Endorine D/O PPt- Josh Flashcards Preview

BioScience II > Endorine D/O PPt- Josh > Flashcards

Flashcards in Endorine D/O PPt- Josh Deck (91):
1

Endocrine System:

5 general fxns

 

  1. Reproduction & CNS development in Fetus
  2. Growth and Development
  3. Reproductive system Coordination
  4. homeostsis of body
  5. adaptive responses when homeostsis is threatened

 

2

Endocrine System:

is a group of glands throughout the body , that synthesize chemical messengers called what?

Hormones

3

Endocrine System:

name 10 glands

  1. Pineal gland
  2. Hypothalamus
  3. Pituitary
  4. Thyroid
  5. Parathyroid
  6. Thymus
  7. Adrenal glands
  8. Pancrease
  9. Ovary
  10. Testis

4

Endocrine System: what Hormomes are released? And what is the function?

Hypothalamus

  • gonadatropin-releasing hormone (GnRH)
  • Oxytocin & ADH formation
  1. hemostasis

5

Endocrine System: what Hormomes are released? And what is the function?

Pineal

  • Melatonin
  • Seratonin
  1. basic needs/ Body Clock

6

Endocrine System: what Hormomes are released? And what is the function?

Pituitary Ant (adenohypophysis)

 

  • TSH
  1. thyroid activity
  • ACTH
  1. Adrenal cortex activity, fats, gylcogen, stress resistance
  • Somatropin
  1. bone growth; fat & sugar levels
  • FSH
  1. Ova & sperm maturation
  • Luteinising (LH)
  1. Corpus Lutem formation; Lactation
  • Interstitial Cell Stimulating (ICSH)
  1. Secretion of testosterone
  • Prolactin
  1. Lactation

7

Endocrine System: what Hormomes are released? And what is the function?

Posterior pituitary

(neurohypophysis)

  • Oxytocin
  1. uterine muscles
  • ADH
  1. Kidney fxn; prevent H2O loss

8

Endocrine System: what Hormomes are released? And what is the function?

thyroid

  • Thyroxine (T4)
  • Tri-iodothyronine (T3)
  1. cellular metabolism
  2. protein breakdown
  3. glucose uptake

9

Endocrine System: what Hormomes are released? And what is the function?

Parathyroid

  • Parathormone
  1. Ca++ balance & utilization
  2. functioning on nervous system

10

Endocrine System: what Hormomes are released? And what is the function?

Thymus

  • Thymosin (blood)
  • Thymopoetine (protein)
  1. Immunity
  2. Neuromuscular activity

11

Endocrine System: what Hormomes are released? And what is the function?

Pancreas

  • Glucagon
  1. rises blood sugar levels
  2. releases glucose into blood
  • Insulin
  1. Lowers blood sugar
  2. converts glucose for uptake

12

Endocrine System: what Hormomes are released? And what is the function?

ovaries

  • Oestrogens
  1. primary & secondary sexual maturity
  • Progesterone
  1. Menstrual flow
  2. fetal development

13

Endocrine System: what Hormomes are released? And what is the function?

testes

  • Tesosterone
  1. Male primary & secondary sexual maturity

14

Endocrine System: what Hormomes are released? And what is the function?

Adrenal cortex

  • Aldosterone
  1. MINERALOCORTICOID regulating Na+ 
  2. K+ Balance
  3. Water regulation
  • Cortisone
  • Cortisol
  • Corticosterone
  1. GLUCOCORTICOIDS maintaining fuel reserve/ reaction to stress/ antiflammatory & tissue repair
  • Androgens & Oestrogens
  1. Reproductive organ fxn
  2. secondary sexual characteristics

15

Endocrine System: what Hormomes are released? And what is the function?

Adrenal medulla

  • Adrenaline (80%)
  • Noradrenaline (20%)
  1. fight or floght

16

Mechanisms of Hormonal Communication:

what are the 3 ways hormones communicate

  • AUTOcrine
  • PARAcrine
  • ENDOcrine

17

Mechanisms of Hormonal Communication:

AUTOcrine?

within cell

18

Mechanisms of Hormonal Communication:

PARAcrine

B/t local cells ( aka just pancreas)

19

Mechanisms of Hormonal Communication:

ENDOcrine

B/t remote cells (AKA ADH and collecting duct of kidney)

20

Regulation of Hormone Release:

what are the 3 mechanisms for regulation of hormone release?

 

  1. Chemical factors (Blood sugar or Ca++ levels)
  2. Endocrine Factors ( hormone from one gland stimulating another)
  3. Neural control

21

what is teh most common type of feedback system in the endocrine system

negative feedback

22

what the fuck is the HPA- axis?

the  Hypothalmic-Pituitary-Adrenal axis

23

Hypothalmic-Pituitary-Adrenal axis (HPA)

what do they release

 

  • Hypothalamus releases CRH to stimulate
  • Anterior pituitary to release ACTH to stimulate
  • adrenal cortex to release CORT (and epi and Norepi)

cool thing is the CORT has a negative feedback loop to re stimulate the hypothalamus

 

24

Hypothalmic-Pituitary-Adrenal axis (HPA)

when does this even kick in?

Stress baby stress

25

Hormone receptors:

what are the 2 different ways the hormones are soluble

  • water
  • lipid

26

Hormone receptors:

what form is usuall free (unbound) in plasma

water soluble

27

Hormone receptors:

what form is usually bound to protein

lipid soluble

28

Hormone receptors:

only what form of hormones can signal a target cell

free

29

Hormone receptors:

water soluble hormones bind w/ receptors where?

In or on the cell membrane

30

Hormone receptors:

steroid hormones are lipid soluble and bind how

diffuse across cell membrane

31

Pancreatitis:

the pancrease in unique b/c of what functions

Both endocrine and exocrine fxns

32

 

what are the pancrease endocrine fxns

secretes

insulin

glucagon

somatostatin

pancreatic polypeptide

33

Pancreas endocrine fxns make up what % of pancreas

1-2%

34

what are the exocrine fxn of pancrease

secretes enzymes and ducts that secrete alkaline fluids w/ digestive fxns

 

AKA digestion

35

what cells of the pancrease are for digestion- these are the cells that secrete the digestive fluids

Acinar

36

exocrine fxn make up what % of pancreas fxn

80-85%

37

what is the inflammation of the pancrease- d/t damage from digestive enzymes that are activated before they are secreted into the duodenum and begin attacking the pancreas

Pancreatitis:

38

Pancreatitis:

what are the 2 types

  1. Chronic
  2. Acute

39

Pancreatitis:

which type is IRREVERSIBLE

Chronic

40

Pancreatitis:

how can acute be reversed

removal of underlying cause

41

Pancreatitis:

what 2 things are responsible for 60-80% of all cases

Gall stones

ETOH

42

Pancreatitis:

what are other causes

  • Meds- Flagyl/tetracycline/ ACEi/ Corticosteroids
  • Infection
  • Trauma
  • Sx -thoracic and Abd & CPB
  • Metabolic D/o- hypercalcemia & hyperlipidemia

43

Pancreatitis:

what is a severe form of acute pancreatitis where necrosis and infectin result

Acute Necrotizing pancreatitis

44

Acute Necrotizing Pancreatitis:

Patho

  • inflammation leads to necrosis
  • Necrotic tissue becomes infected
  • the Acinar cells, ductal tissues, and islets of Langerhans become infected
  • vascular injury leads to massive hemorrhage w/in pancrease

45

Acute Pancreatitis:

patho

  • injury or disruption of Acinar cells permit leakage of pancreatic enzymes
  • Activated proteolases and lipases break tissue and cell membranes down
  • Causing inflammation, edema, vascular damage, hemmorrhage, necrosis, and fibrosis
  •  

46

Acute Pancreatitis:

S/S

Mid epigastric pain that radiates to back

N/V

Fever

Leukocytosis

Ileus

abd pain

acites

tetany (hypoCa++)

tachypenia

Atelectasis

pulmedema

effusion

47

Acute Pancreatitis:

what is teh halmark diagnosis

 

 

elevated serum amylase and lipase

48

Acute Pancreatitis:

which lab is more sensitive and specific for diagnosin AP

Serum Lipase

49


Acute Pancreatitis:

what is a scale for the prediction of severe Acute Pancreatitis:

Ranson's Criteria

50

Acute Pancreatitis:

what opioid is better and why? Morphine or Demerol

Demerol less sphincter of oddi spasm

51

Chronic Pancreatitis:

is irreversible damage caused but what?

  • ETOH
  • Gall stones
  • Autoimmune d/o
  • genetic mutation
  • Smoking
  • Obesity

52

 Pancreatitis: Anesthesia Implications

what do we do for these peps (just name what all you think)

  • Aspiration precautions
  • RSI
  • Glucose monitoring
  • Fluid and electrolyte monitoring
  • Blood products
  • Fluid resuscitation
  • Coags
  • Renal fxn ( >0.5 mL/kg/hr)
  • Pulmonary assessemnt

53

Thyroid:

2 hormones released

  1. T3- tri-idothyronine
  2. T4- Thyroxine

54

Thyroid:

how is T3 formed

  • by the conversion of T4 to T3 @ target cells

55

Thyroid:

which hormone has a higher potency and results in 80% of the metabolic activity?

T3

56

Thyroid:

T3 makes up what % of circulating hormone

10%

(good thing b/c it is way more potent)

57

Thyroid:

what is teh major hormone secreted by the thyroid gland

T4- thyroxine

58

 

Thyroid:

T4-thyroxine makes up what % of ciurculating thyroide hormone

90%

59

regulation of thyroid hormone:

name the 5 steps in its release

  1. HYPOTHALAMUS releases THYROTROPIN-RELEASING HORMONE (TRH)
  2. makes the ANTERIOR PITUITARY release THYROID STIMULATION HORMONE (TSH)
  3. makes the THYROID GLAND release T4 THYROXINE (OR JUST THYROID HORMONES)
  4. goes to target celles and convert to T3 tri-idothyronine
  5. negative feedback to hypothalamus

60

Thyroid:

normal quanities of thyroid hormones depend on what?

exogenous iodine

61

Thyroid:

what is teh best source of exogenous iodine

Diet

62

Thyroid:

what is teh best test of thyroid hormone action at the cellular level

TSH

63

HypoThyroid:

what automimmune disease os assocoated with this

hashimotos's

64

HypoThyroid:

what is a s/s of this ( main sign of extreme condition)

Myxedema

65

HyperThyroid:

what is a main s/s of severe hyperthyroid

exothalmos----big ass eyes

66

Adrenal Disorders:

what are the main adrenal d/o

 

  1. pheochromocytoma
  2. Cushing's
  3. Adrenal insufficiency

67

Adrenal Glands:

are paired pyramid shaped organs, each gland consist of 2 separate portions... what are they

  1. Inner medulla
  2. outer cortex

68

Adrenal Glands:

the inner medulla secretes what?

  • Epi
  • Norepi
  • Dopamine

69

Adrenal Glands:

the outer cortex secretes what?

  • aldosterone
  • mineralocorticoids
  • androgens
  • estrogens
  • glucococorticoids (cortisol)

70

Pheochromocytoma:

they are associated with hyperfunctioning of the what?

 

adrenal medulla

 

71

Pheochromocytoma:

these are tumors of what cells?

chromaffin

72

 

Pheochromocytoma:

since associated with tumors of the chromaffin cells, we should probally know what those cells do.... so what do those cells secrecte?

  • epi
  • nor epii
  • dopamine

(fuck thats not goooood!!) just give them a beta blocker that will fix it.... no don't j/k they will die!!!!!!!!

73

Pheochromocytoma:

s/s

  • HTN ( most freq)
  • H/A
  • sweating
  • pallor
  • palpatations

74

Pheochromocytoma: Pre-op

how long should these peps be alpha blocked

  • undetermined but anywhere from 3 days to 2 or more weeks

75

Pheochromocytoma: Pre-op

it is recomended to stop alpha blockers how long before surgery to avoid vascular unresponsivness immediatly following removal of sx ( some say give a 1/2 dose AM of surgery)

24-48 hours

76

Pheochromocytoma: Pre-op

what are guidelines for sx

 

  • No BP > 160/90 24 hrs preop
  • No orthostatic BP < 80/45
  • No ST segment or T wave abnormalities
  • No marked S/S of catecholamine excess- No more than 1 PVC Q 5 min

77

Pheochromocytoma: Intra-op

Avoid drugs or maneuvers that promotes what?

 

  • catecholamine release

78

Pheochromocytoma: Intra-op

lines

 

CVL

A-line

CVP

+/- PA cath

79

Pheochromocytoma: Intra-op

B/p meds to have

  • Nipride
  • Magnesium
  • Nicardipine
  • Phentolamine
  • Esmolol

80

Pheochromocytoma: Intra-op

prepare for sudden decrease in BP after the tumors blood supply is ligated... so how should you treat this?

  • Volume support
  • DIRECT_ACTING vasopressor -phenylephrine

81

Pheochromocytoma: Intra-op

what can happen to BGL after tumor removal

low- hypoglycemia

82

Pheochromocytoma: Post-op

what is the most common cause of death postop

Hypotension

so give vasopressors- IV fluids

83

Pheochromocytoma: Post-op

d/t hypoglycemia what to ypou want to do

  • BG monitoring 24 hours
  • Dextrose IV fluids

84

Pheochromocytoma: Post-op

where are these pt's transfered to from PACU

ICU for 24 hours

ensure adequate pain control

85

Cushing's Disease:

is a d/o of the ______ or ________

Adrenal cortex

anterior pituitary

86

Cushing's Disease:

is an excess of what?

Glucocorticoid

87

 

Cushing's Disease:

is an excess of what

cortisol

88

Cushing's Disease:

s/s

  • Moon face
  • obese
  • OSA

89

Adrenal Insufficiency:

what d/o is caused by glucocorticoid/ mineralocorticoid deficiency

Addisons disease

90

recap

which one is excesss glucocorticoid/cortisol

 

Cushings

(your fat like a cushin to much cortisol)

91

recap

which one is the deficiency of glucocorticoid/ mineralocorticoid

 

Addisons's

(you need to add some)