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dmd 5248 > Pancreas/Adrenal Hormones and Endocrine Pathology > Flashcards

Pancreas/Adrenal Hormones and Endocrine Pathology Flashcards

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1
Q

What are the subdivisions of the adrenal glands

A

cortex and medulla

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2
Q

what are the functions of the adrenal cortex

A 
store lipids (cholesterol and fatty acids)
maufacture steroid hormones (corticosteroids)
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3
Q

what are the functions of the adrenal medulla

A

production of epinephrine and norepineprhine

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4
Q

what are the divisions of the adrenal cortex, and what do they produce

A 
zona glomerulosa (mineralocorticoids-aldosterone)
zona fasciculata (glucocorticoids-cortisol)
zona reticularis (androgens)
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5
Q

what is the function of aldosterone, and what causes it secretion

A

stimulates conservation of sodium and elimination of potassium.
it is stimulated by low Na in blood (or high K), low blood volume, and low bp

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6
Q

what are the actions of glucocorticoids

A

they accelerate glucose

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7
Q

what are the hormones of the adrenal medulla

A

epinephrine and norepinephrine

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8
Q

what are the actions of epinephrine and norepinephrine

A

mobilization of muscular glycogen and breakdown of glucose for ATP
fats are broken down into fatty acids - ATP production
glycogen breakdown in liver
increased heart rate and contractility

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9
Q

What are the characteristics of the exocrine pancreas

A

clusters of pancreatic acini and ducts that take up almost all of the pancreas and secrete alkaline into the digestive tract

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10
Q

What are the characteristics of the endocrine pancreas

A

cell clusters called pancreatic islets (islets of langerhans) with alpha, beta, delta, and F cells

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11
Q

What are the 4 types of cells in pancreatic islets, and what are their secretions

A

alpha cells - glucagon
beta cells - insulin
delta cells - hormone similar to GH-IH
F cells - pancreatic polypeptide

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12
Q

what does GH do in children and adults

A

children - muscle and skeletal development

adults - maintain blood glucose, mobilizes lipid reserves

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13
Q

what is the general adaptation syndrome (GAS)

A

the hormonal stress response

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14
Q

what are the phases of the general adaptation syndrome

A

alarm phase
resistance phase
exhaustion phase

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15
Q

what are the characteristics of the alarm phase of GAS

A

increased catacholamines from the adrenal medulla due to stress =

  • increased mental alertness
  • increased energy use by cells
  • mobilization of glycogen and lipid reserves
  • changes in circulation
  • sweating
  • increased heart rate
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16
Q

what are the characteristics of the resistance phase of GAS

A

increase in GH, glucagon, cortisol, aldosterone, renin due to stress

  • mobilization of remaining lipids and protein (break down of tissues)
  • elevation of blood glucose
  • conservation of Na and water
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17
Q

What are the charateristics of the exhaustion phase of GAS

A
  • lipid reserves exhausted
  • damage to organs
  • inability to produce glucoccorticoids
  • failure to balance electrolytes
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18
Q

what are the three classifications of endocrine pathologies

A

primary, secondary, and tertiary problems

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19
Q

what are primary, secondary, and tertiary problems of the endocrine system

A 
primary = issue is with the final gland
secondary = issue is with the pituitary gland
tertiary = issue is with the hypothalamus
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20
Q

how does ADH work

A

it places aquaporins into the collecting duct = water reabsorption

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21
Q

how is hypersecretion of ADH diagnosed

A

normal adrenal and tyroid function, water retention, hyponatremia (low Na), and hypoosmolarity

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22
Q

what causes ADH hypersecretion

A

ectopic production of ADH
surgery (stress)
drugs
cranial abnormalities

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23
Q

how is ADH hypersecretion treated

A

water restriction, removal of ADH producing tumor, ADH receptor blockers

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24
Q

What is hyposecretion of ADH called

A

diabetes insipidus (polyuria, and polydipsia - thirst) dilute urine, dehydration

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25
what are the three types of diabetes insipidus
neurogenic - insufficient ADH nephrogenic - insufficient ADH response Psychogenic - drinking too much water
26
how do you clinically differentiate between the three types of diabetes insipidus
1. restrict water if urine osmolarity increases = PSYCHOGENIC 2. if it doesnt increase give them ADH 3. If urine osmolarity increases = NEUROGENIC 4. if it doesn't increase = Nephrogenic
27
what are the treatments for the different types of diabetes insipidus
``` neurogenic = supplement ADH nephrogenic = drink a lot and eat NaCl psychogenic = water restriction ```
28
what causes oxytocin release
cervix stretching, breast stimulation, baby crying, stress
29
what is the problem with low oxytocin, and high oxytocin
hyposecretion = lack of milk, long labor, lack of compassion/bonding hypersecretion - galactorrhea
30
what happens to the anterior pituitary hormones when the hypothalamus isn't working
all pituitary hormones decrease, except prolactin, which increases because PIF (inhibits prolactin) isn't secreted
31
if you have low levels of anterior pituitary hormones how do you determine if that is due to hypothalamic or anterior pituitary issues
1. take a blood sample of hormones 2. give them some hypothalamic releasing factor 3. take another blood sample 4. if the hypothalamic releasing factor increased the hormone levels then it is a hypothalamus problem, if it didn't then its a pituitary problem
32
what is pan hypopituitarism, and what causes it
when all of the anterior pituitary hormones are deficient, it it caused by non specific damage to the pituitary
33
what are the two causes of hypopituitarism
``` pituitary infarction (hemorrage in the brain) empty sella syndrome ```
34
what are the 4 causes of hyperpituitarism
benign pituitary adenoma destruction of an end organ hypothalamic disorder carcinoma
35
what is the most common hormone to be hyper expressed by the pituitary gladn
PRL
36
what effect does a pituitary tumor have on the visual field
as the tumor grows it increases the blind spot in each eye
37
what are the initial symptoms of a hyperpituitarism caused by a tumor
visual defect headache occulomotor palsies
38
What stimulates, and inhibits prolactin release from the ant. pit.
stimulated by - TRH and Oxytocin (from hypothalamus) - stress, high estrogen, ovulation, suckling Inhibited by - somatostatin and dopamine (PRL causes this - feedback) - estrogen and progesterone (pregnancy)
39
what are the actions of PRL
proliferation of mammary tissue sythesis milk proteins calcium mobilization stimulates immune system
40
what are the effects of hypersecretion of PRL
``` females - amenorrhea - galactorrhea - hirsutism - osteopenia males - hypogonadism - impaired libido - infertility - gynecomastia - galactorrhea ```
41
what is the main treatment for PRL hypersecretion
dopamine agonists
42
what is the problem with low PRL
poor milk production | decreased immune function
43
What stimulates and inhibits the secretion of GH
``` stimulated by - GHRH - Ghrelin (from stomach) - estrogen and testosterone inhibited by - somatostatin (- feedback of GH on hypothalamus) - IGF (somatomedins) ```
44
what are the actions of GH
``` stimulate IGF production growth of long bones (with IGF) increase protein AA incorporation (with IGF) inhibit protein breakdown (with IGF) increase lipolysis (with IGF) inhibits hepatic glucose uptake stimulates the immune system ```
45
hypersecretion of GH =
gigantism | acromegaly
46
how is hypersecretion of GH treated
somatostatin analogs
47
What stimulates and inhibits the release of TSH
``` stimulated by - TRH - Cold Inhibited by - T3 - Dopamine - Somatostatin - stress ```
48
what are the actions of T3
regulates the basal metabolic activity of most cells | increase mRNA synthesis
49
What is the difference between congenital cretinism and developmental cretinism
congenital cretinism is when a pregnant mother and the fetus both have hypothyroidism. developmental cretinism is when only the fetus has hypothyroidism (less severe, can be treated with thyroid supplements)
50
What is hashimoto thyroiditis
autoimmune destruction of thyroid gland, most common cause of hypothyroidism
51
what is dequervain thyroiditis
enlaged sore thyroid following a URI
52
What is silent thyroiditis
alternating hypothyroiditis and hyper thyroiditis occuring in middle age, or postpartum women
53
What is Reidel thyroiditis
rare hypothyroidtis with a large mass that compresses the trachea
54
what is graves disease
an autoimmune hyperthyroidism where anti TSH-receptors bind, and ACTIVATE TSH receptors, causing high levels of T3 and T4 (SCALLOPED COLLOID)
55
When do patients get goiters
too much TSH, can be normal, high, or low levels of T3 and T4
56
which goiter is more likely a tumor diffuse or nodular
nodular
57
what is the difference between cushing disease and cushing syndrome
cushing disease is elevated ACTH production due to a pituitary tumor which causes elevated cortisol. cushing syndrome is elevated cortisol caused by an adrenal tumor or taking too much cortisol
58
how does MCH relate to ACTH
when ACTH is synthesized, it is broken off of POMC. one peice becomes ACTH the other becomes MCH
59
what does high MCH cause
hyperpigmentation
60
What does elevated cortisol cause
``` insulin resistance weight gain increased blood glucose muscle wasting osteoporosis decreased immunity sensitivity to catecholectamines ```
61
how do you differentiate between causes of high cortisol levels
``` dexamethasone test (synthetic cortisol) if low does decreases ACTH and cortisol it is chronic stress causing it. if it takes a high does to decrease ACTH and cortisol it is a pituitary tumor if nothing decreases ACTH and cortisol it is caused by ectopic ACTH ```
62
what happens with catecholectamine hypersecretion
it is caused by adrenal medulla hyperfunction (tumors of the chromaffin cells) and it causes elevated HR, elevated BP, diaphoresis, weight loss, hyperglycemia
63
What is addison disease
primary adrenal insufficiency, too little cortisol and mineralocorticoids. typically caused by autoimmunity
64
what are the symptoms of addison disease
slow onset weakness hypotension skin hyperpigmentation
65
What is MEN
multiple endocrine neoplasia
66
What is MEN 1 vs. MEN 2
MEN 1 is when most of the neoplasia is outside of the thyroid (parathyroid, pancreas, and pituitary) MEN 2 is when most of the neoplasia is found in the thyroid
67
What is the main difference between MEN 2a and MEN 2b
MEN 2b includes marfan characteristics
68
What determines which part of the body with store fat
the areas with lipoprotein lipase LPL will gain the most fat

dmd 5248 (12 decks)

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