Endocrine Disorders

Question 1

Functions of the Endocrine System (2)

Answer 1

1. helps maintain physiological homeostasis
2. includes tissues that secrete hormones into the blood

Question 2

How do hormones work?

Answer 2

bind to specific receptors that allow the hormone to exert its effect

Question 3

secretion of most hormones are regulated by a _____ feedback system

Answer 3

negative
-specific hormones are turned on or off by specific physiological changes

Question 4

The hypothalamus is a major link between ____ and _____ systems

Answer 4

nervous and endocrine system

the nervous system triggers the release of hormones by the endocrine system

Question 5

What are the two parts of the pituitary? (both are attached to the hypothalamus)

Answer 5

1. posterior pituitary- storage
2. anterior pituitary- active part of endocrine

Question 6

Why is the hypothalamus so important?

Answer 6

1. synthesizes and secretes regulatory hormones
   -releaseing hormones- simulates release of anterior pituitary hormones
   -releases inhibitory hormones- inhibits releases of ant pituitary hormones
2. synthesizes 2 hormones that are stored in the posterior pituitary

Question 7

what is the role of the posterior pituitary and what hormones are there?

Answer 7

storage
-oxytocin
-vasopressin

Question 8

what is the flow of events for anterior pituitary hormones to be released

Answer 8

hypothalamus—releases a hypothalamic releasing or inhibiting hormone into the Hypophyseal portal system—the anterior pituitary recognizes the hormones and releases the proper anterior pituitary hormone

Question 9

Corticotropin releasing hormone from hypothalamus releases what from anterior pituitary?

Answer 9

adrenocorticotropic hormone

Question 10

Growth hormone-releasing hormone causes releases of what from anterior pituitary?

Answer 10

growth hormone while somatostatin inhbits it

Question 11

Thyrotropin releasing hormone releases what from anterior pituitary?

Answer 11

Thyroid stimulating hormone and prolactin

Question 12

Explain the hormone that causes the following Pituitary disorders:
1. Acromegaly/gigantism-
2. Cushing’s Disease-
3. Diabetes Insipidus-

Answer 12

1. acromegaly/gigantism- too much growth hormone
2. cushing’s diseases- too much cortisol
3. diabetes insipidus- too little vasopressin (ADH)

Question 13

What are the common symptoms of a pituitary disorder?

Answer 13

Headache
visual changes (double vision, vision loss, drooping eyelid)

Question 14

whats the difference between Gigantism and Acromegaly?

Answer 14

Gigantism- excessive secretion of GH in children
Acromegaly- excessive secretion of GH in adults

Question 15

What two hormones are stored by the posterior pituitary?

Answer 15

1. ADH vasopressin
2. oxytocin

Question 16

what does ADH vasopressin do?

Answer 16

sensitive to changes in blood tonicity, releases more vasopressin upon water loss
increased water resorption in the kidneys

Question 17

When is ADH released?

Answer 17

reduced blood volume (baroreceptors sense low BP)
Increased plasma osmotic pressure (osmoreceptors in the hypothalamus sense increased solute in blood)

Question 18

Does ADH increase or decrease during happy hour

Answer 18

increased because it is sensitive to the decreased blood volume and dehydration

Question 19

What are common characteristics of Diabetes Insipidus?

Answer 19

peeing alot and having excessive thirst and increased appetite

Question 20

What are the 2 causes of diabetes insipidus?

Answer 20

1. posterior pituitary does secrete ADH
2. insensitivity of kidney to ADH

Question 21

What do you need to do if you are exercising with a patient with DI?

Answer 21

make sure the patient stays hydrated
watch for signs of dizziness, hypotension
muscle weakness

Question 22

what are the 3 Ps of Diabetes insipidus?

Answer 22

polydipsia- excessive thirst
ployuria- increased urination
polyphagia- increase appetite

Question 23

Do patients with DI have an problem with glucose metabolism

Answer 23

no

Question 24

what are some adrenal gland disorders?

Answer 24

Hyper-functioning
1. cushing’s disease/syndrome
2. hyperaldosteronism (conn’s syndrom)
3. pheochromocytoma

Hypofunctioning
1. hypoaldosteronism/addison’s disease

Question 25

explain the release of cortisol

Answer 25

hypotalamus releases corticotropin----corticotropin hormone goes to anterior pituitary----ant pituitary releases adrenocorticotropic hormone into vascular system ACTH is carried in the blood to the adrenal cortex stimulating the adrenal cortex and sythesis of cortisol--stress hormone

Question 26

normally as cortisol synthesis increases what happens to the CRH production

Answer 26

as cortisol increases then CRH from the hypothalamus should decreases and ACTH should decrease as well

Question 27

What are the functions of cortisol?

Answer 27

Stress hormone- think fight or flight 1. counter-regulatory to insulin- promotes hyperglycemia 2. decreases bone formation (decrease osteoblast formation) and decreases CA++ absorption 3. acts as a diuretic 4. inhibits production/release of inflammatory mediators

Question 28

Does cortisol production have a role in osteoporosis?

Answer 28

yes

Question 29

Hyper-secretion of cortisol causes what disease

Answer 29

cushing's disease and syndrome

Question 30

what are some hallmarks of patients with cushing's disease?

Answer 30

1. rapid weight gain in central area -moon face -buffalo hump 2. skin- thinning of skin and capilllary--bruising easily -poor wound healing 3. muscle wasting and weakness 4. tachycardia; hypertension 5. osteoporosis 6. hyperglycemia/DM -stres response 7. immunosuppression/increased infection risk

Question 31

What is the treatment of cushing's diseases/syndrome

Answer 31

depends on the reason for excess cortisol - pituitary tumor removal-disease -syndrome- adrenal tumor removal

Question 32

What is the primary functions of the Thyroid Gland (4)

Answer 32

1. increased basal metabolic rate 2. important for brain and muscular development 3. increases HR/contractility and cardiac output 4. CNS arousal state

Question 33

what are common signs/sx of hyperthyroidism

Answer 33

-unintended weight loss -anxiety -heat intolerance -fatigue -tachycardia/hypertension/afib -tremors -hyperglycemia -osteopenia (longterm)

Question 34

what is graves disease?

Answer 34

autoimmune disease- hyperthyroidism -causes bulging of eye anteriorly -thyroid eye disease

Question 35

Typical treatment for hyperthyroidism

Answer 35

medication that inhibits the conversion of T4 to T2 betablockers for the CV

Question 36

What are sx/symptoms of hypothyroidism

Answer 36

-lethargy and fatigue -bradycardia -edema -weight gain -cold intolerance -dry skin/brittle hair and fingernails -goiter

Question 37

What is the function of the parathyroid gland and how many are there?

Answer 37

1. secretes parathyroid hormone 2. regulates plasma calcium (osteoclast activity) 3. regulates phosphate level there are 4

Question 38

Too much Parathyroid hormone increase risk of _____-

Answer 38

osteoporosis

Question 39

Function of parathyroid hormone?

Answer 39

increases blood calcium concentrations when serum CA++ is too low (hypocalcemia) -stimulates osteoclasts to relasese more CA++ from bone -deceases CA++ by kidney -activates vitamin D which stimulates the uptake of Ca++ from diet

Question 40

What are some modifiable risk factors for osteoporosis?

Answer 40

vitamin D deficiency lack of physical activity weight loss cigarette smoking alcohol consumption stress

Question 41

what are non-modifiable risk factors for osteoporosis

Answer 41

-history of falls -older age -gender -white and asian -prior fracture -family history of osteoporosis

Question 42

What are medical conditions that are associated with increased risk of osteoporosis?

Answer 42

-prolonged corticosteroid use -hypogonadism -hyperparathyroidism -chronic liver and renal -inflammatory diseases -DM -dementia

Question 43

Increased/decreased survival age after hip fracture

Answer 43

decreased

Question 44

___ fractures are associated with morbidity and decreased ability to cary out independent activities of daily living

Answer 44

ALL fractures

Question 45

DXA scans help diagnose osteoporosis how?

Answer 45

T score compare bone mineral density to a healthy 30 year old femal z scores compare bone density to average people of own age and gender

Question 46

Bisphosphonates are used for what?

Answer 46

FDA approved drug for osteoporosis

Question 47

How do bisphosphonates work

Answer 47

inhibit bone resorption by attaching to bony surfaces and inhibiting the action of osteoclast

Question 48

What are Interventions used to prevent osteoporosis?

Answer 48

stop smoking medication check risk factors reduce alcohol weight bearing exercise vitamin D and Calcium increase

Question 49

What are some key items to remember when working with a patient with osteoporosis?

Answer 49

typically same FITT principles but emphasis on extension while avoiding loaded trunk flexion/rotation activities