polyphagia bc water movement by concentration grade water is lost through kidnets as glucose concentration rises so pt drink a lot of water to compensate excess glucose but body cant take it in bc lack of insulin = very hunger by losing weight

Answer 72

when an autoimmune process develops in indv where immune system attacks and destroys beta cells (ver several months usually but sometimes very quickly or for yrs) once 80% or more of beta cell function is destroyed pt no longer have sufficient insulin capacity to control blood glucose = hyperglycemia

Answer 73

diagnose - urine test to show presence or absence of glucose in urine, fasting blood glucose levels, glucose tolerance testing and glycosylated hemoglobin testing to monitor and diagnose diabetes treat - insulin, regular exercise, maintaining healthy wt, healthy diet and monitoring blood sugar

Answer 74

challenges body's ability to secrete and use insulin after 10hr fast pt drinks standard glucose solution and blood and urine samples are taken and analyzed for next 3 hrs no gluse in urine, blood glucose shouldn't exceed 170 mg/dL

Answer 75

monitor long term control of diabetes indicates avg blood glucose level over past 6 days normal values should be below 6 and for diabetics is should be less than 7

Answer 76

monitor long term control of diabetes indicates avg blood glucose level over past 6 days normal values should be below 6 and for diabetics is should be less than 7

Answer 77

body resists the effect of insulin or doesn't produce enough insulin to maintain glucose levels 90-95% of diabetic cases risk factors r family history, 45+, obesity, history of gestational diabetes, sedentary lifestyle, history of high bp, high cholesterol or hyperlipidemia

Answer 78

polyuria, polydipsia, polyphagia, wt loss, fatigue, blurred vision, numbness or tinglingin hands or feet ad slow wound healing

Answer 79

diagnose - urine testing and blood glucose testing treatment - blood sugar monitoring, healthy eating, regular exercise, possible diabetes medication (increase body's sensitivity to insulin and lower glucose production in liver or stimulate pancreas to produce and release more insulin_ or insulin therapy

Answer 80

diabetes developed during pregnancy where resistance to effects of insulin is related to metabolic changes of pregnancy bc increased need for insulin 4% of pregnancies hormones produced by placenta during pregancanct lead to higher blood glucose levels, usually mother's pancreas is able to make more insulin to overcome effects of pregnancy hormones on blood sugar levels but if mom cant then blood sugar levels rise, =gestational diabetes increased destruction of insulin by placenta, reduced effectiveness of maternal insulin durign pregnancy

Answer 81

- over 25 - family history of T2DM - personal history (prediabetes, gestational diabetes, giving birth to baby weighing more than 9 lb, unexpected stillbirth) and being overweight

Answer 82

mostly doesn't cause s/s rarely causes polydipsia, polyphagia, polyuria

Answer 83

diagnose - oral glucose tolerance test (2-hr postprandial), fasting blood flucose, glucose tolerance test, and glycated hemoglobin test treat - monioring blood sugar, healthy diet, regular physical activity, possibly diabetes meds or insulin therapy, hypoglycemic agents (most women revert to normal glucose tolerance after pregnancy but have big risk for diabetes later in life)

Answer 84

when body doesn't get enough sugar it uses protein and fat as energy source, produces ketones (in blood, breath and urine its called ketosis, aka ketoacidosis ) which are acidic so these produce acidosis or low pH in tissue

Answer 85

diabetic coma and insulin hsock result of improper insulin administration (too much or too little) diabetic coma - no enough insulin or too many carbs s/s r polyuria, polydipsia dehydration and ketoacidosis (person becomes lethargic and falls into coma) insulin shock - too much insulin, not enough food, excessive exercise (s/s r quick and include low blood sugar, sweating, lightheadness and trembling, if not treat person becomes confused and coma) - needs IV glucose and emergency med treatment

Answer 86

occurs in older, debiliated pt with type 2 diabetes similar to DKA, associated with acute stress from infection, medical illness or surgery no ketone formation but hyperglycemia in ranges of 250400 mg/dL treatment aimed at rehtdration, correction of hyperglycemia and electrolyte distrubance (Aggresive IV fluid and electrolyte replacement as pt can loose 10 L or 2.5 G of fluid in short time)

Answer 87

due to chronic pathological insult to microvasculature (small bv) and microvasculature (large bv) microvascular disease - primarily in eyes, kidneys and nerves, damages endothelial cell lining of bv, resulting in progressive narrowing and occlusion of large and small vessels, cells die when vessel occlusion cuts off blood supply macrovascular disease - leads to CV disease, leading cause of death in pt with diabetes

Answer 88

includes retinopathy, nephropathy and neuropathy diabetic retinopathy is leading cause of blidnenss among adults age 20-74 diabetic nephropathy occus in approx 20-30% of pt with diabetes (leading cause of end-stage kidney disease) 60-70% of diabetic pts have nerve damage or neuropathy (s/s of neuropathy is numbness or tingling in hands and ft, severe, burning muscle aches, loss of sensation in ft and poor circulation can lead to sever infections ad requiring amputations) MOre than 60% of nontraumatic limb amputation in US occur annually in ppl with diabetes

Answer 89

result of increased hormone production before puberty by gonads = precocious puberty (age 9 in guys and age 8 in girls) precocious puberty currently affects 1 in 5000 ppl and 10x more likely in girls

Answer 90

- being a girl - obesity - being exposed to sex hormones - having other medical conditions (congenital adrenal hyperplasia, hypothyroidism)

Answer 91

Both - pubic or underarm hair - rapid growth - acne - adult body odor Women - breast developments - first menstruation Men - enlarged testicles and penis - facial hair - voice deepening - spermatogenesis - sebaceous gland activity increases

Answer 92

Girls: - mostly idiopathic - encephalopathy - meningitis - endocrine disorders - ovarian and adrenal tumors - hypersecretion of ovarian hormones in females r rare bc negative-feedback stimulation of gonadotropic hormone stops ovarian hormone secretion Boys: - caused by tumor in testes or pituitary gland - inadvertent ignestion of sex steroids through therapeutic meds or deliberate ingestion of sex steroids

Answer 93

diagnose - child’s and family’s medical history, physical exam, and blood tests to confirm elevated levels of sex hormones, MRI, brain scan, skull and bone radiographic studies, chromosomal karyotype studies (for girls, test for FSH, LH, sex steroids in normal adult range) treat - remove cause of precocious puberty, removal or radiation of tumors and meds to suppress or counteract sex hormones, gonadotropin-releasing romone (GnRH) agonists, meds that inhibit androgen action (spironolactone), inhibit androgen synthesis (ketoconazole), block the coneversion of androgens

Answer 94

growth hormone levels decreases with age (in men thi maifests after 30 as decrease in lean body mass and decrease in thickness and strength of bone matrix) body fat increase = growth hormone level decrease increased body fat correlated with greater risk of diabetes, heart disease, and cancer. Decreased bone density makes bones more susceptible to fracture.

Answer 95

decrease in t3:T4 ratios with age decrease metabolic rate incidence of autoimmune disease of the thyroid among females increases with age. age-related decline in the kidneys’ sensitivity to aldosterone occurs, accompanied by a diminishing capacity of the kidneys to secrete renin when needed. The body is less able to deal with the stress of changes in bp, dehydration, and disease in general. increased incidence of abnormalities in bp, sodium and potassium levels, acid-base balances, and osmotic pressure. The pancreas retains the ability to secrete insulin at normal levels with age, but tissue responsiveness to insulin decreases. Insulin resistance leads to a greater incidence of T2DM.

Answer 96

It is estimated that T2DM occurs in 10% of those over age 56 in 20% of those between 45 and 76, and in 40% of people over age 85. Although T1DM is somewhat less common than T2DM, and its occurrence is unrelated to aging, it remains among the 10 leading causes of death among people over age 65. Androgen and estrogen levels drop with age, although this is considered a normal process of aging.

Answer 97

- growth abn - emotional distrubrances or psychiatric problems - skin, hair and nail changes - edema - hypertension or hypotension - arrhythmia - changes in urine output - muscle weakness and atrophy - menstrual irregularity or amenhorrhea - impotence or changes in libido - sterility - changes in energy level

Answer 98

- blood serum or plasma which is collected by phelobtomy method - blood spot testing (requires capillary blood) - urien and saliva testing - radioimmunoassay or immunometric assay methodology and occasionally 24 hr urine test - CT, ultrasonogrpahy, MRI and biopsy

Answer 99

- condition caused by deficiency or absnece of any of the pituary hormones produced by anterior pituary lobe - pituary tumor, hypothalamus tumor, congential deficiency, some r acquires (ex: hypopituatarism resulting from damage to pituary gland caused by radiaiton or surgical removal or from ischemia of gland caused by infarct, tumor, or basilar skull fracture), destruction of entire anterior lobe (panhypopituitarism)

Answer 100

- metabolic dysfunction - sexual immaturity - delayed growth - atrophy of glands (bc pituary fglands stimulates other endocrine glands) - when thyrotropin secretion is reduced function of thyroid is affected = hypothyroidism - secretion of corticotropin is reduced = salt balance, nutrient metabolism r affected - secretion of gonadotropin = impaired sexual functions includign sexual development, menustration and libido - delayed goewths in kids

Answer 101

- complete medical evaluation - history of head trauma - previous radiation - surgical procudure to gland or nearby tissue - plasma levels of all or some itiaury hormone r low - radiographic films of skull, cranial CT and MRI

Answer 102

- if neoplasia is uase then removal of tumor - replacement therapy w/ hormonal supplements includign thyroxine (t4), cortisone, sex hormones, somatropin (hH)

Answer 103

- chronic lymphocytic thyroiditis is chronic disease of immune system that attack thyroid gland - heredity play prominent role - antibody appear to destroy thyroid tissue - gland enlarges as result of inflammatory process w/ infiltration by lymphocyte and plasma cells - gland tissue is replaced by fibrous tissue and signficant number of pt w/ hashimoto become hypothyroid

Answer 104

- occurs in women 8x more likely - common btwn 45 and 65 - leadign cause of goiter and hypothyroidism - gradual and painless lumpy enlargement of thyroid gland which cause feeling of pressure in neck and may result in difficulty wit hswallowing - sensitivty to cold, wt gain, fatigue, depression, mental apathy

Answer 105

diagnose - serum TSH levels r elevated, autoantibodes against thyroid tissue such as thyroid peroxidase antibodies (TPOs), characteristic chagnes can be seen in thyroid gland through needle boipsy and exam of gland tissue, radioactive idoine uptake will show low uptake treat - lifelong replacement of thyroid hormones in t w/ hypothyroidism

Answer 106

- myxedema (hypothyroidism) is a disease charcteized by clinical manifestiations associated w/ low metabolic rate caused by thyroid hormone deficiency - myxedem coma is result of severe untreated hypothyroidism exacerbated by an acute event such as MI, infection or use of sedatves - result of thyroid gland's inabiluty to synthesize T4 being impaired as a result of reduced amt of thyrotropin, radiation destruction of thyroid gland, surgical removal of gland w/o t4 replacement therapy, tumor, failure of thyroid gland, Hashmito thyroiditis, failure of pituary to produce thyrotropin

Answer 107

- slowing function in multiple organs - excessive fatigue - musclular weakness - loss of hair - wt gain - constipation - intolerance to cold r common symptoms - skin is dry and scaly - puffiness of hands and face - enlarged tongue - severe hypothyroidism - hypothermia - altered mental status (slurred speech and drowsiness, followed by profound lethargy or even unconsciousness)

Answer 108

diagnose - clnical features, low levels of thyroid hormones and significantly elevated TSH levels treat - achieve normla thyroid function w/ lowest possible dose, treat myxedema coma w/ levothyroxine sodium orally or intravenously

Answer 109

- papullary (small nipplelike proejctions) (most common - 30-60 y/os) - follicular (saclike ball of cells) (most common - 30-60 y/os) - medullary (Affecting interior poriton of gland) (80% of cases r sporadic, some r genetic, resulting in multiple endocrine neoplasia (MEN) type 2, mostly in 3rd decade of life) - anaplastic (loss of differntiation of cells) (rare, mainly 60+)

Answer 110

- over 5 yr survival rate for ppl diagnosed 2008-2014 is greater than 99% for papullary, follicular and medullary and 30% for anaplastic - regional thyroid cancer if spread to other iorgans or tissues close to thyroid gland (follicular - 96%, papillary - 99%, medullary - 91%, anaplastic - 13%) - if metastic papillary - 78%, follicular - 56%, medullary - 37%, anaplastic - 3%

Answer 111

- retinopathy = blindness - neuropathy - renal failure - atherosclerosis = myocardial infarction - cerebrovascular accident - hyperglycemia = delayed healing and impaired resistance to infection

Answer 112

- sulfonylureas - meglitinide drugs (oral hypoglycemic drugs) such as glipizide (Glucotrol0, glyburide (DiaBeta or Micronase), repaglinide (Prandin), and nateglinide (Starlix) stimulide pancrease to produce insulin - Meformin (Glucophage) prevents liver fro m producign hepatic glucose and helps enchance behefits of avaiable insulin) - acarbose (Precose) delays digestion of carbs - Rosiglitazone (avandia) and pioglitazone (actos) beling to thiaz0olidinedione class of drugs = insulin sensitizer by binding to peroxisome proliferator-activated receptor (PPARs) of cells - pramlintide (symlin) resembles human amylin produced by pancrease - pramlintide (Symlin) increases production of insulin right after eating - incretion hrmones - DPP IV inhibitors inhibit DPP IV wich breaks down incretin hormones that regulate gluvose levels (Sitagliptin (Januvia), saxagliptin (Onglyza), linagliption (Tradjenta) and alogliptin (Nesina) - Bromocriptine (Cycloset) increases dopamine receptor - sodium-glucose linked transporter 2 inhibitor = reduction of blood glucose (Canagluflozin (Invokana) and dapagliflozin (Farxiga))

Answer 113

- rare side effect from metformine and is seen in pt w/ renal failure, liver failure and congestive heart failure - weakness, fatigue, unusual muscle pain, dyspnea, unusual stomach discomfort, dizziness or lightheadness, bradycardia or cardiac arrhythmias

Answer 114

0 aka syndrome X - may increase indv risk for type 2 diabetes and CV disease 5 components: 1. Central obesity (waist circumference of greater than 35 in) 2. increased blood pressure (130/85 mm Hg) 3. abn triglyceride levels above 150 mg/dL 4. abn HDL cholesterol levels below 40 mg/dL 5. fasting glucose levels above 100 mg/dL

Answer 115

- abn low glucose levels in blood - ,ajor cause is insulin overdose - failure to eat menal or excessive exercise - elevated blood alcholo level - sulfonylureas - fasting, delayed or excessive secretion of insulin by pancrease, adenoma or carcinoma of pancreas, GI disorder, various hereditary or endocrine disorders

Answer 116

- occurs when excessive insulin enters bloodstream or when glucose relase rate falls below tissue demands - may occyyr despute adequate food intake - sweating, nervousness, weakness, hunger, dizziness, trembling, headache, palpitations, confusion, visual distruvrances, behavior that may mistaken for drunkeness, stupor, coma and seizures,

Answer 117

diagnose - glucometer, glucose tolerance test (lower than 50 mg/dL), s/s that resolve w/ administration of glucose treat - IV infusion of glucose, hormone glucagon, complex carb and protein snack is given, if tumor then surgery, diet is modified to correct herreditary fructose intoleramce or gastrointestinal condition

Diseases and disorders of Endocrine system Flashcards

(142 cards)