endocrine and metabolic systems 1

Question 1

what is the function of the endocrine system and the nervous system?

Answer 1

control and integrate body function to maintain homeostasis

Question 2

what role do hormones play in the endocrine system and how do they travel?

Answer 2

endocrine system sends its messages in the form of hormones via the blood stream

Question 3

what are the five general functions of the endocrine system?

Answer 3

1. differentiation of the reproductive and central nervous system of the developing fetus
2. stimulation of sequential growth and development during childhood and adolescence
3. coordination of the male and female reproductive systems
4. maintenance of optimal internal environment throughout the life span
5. initiation of corrective and adaptive responses when emergency demands occur

Question 4

what is the main integrative center for the endocrine and autonomic nervous systems?

Answer 4

hypothalamus

Question 5

what is the function of the hypothalamus?

Answer 5

controls the function of endocrine organs by neural and hormonal pathways

Question 6

what is classified as an endocrine gland because it secretes several hormones responsible for metabolism, hunger, vasoconstriction, and cellular growth?

Answer 6

adipose tissue

Question 7

what does the secretion of ADH depend on?

Answer 7

plasma volume and osmolality

Question 8

what are the most powerful stimulators of ADH?

Answer 8

pain
emotional stress
trauma
morphine

Question 9

hyposecretion of GH causes what medical condition?

Answer 9

dwarfism

Question 10

hypersecretion of GH causes what medical condition? (children vs adults)

Answer 10

gigantism in children
acromegaly in adults

Question 11

what does ectopic hormone production cause?

Answer 11

cancer

Question 12

what is psychoneuroimmunology?

Answer 12

endocrine system, together with the immune system and the nervous system, mounts an integrated response to stressors

Question 13

which three hormones or catecholamines are responsible for the fight or flight responses?

Answer 13

epinephrine
norepinephrine
dopamine

Question 14

what are the physiological effects of cortisol?

Answer 14

food metabolism
body response to stress
gluconeogenesis
suppresses inflammation and immune function

Question 15

true or false: equilibrium concentrations are the principal hormones necessary to maintain homeostasis are altered with age.

Answer 15

FALSE: it is does not alter with age, but what may differ as we get older is the way we achieve equilibrium hormone levels, which points to changes in regulatory control

Question 16

what is neuroendocrine theory of aging?

Answer 16

suggests that cells are programmed to function only for a given time

Question 17

what is an example of neuroendocrine theory of aging?

Answer 17

menopause (a result of programmed changes in the reproductive system is an example of this theory)

Question 18

what are some symptoms that clients with a variety of endocrine and metabolic disorders report to PTs?

Answer 18

fatigue
muscle weakness
muscle or bone pain

Question 19

what does the lack of progress in therapy signal to to therapist?

Answer 19

the possibility of a systemic origin of musculoskeletal symptoms

Question 20

rheumatoid arthritis can be an indicator of what medical condition?

Answer 20

endocrine disease

Question 21

what four signs are early manifestations of thyroid or parathyroid disease, acromegaly, diabetes, Cushing syndrome, or osteomalacia?

Answer 21

muscle weakness
atrophy
myalgia
fatigue

Question 22

_____ is a common finding in people with certain endocrine and metabolic conditions such as acromegaly, diabetes, pregnancy, and hypothyroidism.

Answer 22

carpal tunnel syndrome (CTS)

Question 23

what one characteristic may distinguish endocrine related CTS from overuse syndromes and other causes of CTS?

Answer 23

it is bilateral (happens in both wrists)

Question 24

flexor tenosynovitis with stiffness is a common finding in people with what endocrine malfunction?

Answer 24

hypothyroidism

Question 25

what are two anterior lobe disorders?

Answer 25

hyperpituitarism hypopituitarism

Question 26

where do individuals with acromegaly have back pain?

Answer 26

thoracic and lumbar region

Question 27

what are skeletal manifestations of anterior lobe disorders

Answer 27

arthritis of the hands osteoarthritis of the spine

Question 28

what should the program a therapist provides promote to counter orthopedic considerations that accompany acromegaly, arthritis, or osteoarthritis?

Answer 28

maximum joint mobility muscle strength functional skills

Question 29

what is acromegaly?

Answer 29

excessive secretion of growth hormone after normal completion of body growth

Question 30

acromegaly results the overgrowth of bone in the ____, _____, and _____.

Answer 30

face head hands

Question 31

what should someone with acromegaly be screened for?

Answer 31

weakness changes in joint mobility poor exercise tolerance

Question 32

what are the three primary hormones produced by the thyroid?

Answer 32

T4 T3 Calcitonin

Question 33

what is the function of the T3 and T4 hormones?

Answer 33

regulate the metabolic rate of the body and increase protein synthesis

Question 34

calcitonin has a weak physiologic effect on ____ and _____ balance in the body

Answer 34

calcium phosphorus

Question 35

thyroid function is regulated by what feedback controls and an intrinsic regulator mechanism with the gland?

Answer 35

hypothalamus and pituitary

Question 36

disorders of the thyroid gland may lead to anatomic abnormalities such as? (3)

Answer 36

thyroiditis, goiter, and thyroid cancer

Question 37

changes in nails, hair, skin, eyes, GI tract, respiratory tract, heart, and blood vessels, nervous tissue, bone, and muscle are signs of what malfunction?

Answer 37

alterations in thyroid function

Question 38

how do women know if they have a thyroid gland problem?

Answer 38

mood and in menstrual cycles

Question 39

true or false: both hyperthyroidism and hypothyroidism can adversely affect cardiac function

Answer 39

true

Question 40

what is hyperthyroidism?

Answer 40

creates a generalized elevation of body metabolism

Question 41

what is the most common form of hyperthyroidism?

Answer 41

graves disease

Question 42

what hormone does graves disease effect? and how?

Answer 42

increases T4 production creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system

Question 43

true or false: hyperthyroidism affects men more than women

Answer 43

FALSE (affects women more than men in a 4:1 ratio)

Question 44

what is a thyroid storm?

Answer 44

acute episode of thyroid-over activity

Question 45

about 95% of people with Graves disease have circulating autoantibodies called? (they react against thyroglobulin, a precursor for thyroid hormone)

Answer 45

TSI (thyroid stimulating immunoglobulins

Question 46

TSI is associated with pathogenesis of what disorder of the thyroid gland?

Answer 46

hyperthyroidism

Question 47

what is the function of TSIs?

Answer 47

stimulates enlargement of the thyroid gland react against a component of the thyroid cell membrane secretion of excess thyroid hormone

Question 48

what thyroid disfunction is manifested with these symptoms? 1. mild symmetric enlargement of the thyroid 2. nervousness 3. heat intolerance 4. weight loss despite increased appetite 5. sweating 6. diarrhea 7. tremor 8. palpitations

Answer 48

hyperthyroidism

Question 49

should a PT work with a patient with hyperthyroidism?

Answer 49

no, pt is not recommended until after the endocrine problem is solved

Question 50

true or false: hyperthyroidism may induce atrial fibrillation, precipitate congestive heart failure, and increase the risk of underlying CAD for myocardial infarction

Answer 50

true

Question 51

what is per-arthritis? and what thyroid dysfunction is it associated with?

Answer 51

inflammation that involves the per-articular structures, including the tendons, ligaments, and joint capsule hyperthyroidism

Question 52

is per-arthritis unilateral or bilateral?

Answer 52

can be either

Question 53

what is myopathy? and what thyroid dysfunction is it associated with?

Answer 53

hyperthyroidism

Question 54

what is dyspnea or respiratory muscle weakness associated with?

Answer 54

hyperhyroidism

Question 55

what lab tests should be conducted for graves disease?

Answer 55

TSH and antithyroid antibodies

Question 56

what is positive in lab tests for people with grave disease?

Answer 56

TSI

Question 57

what are three major forms of therapy for hyperthyroidism?

Answer 57

antithyroid medication radioactive iodine surgery

Question 58

what is the prognosis for hyperthyroidism?

Answer 58

lifelong follow up is recommended because many remissions are not permanent

Question 59

if a PT sees unusual swelling, enlargement with or without symptoms of pain, tenderness, hoarseness, or dysphagia, what is the next plan of action?

Answer 59

medical referral

Question 60

true or false: hyperthyroidism is not associated with exercise intolerance and reduce exercise capacity

Answer 60

FALSE; IT IS!

Question 61

what is hypothyroidism?

Answer 61

a generalized slowed body metabolism (basal metabolic rate)

Question 62

what is primary or type 1 hypothyroidism?

Answer 62

hormone deficient

Question 63

what is secondary or type 2 hypothyroidism?

Answer 63

hormone resistant

Question 64

what is elevated or increased in hypothyroidism?

Answer 64

TSH secretion from the anterior pituitary gland

Question 65

what type of hypothyroidism involves reduced functional thyroid tissue mass or impaired hormonal synthesis or release?

Answer 65

type 1

Question 66

hypothyroidism: _____ of all body processes which leads to bradycardia, ____ GI tract motility, _____ neurologic functioning, a _____ in body heat production, and achlorhydria

Answer 66

slow and decrease

Question 67

what happens to lipid metabolism during hypothyroidism?

Answer 67

lipid metabolism is altered --> increase in serum cholesterol and triglyceride levels --> increase in arteriosclerosis and coronary heart disease

Question 68

true or false: hypothyroidism develops anemia

Answer 68

TRUE: thyroid hormones also play a role in the production of RBCs

Question 69

what is type 2 or secondary hypothyroidism?

Answer 69

the result of failure of the pituitary gland to synthesize and release adequate amounts of TSH

Question 70

what type is more common in hypothyroidism?

Answer 70

type 1

Question 71

what is myxedema and what is it associated with?

Answer 71

non-pitting, boggy edema, especially around the eyes, hands, feet, and in supraclavicular fossae hypothyroidism

Question 72

what is the most sensitive indicator of primary hypothyroidism?

Answer 72

TSH levels

Question 73

how are T3 and T4 levels effected in hypothyroidism?

Answer 73

T3 does not change dramatically T4 levels decrease gradually until they are well below normal in advanced hypothyroidism

Question 74

what happens to levels of serum cholesterol, alkaline phosphatase, and triglyceride levels in hypothyroidism?

Answer 74

they are significantly elevated

Question 75

what are the goals of hypothyroidism treatment?

Answer 75

correct thyroid hormone deficiency, reverse symptoms, and prevent further cardiac and arterial damage

Question 76

what condition is hypothyroidism similar to?

Answer 76

rheumatoid arthritis

Question 77

what do patients with hypothyroidism complain of?

Answer 77

muscle complaints (aches, pain, and stiffness) pain increases with onset of cold, rainy weather

Question 78

what is CPPD or calcium pyrophosphate dihydrate associated with?

Answer 78

hypothyroidism

Question 79

what should PTs be more aware of with people that have hypothyroidism and fibromyalgia?

Answer 79

they have more dry and swollen tissues which makes their skin more likely to tear or develop sores

Question 80

in older adults with hypothyroidism who just got a thyroid replacement, a PT should screen for what?

Answer 80

symptoms of hyperthyroidism, aggravated CVD, and abnormal vital signs and fall risk (due to increased risk of osteoporosis and fracture)

Question 81

what hormones do the parathyroid gland secrete? and what do they regulate?

Answer 81

PTH, regulates calcium and phosphorus metabolism

Question 82

how does PTH exert its effect?

Answer 82

increasing the release of calcium and phosphate from the bone increasing the absorption of calcium and excretion of phosphate by the kidneys promoting calcium absorption in the GI tract (CALCIUM ABSORPTION)

Question 83

what is hyperparathyroidism?

Answer 83

increased bone resportion

Question 84

what is hypoparathyroidism?

Answer 84

decreased bone resorption

Question 85

what does the PTH hormone target?

Answer 85

bone, kidney, intestinal tract

Question 86

what is the full definition of hyperparathyroidism?

Answer 86

over-activity of one or more of the four parathyroid glands that disrupts calcium, phosphate, and bone metabolism

Question 87

who are more affected by hyperparathyroidism?

Answer 87

women are more affected more than men (2:1), usually after 60 years (post menopausal)

Question 88

what is primary hyperparathyroidism?

Answer 88

one or more of the parathyroid glands enlarged

Question 89

what level of hyperparathyroidism is the following lab result: normal regulatory relationship between serum calcium levels and PTH secretion is interrupted

Answer 89

primary

Question 90

what is secondary hyperparathyroidism?

Answer 90

glands are hyperplastic from malfunction of another organ system

Question 91

what level of hyperparathyroidism is the following: this level is a compensatory response to chronic hypocalcemia due to renal failure (decreased renal activation of vitamin D)

Answer 91

secondary

Question 92

what is tertiary hyperthyroidism?

Answer 92

glands ultimately become autonomous in function and unresponsive to serum calcium levels

Question 93

what level of hyperparathyroidism is exclusive to dialysis clients?

Answer 93

tertiary

Question 94

what does excessive circulating PTH lead to?

Answer 94

bone damage

Question 95

true or false: PTH is regulated by the pituitary and hypothalamus

Answer 95

FALSE: it maintains blood calcium levels by increasing bone resorption and GI absorption of calcium

Question 96

what happens if hyperparathyroidism is left untreated?

Answer 96

exacerbates many conditions in older adults such as osteoporosis and coronary artery disease

Question 97

what is the treatment for hyperparathyroidism?

Answer 97

surgical removal for primary hyperparathyroidism

Question 98

what is periarthritis and tendinitis caused by?

Answer 98

hyperparathyroidism

Question 99

true or false: it is important to treat the underlying cause first (hyperparathyroidism) because the intervention for arthritis will be frustrating and poorly effective

Answer 99

true

Question 100

why should you monitor a person on digitalis drug when they have hyperparathyroidism?

Answer 100

monitor for toxic effects produced by elevated calcium levels because clients with hypercalcemia are hypersensenstive to digitalis drug and may quickly develop symptoms

Question 101

what is the true definition of hypoparathyroidism?

Answer 101

causes hypocalcemia and produces a syndrome opposite that of hyperparathyroidism with abnormally low serum calcium levels, high serum phosphate levels, and possible neuromuscular irritability

Question 102

what is the most common form of hypoparathyroidism?

Answer 102

iatrogenic (acquired)

Question 103

what is iatrogenic?

Answer 103

glandular damage or accidental removal during thyroid removal or anterior neck surgery

Question 104

what is idiopathic hypoparathyroidism?

Answer 104

affect more children; may be an autoimmune disorder with a genetic basis

Question 105

what happens to serum phosphate levels in hypoparathyroidism?

Answer 105

rises

Question 106

what happens to bone resorption during hypoparathyroidism?

Answer 106

slows down

Question 107

what hormone is reduce during hypoparathyroidism?

Answer 107

PTH

Question 108

what is tetany? and what thyroid condition is it associated with?

Answer 108

neuromuscular irritability hypoparathyroidism

Question 109

what is acute tetany?

Answer 109

a life threatening disorder due to laryngeal spasm and subsequent respiratory obstruction

Question 110

adrenal glands!