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NUR 280 > Hormonal Regulation > Flashcards

Hormonal Regulation Flashcards

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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
what is the most common cause of hypothyroidism
hashimoto's thyroiditis
26
what is happening in hashimoto's thyroiditis
increased # of lymphocytes antibodies to TSH T3 and T4 cannot be synthesized
27
what are other causes of hypothyroidism
drugs genetics cretinism (physical deformities and learning disabilities d/t poor thyroid fx)
28
s&s of hypothyroidism
wt gain lethargy coldness hair loss hyperlipidemia
29
what do levels look like for primary hypothyroidism
high TSH low free T3 and T4
30
what do levels look like for secondary hypothyroidism
low TSH low free T3 and T4
31
how do you diagnose hashimoto's
anti-Tg and anti-TPO (antibodies)
32
what is the treatment for hypothyroidism
levothyroxine- synthesizes T4
33
what disease is the primary problem with hyperthyroidism
grave's disease
34
what is grave's diease
autoimmune stimulation of thyroid gland excess secretion of T3 and T4 speeds up metabolism
35
s&s of hyperthyroidism
wt loss anxiety exophthalamos (eyes) warmness tachycardia
36
what do the levels look like for primary hyperthyroidism
low TSH high free T3 and T4
37
what do the labs look like for secondary hyperthyroidism
high TSH high free T3 and T4
38
how do we diagnose graves
anti-TPO and thyroid stimulating Ig (antibodies)
39
what is the treatment for hyperthyroidism
antithyroid hormone
40
what is thyrotoxic crisis (thyroid storm)
overwhelming release of thyroid hormones that stimulates metabolism
41
s&s for thyroid storm
high fever tachycardia agitation psychosis
42
what is thyroid storm usually caused by
surgery/trauma
43
what can happen with thyroid storm
MEDICAL EMERGENCY heart failure flash pulmonary edema death
44
what is the parathyroid
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
what causes hypoparathyroidism
damage done from thyroid surgery or genetic disorders
46
what is not being released in hypoparathyroidism
PTH
47
s&s of hypoparathyroidism
hypocalcemia: positive trousseau's and chvostek's sign muscle cramps, tetany convulsion
48
tx for hypoparathyroidism
replacement PTH normalize calcium and vit d levels
49
what is hyperparathyroidism caused by
parathyroid adenoma: produces excess PTH
50
what is primary hyperparathyroidism
elevated PTH and calcium
51
what is secondary hyperparathyroidism
not in parathyroid elevated PTH low/normal calcium disorders that cause hypocalcemia can induce secondary
52
s&s of hyperparathyroidism
excess calcium: neuropathies kidney stones osteopenia pathological fractures
53
tx for hyperparathyroidism
iv fluids to decrease calcium surgery
54
what does the adrenal medulla secrete
epi and norepi
55
what does the cortex of the adrenal gland secrete
glucocorticoids sex hormones ATCH
56
what is primary adrenal insufficiency and what is it also called
adrenal gland does not work addison's disease: autoimmune destruction of adrenal cortex
57
what does prolonged glucocorticoid use do
CRF-ACTH signals to adrenal cortex suppressed adrenal gland down regulates receptors
58
s&s of adrenal insufficiency
hypotension hypoglycemia anorexia tanned appearance d/t MSH women: loss of pubic and axillary hair, amenorrhea (not producing sex hormones)
59
diagnosis of adrenal insufficiency
metabolic pannel rapid ACTH test (determines if it is pituitary or adrenal)
60
tx of adrenal insufficiency
daily replacement of glucocorticoid and mineralocorticoid parenteral steroid coverage in times of major stress, trauma, and surgery
61
what is hyperadrenalism also called
hypercortisolism
62
what are the causes of hyperadrenalism
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
what does excess corticosteroids do
weakens immune system increases bg and fat levels
64
diagnosis of hyperadrenalism
cortisol levels (blood, saliva, urine) dexamethasone suppression test (determine if its pituitary or adrenal) MRI, CT
65
tx for hyperadrenalism
treat adrenal gland/pituitary tumor surgery ketoconazole: inhibits steroidogenesis
66
s&s of hyperadrenalism
redistribution of fat: face, trunk, abdomen moon face striae buffalo hump easy bruising poor wound healing (excess sugar) wt gain (metabolic syndrome)
67
what is pheochromocytoma
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
what is multiple endocrine neoplasia
MEN1 common defector tumor suppressor gene allows tumor growth throughout endocrine system parathyroid, pituitary, and pancreas commonly affected surgery to remove tumor
69
what is pineal gland dysfunciton
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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