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Endocrine Flashcards

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1
Q

what are the major glands of the endocrine system?

A

Hypothalamus
Pituitary
Thyroid
Parathyroid
Pancreas
Adrenals
Ovaries/Testes
Pineal Gland

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2
Q

What is a specific cell with specific receptors that will respond to specific hormones

A

target cells

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3
Q

Why does TSH bind to receptos on cells of the thyroid gland but not to the cells of ovaries

A

because ovarian cells do not have TSH receptors

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4
Q

What are the lipid soluble hormones

A

steroid hormones
thyroid hormones
nitric oxide

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5
Q

what are water soluble hormones

A

amino acids:
Short chain- Antidiuretic hormone
Long Chain - Insulin

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6
Q

how do hormones influence their target cells

A

by chemically binding to specific protein receptors

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7
Q

what is the master gland of the body because it regulates the activity of endocrine glands

A

pituitary gland

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8
Q

what is the stalk like structure that attaches the pituitary gland to the hypothalamus

A

infundibulum

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9
Q

what is the blood vessels of the infundibulum called

A

hypophyseal portal veins which connect capillaries in the hypothalamus to capillaries in the anterior pituitary and carries hormones secreted by the hypothalamus

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10
Q

what is a hormone that stimulates an endocrine gland to grow and secrete its hormones

A

tropic hormones

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11
Q

what hormone promotes synthesis and secretion of Insulinlike Growth Factors (IGF’s)

A

Human Growth Hormone (hGH)

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12
Q

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

A

Insulinlike growth factor

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13
Q

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

A

Thyroid stimulating hormone

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14
Q

What initiates the development of ovarian follicles and stimulates follicular cells to excrete estrogen

A

Follicle- stimulating hormone (FSH)

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15
Q

What triggers ovulation in females and stimulates the testes to secrete testosterone

A

Luteinizing hormone (LH)

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16
Q

Where is ACTH secreted from

A

The anterior pituitary

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17
Q

What hormone causes construction of arterials thus causing an increase in blood pressure

A

Antidiruretic hormone (ADH)

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18
Q

Follicular cells produce which two thyroid hormones

A

Thyroxine (T4)
Triiodothyronine (T3)

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19
Q

Where is T3/T4 produced

A

Follicular cells of the thyroid

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20
Q

What stimulates protein synthesis, increases the use of glucose and fatty acid for ATP production, increase triglyceride breakdown and reduce cholesterol

A

Thyroid hormones

Which also play an important role in maintenance of normal body temperature

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21
Q

What hormone is produced by the parafollicular cells of the thyroid gland

A

Calcitonin (CT)

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22
Q

What is within the parathyroid glands that release parathyroid hormone

A

Secretory cells called CHIEF CELLS

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23
Q

What promotes the formation of calcitrol (active form of vitamin D) which acts in the gut to instead the rate of calcium, magnesium and phosphate absorption from food into the blood

A

Parathyroid hormone

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24
Q

Alpha cells in the pancreatic islets secrete what and is stimulated from where

A

Secretes glucagon
Stimulated by the sympathetic division of the autonomic nervous system

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25
Beta cells in the pancreatic islets secrete what and is stimulated from where
secretes insulin stimulated by the parasympathetic division of the ANS
26
what conditions initiate the renin-angiotensis-aldosterone pathway
dehydration sodium deficiency hemorrhage
27
in the adrenal cortex- zona fasciculata the most abundant glucocorticoid is cortisol, how does cortisol have anti-inflammatory effects
inhibit white blood cells that participate in inflammatory response
28
what are the female sex hormones
estrogen progesterone
29
what is a protein hormone that inhibits the secretion of FSH
inhibin
30
what produces testosterone, the primary androgen/ male sex hormone
the testes
31
what is a small endocrine gland attached to the roof of the third ventricle of the brain at the midline
the pineal gland
32
what is the hormone secreted by the pineal gland
melatonin
33
With age, what happens to human growth hormone
decreses- causing muscle atrophy
34
with age, what happens to the thyroid hormones
decreases - causing decreased metabolic rate, increased body fat and hypothyroidism
35
with age, what happens to the parathyroid hormone
rises - rise in PTH and fall in calcitonin decreases bone mass
36
with age, what happens with insulin production
releases more slowly - blood glucose levels will increase faster
37
pronlonged exposure to high levels of cortisol causes what
wasting of muscles supression of immune system ulceration of GI tract Failure of the pancreatic beta cells
38
what is whipples triad
< 70 mg/dl glucose altered mental status signs and symptoms resolve with glucose elevation
39
where does ACTH come from
corticotropin-releasing hormone
40
what are two types of spontaneous hypoglycemia
fasting and postprandial
41
what glucose level shows impairment of brain function
50 mg/dl
42
what are symptoms of sympathomimetic hypoglycemia
anxiety nervousness irritability nausea vomiting palpations tremors
43
what are clinical finding of neuroglycopenic hypoglycemia
altered consciousness lethargy confusion combative agitation unresponsive
44
what is the treatment for hypoglycemia
eat or drink glucose glucagon if unable to eat/drink 50% dextrose 50-100mg IV
45
what are three stages of stress response
fight or flight slower stress response exhaustion
46
what is the fasting glucose in someone who is prediabetic
100-125 mg/dl
47
what could cause abnormal glucose values that may seem as though someone might be prediabetic
patient forgot to fast well controlled type I or II cushing syndrome (excess cortisol) medications such as corticosteroids, antibiotics, beta blockers, psychiatric meds, HCTZ Hyper thyroidism
48
what is the first line treatment for prediabetes
weight loss/ exercise
49
if weight loss and exercise do not work for prediabetes what is the second line of treatment
metformin
50
what is the overnight fasting glucose value that must occur on more than one occasion for type one diabetes
126 mg/ml
51
how is type I diabetes characterized
autoimmune antibodies children to 30 years old deficiency of insulin production
52
what are the essentials of diagnosis for type I
3 P's polyuria polydipsia polyphagia
53
what are the clinical finding in type I
unexplained weight loss fatigue poor wound healing blurred vision higher prevalence of STI, UTI, YEAST infection
54
what is the treatment for type I
insulin is the only medication effective in lowering glucose levels in type I
55
what are some complications of type I diabetes
insulin overdose neuropathy nephropathy heart disease opthalmology
56
what are the essentials of diagnosis for type II diabetes
insulin resistant due to inadequate activity over 40 obese
57
what are the glucose parameters for someone with type II. Random and overnight fasting
Overnight fasting- 126 or higher on more than one occasion Random - 200+
58
what is the stage one treatment for type II
diet and exercise
59
what is the stage two treatment for type II
Metformin/Glucophage is first line medication
60
what is stage III treatment for type II
insulin requirement due to inability to control with oral medications
61
what is macrosomia
high birth weight
62
what is the glucose level of someone with DKA
>250
63
what are the findings in someone in DKA
dehydration- possible stupor rapid deep breathing with "FRUITY" breath hypotension with tachycardia mild hypothermia
64
what is the treatment for DKA
volume repletion is the initial management priority (3-4L of LR first 8 hours) insulin MEDEVAC
65
what are the complications of DKA
AMI Bowel infarction renal failure rarely cerebral edema
66
what is the most common cause of endemic goiter
iodine deficiency
67
what are the clinical findings of a goiter
usually asymptomatic or tracheal compression respiratory distress dysphagia
68
what are the essentials of diagnosis for hypothyroidism
weak cold intolerance constipation depression menorrhagia delayed DTR
69
what are some causes of hypothyroidism with a goiter
autoimmune - hashimotos - thyroiditis subacute (de quervains thyroiditis) IODINE DEFICIENCY genetic hep C Drugs: lithium, amiodarone, methimazole
70
what early signs of hypothyroidism occur with the hair
thinning of hair thin, brittle nails
71
primary hypothyroidism is due to what
thyroid gland disease
72
secondary hypothyroidism is due to what
lack of pituitary TSH
73
what are causes of hypothyroidism without goiter
thyroid surgery deficient pituitary TSH severe illness drugs: lithium, amiodarone.....iodine radiation therapy
74
what is the treatment for hypothyroidism
Levothyroxine (T4)
75
what are the symptoms of hyperthyroidism
sweating weight loss heat intolerance menstrual irregularity tachycardia tremor stare (exophthalmos)
76
what is the seen in graves disease
goiter often with a bruit ophthalmopathy thyroid stimulating immunoglobulins
77
whais the most common cause of hyperthyroidism
graves disease
78
what lab results will you see in hyperthyroidism
TSH will be low T4 sometimes normal, T3 elevated
79
what is the treatment for graves disease
radioactive iodine is the treatment of choice in active duty personnel Propranolol (Beta blocker) for symptomatic relief of tachycardia, tremors, and anxiety
80
what signs and symptoms will you see in a toxic multinodular goiter
can cause hyperthyroidism sweating weight loss anxiety loose stools heat intolerance tachycardia tremor
81
what suggests a possible malignant thyroid nodule
hoarseness or vocal cord paralysis nodules in men or young women nodule that is firm, large and adherent to trachea or strap muscles
82
what is the imaging of choice for a nodule
ultrasound
83
what is the treatment of a thyroid nodule
refer to endo ultrasound guided fine needle aspiration
84
what are signs of acute adrenal crisis
headaches lassitude nausea/vomitting abdominal pain and diarrhea confusion or coma cyanosis dehydration sparse axillary hair
85
what are two causes of acute adrenal crisis
primary - destruction or dysfunction of the adrenal cortex Secondary - resulting from ACTH hyposecretion
86
what is the hallmark for adrenal crisis
sudden withdrawl of steroid medication
87
what is the treatment for adrenal crisis
dexamethasone or hydrocortisone
88
what is a common cause of chronic adrenal insufficiency
addisons disease
89
what are the symptoms of chronic adrenal
weakness fatigue weight loss myalgia anorexia n/v anxiety mental irritability
90
what is the treatment for chronic adrenal
hydrocortisone is the drug of choice
91
what medications can increase blood glucose
prednisone HCTZ
92
what is the treatment for gestational diabetes
diet and exercise
93
what is characterized by Anovulation, polycystic ovaries and hyperandrogenism
polycystic ovarian syndrome
94
what will you see on LH/FSH lab on someone with pcos
typically 2:1 to 3:1 normal is 1:1
95
what is the treatment for pcos
weight management and exercise doesnt work? metformin
96
how will a male with hypogonadism present
fatigue decreased strength poor libido hot flashes ERECTILE DYSFUNCTION gynecomastia infertility small testes
97
what does high fsh/lh indicate in males
primary testicular failure from: atrophy from previous mumps (ask in history about mumps dx in past) autoimmune destruction previous chemo/rad exposure
98
what does low FSH/LH indicate in males
secondary hypogonadism from: Hypogonadotropic hypogonadism hyperprolactinemia use of opiates or steroids other hypothalamus or pituitary disorders
99
what is the treatment for hypogonadism
should only be initiated with MO guidance -check additional labs -Transdermal testosterone (preferred) -IM testosterone (longer acting)
100
what causes gynecomastia
excess estrogen in males
101
what causes excess estrogen in males
aging obesity puberty
102
what drug could cause gynecomastia
Isoniazid (INH) alcohol anabolic steroid opioids marijuana antipsychotics
103
true gynecomastia will be localized where
subareolar region only
104
what is the treatment for gynecomastia
puberty - self resolving Adult- behavior mod Adult- selective estrogen receptor modulator testosterone therapy
105
what is metabolic syndrome
3 or more of the following: abdominal obesity high triglycerides HDL <40 male 50 for female fasting glucose 100 or higher hypertension
106
what is the treatment for metabolic syndrome
weight management and physical activity
107
complications of metabolic syndrome
cardiovascular risk
108
treatment for gynocomastia if no red flags are present
do nothing
109
clinical findings for pcos
menstral disorder infertility obesity acne insulin resistant dyslipidemia
110
if a pcos patient is desiring pregnancy what is the treatment
clomiphene
111
who manages pcos
obgyn
112
if testosterone is low what other labs will you order
obtain LH, FSH and Prolactin
113
primary hypogonadism is from
mumps
114
secondary hypogonadism is from
opiates or steroid s
115
what additional labs will be drawn with treatment of hypogonadism
hematocrit prostate specific antigen (psa)
116
what are red flags for gynecomastia
asymmetry nipple retraction nipple bleeding, discharge unusual firmness
117
what labs are ordered for gynecomastia
free testosterone LH/FSH Beta Hcg Thyroid function panel Liver function panel
118
pcos FHS/LH lab ratio
2:1 to 3:1
119
What is the leading cause of Addison disease
Tuberculosis
120
Symptoms of Addison disease
Weakness fatigue Weight loss Anorexia N/V Anxiety Mental irritability Hyperpigmentation of skin

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