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Pathophysiology > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

What are 5 functions of the endocrine system?

A
  1. Differentiation of the reproductive and central nervous system fetus
  2. Stimulation of sequential growth and development
  3. Coordination of the male and female reproductive
  4. Maintenance of an optimal internal environment
  5. Initiation of corrective and adaptive responses
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2
Q

The endocrine system is a system of ___

A

Glands

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3
Q

What is the endocrine system stimulated by?

A

-Central Nervous System
-Physiologic state

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4
Q

____ are produced, secreted, and sent to the site of action

A

Hormones

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5
Q

____ are highly specific to each hormone

A

Receptors

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6
Q

____ refers to the “fit” of the receptor and the ligand

A

Specificity

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7
Q

Receptors and ligands are similar to a ___ and ___ mechanism

A

Lock and key

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8
Q

_____ is the strength of the attraction between the ligand and the receptor

A

Affinity

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9
Q

___ ____ is the production of more receptors when more hormone is needed

A

Up-regulation

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10
Q

With down-regulation, less _____ are expressed so there is less protein and less action

A

Receptors

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11
Q

____ is when the presence of one hormone permits or impacts the effectiveness of another hormone (ex: high thyroid hormone makes more receptors for epinephrine)

A

Permissiveness

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12
Q

Hormones are made in one place and released into the ____ where they can travel to a distant cell where they have their action

A

Bloodstream

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13
Q

There are ___ soluble and ____ soluble hormones

A

Water and lipid

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14
Q

Hormone release is controlled via ___ ___

A

Feedback loops

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15
Q

With a ___ feedback loop, hormone release is inhibited by some other action or substance

A

Negative

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16
Q

One example of a negative feedback loop is ____, in which high levels shut off additional production

A

Cortisol

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17
Q

With a ____ feedback loop, something stimulates the release of more hormone

A

Positive

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18
Q

One example of a positive feedback loop is ____ release during breastfeeding; the pituitary releases it and stimulates milk production and so as long as the baby keeps suckling, it will continue to be released

A

Oxytocin

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19
Q

Mechanism of the physiological axis:

A

The hypothalamus stimulates the pituitary gland which stimulates either the thyroid, adrenal, or gonad gland

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20
Q

The ____ links the brain to the endocrine system and the rest of the body

A

Hypothalamus

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21
Q

The hypothalamus is important for ___ ___ ___ function and also provides feedback and produces hormones

A

Autonomic nervous system

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22
Q

____ will stimulate the anterior pituitary gland

A

Neurohormones

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23
Q

The formal endocrine glands include…

A

-Pituitary (anterior and posterior)
-Thyroid
-Adrenals
-Gonads
-Endocrine pancreas

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24
Q

Hormones released by the anterior pituitary (adenohypophysis) include…

A

-ACTH
-TSH
-FSH
-LH
-Prolactin
-Growth hormone
-Melanocyte-stimulating hormone
-Lipotropin
-Endorphins

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25
Q

Hormones released by the posterior pituitary (neurohypophysis) gland:

A

-Oxytocin
-Arginine
-Vasopressin

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26
Q

Hormones released by the thyroid gland:

A

-Thyroxine (T4)
-Triiodothyronine (T3)

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27
Q

Mechanism of the hypothalamus-pituitary-thyroid (HPA) axis:

A

-The hypothalamus secretes TRH
-TRH stimulates TSH production and release
-TSH stimulates T3 and T4

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28
Q

Thyroxine (T4) makes up ___% of circulating hormone and will be converted to T3

A

90

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29
Q

Triiodothyronine (T3) is ___ ___

A

Biologically active

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30
Q

___% of triiodothyronine (T3) is released from the endocrine gland, and the remaining is converted from T4 in the periphery

A

15%

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31
Q

What are 4 functions of the thyroid hormone?

A
  1. Increases cellular metabolism
  2. Increases blood pressure maintenance
  3. Some growth functions (skeletal)
  4. Temperature maintenance (primarily increases)
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32
Q

Adrenal glands are located above the ___ on either side

A

Kidneys

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33
Q

Adrenal glands get stimulus from the ____

A

Pituitary

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34
Q

The adrenal glands are a very ____ structure

A

Vascular

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35
Q

The adrenal gland is broken up into different ____ that make different hormones

A

Zones

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36
Q

The ____ is the outer layer of the adrenal gland

A

Cortex

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37
Q

The cortex of the adrenal gland contains the ___ ____, which is the outermost layer

A

Zona glomerulosa

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38
Q

The zona glomerulosa produces mineralocorticoides like ____

A

Aldosterone

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39
Q

The cortex also contains the ___ ____ (one layer in from the glomerulosa)

A

Zona fasiculata

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40
Q

The zona fasiculata produces things like ____, which helps with low blood pressure and also regulates the autonomic nervous system

A

Cortisol

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41
Q

The ___ ___ is the next innermost layer

A

Zona reticularis

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42
Q

The zona reticularis produces ___ ___

A

Androgenous steroids (sex hormones)

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43
Q

____ are produced in the medulla

A

Catecholamines

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44
Q

The ___ axis functions in the production of cortisol

A

HPA

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45
Q

Gonads are very important for ___ ___

A

Reproductive function

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46
Q

In the HPA axis, the hypothalamus is ____, the pituitary is ____ and the thyroid, adrenal, and gonal are ____

A

Tertiary, secondary, primary

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47
Q

Syndrome of ____ ___ ____ causes increased secretion of the hormone which leads to excess water retention which leads to hyponatremia and hypervolemia

A

Inappropriate antidiuretic hormone

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48
Q

Syndrome of inappropriate antidiuretic hormone is caused by ____ ____ dysfunction

A

Posterior pituitary

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49
Q

Syndrome of inappropriate antidiuretic hormone can be caused by…

A

-Tumors
-Head trauma
-Medications

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50
Q

____ ___ is caused by decreased posterior pituitary function

A

Diabetes Insipidus

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51
Q

What are the two types of diabetes insipidus?

A

-Neurological DI
-Nephrogenic DI

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52
Q

Neurological diabetes insipidus can be seen in people with high ____ consumption

A

Alcohol

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53
Q

Nephrogenic diabetes insipidus can be caused by poor binding of receptors and this can be seen with ___ ___

A

Renal transplant

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54
Q

With diabetes insipidus, people don’t have enough ___ ___ ____ which leads to too much water being excreted, highly concentrated blood, and hypernatremia

A

Antidiuretic hormone

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55
Q

What hormones are produced by the anterior pituitary gland?

A

-ACTH
-TSH
-FSH
-LH
-Prolactin
-Growth hormone
-

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56
Q

With ____, there is too much production of thyroid hormones which ramps up the metabolic rate and oxygen consumption

A

Hyperthyroidism

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57
Q

What are some possible causes of hyperthyroidism?

A

-Graves disease (autoimmune disorder)
-Adenoma (benign tumor of the gland)
-Thyroiditis (inflammation of the thyroid gland)
-Overtreatment of hypothyroidism
-Sudden discontinuation of antithyroid meds
-Iodine overload

58
Q

What are some manifestations of hyperthyroidism?

A

-Tachycardia
-High sweat output
-Increased growth and development
-Anxiety
-Heat intolerance
-Diarrhea
-Bulging eyes
-Goiter
-Dyspnea
-Weight loss

59
Q

A hyperthyroid crisis, also known as a ___ ___, can be caused by pre-existing hypersecretion, stress, or increased catecholamine receptors

A

Thyroid storm

60
Q

A thyroid storm causes sudden onset of ____ symptoms

A

Hyperthyroid

61
Q

With ____, there is not enough production of thyroid hormone

A

Hypothyroidism

62
Q

What are some possible causes of hypothyroidism?

A

-Surgical removal of the gland
-Tertiary disorders of the hypothalamus
-Secondary disorders of the pituitary
-Primary disorders of the thyroid gland
-Hashimoto’s
-Pituitary radiation or removal

63
Q

Manifestations of hypothyroidism include…

A

-Bradycardia
-Lethargy
-Decreased level of consciousness
-Coma
-Hypothermia
-Hypoventilation
-Decreased GI motility
-Constipation
-Weight gain

64
Q

____ ____ is a primary disorder of the thyroid gland

A

Myxedema coma

65
Q

Myxedema coma can be caused by ____ with pre-existing hypothyroidism (low-level hypothyroidism, commonly undiagnosed)

A

Stress

66
Q

What are manifestations of myxedema coma?

A

-Extreme hypothyroid state
-Lowered metabolic rate (severe)
-Altered mental status
-Hypothermia
-Hypoglycemia
-Hypotension
-Hyponatremia
-Bradycardia
-Hypoventilation

67
Q

Interstitial accumulation of _____ may cause myxedema

A

Mucopolysaccharide

68
Q

____ ____ ____ is an adaptive response

A

Sick euthyroid syndrome

69
Q

With sick euthyroid syndrome, rather than ___ being converted to ___, it is converted to ___

A

T4 to T3; rT3

70
Q

rT3 is identical to T3 except flipped in conformation which makes it ___ ___

A

Biologically inactive

71
Q

In hospitalized patients, we often see low ___ but high ___ because there is less metabolic driving hormone which explains why we rent and heal while we are sick

A

T3; rT3

72
Q

With sick euthyroid syndrome, we see ____ levels of thyroid stimulating hormone

A

Normal

73
Q

What can stimulate sick euthyroid syndrome?

A

-Fasting
-Sepsis
-Trauma
-Burns
-Cardiopulmonary bypass
-Malignancy
-Heart failure
-Myocardial infarction
-Hypothermia
-Chronic renal failure
-Cirrhosis
-Diabetic ketoacidosis

74
Q

What are two adrenal hormones produced by the pituitary?

A

-Cortisol
-Aldosterone

75
Q

Adrenal insufficiency is also known as ___ ___

A

Addison’s Disease

76
Q

Addison’s Disease causes sudden and severe drop in ___ ___

A

Hormone levels (aldosterone and cortisol)

77
Q

Many times, Addison’s Disease goes ____ until it is far gone and severe

A

Undetected

78
Q

Possible causes of Addison’s Disease (adrenal insufficiency) include…

A

-Decompensation in patients with chronic adrenal insufficiency
-Destruction of the adrenal glands
-Discontinuation of corticosteroid therapy
-Kidney injury
-Genetic disorders
-Pituitary disorders
-Pituitary of Hypothalamus damage
-Infection

79
Q

What are some clinical presentations of Addison’s Disease?

A

-Hypoglycemia
-Hypotension
-Hyponatremia
-Hyperkalemia
-Hyperpigmentation

80
Q

____ causes elevated cortisol levels in the body

A

Hypercortisolism

81
Q

What are two possible causes of hypercortisolism?

A

-Exogenous glucocorticoid ingestion
-Tumors

82
Q

Cushing’s Disease is ____ _____ hypercortisolism

A

Adrenocorticotropic hormone (ACTH) dependent

83
Q

Cushing’s Disease can be caused by…

A

-Pituitary-driven rise in adrenocorticotropic Hormone
-Ectopic adrenocorticotropic hormone release
-Exogenous adrenocorticotropic hormone administration

84
Q

With Cushing’s Disease, increased adrenocorticotropic hormone stimulates increased ____ production

A

Cortisol

85
Q

___ ___ is adrenocorticotropic hormone-independent hypercortisolism

A

Cushing’s Syndrome

86
Q

With Cushing’s Syndrome, the ___ ___ increases cortisol output

A

Adrenal gland

87
Q

With Cushing’s Syndrome, adrenocorticotropic hormone level is often ____

A

Decreased

88
Q

What are some manifestations of hypercortisolism?

A

-Sodium and water retention
-Buffalo hump and back pain
-Osteoporosis
-Cardiac hypertrophy
-Hypertension
-Diabetes
-Polydipsia
-Catabolism
-Moon face/tomato face
-Muscle wasting
-Fat accumulation
-Pendulous abdomen and breasts
-Thin arms and legs
-Thin skin
-Easily bruising

89
Q

___ hyperaldosteronism is due to a problem of the adrenal glands themselves (usually due to a noncancerous tumor of the adrenal gland)

A

Primary

90
Q

____ hyperaldosteronism is due to a problem somewhere else in the body that causes the adrenal glands to release too much aldosterone

A

Secondary

91
Q

Hyperaldosteronism causes alterations in ___ and ____ balance

A

Fluid and electrolyte

92
Q

Secondary hyperaldosteronism occurs due to excessive activation of the ___-___-___ system due to a tumor, renal artery stenosis, or edematous disorders like heart failure, pregnancy, cor pulmonale, or cirrhosis with ascites

A

Renin-angiotensin-aldosteronism

93
Q

What are some manifestations of hyperaldosteronism?

A

-Hypertension
-Edema
-Hypernatremia
-Hypokalemia

94
Q

____ is a unique disorder of the adrenal gland

A

Pheochromocytoma

95
Q

Pheochromocytoma causes an excess of _____ production

A

Catecholamine

96
Q

Pheochromocytoma is caused by ____

A

Tumors

97
Q

Manifestations of pheochromocytoma:

A

-Hypertension
-Headache
-Diaphoresis
-Palpitations
-Tachycardia
-Anxiety and emotional lability
-Weight loss

98
Q

Diabetes is heavily influenced by the ____

A

Pancreas

99
Q

The pancreas produces enzymes for ____ as well as pancreatic enzymes

A

Digestion

100
Q

____ is released from the pancreas in response to increased protein and glucose in the blood, usually due to the absorption of food

A

Insulin

101
Q

4 steps of endocrine glucose management:

A
  1. Glucose binds to a GLUT1 transporter protein that has its binding site open to the outside of the cell (T1 conformation)
  2. Glucose binding causes the GLUT1 transporter to shirt to its T2 conformation with the binding site open to the inside of the cell
  3. Glucose is released to the interior of the cell, initiating a second conformational change in GLUT1
  4. Loss of bound glucose causes GLUT1 to return to its original T1 conformation, ready for a further transport cycle
102
Q

4 steps of endocrine release of insulin:

A
  1. When the insulin receptor binds insulin, the activated receptor phosphorylates the IRS-1 protein; IRS-1 can lead to recruitment of GRB2, activating the Ras pathway
  2. IRS-1 activates PI 3-kinase, which catalyzes the addition of a phosphate group to the membrane lipid PIP2, thereby converting it to PIP3; PTEN can convert PIP3 back to PIP2.
  3. PIP3 binds a protein kinase called Akt, which is activated by other protein kinases
  4. Akt catalyzes phosphorylation of key proteins, leading to an increase in glycogen synthase activity and recruitment of the glucose transporter, GLUT4, to the membrane
103
Q

Insulin upregulates…

A

-Glucose uptake in muscles and adipose tissue
-Glycolysis
-Glycogen synthesis
-Protein synthesis
-Uptake of ions (especially potassium and phosphate)

104
Q

Insulin downregulates…

A

-Gluconeogenesis
-Glycogenolysis
-Lipolysis
-Ketogenesis
-Proteolysis

105
Q

_____ has the opposite effect of insulin and is released with low blood glucose

A

Glucagon

106
Q

____ is a hormone that regulates a variety of bodily functions by hindering the release of other hormones, the activity of the GI tract, and the rapid reproduction of cells

A

Somatostatin

107
Q

___ ___ is a metabolic disorder when there is either not enough insulin or inadequate response to insulin (or both)

A

Diabetes mellitus

108
Q

____ intolerance is a common condition associated with diabetes mellitus

A

Glucose

109
Q

With type 1 diabetes, the body does not produce insulin due to ___ ___ ___

A

Beta cell destruction

110
Q

Only about ___-__% of diabetics are type 1

A

5-10

111
Q

Individuals with type 1 diabetes are prone to ____

A

Ketoacidosis

112
Q

What are some symptoms of type 1 diabetes?

A

-Ketoacidosis
-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss

113
Q

With thype 2 diabetes, there is a defect in ___ ___ and its’ use in the body

A

Insulin secretion

114
Q

___% of diabetics are type 2

A

90

115
Q

Type 2 diabetes is no longer an ___ onset disorder

A

Adult

116
Q

Type 2 diabetes is ____ diabetes

A

Secondary

117
Q

Type 2 diabetes is associated with…

A

-Poor diet
-Low activity
-Insulin resistance
-Defect in insulin selection so the body doesn’t produce enough or the body can’t respond to it

118
Q

Symptoms of type 2 diabetes:

A

-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss

119
Q

With ___ ___, women who are not diabetic develop diabetes during pregnancy (secondary diabetes)

A

Gestational diabetes

120
Q

Gestational diabetes has features of ___ ___ diabetes

A

Type 2

121
Q

Gestational diabetes occurs in about ___% of pregnancies

A

10

122
Q

___-___% of women who develop gestational diabetes go on to develop type 2 diabetes after birth

A

5-10

123
Q

Symptoms of gestational diabetes:

A

-Elevated blood and urine glucose
-Polyuria
-Polydipsia
-Vision changes
-Irritability
-Weight loss

124
Q

Diabetic ketoacidosis is much more common in type ___ diabetes

A

1

125
Q

Diabetic ketoacidosis is caused by an absolute lack of ___

A

Insulin

126
Q

Precipitating factors of diabetic ketoacidosis:

A

-Infection
-New onset diabetes

127
Q

Physical or emotional ___ can increase risk of diabetic ketoacidosis

A

Stress

128
Q

Pathophysiology of diabetic ketoacidosis:

A

-Increased cortisol
-Lack of insulin
-Increased gluconeogenesis
-Increased fatty acid metabolism

129
Q

Symptoms of diabetic ketoacidosis:

A

-Frequent urination
-Dehydration
-Increased lipolysis
-Sweet-smelling breath
-Altered consciousness
-Coma

130
Q

Hyperosmolar nonketotic state is more common in type ___ diabetes

A

2

131
Q

Hyperosmolar nonketotic state is brought on by ___ ___

A

Physiologic stress

132
Q

Hyperosmolar nonketotic state has a much ____ onset than diabetic ketoacidosis

A

Slower

133
Q

With hyperosmolar nonketotic state, there is reduced ____ uptake at the cellular level, causing higher blood glucose levels

A

Glucose

134
Q

The hyperosmolar nonketotic state causes dumping of ___ and ___ into the blood which causes a hyperglycemia state and dehydrated cells

A

Water and electrolytes

135
Q

With hyperosmolar nonketotic state, blood glucose levels are around 1200 which is much ____ that with diabetic ketoacidosis

A

Higher

136
Q

Symptoms of hyperosmolar nonketotic state:

A

-Dry mouth
-hyperglycemia
-Extreme thirst
-Warm skin without sweat
-Fever
-Confusion
-Vision loss
-Hallucinations

137
Q

____ may occur in diabetics as a response to treatment or not eating (can also happen in people without diabetes)

A

Hypoglycemia

138
Q

Symptoms of hypoglycemia:

A

-Cellular energy failure
-Adrenal gland goes into overdrive and secretes catecholamines
-Increased gluconeogenesis
-Anxiety
-Tachycardia
-Nausea
-Confusion
-Weakness
-Seizures

139
Q

The ____ ____ states that early morning hyperglycemia occurs due to a rebound effect from late-night hypoglycemia

A

Somogyi Phenomenon

140
Q

What are some manifestations of the Somogyi phenomenon?

A

-Nightmares
-Morning headache
-Inconsistent glucose levels (morning glucose level may show the initial hypoglycemia or the rebound hyperglycemia)

Pathophysiology (18 decks)

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