Pancreas/Adrenal Hormones and Endocrine Pathology Flashcards Preview

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Flashcards in Pancreas/Adrenal Hormones and Endocrine Pathology Deck (68):
1

What are the subdivisions of the adrenal glands

cortex and medulla

2

what are the functions of the adrenal cortex

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

3

what are the functions of the adrenal medulla

production of epinephrine and norepineprhine

4

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

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

5

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

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

6

what are the actions of glucocorticoids

they accelerate glucose

7

what are the hormones of the adrenal medulla

epinephrine and norepinephrine

8

what are the actions of epinephrine and norepinephrine

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

9

What are the characteristics of the exocrine pancreas

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

10

What are the characteristics of the endocrine pancreas

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

11

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

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

12

what does GH do in children and adults

children - muscle and skeletal development
adults - maintain blood glucose, mobilizes lipid reserves

13

what is the general adaptation syndrome (GAS)

the hormonal stress response

14

what are the phases of the general adaptation syndrome

alarm phase
resistance phase
exhaustion phase

15

what are the characteristics of the alarm phase of GAS

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

16

what are the characteristics of the resistance phase of GAS

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

17

What are the charateristics of the exhaustion phase of GAS

- lipid reserves exhausted
- damage to organs
- inability to produce glucoccorticoids
- failure to balance electrolytes

18

what are the three classifications of endocrine pathologies

primary, secondary, and tertiary problems

19

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

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

20

how does ADH work

it places aquaporins into the collecting duct = water reabsorption

21

how is hypersecretion of ADH diagnosed

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

22

what causes ADH hypersecretion

ectopic production of ADH
surgery (stress)
drugs
cranial abnormalities

23

how is ADH hypersecretion treated

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

24

What is hyposecretion of ADH called

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

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