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Pathophysiology - Test 3 > Endocrine Module > Flashcards

Endocrine Module Flashcards

0
Q

What is the endocrine system responsible for?

A

Reproductive system, CNS in the fetus, growth and development, maintenance of internal environment, and response to emergency situations

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1
Q

What is the feedback loop?

A

Hormones travel through the body to their target organ and the organ is told whether or not to continue to secrete the hormone or to slow down the production of the hormone

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2
Q

What are some dysfunctions of the endocrine system?

A

Musculoskeletal issues, neuromuscular issues, and reproductive issues

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3
Q

What is dysfunction a result of?

A

Hyperfunction or hypofunction

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4
Q

What is the endocrine system intimately related to?

A

Immune system

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5
Q

Describe the effect of stress on the endocrine system.

A

Increase in stress increases SNS…

  1. signals the adrenal gland to release catecholamines
  2. signals the pituitary to release ADH, prolactin, GH, and ACTH
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6
Q

What hormones does the adrenal gland release?

A

Catecholamines

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7
Q

What hormones does the pituitary release?

A

ADH, prolactin, GH, and ACTH

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8
Q

What are the three types of catecholamines?

A

Epinephrine, norepinephrine, and dopamine

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9
Q

What are effects of catecholamines on the body?

A

Increase HR and strength, peripheral vasoconstriction, elevated BP, increased blood glucose, and stimulates breakdown of fats

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10
Q

What does the adrenal cortex release?

A

Cortisol

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11
Q

What is the effect of cortisol on the body?

A
  1. Regulates proteins, carbs, and lipids to increase blood glucose
  2. Inhibits fibroblast proliferation –> poor wound healing and increased risk of infection
  3. Fight or flight response
  4. Reduces inflammation
  5. Sleep cycle, reproductive cycle, and mental acuity
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12
Q

What are MS signs and symptoms of endocrine disease?

A
  1. Proximal muscle weakness (hip and shoulder girdle)
  2. Hand contractures/ROM deficits
  3. Carpal tunnel (fluid volume) - bilateral
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13
Q

What hormones does the anterior pituitary gland secrete?

A

GH, ACTH, and prolactin

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14
Q

What are the two types of pituitary tumors?

A

Primary and secondary

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15
Q

What are the two kinds of pituitary tumors?

A

Functional - secretes hormones

Non-functional - don’t secrete hormones

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16
Q

What are symptoms of pituitary tumors?

A
  1. Headaches - increase ICP and drainage from 3rd ventricle
  2. Visual disturbances - location near optic chiasm and bilateral temporal hemianopsia
  3. Endocrine abnormalities
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17
Q

What is hyperpituitarism?

A

Oversecretion of at least one hormone

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18
Q

What is the anterior lobe disease related to hyperpituitary GH called?

A

Acromegaly

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19
Q

What is acromegaly?

A

Usually a benign tumor - causes excessive growth, overgrowth of long bones, and malformation of human bones

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20
Q

What population does GH acromegaly affect?

A

Children and adults (30-50 years)

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21
Q

What are symptoms of adult acromegaly?

A

Increased size of jaw bones and hands/feet

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22
Q

How tall can children with GH hyperpituitarism grow?

A

> 7 ft

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23
Q

What is the anterior lobe disease associated with the ACTH called?

A

Cushing’s disease

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24
Q

What is Cushing’s disease?

A

Due to a tumor of the anterior lobe or exposure to glucocorticoids

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25
Q

What sex is Cushing’s disease more prevalent in?

A

Women (5:1)

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26
Q

What age is Cushing’s disease most prevalent?

A

Childbearing years

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27
Q

What are signs of Cushing’s disease?

A

Obesity, glucose intolerance, muscle wasting, osteopenia, buffalo hump, moon face, easy bruising, stretch marks, and acne

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28
Q

What is prolactin important for?

A

Lactation

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29
Q

What are symptoms of anterior lobe prolactin hyperpituitarism?

A

Ceasing of the menstrual cycle (amenorrhea), overproduction of breast tissue (gynecomastia), lactation, decreased libido, and impotence

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30
Q

What are general symptoms of hyperpituitary diseases?

A

Diaphoresis (sweating), milk production, sleep apnea, carpal tunnel, joint pain, and weakness

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31
Q

What is treatment regarding hyperpituiatrism?

A
  1. Benign tumors - surgery or radiation

2. Medication to decrease or stunt hormone production

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32
Q

What is hypopituitarism?

A

Under secretion by anterior lobe (loss of >70%)

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33
Q

What is the etiology of hypopituitarism?

A

Congenital and acquired…

  1. Tumors
  2. Destruction of pituitary by surgery
  3. Postpartum hemorrhage
  4. Anorexia
  5. Anemia
  6. GI dysfunction
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34
Q

What are the effects of GH hypopituitarism?

A

Somatotropin –> decreased growth and delayed puberty

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35
Q

What can LH/FSH hypopituitarism cause?

A

Sexual/reproductive disorders

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36
Q

What are general signs and symptoms of hypopituitarism?

A

Fatigue, muscle weakness, weight loss, poor appetite, joint stiffness, low BP, headaches, ED, irregular menstruation, and delayed growth in children

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37
Q

What is congenital GH deficiency?

A

Normal birth length, but drop off height curve by 1-2 years of age

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38
Q

What are effects of congenital GH deficiency?

A

Normal intelligence, obesity, delayed skeletal maturation, delayed puberty, and being short

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39
Q

What is the treatment for congenital GH deficiency?

A

GH replacement therapy

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40
Q

What is acquired GH deficiency?

A

Tumor or treatment for tumor

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41
Q

What are effects of acquired GH deficiency?

A

Increased cardiac disease, central adiposity, insulin resistance, and poor lipid profile

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42
Q

What does gonadotropin effect?

A

Sexual functions and sex organs

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43
Q

What are effects of gonadotropin hypopituitarism?

A

Amenorrhea, breast atrophy, testicular atrophy, diminished libido, minimal pubic and axillary hair, and low temp, BP, and blood gluscose

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44
Q

What are the tests for hypopituitarism?

A

Serum cortisol, prolactin, thyroxine and TSH, testosterone, and estrogen, LH/FSH, GH, MRI of pituitary, and X-ray of hands in children

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45
Q

What is the treatment for hypopituitary disease?

A

Surgery or hormone replacement therapy

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46
Q

What is a disease associated with the posterior lobe?

A

Diabetes insipidus

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47
Q

What is DI?

A

Caused by damage to the hypothalamus or posterior pituitary – ADH deficiency

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48
Q

What hormone does the posterior pituitary secrete?

A

ADH

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49
Q

What are effects of DI?

A

Kidneys don’t absorb enough water –> diluted urine, dehydration, dizziness, fatigue, and extreme thirst (polydipsia)

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50
Q

What is the treatment for DI?

A

Replacement of ADH with medications

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51
Q

What is SIADH?

A

Syndrome of inappropriate antiduretic hormone secretion - increased secretion of ADH

52
Q

What are causes of SIADH?

A

Infections, trauma, tumor, or medications

53
Q

What are effects of SIADH?

A

Low levels of Na+ (hyponatremia) and electrolytes, increased water retention, lethargy, confusion, weakness, and coma

54
Q

What is the treatment for SIADH?

A

Correct Na+ balance, surgery, chemotherapy, radiation therapy, restriction of fluid intake, and diuretics

55
Q

What are the two hormones secreted by the thyroid?

A

Thyroxine (T4) and triiodothyronine (T3)

56
Q

What are the actions of T3 and T4?

A

Regulates basal metabolism, promotes growth and development, mobilizes fat, and exchange of electrolytes and protein

57
Q

What sex is thyroid disorders more common in?

A

Women

58
Q

What is a risk factor for thyroid disorders?

A

Family history

59
Q

How many body systems are effected by thyroid disorders?

A

MANY

60
Q

What is the disease associated with hyperthyroidism called?

A

Graves’ disease

61
Q

What is Graves’ disease?

A

Autoimmune disease - amounts an attack against the thyroid - increased production of T4

62
Q

What age is effected most by Graves’ disease?

A

20-40 years old (can also occur during pregnancy)

63
Q

What is the etiology of Graves’ disease?

A

Autoantibodies cause enlargement of thyroid and increased secretions which increases body metabolism and SNS activity

64
Q

What are signs of hyperthyroidism?

A

Goiter, heat intolerance, weight loss, sweating, tremor, tachycardia, irritability, poor concentration, diarrhea, mood swings, and eye protrusions (exophthalmos)

65
Q

What other system can be problematic with hyperthyroidism?

A

MS system

67
Q

How is hyperthyroidism diagnosed?

A

Decreased or normal TSH, T3 and T4 elevation, and increased radioactive iodine uptake

68
Q

What is the treatment for hyperthyroidism?

A

Medication, radioactive iodine followed by thyroid medication, and surgery

69
Q

What is the disorder associated with hypothyroidism?

A

Hashimoto’s thyroiditis

70
Q

What are causes for Hashimoto’s thyroiditis?

A
  1. Autoimmune disorder
  2. Surgery that effects the thyroid
  3. Overmedicated for hyperthyroid disease
  4. Diet
  5. Congenital
71
Q

What sex and age is hypothyroidism more prevalent?

A 
Sex = Women 
Population = ages 30-60 years
72
Q

Is congenital hypothyroidism rare?

A

Yes: 1/5000

73
Q

What are effects of congenital hypothyroidism?

A

Cretinism - mental retardation, motor retardation, and delayed puberty

74
Q

What is treatment for congenital hypothyroidism?

A

Thyroid replacement medications

75
Q

What is the pathology of hypothyroidism?

A

Destruction of the thyroid tissue results in decreased secretion of thyroid hormone which causes increased secretion of TSH from the anterior pituitary

76
Q

What are symptoms of hypothyroidism?

A

Slowed metabolism, decreased GI tract mobility, weight gain, bradycardia, slowed neurological functioning, increased cholesterol and triglycerides, and anemia

77
Q

What are the MS effects of hypothyroidism?

A

Proximal hip weakness, myalgia, stiffness, paresthesia, joint edema, increased bone density, and carpal tunnel

78
Q

What are general symptoms of hypothyroidism?

A

Fatigue, dry skin, hair loss, cold intolerance, and hoarse voice

79
Q

How is hypothyroidism diagnosed?

A

Blood test to check hormone levels - TSH elevated, T3 normal, T4 decreased, and CPK-MB elevated

80
Q

What is the treatment for hypothyroidism?

A

Synthetic thyroids

81
Q

What is the prognosis for hypothyroidism?

A

Severe CAD if left untreated - increased triglycerides and cholesterol

82
Q

Is thyroid cancer common?

A

No

83
Q

What sex and population is thyroid cancer more prevalent in?

A 
Sex = women
Population = 20-60 years old
84
Q

What are risk factors for thyroid cancer?

A

Low iodine and radiation exposure

85
Q

What are the two types of thyroid cancer?

A
  1. Papillary carcinoma - one lobe, slow growing, and spread to lymph nodes
  2. Follicular carcinoma - spreads to the lungs and bones
86
Q

What is the treatment of thyroid cancer?

A

Surgery, radioactive iodine, chemotherapy, and radiation

87
Q

What is the prognosis of thyroid cancer?

A

97% 5 year survival rate

88
Q

What hormone does the parathyroid secrete?

A

PTH (parathyroid hormone)

89
Q

What is the effect of PTH on the body?

A

Increases serum calcium and phosphate and reabsorbs from bone, kidneys, and GI tract

90
Q

When is the onset for hyperparathyroidism?

A

After age 60

91
Q

What are the risk factors of hyperparathyroidism?

A

Benign tumor, renal failure, Paget’s disease, multiple myeloma, cancer with bone metastasis, laxative abuse, and vitamin D deficiency

92
Q

What can the risk factors of hyperparathyroidism cause?

A

Hypocalcemia –> triggers parathyroid to increase secretions

93
Q

What are the effects of hyperparathyroidism?

A

Increased osteoclast activity (cause lesions and fractures) and kidney dysfunction (kidney stones)

94
Q

What is the diagnosis for hyperparathyroidism?

A

PTH and electrolyte measurement and x-ray of bones

95
Q

What is the treatment for hyperparathyroidism?

A

Parathyroidectomy and IV hydration to drop calcium levels

96
Q

What are effects of hypoparathyroidism on the body?

A

Increased phosphate, tetany, and decreased bone reabsorption

97
Q

What does hypoparathyroidism result in?

A

Hypocalcemia

98
Q

What are causes of hypoparathyroidism?

A
  1. Iatrogenic - accidental removal during surgery
  2. Hypovolemia and infarction of parathyroid
  3. Scar tissue, tumor, or trauma
99
Q

What are the three system effects of hypoparathyroidism?

A
  1. CNS effects - irritable, anxiety, agitation, confusion
  2. MS effects - increased osteoclast activity, tetany, spasm of respiratory musculature
  3. Cardiac effects - dysrhythmia
100
Q

How is hypoparathyroidism diagnosed?

A

Electrolyte evaluation (low calcium and high phosphate) and decreased PTH

101
Q

What is the treatment for hypoparathyroidism?

A

Tetany (go to emergency), IV calcium, maintain open airway, and medication

102
Q

Can hypoparathyroidism be reversible?

A

Yes, if treated early

103
Q

What is the prognosis for late treatment of hypoparathyroidism?

A

Cataracts, basal ganglia calcification, and death from respiratory involvement

104
Q

What are the MS signs of hyperthyroidism?

A
  1. Periarthritis - decreased ROM and pain
  2. Calcification in joints - limited ROM and “hard end-feel”
  3. Proximal muscle weakness
  4. Decreased coordination
105
Q

What is the function of PTH?

A

Manages calcium levels in the body

106
Q

What does hyperparathyroidism cause?

A

Hypercalcemia

107
Q

What are symptoms of hypercalcemia?

A

Thirst, frequent urination, HTN, heartburn, mental confusion, kidney stones, and joint pain

108
Q

What are the two components of adrenal glands?

A

Outer cortex and inner medulla

109
Q

What are the three things that the adrenal cortex secretes?

A
  1. Mineralocorticoids - aldosterone
  2. Glucocorticoids - cortisol
  3. Sex steroids - testosterone, estrogen, and progesterone
110
Q

What is the function of aldosterone?

A

Reabsorption of sodium and excretion of potassium - REGULATES BP

111
Q

What is the function of cortisol?

A

Food metabolism, response to stress, and decreases inflammation

112
Q

What does the adrenal medulla secrete?

A

Epinephrine

113
Q

What is the function of epinephrine?

A

Increases: HR, heart contractility, BP through vasoconstriction, and blood glucose

114
Q

What is the disease associated with primary adrenal insufficiency?

A

Addison’s disease

115
Q

What sex and population is affected by Addison’s disease?

A 
Sex = both
Age = all
116
Q

What are causes of primary adrenal insufficiency?

A

TB, autoimmune, radiation, neoplasm, and infections

117
Q

What are risk factors of Addison’s disease?

A

Surgery, pregnancy, trauma, and infection

118
Q

What two hormones are dropped in Addison’s disease?

A

Aldosterone and cortisol

119
Q

What are results of decreased aldosterone?

A

Dehydration, hypotension, increased workload on the heart, and poor coordination

120
Q

What are results of decreased cortisol?

A

Hypoglycemia, weakness, hypotension, nausea, emotional lability, paranoia, and increase in skin pigmentation

121
Q

What is the diagnosis for Addison’s disease?

A

Test cortisol levels

122
Q

What is the treatment for Addison’s disease?

A

Corticosteroids - replace cortisol via pill or IV form

123
Q

What is the prognosis of Addison’s disease?

A

If untreated, fatal

124
Q

What are causes for secondary adrenal insufficiency?

A

Tumors in hypothalamus or pituitary gland and rapid taper of corticosteroids

125
Q

What are the symptoms of secondary adrenal insufficiency?

A

Arthralgia and myalgia

126
Q

What is the treatment of secondary adrenal insufficiency?

A

Replacement of ACTH and managing fluid/electrolyte balances

127
Q

What is a disease associated with secondary adrenal insufficiencies?

A

Cushing’s syndrome

128
Q

What does Cushing’s syndrome result from?

A

Tumor of adrenal gland and high dose steroid treatments

Pathophysiology - Test 3 (2 decks)

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