Notes in thyroid and adrenal hormones part 2

Question 1

Bertha is 71-year old woman who takes daily medication for **Hashimoto thyroiditis. **Although she did her best to run errands for her husband, she tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke her, Bertha’s voice was hoarse, and her words didn’t make sense to him. Her respirations were also shallow and slow. Suspected low thyroid hormone levels where causing the signs, her husband called for an ambulance.

Bertha has _____________

Answer 1

hypothyroidism

Question 2

Hyperthyroidism

Causes
__________________

Answer 2

Grave disease

Question 3

Most of thyroid tumors tend to be nonfunctional and lead to hypothyroidism…sometimes treatment will knock out thyroid hormone and make you take thyroid hormone

Question 4

Hypothyroidism can be caused by autoimmune disorder such a _____________

Answer 4

Hashimoto

Question 5

The most common cause of hyperthyroidism and hypothyroidism is autoimmune

Question 6

_____________can be caused by autoimmune disorder through thyroid stimulating antibodies (TSI)…these antibodies stimulate the thyroid gland binding the receptor and activating it and this is not what we necessarily think about when we think autoimmune but its able to activate the receptor and cause an overproduction of thyroid hormone and it basically think its getting a whole bunch of TSH when instead its getting an autoimmune antibody that isn’t generally around

Answer 6

Hyperthyroidism

Question 7

Manifestations of Hyperthyroidism
___________-end stage,really severe, heat intolerance…can’t cool down, nails breaking

Answer 7

Thyroid storm

Question 8

_________ is something you can measure

Answer 8

Sign

Question 9

__________ is something that is being described

Answer 9

Symptom

Question 10

You measure heart rate, and muscle weakness

Question 11

_________ is found in end stage severe hyperthyroidism.

Answer 11

Thyroid storm

Question 12

_________is found in end stage severe hypothyroidism.

Answer 12

Myxedema coma

Question 13

ACT produced 3 major types of hormones and they are all steroid hormones that released in adrenal gland
The first is aldosterone…mineralcorticosteroids
Cortisol (glucocorticoids)
You need cortisol in a stressful situation

Question 14

Aldosterone
What about if levels are too low? _________, __________, hyperkalemia, metabolic acidosis

Answer 14

hypotension,hyponatremia

Question 15

Cortisol is essential for dangerous situations when the body is under stress

Question 16

Corticotropin releasing hormone goes to ACTH and this will release cortisol out to its target tissues and same negative feedback as we saw with thyroid

Question 17

From cholesterol you make _________ and these conversions will bring us down to these 3 kind of steroid hormones…there are some genetic deficiencies that can exist in some of these which can make hypercortisolism but just know cholesterol is the basis of these…these are steroid like hormones and are lipophilic

Answer 17

progesterone

Question 18

Corticotropin releasing hormone goes to ACTH (Adrenocorticotropic hormone) and this will release cortisol out to its target tissues and same negative feedback as we saw with thyroid

Question 19

Actions of Cortisol
Metabolism of _______,protein, fat, has anti-inflammatory actions

Can have a psychic effect, permissive effect (Don’t have worry about those so much professor stated)

Answer 19

glucose

Question 20

Actions of Cortisol
Metabolism of glucose,protein, fat, has anti-inflammatory actions
One of the main things we see with cortisone shots…has ____________

Answer 20

anti-inflammatory stuff

Question 21

Focus on glucose metabolism, protein metabolism, fat metabolism, and anti-inflammatory action for exam professor stated

Question 22

Cortisol is involved in metabolism and _______________

Answer 22

anti-inflammatory

Question 23

Adrenal Cortisol insufficiency: ACTH levels are elevated because of lack of feedback inhibition…problem is in the adrenal gland the body is trying to compensate and I know I need more cortisol I’m telling the pituitary to release more ACTH and I have high levels of ACTH…its just the adrenal gland isn’t responding and that’s ___________

Answer 23

primary

Question 24

Secondary you don’t have enough ACTH and that can result from pituitary wide…such as hypopituitarism

Question 25

Hypopituitarism is everything is going to be low in this case…we were talking about a nonfunctional pituitary tumor

Question 26

Addison’s disease is an autoimmune disorder

Question 27

___________ caused by pituitary form (pituitary making too much ACTH, adrenal form (the adrenal itself is making too cortisol), ectopic form (something strange or random that is in the pituitary

Answer 27

Cushing syndrome

Question 28

Pituitary tends to be a little bit more common of tumor than an adrenal tumor

Question 29

Glucocorticoid Hormone Excess
______________(back of shoulder is raised higher than expected…telltale sign of Cushing’s), hirsutism (hair growth on a woman), purple striate (purple dots on skin)

Answer 29

Buffalo hump