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Patho Exam 2 > Endocrine > Flashcards

Endocrine Flashcards

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1
Q

Functions of endocrine system

A
  • growth and development
  • sex differentiation
  • metabolism
  • adaption
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2
Q

4 hormones of hypothalamus

A
  • TRH
  • CRH
  • growth hormone
  • GnRh
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3
Q

Hormones of anterior pituitary

A
  • TSH
  • LH
  • FSH
  • ACTH
  • GH
  • Prolactin
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4
Q

Hormones of posterior pituitary

A
  • Oxytocin

- ADH

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5
Q

Primary disorder

A

Malfunction of the actual target organ

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6
Q

Secondary disorder

A

Target gland is normal, however altered function of the stimulating hormones - it is a pituitary problem

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7
Q

Tertiary

A

Both pituitary and target problem

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8
Q

Low TSH

High T3 and T4

A

Primary hyperthyroidism

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9
Q

High TSH

Hight T3 and T4

A

Secondary hyperthyroidism

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10
Q

High TSH

Low T3 and T4

A

Primary hypothyroidism

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11
Q

Low TSH

Low T3 and T4

A

Secondary hypothyroidism

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12
Q

What are the basics of the hypothalamus-pituitary axis-thyroid gland axis?

A

Hypothalamus (TRH) –> Pituitary (TSH) –> Thyroid (T3 and T4)

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13
Q

What mineral deficiency can lead to hypothyroidism?

A

Iodine deficiency

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14
Q

How does hypothyroidism affect metabolism?

A

Metabolism decreases

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15
Q

What happens in long-standing hypothyroidism?

A

Myxedema

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16
Q

What are the clinical manifestations of hypothyroidism

A
  • Bradypnea
  • Constipation
  • Cold intolerance
  • Fatigue
  • Weakness
  • Dry skin
  • Coarse hair
  • Impaired memory and reproduction
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17
Q

What are the clinical manifestations of Myxedema

A
  • Swollen face
  • Puffiness around the eyes
  • Swelling of tongue
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18
Q

Another term for Myxedema

A

Cardiomegaly

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19
Q

What kind of patients would you see Myxedema in?

A
  • Patients who haven’t been compliant with the hormone treatment
  • Get sick
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20
Q

What differs in Myxedema Coma from Myxedema

A

More diffuse edema, precipitated by an acute event, weakness, confusion

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21
Q

What do you look for in lab diagnostics of hypothyroidism?

A

TSH levels
T3 and T4 levels
Thryoid autoantibodies - to see if an autoimmune disease attacked the thyroid
Antithyroglobulin

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22
Q

How do you treat primary hypothyroidism?

A

Thyroid hormone replacement therapy

i. e. levothyroxine and syntheroid
- slowly raise the levels

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23
Q

How do you treat secondary hypothyroidism?

A

Removal of the pituitary tumor

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24
Q

What happens to the metabolism in hyperthyroidism?

A

Metabolism increases

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25
What condition is a form of secondary hyperthyroidism?
Grave's disease (autoimmune disease) | -IgG binds to TSH receptors on the thyroid
26
What clinical manifestation is present in both hypo and hyperthyroidism?
Goiter
27
What are clinical manifestations of hyperthyroidism?
- Diarrhea - Weight loss - Oily skin - Fine hair - Exopthalmus - Heat intolerance - Tachycardia, agitation
28
What is Thyroid Storm ?
Worsening of hyperthyroidism symptoms due to stress, infection, pulmonary or cardiovascular disorders -extreme vitals
29
What can occur after thyroidectomy?
Thyroid crisis = exaggeration of the effects of hyperthyroidism
30
Describe the effect of immobility on serum Ca and PTH
Immobile --> bone release Ca --> hypercalcemia --> inhibit PTH
31
Describe the effect of renal disease on serum Ca and PTH
Renal disease --> inability reabsorb Ca --> hypocalcemia --> stimulation of parathyroid --> releases PTH --> bone release Ca --> bone loss
32
What are the calcium levels in hypoparathyroidism?
Low serum calcium (hypocalcemia)
33
What state of serum magnesium causes hypothyroidism?
Hypomagnesemia
34
How does magnesium affect PTH
Magnesium is needed for adequate production of PTH
35
What is the relationship between calcium and phosphate?
They are inverse | Hypocalcemia = hyperphophatemia
36
Describe the relationship between hyperphosphatemia and hypocalcemia?
High phosphate levels interfere with vitamin D activation --> cannot absorb calcium --> hypocalcemia
37
How does vitamin D affect calcium absorption
Vitamin D activation is needed for calcium absorption in the GI
38
What is the relationship between calcium and neuromuscular excitability?
They are inverse | -Calcium is necessary for resting membrane potential, thus lack of calcium = increased neuromuscular excitability
39
Clinical Manifestations of Hypothyroidism?
- Tetany - Muscle spasm - dry skin - loss of body hair - diarrhea - increased peristalsis
40
What are unique diagnostic findings in hypothyroidism?
Chvostek and Trousseau signs - low Ca - low PTH
41
What causes primary hyperparathyroidism?
Error in the negative feedback loop -High Ca levels normally inhibit PTH release --> but neg feedback loop is malfunctioning --> so PTH continues to be released
42
What causes secondary hyperparathyroidism
Increase PTH due to issues not related to the feedback loop (hypocalcemia)
43
How does chronic renal failure affect PTH levels?
Chronic renal failure --> lack of Ca reabsorption --> hypocalcemia --> high PTH
44
How does lack of vitamin D activation affect PTH levels?
Vitamin D is necessary to absorb Ca through GI --> lack of vitamin D = lack of Ca absorption --> hypocalcemia --> high PTH
45
Clinical manifestations of Hyperparathyroidism
- Decreased neuromuscular excitability - Bone disease - Calcium stones - Polyuria (b/c kidneys are trying to flush calcium out) - Constipation - Abdominal pain - Anorexia
46
In chronic kidney disease, are the phosphate levels increased or decreased?
In CKD, hyperphosphatemia due to decreased phosphorus secretion.
47
How does the kidney response to the hyperphoshatemia lead to hypocalcemia?
Kidneys excrete calcium as a precept with the phosphorus --> excretion of Ca --> hypocalcemia
48
Why are patients with CKD stay in hypocalcemia states despite hyperparathyroidism?
PTH causes release of calcium from the bone but their inability to activate vitamin D decreases calcium absorption
49
What is another term for ADH?
Vasopressin
50
What is the most common cause of SIADH?
Ectopic secretion
51
What kind of sodium imbalance occurs with SIADH?
Hypotonic hyponatremia
52
Clinical Manifestations of SIADH
- decreased urine output - concentrated urine - hyponatermia --> irritability, weakness, nausea and vomiting, coma - edema / third spacing
53
How does water intoxication mimic DI?
Water intoxication --> body has sufficient water --> body thinks we no longer need ADH --> less ADH production --> mimics DI
54
Clinical Manifestations of DI?
- polyuria - dilute urine - hypernatremia --> CNS manifestations (seizures and coma) - hypovolemic shock
55
What is the serum osmolality in DI?
High serum osmolality due to the hypernatremia
56
Will the specific urine gravity be high or low in DI?
Low (because of low electrolyte content)
57
When is the adrenal gland axis triggered?
When the body is under stress
58
What is the pathway of the adrenal gland axis?
Hypothalamus --> secretes CRH --> anterior pituitary releases ACTH --> triggers adrenal gland --> production and release of steroids, glucoroticoids, and corticoids
59
What are the two different causes of Cushing's?
- Long term administration of glucocorticoids (i.e. prednisone) --> cushing's syndrome - Ectopic secretion --> cushing's disease
60
Clinical manifestations of Cushing's
- Moon face - Buffalo hump - Fat pad - Obesity of trunk - Weakness - Osteoporosis - Kidney Stones - Hyperglycemia (due to cortisol inhibiting insulin production) - Suppression of immunity - Hypokalemia
61
In Cushing's is cortisol high or low?
High cortisol
62
Is ACTH high or low in Cushing's
High ACTH
63
Is ACTH high or low in Addison's
Low ACTH
64
What does PTH respond to?
Low levels of calcium
65
Describe primary Addisons's
Problem with the adrenal gland --> low glucocorticoid, mineralcorticoid, and androgen production - Low levels trigger ACTH b/c of negative feedback - Increased level of ACTH
66
Is glucocorticoid/mineralcorticoid/androgen level high or low in Cushing's?
High
67
Is glucocorticoid/mineralcorticoid/androgen level high or low in Addison's?
Low
68
What is secondary Addison's?
Low ACTH (and low production by adrenal gland)
69
Clinical manifestations of Addison's
If primary (high ACTH) --> hyper pigmentation - Hypoglycemia - Lack of aldosterone --> salt cravings - Dehydration - Hyperkalemia --> arrhythmia
70
What is the adrenal stimulation test?
ACTH is given, and serum cortisol levels are monitored over time to see if adrenals are responding to the ACTH.
71
What type of Addison's does the adrenal stimulation test test for? (Primary or secondary)
Primary Addison's
72
In treating a patient with Addison's what should you educate them on?
Signs and symptoms of addison/adrenal crisis

Patho Exam 2 (4 decks)

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