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Pathophys > Quiz 5a > Flashcards

Quiz 5a Flashcards

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1
Q

What are the 5 functions of the endocrine system?

A

Differentiation of reproductive and CNS of fetus
Stimulation of growth/development during childhood/adolescence
Coordination of reproductive systems
Maintaining optimal internal environment
Initiation of corrective and adaptive responses

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2
Q

Where does the endocrine system meet the nervous system?

A

Hypothalamic-Pituitary interface

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3
Q

What pathways do the hypothalamus control?

A

Neural and hormonal

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4
Q

What hormones stimulate the posterior pituitary?

A

ADH and Oxytocin

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5
Q

What hormones stimulate the anterior pituitary?

A

ACTH
TSH
LH
FSH

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6
Q

What inhibitory hormones act on the pituitary?

A

GH

Prolactin

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7
Q

What hormones act on the thyroid?

A

T4 and T3

Calcitonin

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8
Q

What hormone acts on the Parathyroid?

A

PTH

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9
Q

What hormones act on the Adrenal Cortex?

A 
Aldosterone
Cortisol
Sex hormones (testosterone, estrogen, progesterone)
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10
Q

What hormones act on the Adrenal Medulla?

A

Epinephrine

Norepinephrine

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11
Q

What hormones act on the Pancreas?

A

insulin

Glucagon

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12
Q

What hormones act on the Gonads?

A

Estrogen
Progesterone
Testosterone
Adiponectin, Leptin, and Angiotensin

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13
Q

How does stress impact endocrine system?

A

Stress arouses the sympathetic nervous system, causing the medulla to release catecholamines (epinephrine, norepinephrine, and dopamine) into the blood

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14
Q

How do catecholamines impact the endocrine system?

A

They are released at the sympathetic nerve endings, causing the rate and force of contraction of the heart to increase, constriction of vessels, inc BP, inc blood glucose, inc blood lipids

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15
Q

What are the main functions of Cortisol?

A

Regulation of the metabolism of proteins, carbs, and lipids, causing an elevation of blood glucose

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16
Q

How does stress impact Endorphins?

A

They modulate the transmission of pain perceptions by raising the pain threshold

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17
Q

How does stress impact GH?

A

Levels increase in the blood after a variety of physically/physiologically stressful stimuli such as surgery, fever, physical exercise

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18
Q

How does stress impact Prolactin?

A

Levels in plasma increase by: gastroscopy, proctoscopy, pelvic exam, surgery

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19
Q

How does stress impact testosterone?

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A

Decreases after: anesthesia, surgery, marathon, acute illness; decrease helps to preserve energy for protective responses

20
Q

What signs/symptoms are associated with RA?

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A

Myalgia
Arthralgia
Diabetes Mellitus

21
Q

What signs/symptoms are associated with muscle weakness/atrophy?

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A 
Parathyroid or Thyroid disease
Acromegaly
Diabetes
Cushing's Syndrome
Osteomalacia
22
Q

What signs/symptoms are associated with Carpal Tunnel?

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A

Acromegaly, Hypothyroidism
Tenosynovitis (inflammed tendon sheaths)
Diabetes (neuropathy related to ischemia)

23
Q

What signs/symptoms are associated with Periarthritis?

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A 
Inflammation of tendons, ligaments, joint capsule
Calcific tendinitis (shoulders in endocrine disease)
Chondrocalcinosis: deposition of calcium salts in joint cartilage
Pseudogout: when accompanied with gout symptoms
Hypothyroidism, hyperparathyroidism, acromegaly
24
Q

What signs/symptoms are associated with Spondyloarthropathy?

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A

OA
Hemochromatosis (iron metabolism)
Ochronosis: alkali deposits; discoloration
Acromegaly and DM

25
What signs/symptoms are associated with hand stiffness?
Pain, arthralgias of the small joints in the hand | Flexor tenosynovitis: common in hypothyroidism
26
What are the common neuromusculoskeletal signs/symptoms of endocrine dysfunction?
Rheumatic s/s, weakenss, myalgai, fatigue, CTS, DM, chondrocalcinosis, OA, Osteoporosis
27
What are the common systemic signs/symptoms of endocrine dysfunction?
excessive/delated growth, polyuria, mental changes, hair quality, skin pigmentation, body fat distribution, vital signs, heart palpitations, Kussmaul's, dehydration
28
What are the main concepts of Hyperpituitarism?
Over secretion of one or more in anterior lobe (especially GH) leading to acromegaly (increased bone thickness and hypertrophy of soft tissues), gigantism (overgrowth of long bones), or Cushing's (over secretion of ACTH, leads to excessive growth from GH, hyperprolactinemia, and overstimulation of target glands leads to excessive adrenocortical thryroid or sex hormones) Usually caused by tumors, infarction, genetics, trauma
29
What are the main concepts of hypopituitaryism?
Decreased secretion leads to dwarfism or panhypopituitarism (partial/total failure of all pituitary hormones): hypophysectomy (removal of pituitary by surgery/radiation), nonsecreting tumors, reversible function disorders (anorexia, anemia, starvation)
30
What are the main concepts of Diabetes Insipidus?
Rare, physiologic imbalance of water from ADH Caused by injury to hypothalamus/posterior pituitary Large amounts of dilute urine without glucose, dehydration, muscle weakness, dizziness, fatigue
31
What are the main concepts of SIADH?
Excessive release of ADH; fluid/electroly imbalance; opposite of Diabetes Insipidus Pituitary damage, surgery stress, systemic disorders Fluid retention, swelling of brain tissues and sodium changes with the tissue, DNS dysfunction, hyponatremia, muscle cramps
32
What are the main concepts of Hyperthyroidism?
Elevation of body metabolism Graves Disease (most common, increased T4, autoimmune): mild enlargement of thyroid, nervousness, heat intolerance, weight loss, increased appetite, sweating, diarrhea Thyroid Storm: could be fatal in acute thyroid overactivity; fever, tach, delirium, dehydration Exophthalmos: abnormal protrusion of eyes Neuromusculoskeletal: pain, reduced ROM, calcification, frozen shoulder, weakness Genetics, over function, over treatment of hypothyroidism, cancer
33
What are the main concepts of Hypothyroidism?
Slowed metabolism, most common thyroid disorder, Type I: reduced thyroid tissue (slowed BMR, bradycardia, decreased GI) Type II: inadequate stimulation because of pituitary and hypothalamic disease (failure of pituitary to release adequate TSH Autoimmune, thyroid ablation (surgery) Fatigue, cold, weight gain, forgetful, dry skin/hair, hoarseness, dec CO, sowed pulse, poor circulation, stiffness, RA, CTS, weakness Thyroiditis causes
34
What are the main concepts of Thyroiditis?
Inflamed thyroid (autoimmune) Destruction of thyroid (lymphocyte/antibody infiltration) Increases TSH, Hypothyroidism develops Painless, enlargement of gland, irregular surfaces, hypo/hyperthyroidism
35
What are the main concepts of thyroid cancer?
Rarely malignant tumors Past Med History, radiation history Hard, painless nodules on thyroid gland: vocal cord paralysis, cervical lymphadenopathy, malignant tumor (rarely metastasize) Fine needle aspiration biopsy
36
What are the main concepts of Hyperparathyroidism?
At least one of the four, disrupts metabolism (calcium, phosphate, and bone) Primary: PTH is interrupted, glands enlarged, increased PTH secretion Secondary: hyperplastic, response to hypocalcemia (renal disease) Tertiary: dialysis patients; hyperplasia, glands unresponsive to serum calcium levels PTH maintains CA and Phosphate balance (ca is released into blood and bone damage/ hypercalcemia/ kidney damage
37
What are the main concepts of Hypoparathyroidism?
Hypocalcemia, children and women Iatrogenic (radiation, drugs, surgery) PTH low, bone reabsorption low, GI tract absorption low, low serum calcium, neuromusculoskeletal irritability Acute is bad and there is a need to increase Ca levels quickly (IV, not surgery)
38
What are the main concepts of Adrenal Insufficiency?
Insufficient cortisol and aldosterone release -> metabolic disturbances Autoimmune; originally thought from TB Weak, exhausted, anorexia, weight loss, nausea, vomiting, emotional disturbances Acute: abdominal pain, LBP, leg pain Further: trauma or infection ACTH secretion continues (tan appearance to skin) Blood and urine tests
39
What are the main concepts of Adrenocortical Hyperfunction?
Excessive glucocortisols and androgens Cushing's (hypercortisolism): excessive cortisol/ATCH; hyperphysiologic doses/tumors of pituitary; protruding abdomen, purple striations, poor wound healing, thin skin, weakness, osteoporosis Conn's (adrenal lesion -> hypersecretion of aldosterone): benign aldosterone tumors; hypernatremia, alkalosis, HTN, renal disease, heart failure
40
What are the special implications for working with endocrine conditions?
``` Observe s/s Limit stress PT isn't likely with acute conditions Hypoparathyroidis: treat muscle weakness, LBP, and arthritis (listen for pulmonary adema, monitor vitals, early ambulation, encourage good fluid intake) Prevent loss of ROM Palpate for nodules Stretch ```
41
What are the two phases of metabolism?
Anabolic (building) and Catabolic (energy-production)
42
What increases metabolism?
Exercise, elevated temperature, hormonal activity, increased digestive action after eating
43
Why is adipose tissue considered an endocrine tissue?
Neurotransmitters and glucose directly act on adipocytes to induce the release of different proteins (adipokines) that act locally as autocrine hormones or through the blood as endocrine hormones
44
What impact do the adipokines have?
Assist to maintain energy balance, vasoconstriction, inflammation, or angiogenesis
45
What is the relationship between obesity and cancer?
High correlation Men: colon and pancreatic Women: weak -> increased BMI and all cancers; strong -> nonhodgkins lymphoma and uterine Breast cancer rate increases with high BMI after 65 y/o Obese pts vs lean pts have higher reoccurrence of cancer, malignancy, and worsened lifespan
46
What are the main concepts of Phenylkeonuria?
Autosomal recessive disease resulting from genetic defect in metabolism of amino acids phenylalanine Accumulation of Phe in blood w/ excretion of phenylpyruvic acid in urine Mental retardation, tremors, poor coordination, perspiration, mousy odors No cure, nutrition key
47
What are the main concepts of Wilson's Disease?
Progressive inherited autosomal recessive trait Defect in metabolism of copper (accumulates in liver, brain, kidney, cornea) Kayserfleischer rings around iris, cirrhosis of liver, degenerative brain changes Liver disease (peds); neurologic (young adults) Unsteady gait and uncontrollable rhythmic movements of writing and hands Pill-rolling tremors, facial/muscle rigidity, dysarthria, emotional/behavioral changes Pharmacological aimed at reducing copper in tissues Aim to manage heptic disease

Pathophys (3 decks)

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