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Post TAV I IDC School > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What are the major glands of the Endocrine System

A

Hypothalamus
Pituitary
Thyroid
Parathyroid
Pancreas
Adrenal
Ovaries/testes
Pineal

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2
Q

What are target cells

A

A specific cell with receptors that responds to specific hormones

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3
Q

How many hormones are in target cells

A

2,000 - 100,000

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4
Q

What are 3 lipid soluble hormones

A

Steroid hormones
Thyroid hormones
Nitric oxide

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5
Q

What are 2 water soluble hormones

A

Amino acids

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6
Q

Where is the hypophyseal Portal Vein contained in

A

The infundibulum

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7
Q

What allows for the transfer of hormones from the hypothalamus to the anterior pituitary gland

A

Hypophyseal Portal Vein

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8
Q

Secretion of anterior pituitary hormones is stimulated/suppressed by

A

Releasing hormones and suppressed by selective inhibiting hormones

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9
Q

Follicle Stimulating Hormone (FSH) release is stimulated by

A

GnRH

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10
Q

FSH is suppressed by

A

Elevated levels of estrogen in females and testosterone in males

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11
Q

Luteinizing Hormone (LH) has what function in females

A

Trigger ovulation
Stimulate corpus luteum to secrete progesterone

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12
Q

What is the function of LH in males

A

Promotes testes to release testosterone

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13
Q

Prolactin releasing hormone function

A

Initiates and maintains milk production by the mammary glands

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14
Q

Prolactin-Inhibiting Hormone (PIH) has what function

A

Suppresses the release of prolactin

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15
Q

What is Adrenocorticotropic Hormone (ACTH)

A

Controls the production and secretion of Glucocorticoids

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16
Q

What are the functions of the Posterior Pituitary

A

Stores 2 hormones
Does not synthesize hormones
Contains neurosecretory cells

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17
Q

What is released in large quantities prior to childbirth to enhance contractions

A

Oxytocin

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18
Q

What is the function of Oxytocin in breasts

A

Stimulates ejection of milk

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19
Q

What is T4

A

Thyroxine

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20
Q

What is T3

A

Triiodothyronine

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21
Q

What are the 2 Islets cells

A

Alpha cells - secrete glucagon
Beta cells - secrete insulin

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22
Q

What are the 2 adrenal gland regions

A

Adrenal cortex
Adrenal medulla

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23
Q

What are the 3 zones of the adrenal cortex

A

Zona Glomerulosa - secretes aldosterone
Zona Fasciculata - secretes glucocorticoids, cortisol
Zona Reticularis - secretes androgens

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24
Q

Glucocorticoid functions

A

Protein breakdown
Glucose formation
Breakdown triglycerides
Anti-inflammatory
Depress immune response

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25
Q

What are the gamete’s in males

A

Sperm

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26
Q

What are the gametes in females

A

Oocyte

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27
Q

What hormone produced by the placenta increases the flexibility of pubic symphysis and uterine cervix during labor

A

Relaxin

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28
Q

What hormone is produced and secreted by the pineal gland

A

Melatonin

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29
Q

What hormone stimulates the secretion of cortisol

A

HgH

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30
Q

What gland secretes cortisol

A

Adrenal cortex

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31
Q

What peptide hormone lowers plasma calcium levels

A

Calcitonin

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32
Q

The C-cells of what gland produce calcitonin

A

Thyroid

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33
Q

What cells are responsible for secreting PTH

A

Chief cells

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34
Q

What hormone is essential for the stress response

A

CrH

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35
Q

What hormone inhibits the release of prolactin

A

Prolactin inhibiting hormone (PIH)

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36
Q

What hormone is a stimulus for sperm production and ovarian follicle maturation

A

FSH

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37
Q

Zona Glomerulosa primarily produces what hormone

A

Aldosterone

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38
Q

What promotes reabsorption of sodium and potassium

A

Aldosterone

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39
Q

What is the insulin pathway

A

Pancreas -> pancreatic islets -> B cells

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40
Q

What is the progesterone pathway

A

GnRH -> anterior pituitary -> LH -> ovaries -> corpus luteum

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41
Q

What is the cortisol pathway

A

Hypothalamus -> corticotropin releasing hormone -> anterior pituitary -> ATCH -> adrenal cortex

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42
Q

What is the growth hormone pathway

A

Hypothalamus-> GnRH -> Anterior pituitary

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43
Q

What is the adrenaline pathway

A

Adrenal Medulla -> Epinephrine or norepinephrine

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44
Q

What is the testosterone pathway

A

Hypothalamus -> anterior pituitary -> LH -> testes

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45
Q

What is the oxytocin pathway

A

Hypothalamus -> posterior pituitary -> uterus or mammary glands

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46
Q

What gland produces a hormone called insulin

A

The pancreas

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47
Q

What are the 9 hormones of the hypothalamus

A

Gonadotropin releasing hormone
Growth hormone releasing hormone
Growth hormone inhibiting hormone
Prolactin releasing hormone
Prolactin inhibiting hormone
Corticotropin releasing hormone
Oxytocin
Antidiuretic hormone
Thyroid releasing hormone

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48
Q

What are the 2 hormones stored in the posterior pituitary

A

Oxytocin and Antidiuretic hormone

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49
Q

What is tropic hormone

A

Hormone that stimulates endocrine gland to grow and secrete hormones

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50
Q

What are the 5 tropic hormones

A

Human growth hormones
Thyroid stimulating hormone
Follicle stimulating hormone
Luteinizing hormone
Adrenocorticotropic hormone

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51
Q

What are 2 direct acting hormones

A

Prolactin
Melanocyte stimulating hormone

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52
Q

What is the main function of the human growth hormone

A

Promote synthesis and secretion of hormone insulin like growth factor
- stimulate protein synthesis
- help maintain muscle and bone mass

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53
Q

What is the most abundant thyroid hormone

A

T4

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54
Q

What are the 4 actions of the thyroid hormone

A

Stimulate protein synthesis
Increase use of glucose and fatty acids for ATP
Breakdown triglycerides and andante cholesterol secretion
Assist in stimulating body growth

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55
Q

What is calcitonin produced by

A

The parafollicular cells of the thyroid gland

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56
Q

What is the function of calcitonin

A

Decreases the level of calcium in the blood by inhibiting the action of osteoclasts, the cells that break down bone

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57
Q

What does the parathyroid hormone regulate

A

Calcium, magnesium, and phosphate

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58
Q

What is the function of the parathyroid hormone function in the kidneys

A

Slows rate of calcium and magnesium loss
Increases loss of hydrogen phosphate from blood
Promote formation of calcitrol

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59
Q

What is a flattened organ located in the curve of the duodenum

A

Pancreas

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60
Q

What are resistance reaction hormones

A

Corticotropin releasing hormone
Growth hormone releasing hormone
Thyrotropin releasing hormone

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61
Q

What gland stimulates development of the ovarian follicle

A

Pituitary

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62
Q

What gland controls blood glucose levels

A

Pancreas

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63
Q

What gland influences the rate of growth and development

A

Thyroid

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64
Q

What gland stimulates the growth of long bones

A

Anterior pituitary

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65
Q

What gland stimulates absorption of water in kidney tubule

A

Hypothalamus (produced) and posterior pituitary (stored)

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66
Q

What gland prepares the body for fight or flight

A

Adrenal

67
Q

What gland affects glucose, protein, and fat metabolism

A

Thyroid

68
Q

What gland prepares the body for emergency situations

A

Adrenal

69
Q

Hormones act at specific target organs because these organs contain what

A

Target cells

70
Q

Growth hormone is secreted by what gland

A

Anterior pituitary

71
Q

Intermediary proteins that stimulate growth of bones

A

IGF

72
Q

Where is the lipid soluble hormone receptor located

A

Located in the nucleus and changes gene expression

73
Q

Where is the receptor located for water soluble hormones

A

On plasma membranes and causes changes

74
Q

Hormones influence their target cells by doing what

A

Chemically binding to specific protein receptors

75
Q

How many atoms do T4 contain

A

4 atoms of iodine are in Thyroxine

76
Q

How many atoms are in T3

A

Triiodothyronine contains 3 atoms of iodine

77
Q

What is the most abundant Thyroid hormone

A

T4

78
Q

T4 converts to what after entering the cell

A

T3

79
Q

The thyroid hormones stimulate what

A

Protein synthesis
Increase the use of glucose and fatty acids for ATP production
Increase the breakdown of triglycerides
Enhance cholesterol excretion reducing blood cholesterol

DONE THROUGH NEGATIVE FEEDBACK

80
Q

Actions of the pancreas: he main action of glucagon is to increase blood glucose when what occurs

A

When blood glucose falls below normal

81
Q

Actions of the pancreas: Insulin helps glucose move into cells, especially muscle fibers which do what

A

Lower blood glucose level when it is too high

82
Q

Actions of the pancreas: the level of blood glucose controls secretion of both glucagon and insulin via what

A

NEGATIVE FEEDBACK

83
Q

Where does adrenal crisis typically occur

A

In the adrenal cortex - Zona fasciculata

84
Q

What hormone is secreted from the pineal gland

A

Melatonin

85
Q

Melatonin contributes to what

A

Setting the body’s biological clock (circadian rhythm)

86
Q

As we age, human growth hormone decreases which is the cause of what

A

One cause of muscle atrophy

87
Q

As we age thyroid hormones (T3, T4, and calcitonin) decrease which causes what

A

Decreased metabolic rate, increased body fat, and hypothyroidism

88
Q

As we age, parathyroid hormone rises which causes what

A

The rise in PTH and the fall in calcitonin decrease bone mass leading to osteoporosis

89
Q

As we age, insulin is released more slowly causing what

A

Blood glucose levels to increase faster

90
Q

As we age, estrogen decreases causing what

A

As the ovaries decrease in size, they no longer respond to gonadotropins which leads to conditions such as osteoporosis, high blood cholesterol and arethrosclerosis

91
Q

The hypothalamus is known as the master switchboard because it’s the part of the brain that controls what

A

The endocrine system

92
Q

What is a stalk like structure that is attaches the pituitary gland to the hypothalamus

A

The infundibulum

93
Q

What hormone is secreted by the hypothalamus and stimulates HGH and IGF

A

GHRH - growth hormone, releasing hormone

94
Q

What hormone is secreted by the hypothalamus that inhibits HGH and IGF

A

GHIH - growth hormone, inhibiting hormone

95
Q

What stimulates protein synthesis, helps maintain muscle and bone mass, and promotes healing of injury and tissue repair

A

Human growth hormone - hGH

96
Q

What stimulates the synthesis and secretion of thyroid hormones by the thyroid gland

A

Thyroid-stimulating Hormone - TSH

97
Q

What initiates the development of ovarian follicles in females

A

Follicle-Stimulation Hormone - FSH

98
Q

What controls the production and secretion of hormones called Glucocorticoids by the cortex (outer portion) of the adrenal gland

A

Adrenocorticotropic hormone - ACTH

99
Q

What causes constriction of arterioles, thus causing an increase in blood pressure

A

Antidiuretic Hormone - ADH

100
Q

The walls of each follicle consists of cells called what that produce the two thyroid hormones

A

Follicular cells

101
Q

What are the two types of follicular cells

A

T4- thyroxine
T3- triiodothyronine

102
Q

What is produced by the parafollicular cells of the thyroid gland

A

Calcitonin - CT

103
Q

What is the parathyroid gland

A

Small round masses of glandular tissue that are partially embedded in the posterior surface of the thyroid gland

104
Q

Within the parathyroid glands are secretory cells called what

A

Chief cells: which release PTH

105
Q

PTH is the major regulator of the levels of what

A

Calcium, magnesium, and phosphate ions in the blood

106
Q

PTH produces a change in the kidney that promotes formation of what hormone

A

Calcitrol

107
Q

Alpha cells secrete the hormone glucagon which release is stimulated by what

A

Sympathetic division of the autonomic nervous system

108
Q

Beta cells secrete the hormone insulin which release is stimulated by what

A

The parasympathetic division of the ANS

109
Q

The outer zone of the adrenal cortex is also known as what and secretes what hormone

A

Zona Glomerulosa and secretes aldosterone

110
Q

The middle zone of the adrenal cortex is also known as what and secretes what hormone

A

Zona Fasciculata and secretes cortisol

111
Q

The inner zone of the adrenal cortex is also known as what and secretes what hormone

A

Zona Reticularis and releases androgens (male and female sex hormones)

112
Q

Secretion of aldosterone occurs as part of what pathway

A

Renin-angiotensin-aldosterone pathway

113
Q

Conditions that initiate the renin-angiotensin-aldosterone pathway include what

A

Dehydration
Sodium (Na+) deficiency
Hemorrhage

Which decreases blood pressure and blood volume

114
Q

The most abundant glucocorticoid is cortisol and glucocorticoids have what actions

A

Protein breakdown
Glucose formation
Breakdown of triglycerides
ANTI-INFLAMMATORY EFFECTS
Depression of immune response

115
Q

What also produces inhibin, a protein hormone that inhibits the secretion of follicle-inhibiting hormone (FSH)

A

The ovaries

116
Q

What produces testosterone , the primary androgen or male sex hormone

A

Testes

117
Q

Testosterone regulates what for the action of the testes

A

Production of sperm
Stimulates the development and maintenance of masculine characteristics such as beard growth and deepening of the voice

118
Q

What is the structure of the pineal gland

A

A small endocrine gland attached to the roof of the third ventricle of the brain at the midline

119
Q

What is a stress response and how many stages are involved

A

Stress response is a sequence of bodily changes that can progress through stages:
First stage - an initial fight-or-flight response
Second stage - a slower resistance reaction
Third stage - exhaustion

120
Q

During the second stage of the stress response, what reduces inflammation

A

Cortisol

121
Q

During the exhaustion phase of the stress response, prolonged exposure to high levels of cortisol and other hormones involved in the resistance reactions causes what

A

Wasting of muscles
Suppression of the immune system
Ulceration of the gastrointestinal tract
Failure of pancreatic beta cells
Pathological changes may occur

122
Q

What is the blood glucose measured to diagnose with hypoglycemia

A

<70mg/dl = abnormal

123
Q

When do symptoms begin for a hypoglycemic patient

A

At plasma glucose levels in the range of 60 mg/dl and impairment of brain function at approx. 50 mg/dl

124
Q

Spontaneous hypoglycemia in adults is of what principal types

A

Fasting and postprandial

125
Q

Postprandial hypoglycemia is relatively acute and is often heralded by what symptoms

A

Sweating
Palpitations
Anxiety
Tremulousness

Mainly seen in patients after surgery

126
Q

What lab(s) can be performed to diagnose a patient with hypoglycemia

A

Finger stick blood glucose

127
Q

What is the treatment for a patient with hypoglycemia

A

Immediate treatment involves provision of glucose - patients able to eat or drink can drink juices, sucrose water, or glucose solutions; eat candy or other foods; or chew on glucose tablets when sx occur

**can be done if member has NO altered mental status

128
Q

What are the essentials of diagnosis for a patient with prediabetes

A

Impaired fasting glucose ranging from 100 - 125 mg/dl ***

129
Q

What are the risk factors of a pre-diabetic

A

Family history/genetic predisposition
Obesity
*DIET
Physical inactivity
Race
Women who delivered a baby weighing 9lb or grater or had previous sx of gestational diabetes

130
Q

What medications can cause a patient to present as a pre-diabetic

A

**Corticosteroids
Antibiotics
Beta-blockers
HCTZ

131
Q

What is the first-line of treatment for a patient with prediabetes

A

Weight loss if overweight/obese & increased physical activity/exercise

132
Q

What is the nest line of treatment for prediabetes if first-line treatment fails

A

Metformin

133
Q

What will the plasma glucose be in a patient presenting with diabetes mellitus

A

126 mg/dl or higher AFTER an overnight fast, documented on more than one occasion

134
Q

What clinical findings will be present for a Type 1 diabetic patient

A

3 P’s: polyuria, polydipsia, polyphagia

Higher prevalence of certain infections, especially candidal vaginitis and balanitis, recurrent/severe urinary tract infections, recurrent skin infections, and malignant otitis externa

135
Q

What are some complications of type 1 diabetes

A

Insulin overdose
Insulin overdose treatment
Neuropathy
Nephropathy
Heart disease
Ophthalmology

136
Q

What is macrosomia

A

High birth weight for mothers who have untreated gestational diabetes may give birth to these babies

137
Q

What is the treatment for gestational diabetes

A

Nutrition counseling, strict DIET CONTROL can prevent need for use of insulin

138
Q

When is insulin used for women with gestational diabetes

A

Those with persistent fasting hyperglycemia despite strict diet control

139
Q

What are the essentials for diagnosis of diabetic Ketoacidocis (DKA)

A

**Hyperglycemia > 250 mg/dl
Acidosis with blood pH less than or equal to 7.3
Serum bicarbonate less than or equal to 15 mEq/l
Serum positive for ketones

140
Q

What are clinical findings for DKA

A

3 P’s
Dehydration, possible stupor
**raid deep breathing and a “fruity” breath odor of acetone (nail polish remover)
Hypotension with tachycardia
Mild hypothermia

141
Q

What is the initial management priority to treat a patient for DKA

A

4-5 L of 0.9% normal saline within the first hour (lactated ringer’s is fluid of choice if available)

142
Q

What is the most common cause of endemic goiter

A

Iodine deficiency

143
Q

What is endemic goiter a sign of

A

Thyroid disorder

144
Q

What are the essentials of diagnosis for hypothyroidism

A

Menorrhagia, delayed DTR, serum free thyroxine (T4) low, TSH elevated in primary hypothyroidism

145
Q

What are the causes of hypothyroidism WITH goiter

A

Autoimmune
Subacute
Iodine deficiency
Genetic thyroid enzyme defects
HEP C
Drugs

146
Q

What are the causes of hypothyroidism WITHOUT goiter

A

Thyroid surgery, irradiation
Deficient pituitary TSH
Severe illness
Drugs
Radiation therapy
“Subclinical” hypothyroidism

147
Q

What are the clinical findings for hypothyroidism: Early Sx

A

Cold intolerance
Constipation
Menorrhagia

148
Q

What are the clinical findings of hypothyroidism: Late Sx

A

Amenorrhea or menorrhagia
Galactorrhea

149
Q

What are some clinical findings for hypothyroidism: Early signs

A

Thin, brittle nails
Thinning of hair (Think HEENT)
Pallor
Delayed DTR

150
Q

What is the treatment for a patient with hypothyroidism

A

Levothyroxine (T4)

151
Q

What are some complications for a patient with hypothyroidism

A

Myxedema coma
Adrenal crisis

152
Q

What is the most common cause of hyperthyroidism

A

**Graves’ disease
Hashimoto’s thyroiditis
High serum human chorionic gonadotropin levels n first 4 months of pregnancy

153
Q

What is a common clinical finding of the thyroid in a patient with hyperthyroidism

A

Goiter (often with a bruit) in Graves’ disease

154
Q

What is a common clinical finding of the eyes in a patient that has hyperthyroidism

A

Stare and lid lag
Opthalmopathy (chemo sis, conjunctivitis, and mild protosis) in 20-40% of patients with Graves’ disease

155
Q

What is the treatment for Graves’ disease in hyperthyroidism

A

Radioactive iodine
Propranolol (generally used for symptomatic relief)

156
Q

What are some common clinical findings in patients with a thyroid nodule

A

Toxic multinodular goiter and hyper functioning nodules can cause hyperthyroidism

Sweating, weight loss, anxiety, loose stools, heat intolerance, tachycardia, tremor

157
Q

Malignancy of a thyroid nodule is suggested by what

A

Hoarseness or vocal cord paralysis
Nodules in men or young women
Nodule that is solitary, firm, large, or adherent to trachea or strip muscles
Vocal cord paralysis
Enlarged lymph node(s)
Distant metastatic lesions

158
Q

What is the preferred method of lab/image findings of a thyroid nodule

A

Ultrasound is preferred over CT and MRI because of its accuracy

159
Q

What is the treatment for a patient with thyroid nodule(s)

A

Ultrasound guided fine-needle aspiration biopsy of suspicious nodules after referral to endocrinology

160
Q

What are some essentials of diagnosis for a patient in adrenal crisis

A

Weakness, abdominal pain, fever, confusion, vomiting
Low blood pressure, dehydration
skin pigmentation may be increased

161
Q

What is another name for acute adrenal crisis

A

Adrenocorticotropic insufficiency

162
Q

What is the treatment for a patient in acute adrenal crisis

A

If symptomatic adrenal insufficiency is suspected, treat with hydrocortisone100-300 mg IV and saline

*or deximethizone

163
Q

What is an etiology for chronic adrenal insufficiency

A

Autoimmune destruction of the adrenals is the most common cause of Addison disease in the US

*TB is a leading cause of Addison disease (rare in US), decreased since 1960s

164
Q

What is Addison disease

A

An uncommon disorder caused by destruction or dysfunction of the adrenal cortices

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