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NUR 280 > Hormonal Regulation > Flashcards

Hormonal Regulation Flashcards

1
Q

what is upregulation for receptor activty

A

increase receptors
not getting enough stimulation

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2
Q

what is downregulation

A

overstimulated
they stop responding
decreased number of receptors

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3
Q

what is neoplasia

A

tumor

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4
Q

what hormones does the anterior pituitary make

A

ACTH
GH
TSH
FSH
LH
PRL

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5
Q

what hormones are released by the pituitary but synthesized by the hypothalamus

A

oxytocin
ADH

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6
Q

what is the most common cause of hypopituitarism

A

primary adenoma

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7
Q

what are we concerned about with hypopituitarism

A

adrenal insufficiency
thyroid
diabetes insipidus

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8
Q

what lack of hormone/response is there with DI

A

ADH

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9
Q

what part of the pituitary causes DI

A

posterior

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10
Q

what is happening in DI

A

dilute urine
increase in plasma concentration (high electrolytes, hypernatremic, hypovolemic)

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11
Q

what is the most common cause of hyperpituitarism

A

pituitary adenoma (prolactinoma- self secretes prolactin)

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12
Q

what is PRL

A

sex hormone

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13
Q

s&s for hyperpituitarism

A

headaches and visual disturbances

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14
Q

symptoms of DI

A

frequent urination
thirst
dehydration
disorientation
seizures

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15
Q

diagnosis for DI

A

glucose testing (urine and blood)
specific gravity
osmolality
sodium

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16
Q

tx for DI

A

give ADH

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17
Q

diagnosis for hyperpituitarism

A

hormone levels (blood and urine)
dexamethasone suppression test

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18
Q

what hormone is excessive in SIADH

A

ADH

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19
Q

what are the causes of SIADH

A

brain injury
neurosurgery
neoplasms in brain

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20
Q

what is happening in SIADH

A

fluid volume overload (hypervolemia)
concentrated urine (polyuria)
dilute plasma

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21
Q

tx for SIADH

A

fluid restriction
slow correction of hyponatremia
ADH receptor agonists to block receptors in kidneys

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22
Q

what is required for synthesis of T3 and T4

A

iodine

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23
Q

what is an enlargement of the thyroid called

A

goiter

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24
Q

how do goiters develop

A

excess TSH
low iodine
goitrogens- foods/meds that interfere w/ thyroid

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25
Q

what is the most common cause of hypothyroidism

A

hashimoto’s thyroiditis

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26
Q

what is happening in hashimoto’s thyroiditis

A

increased # of lymphocytes
antibodies to TSH
T3 and T4 cannot be synthesized

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27
Q

what are other causes of hypothyroidism

A

drugs
genetics
cretinism (physical deformities and learning disabilities d/t poor thyroid fx)

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28
Q

s&s of hypothyroidism

A

wt gain
lethargy
coldness
hair loss
hyperlipidemia

29
Q

what do levels look like for primary hypothyroidism

A

high TSH
low free T3 and T4

30
Q

what do levels look like for secondary hypothyroidism

A

low TSH
low free T3 and T4

31
Q

how do you diagnose hashimoto’s

A

anti-Tg and anti-TPO (antibodies)

32
Q

what is the treatment for hypothyroidism

A

levothyroxine- synthesizes T4

33
Q

what disease is the primary problem with hyperthyroidism

A

grave’s disease

34
Q

what is grave’s diease

A

autoimmune stimulation of thyroid gland
excess secretion of T3 and T4
speeds up metabolism

35
Q

s&s of hyperthyroidism

A

wt loss
anxiety
exophthalamos (eyes)
warmness
tachycardia

36
Q

what do the levels look like for primary hyperthyroidism

A

low TSH
high free T3 and T4

37
Q

what do the labs look like for secondary hyperthyroidism

A

high TSH
high free T3 and T4

38
Q

how do we diagnose graves

A

anti-TPO and thyroid stimulating Ig (antibodies)

39
Q

what is the treatment for hyperthyroidism

A

antithyroid hormone

40
Q

what is thyrotoxic crisis (thyroid storm)

A

overwhelming release of thyroid hormones that stimulates metabolism

41
Q

s&s for thyroid storm

A

high fever
tachycardia
agitation
psychosis

42
Q

what is thyroid storm usually caused by

A

surgery/trauma

43
Q

what can happen with thyroid storm

A

MEDICAL EMERGENCY
heart failure
flash pulmonary edema
death

44
Q

what is the parathyroid

A

4 pea-sized glands w/in thyroid
produces PTH (promotes calcium reabsorption in renal tubules and release of calcium from bone)
promotes vit D production by kidney (needed for calcium absorption)

45
Q

what causes hypoparathyroidism

A

damage done from thyroid surgery or genetic disorders

46
Q

what is not being released in hypoparathyroidism

A

PTH

47
Q

s&s of hypoparathyroidism

A

hypocalcemia:
positive trousseau’s and chvostek’s sign
muscle cramps, tetany
convulsion

48
Q

tx for hypoparathyroidism

A

replacement PTH
normalize calcium and vit d levels

49
Q

what is hyperparathyroidism caused by

A

parathyroid adenoma: produces excess PTH

50
Q

what is primary hyperparathyroidism

A

elevated PTH and calcium

51
Q

what is secondary hyperparathyroidism

A

not in parathyroid
elevated PTH
low/normal calcium
disorders that cause hypocalcemia can induce secondary

52
Q

s&s of hyperparathyroidism

A

excess calcium:
neuropathies
kidney stones
osteopenia
pathological fractures

53
Q

tx for hyperparathyroidism

A

iv fluids to decrease calcium
surgery

54
Q

what does the adrenal medulla secrete

A

epi and norepi

55
Q

what does the cortex of the adrenal gland secrete

A

glucocorticoids
sex hormones
ATCH

56
Q

what is primary adrenal insufficiency and what is it also called

A

adrenal gland does not work
addison’s disease: autoimmune destruction of adrenal cortex

57
Q

what does prolonged glucocorticoid use do

A

CRF-ACTH signals to adrenal cortex suppressed
adrenal gland down regulates receptors

58
Q

s&s of adrenal insufficiency

A

hypotension
hypoglycemia
anorexia
tanned appearance d/t MSH
women: loss of pubic and axillary hair, amenorrhea (not producing sex hormones)

59
Q

diagnosis of adrenal insufficiency

A

metabolic pannel
rapid ACTH test (determines if it is pituitary or adrenal)

60
Q

tx of adrenal insufficiency

A

daily replacement of glucocorticoid and mineralocorticoid
parenteral steroid coverage in times of major stress, trauma, and surgery

61
Q

what is hyperadrenalism also called

A

hypercortisolism

62
Q

what are the causes of hyperadrenalism

A

cushing’s disease- pituitary (increase in ATCH)
cushing’s syndrome- adrenal (increase in cortisol)
pituitary adenoma
adrenal neoplasms
ACTH secretion from cancerous tumors
exogenous corticosteroids

63
Q

what does excess corticosteroids do

A

weakens immune system
increases bg and fat levels

64
Q

diagnosis of hyperadrenalism

A

cortisol levels (blood, saliva, urine)
dexamethasone suppression test (determine if its pituitary or adrenal)
MRI, CT

65
Q

tx for hyperadrenalism

A

treat adrenal gland/pituitary tumor
surgery
ketoconazole: inhibits steroidogenesis

66
Q

s&s of hyperadrenalism

A

redistribution of fat: face, trunk, abdomen
moon face
striae
buffalo hump
easy bruising
poor wound healing (excess sugar)
wt gain (metabolic syndrome)

67
Q

what is pheochromocytoma

A

adrenal medulla tumor
secretes norepi and epi
excessive sympathetic stimulation
HTN, tremors, increased cardiac contractility, cardiac arrhythmias, tachycardia
24-hr urine for catecolamine metabolites
surgery to remove tumor

68
Q

what is multiple endocrine neoplasia

A

MEN1 common
defector tumor suppressor gene
allows tumor growth throughout endocrine system
parathyroid, pituitary, and pancreas commonly affected
surgery to remove tumor

69
Q

what is pineal gland dysfunciton

A

produces melatonin
tumor blocks pineal gland
blocks CSF flow
headache, nausea, vomiting, seizures, increased IC pressure, memory disturbances, visual changes
treatment: ventriculoperitoneal shunt- tube that drains CSF

NUR 280 (7 decks)

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