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Marie- NUR 280 > Hormonal Regulation > Flashcards

Hormonal Regulation Flashcards

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1
Q

hypothalamus

A
  • secretes a releasing factor that stimulates the pituitary gland
  • sits right on top of the pituitary gland, connected by a stalk
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2
Q

pituitary gland

A
  • master gland
  • releases tropic hormones that target a specific endocrine organ
  • the target organ secretes a hormone that acts on the body
  • pea sized organ located in the center of the brain
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3
Q

what does too much of growth hormone result in (in children)

A

gigantism

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4
Q

too much growth hormone in adults results in

A

acromegaly

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5
Q

Growth hormone is secreted by

A

anterior pituitary

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6
Q

adrenocorticotropic hormone

A
  • secreted by anterior pituitary
  • goes to adrenal glands
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7
Q

thyroid stimulating hormone

A
  • secreted by anterior pituitary
  • to thyroid
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8
Q

posterior pituitary stores and releases

A
  • oxytocin
  • antidiuretic hormone (ADH): tells kidneys not to diurese
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9
Q

end organ

A
  • bones
  • adrenal cortex
  • adrenal medulla
  • thyroid
  • parathyroid
  • testes/ovaries
  • mammary glands
  • uterus
  • kidneys
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10
Q

primary disorder

A

problem with the end organ

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11
Q

secondary disorder

A

problem with the pituitary gland

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12
Q

tertiary disorder

A

dysfunction caused by a hypothalamic origin

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13
Q

hypopituitarism

A
  • secondary dysfunction
  • most concerned about: adrenal glands, thyroid, diabetes insipidus
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14
Q

causes of hypopituitarism

A
  • primary adenoma (benign tumor): MOST COMMON CAUSE
  • pituitary tumor
  • brain surgery
  • radiation of brain tumor
  • congenital tumor
  • trauma, ischemia, and infarction can cause sudden loss of pituitary function
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15
Q

clinical presentation of hypopituitarism

A
  • s/s depend on which hormones are NOT secreted
  • age of onset
  • acute = rapid deterioration of pt
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16
Q

how is hypopituitarism diagnosed

A
  • blood tests to assess hormone levels
  • MRI, CT
  • corticotropin stimulation test (give ACT, cortisol levels should rise
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17
Q

tx for hypopituitarism

A
  • giving hormones that pt needs
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18
Q

diabetes insipidus

A
  • posterior pituitary malfunctioning
  • lack of ADH or response to ADH
  • kidneys are not told to diurese
  • dilute, large volumes of urine
  • plasma concentration increases
  • central = pituitary not working
  • nephrogenic = kidneys not working
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19
Q

clinical presentation of diabetes insipidus

A
  • frequent urination
  • thirst
  • dehydration
  • disorientation
  • seizures
  • hypovolemia
  • hyponatremia
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20
Q

how is diabetes insipidus diagnosed

A
  • differentiate from other causes of polyuria
  • blood glucose testing
  • urine analysis for glucose
  • specific gravity
  • osmolality
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21
Q

tx for diabetes insipidus

A
  • administration of desmopressin or synthetic vasopressin
  • surgical tx if caused by tumor
  • ADH administration
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22
Q

most common cause of hyperpituitarism

A

pituitary adenoma (prolactinoma)

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23
Q

clinical presentation of hyperpituitarism

A
  • acromegaly in adults
  • gigantism in kids
  • large tumors may cause headaches and visual disturbances bc of proximity to optic nerve
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24
Q

how is hyperpituitarism diagnosed

A
  • high serum levels of tropic hormones, particularly GH and PRL
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25
treatment for hyperpituitarism
depends on elevated hormones
26
syndrome of inappropriate antidiuretic hormone
- common in patients who sustain brain injury - hyponatremia - hypo-osmolality of blood causes excess water reabsorption into the bloodstream creating hypovolemia, dilutional natremia
27
clinical presentation of SIADH
- hypertension - edema - fluid retention - concentrated urine - dilute plasma - hypervolemia
28
how is SIADH diagnosed
- elevated urine osmolality - slow correction of hyponatremia - ADH receptor antagonists may be used - meds to diurese
29
tx for SIADH
- fluid restriction - slow correction of hyponatremia - ADH receptor antagonists may be used - meds to diurese
30
what is goiter and what causes it
- enlargement of thyroid - caused by excess TSH - low iodine levels - goitrogens - foods or meds
31
causes of hypothyroidism aka Hashimoto's thyroiditis
- drugs - genetics - cretinism
32
clinical presentation of hypothyroidism
- weight gain - lethargy - cold feeling - hair loss - hyperlipidemia
33
how is hypothyroidism diagnosed
- Primary: high TSH, low free T3, low free T4 - Secondary: low TSH, low free T3, low free T4
34
how is hypothyroidism treated
- replacement therapy with levothyroxine (synthetic T4) - surgical intervention if necessary
35
hyperthyroidism- Grave's disease causes
- autoimmune stimulation of the thyroid gland
36
clinical presentation of hyperthyroidism
- weight loss - feeling warm - tachycardia - anxiety - exophthalmos (eyes pushing forward)
37
how is hyperthyroidism diagnosed
- TSH level low - high T3 and T4 - ultrasound radioactive iodine scanning
38
treatment for hyperthyroidism
- anti thyroid hormone (propylthiouracil PTU)
39
what is thyroid storm
- life threatening condition - intense, overwhelming release of thyroid hormones - MEDICAL EMERGENCY - heart failure and pulmonary edema can develop rapidly and cause death
40
s/s of thyroid storm
- high fever - tachycardia (170s and up - agitation - psychosis
41
hypoparathyroidism causes
- RARE - inadvertent damage with thyroid surgery - genetic disorders
42
hypoparathyroidism clinical presentation
- r/t decrease in serum calcium levels - muscle cramps - irritability - tetany - convulsions - positive Trousseau's sign - positive Chvostek's sign
43
how is hypoparathyroidism diagnosed
by seeing what PTH levels are in blood
44
hypoparathyroidism treatment
- replace TPH - normalize serum calcium and Vitamin D levels - educate that medications need to be taken consistently
45
hyperparathyroidism causes
- usually due to parathyroid adenoma
46
clinical presentation of hyperparathyroidism
- hypercalcemia - neuropathies - kidney stones - osteopenia - pathological fractures
47
treatment for hypothyroidism
- replacement therapy with levothyroxine (synthetic T4) - surgical intervention if necessary
48
causes of hyperthyroidism
- Graves disease - autoimmune stimulant of the thyroid gland
49
clinical presentation of hyperthyroidism
- weight loss - anxiety - exophthalmos - feeling warm - TACHYCARDIA (concerned about cardiac issues)
50
how is hyperthyroidism diagnosed
- TSH low, high T3 and T4 - ultrasound radioactive iodine scanning - primary: low TSH, high T3 and T4 - secondary: high TSH, high T3 and T4
51
treatment for hyperthyroidism
- antithyroid hormone: propylthiouracil (PTU)
52
what is thyroid storm
- LIFE THREATENING CONDITION - intense, overwhelming release of thyroid hormones
53
s/s thyroid storm
- high fever - tachycardia (170s and up) - agitation - psychosis - it is a MEDICAL EMERGENCY - heart failure and pulmonary edema can develop rapidly and cause death
54
causes of hypoparathyroidism
- rare - inadvertent damage with thyroid surgery - genetic disorders
55
clinical presentation of hypoparathyroidism
- r/t decrease in serum calcium levels (hypocalcemia) - muscle cramps - irritability - tetany - convulsions - positive Trousseau's sign - positive Chvostek's sign
56
how is hypoparathyroidism diagnosed
- seeing what PTH levels are in blood
57
treatment for hypoparathyroidism
- replace TPH - normalize serum calcium and Vitamin D levels - educate that medications need to be taken consistently
58
causes of hyperparathyroidism
usually due to parathyroid adenoma
59
clinical presentation of hyperparathyroidism
- hypercalcemia - neuropathies - kidney stones - osteopenia - pathological fractures
60
how is hyperparathyroidism
- blood test - primary: high PTH, high calcium - secondary: high PTH, low calcium
61
treatment for hyperparathyroidism
- reduce elevated serum calcium levels with - diuretics - calcitonin - bisphosphonates - vitamin D - Surgical Intervention if cause by tumor - IV fluids to dilute calcium - any disorder that causes hypocalcemia can induce secondary hyperparathyroidism
62
causes of Addison's disease (hypoadrenalism)
- gradual autoimmune destruction of the adrenal gland leads to decreased cortisol response to stress and reduced cortisol reserves - prolonged glucocorticosteroid use
63
clinical presentation hypoadrenalism
- hypotension - hypoglycemia - tanned appearance - in women: amenorrhea, loss of pubic and axillary hair
64
how is hypoadrenalism diagnosed
- rapid ACTH - abdominal CT - BMP
65
treatment for hypoadrenalism
- daily replacement of glucocorticoid and mineralocorticoid - parenteral steroid coverage in times of major stress, trauma, surgery
66
causes of hypoadrenalism (Cushing's)
- excess corticosteroid use - pituitary adenoma - adrenal neoplasms - ACTH secretion from cancerous tumors
67
clinical presentation hyperadrenalism
- weight gain -weight redistribution to face, trunk and abdomen, moon faces, buffalo hump, striae - easy bruising - poor wound healing - amenorrhea
68
how is hyperadrenalism diagnosed
- MRI - CT - blood tests, salivary levels, and urine levels of cortisol
69
treatment for hyperadrenalism
- surgery to remove adenoma - ketconazole
70
what is pheochromocytoma
caused by adrenal medulla tumor - excessive sympathetic stimulation - presents with HTN, tremors, tachycardia, arrhythmias
71
treatment for pheochromocytoma
surgery to remove tumor
72
cause of multiple endocrine neoplasia
- defective tumor suppressor gene
73
treatment for multiple endocrine neoplasia
surgery to remove tumor
74
cause of pineal gland dysfunction
- excess pressure in blood - produces melatonin with the phases of the light and dark cycle - presents with headache, nausea, vomiting, seizures, memory disturbances, visual changes
75
treatment for pineal gland dysfunction
ventriculoperitoneal shunt to drain CSF fluid

Marie- NUR 280 (12 decks)

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