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clincial pathophysiology > endocrine disorders > Flashcards

endocrine disorders Flashcards

1
Q

what are the functions of the endocrine system

A

growth and development
sex differentiation
metabolism
adaptation to changing environment

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2
Q

how does the endocrine system adapt to a changing environment

A

regulation of digestion
use and storage of nutrients
electrolyte and water metabolism
reproductive fitness

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3
Q

true or false: hormones interact with high-affinity receptors

A

true

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4
Q

what are the categories of hormones

A

amines and amino acids
peptides, polypeptides, proteins, and glycoproteins
steroid
fatty acid derivatives

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5
Q

which of the following is a characteristic of a hormone?
a. a single hormone can exert various effects in different tissues
b. a single function can be regulated by several hormones
c. both

A

c

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6
Q

which is more predominant, positive or negative feedback?

A

negative

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7
Q

what hormones are essential for normal body growth and maturation

A

growth hormone (GH)
insulin
thyroid hormone
androgens

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8
Q

what are the three different endocrine disorders

A

hormone excess
hormone deficiency
altered response to hormone

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9
Q

what do thyroid glands do

A

increases metabolism and protein synthesis
influence growth and development in children (mental development and attainment of sexual maturity)

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10
Q

what are the primary functions of the thyroid

A

metabolism
cardiovascular system (increased O2 consumption)
gi function (promotes gi motility and vasodilation -> CO)
neuromuscular function (muscle function and control)

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11
Q

what is hyperthyroidism

A

a sustained increase in synthesis and release of thyroid hormones by thyroid gland

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12
Q

true or false: hyperthyroidism occurs more often in men

A

false: women

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13
Q

true or false: the highest frequency of hyperthyroidism is between ages 20-40 years

A

true

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14
Q

what is the most common form of hyperthyroidism

A

graves’ disease (75%)

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15
Q

what are other causes of hyperthyroidism

A

toxic modular goiter
thyroiditis
excess iodine intake
pituitary tumors
thyroid cancer

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16
Q

what are the signs of subclinical hyperthyroidism

A

low serum TSH level <0.4mlU/L
normal T4 and T3 levels

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17
Q

what are the signs of overt hyperthyroidism

A

low or index table TSH
elevated T4 and T3 levels
symptoms may or may not be present

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18
Q

what are the symptoms of hyperthyroidism

A

thyroid storm
restlessness, irritability, anxiety
wakefulness
increased cardiac output
tachycardia and palpitations
diarrhea, increased appetite
dyspnea
heat intolerance, increased sweating
thin and silky skin and hair
weight loss

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19
Q

what are the manifestations of thyroid storm

A

very high fever
extreme cardiovascular effects (tachycardia, congestive failure, and angina)
severe CNS effects (agitation, restlessness, and delirium)
GI symptoms
high mortality rate

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20
Q

true or false: thyroid storm results in delayed puberty

A

false

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21
Q

what are diagnostic tests for thyroid disease

A

measures of T3, T4, and TSH
resin uptake test
assessment of thyroid autoantibodies
radioiodine uptake test
thyroid scan
ultrasonography
CT and MRI
fine-needle aspiration biopsy of a thyroid nodule

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22
Q

what is primary hypothyroidism caused by

A

destruction of thyroid tissue or defective hormone synthesis

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23
Q

what is secondary hypothyroidism caused by

A

pituitary or hypothalamic dysfunction (low TSH or TRH)

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24
Q

what are the clinical manifestations of hypothyroidism

A

fatigue
cold intolerance
loss of eyebrow hair
sleep problems
muscle aches
infertility
slow heart beat
weight gain
constipation
headaches
depression
dizziness
brain fog
arthritis
brittle nails
heavy menstrual periods

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25
Q

what are the signs of subclinical hypothyroidism

A

TSH is >4.5 mlU/L
T4 levels normal
affects up to 10% of women over

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26
Q

what are the signs of nonthyroidal illness syndrome (NTIS)

A

critically ill patients
low T3, T4, and TSH levels

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27
Q

what condition does a thyroid goiter appear

A

any thyroid state

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28
Q

true or false: pancreas is only endocrine and not exocrine gland

A

false: both endocrine and exocrine

29
Q

what does the islet of langerhans consist of and what do they secrete

A

alpha cells: glucagon
beta cells: insulin and amylin
delta cells: somatostatin and gastrin
F cells: pancreatic polypeptide

30
Q

what is insulin regulated by

A

chemical, hormonal, and neural mechanisms

31
Q

what is insulin’s secretion promoted by

A

increased blood glucose levels

32
Q

what does insulin facilitate

A

the rate of glucose uptake into the body’s cells

33
Q

what is diabetes mellitus and what is it characterized by

A

dysfunction in the production or action of insulin
characterized by hyperglycemia, resulting from defects in insulin secretion, insulin action, or both

34
Q

what does diabetes mellitus affect

A

metabolism of fat, protein, and carbohydrates

35
Q

what are the categories of diabetes mellitus

A

type 1
type 2
other specific types
gestational diabetes

36
Q

what race has the highest percentage of diabetes

A

american indian or alaska native

37
Q

what are the glucose regulating hormones

A

insulin
glucagon
somatostatin, amylin, and gut-derived hormones
counter-regulatory hormones

38
Q

true or false: type 1 diabetes typically affects older people

A

false: younger

39
Q

what is the genetic susceptibility of type 1 diabetes

A

1st degree relative (parent or sibling) with type 1 diabetes
strongest association with major histocompatibility complex (MHC) in HLA testing

40
Q

what ages does type 1 diabetes usually peak at

A

4-7
10-14

41
Q

what are the environmental factors of type 1 diabetes

A

viral infection
exposure to cow’s milk proteins
relative lack of vitamin D

42
Q

what are the symptoms of diabetes

A

polyuria
polydipsia
polyphagia
weight loss or gain
blurred vision
fatigue/weakness
skin infections

43
Q

true or false: type 1 diabetes is more common than type 2

A

false: type 2 is 90-95%

44
Q

true or false: type 2 diabetes has insulin but it doesn’t work properly

A

true

45
Q

true or false: people with type 2 diabetes are usually underweight

A

false: overweight

46
Q

what is polyuria

A

excessive urination

47
Q

what is polydipsia

A

excessive thirst

48
Q

what is polyphagia

A

hungry

49
Q

what are the diagnostic tests for diabetes

A

fasting plasma glucose test (FPG) 70-100 is normal, >126 = diabetic
random glucose test
oral glucose tolerance test (OGTT)
capillary whole blood glucose monitoring
hemoglobin A1C
urine tests (ketobodies and glucose)

50
Q

how to treat diabetes

A

insulin replacement
- type 1 = insulin pump
- type 2 = oral therapies (metformin , etc)
weight loss (type 2)
diet control (ADA diet)
hydration
exercise

51
Q

what are the acute complication of diabetes mellitus

A

diabetic ketoacidosis
hyperosmolar hyperglymeic state
hypoglycemia

52
Q

what is the somogyi effect

A

hypoglycemia with rebounding hyperglycemia
counter regulatory hormones cause gluconeogensis
most common persons with type 1 diabetes and in children

53
Q

what is the dawn phenomenon

A

early morning glucose elevation without nocturnal hypoglycemia
related to nocturnal growth hormone elevation

54
Q

how do you treat dawn phenomenon

A

alter timing and dose of insulin

55
Q

what are the microvascular chronic complication of diabetes

A

diabetic retinopathy
diabetic neuropathy
diabetic neuropathies

56
Q

what are the macrovascular chronic complication of diabetes

A

coronary artery disease
myocardial infarction
cerebral vascular disease
peripheral vascular disease

57
Q

what hyperfunctions increase cortisol

A

cushing disease
cushing syndrome

58
Q

what hyperfunction increases aldosterone

A

primary or secondary hyperaldosteronism

59
Q

what is a hypofunction of the adrenal cortex

A

addison disease

60
Q

what is cushing syndrome

A

chronic excessive cortisol level, regardless of cause

61
Q

what is cushing disease

A

overproduction of pituitary ACTH by a pituitary adenoma
lose diurnal and circadian patterns of ACTH and cortisol secretion

62
Q

what is cushing-like syndrome

A

exogenous administration of glucocorticoids

63
Q

how to diagnose cushing’s disease

A

urine and blood test
saliva cortisol test
CT and MRI
petrosal sinus sampling

64
Q

what is hypoadrenalism

A

deficient production of adrenal hormones
- aldosterone (stimulus angiotensin II)
- cortisol (stimulus ACTH)
- androgens (stimulus ACTH)
- epinephrine (stimulus SNS)

65
Q

what is the etiology/pathophysiology of hypoadrenalism

A

primary
- addison’s disease (autoimmune)
- lack of glucocorticoids, mineralocorticoids, and androgens
secondary
- lack of pituitary ACTH
- lack of glucocorticoids and androgens

66
Q

what are the symptoms of addison’s disease

A

insidious onset (comes on slowly and does not have obvious symptoms at first)
- anorexia/weight loss
- nausea
- progressive weakness
- fatigue
disease often advances before detected

67
Q

what is an acute adrenal insufficiency

A

insufficient or sudden, sharp decrease in hormones
life threatening
various triggers
iatrogenic - abrupt discontinuation of exogenous steroids

68
Q

how to diagnose addison’s disease

A

CBC, CMP
ACTH stim test
insulin-induced hypoglycemia test
abd CT scan
MRI

clincial pathophysiology (7 decks)

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