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Differential Diagnosis > Week 4 > Flashcards

Week 4 Flashcards

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1
Q

What are the endocrine organs?

A

Hypothalamus

Pituitary gland

Thyroid and parathyroid glands

Adrenal glands

Pancreas

Ovaries and testes

Adipose tissue

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2
Q

What are the jobs of endocrine organs?

A

Synthesize and release hormones

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3
Q

What do hormones do?

A

Travel in the blood to exert regulatory effects on distant cells and organs (special chemical messengers)

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4
Q

Why do hormones function with the CNS?

A

To maintain homeostasis

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5
Q

What is metabolism?

A

Chemical and physical processes that allow cells to utilize food to rebuild body cells and transform food into energy

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6
Q

What does anabolic mean?

A

Tissue building

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7
Q

What does catabolic mean?

A

Energy producing

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8
Q

What is endocrine dysfunction pathophysiology?

A

Dysfunction of releasing or inhibiting hormones at the level of the endocrine (primary), pituitary (secondary), or hypothalamus (tertiary)

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9
Q

What is endocrine dysfunction generally classified as?

A

Hypofunction or hyperfunction

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10
Q

What may cause endocrine dysfunction?

A

Inflammatory or autoimmune conditions

Tumor or trauma

Drug induced

Necrosis or infarction

Iatrogenic (surgery, radiation)

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11
Q

What do chronic endocrine conditions require for survival?

A

Hormone replacement therapy

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12
Q

What does the hypothalamus release?

A

Inhibitory hormones

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13
Q

What hormones does the anterior pituitary release?

A

Growth hormone (GH)

Prolactin (PRL)

Melanocyte-stimulating hormone (MSH)

Adrenocorticotropic hormone (ACTH)

Thyroid-stimulating hormone (TSH)

Follicle-stimulating hormone (FSH)

Luteinizing hormone (LH)

Lipotropin (LPH)

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14
Q

What hormones does the posterior pituitary release?

A

Antidiuretic hormone (ADH)

Oxytocin (OXT)

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15
Q

What do the adrenal glands release?

A

Aldosterone and cortisol

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16
Q

What does the thyroid gland release?

A

T3 and T4

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17
Q

What are the feedback loops involved in the endocrine gland?

A

Mostly negative

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18
Q

What is a simple negative feedback loop?

A

When a hormone (or response to the hormone) inhibits further hormone secretion

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19
Q

What is a complex negative feedback loop?

A

When a hormone secreted from a primary target gland exerts negative feedback on the hypothalamus and pituitary gland

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20
Q

What is hyperpituitarism?

A

Hyper secretion of 1 or more hormones secreted by pituitary

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21
Q

What are the causes of hyperpituitarism?

A

Hormone secreting pituitary tumor

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22
Q

What are some examples of hyperpituitarism?

A

Gigantism, acromegaly, infertility, and impotence

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23
Q

What is hypopituitarism?

A

Hypo secretion or absent secretion by pituitary

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24
Q

What are the causes of hypopituitarism?

A

Removal of pituitary via surgery, radiation, chemo, non secreting pituitary tumor, and reversible functional disorders like starving

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25
What are examples of hypopituitarism?
Dwarfism and diabetes insipidus
26
What is more common hyper or hypo pituitarism?
Hyperpituitarism
27
Who does gigantism occur in?
Children (overgrowth of long bones before epiphyses close)
28
How does gigantism develop?
Abruptly
29
Who develops acromegaly?
Adults (after closure of epiphysis)
30
How does acromegaly develop?
Slowly
31
What are the structures affected in acromegaly?
Face, jaw, hands, and feet
32
What causes diabetes insipidus?
Insufficient antidiuretic hormone
33
What are signs and symptoms of diabetes insipidus?
Polyuria, nocturia, polydipsia, and dehydration
34
What is syndrome of inappropriate antidiuretic hormone (SIADH)?
Excessive secretion of ADH leading to increased water retention and hyponatremia
35
What are the signs and symptoms of syndrome of inappropriate antidiuretic hormone (SIADH)?
Headache, confusion, and lethargy
36
Who is most at risk for thyroid dysfunction?
Older age and women
37
What are symptoms of thyroid dysfunction?
Mood disturbances (depression, post partum depression, anxiety, and changes in menstruation)
38
What are the types of thyroid dysfunction?
Hyperthyroidism Hypothyroidism Thyroiditis
39
What can occur with any type of thyroid dysfunction?
Goiter
40
What is the most common type of disease associated with hyperthyroidism?
Graves’ disease (autoimmune)
41
What is an emergency disorder that may occur with hyperthyroidism?
Thyroid storm (thyrotoxic crisis)
42
What is the most common type of disease associated with hypothyroidism?
Hashimoto’s thyroiditis (autoimmune)
43
What is an emergency disorder that is associated with hypothyroidism?
Myxedema coma
44
What are the characteristics of hyperthyroidism?
Metabolic- Increased metabolism CNS- nervousness and irritability CVP- tachycardia Integ- heat intolerance
45
What are the characteristics of hypothyroidism?
Metabolic- decreased metabolism CNS- slowed mental functions CVP- bradycardia Integ- cold intolerance
46
What is a thyroid storm?
When an excessive amount of thyroid hormones release in a short period
47
What is clinical presentations of a thyroid storm?
High fever Rapid HR Sweating Severe agitation/anxiety Confusion
48
What does the inner medulla of the adrenal glands secrete?
Epinephrine and norepinephrine
49
What is the pathogenesis of adrenal dysfunction?
Deficient or excess adrenal hormones
50
What does primary adrenal insufficiency/hypocortisolism lead to?
Addisons disease
51
What causes secondary adrenal insufficiency?
Conditions outside of the adrenals
52
What does hypercortisolism lead to?
Cushing syndrome
53
Who is addisons disease most common in?
Females age 40-60
54
What are the causes of addisons disease?
Autoimmune (most common)
55
What are the clinical manifestations of addisons disease?
Hypoglycemia Weakness Fatigue Low BP Emotional disturbances Weight loss Skin hyperpigmentation or vitiligo
56
What needs to be monitored in addisons disease?
Addisonian crisis
57
Who is at an increased risk for Cushing syndrome?
Females age 20-50 (overweight, type 2 DM, long term steroid use, and immunosuppressed)
58
What is exogenous Cushing syndrome?
Medication induced or iatrogenic (more common)
59
What is endogenous Cushing syndrome?
Benign or malignant tumor and excess ACTH stimulation from pituitary
60
What are the clinical manifestations of Cushing syndrome?.
Osteoporosis with kyphosis Central obesity and thin extremities Purple stretch marks Buffalo hump Moon face appearance
61
What should you monitor for in Cushing syndrome?
Acute adrenal insufficiency (medical emergency)
62
What is acute adrenal insufficiency?
Extreme lack of cortisol
63
What is the biggest clinical presentation of acute adrenal insufficiency?
Hypotension
64
What are neuromuscular and MSK signs associated with endocrine dysfunction?
Muscle weakness/cramps Bilateral carpal tunnel Chondrocalcinosis Osteoarthritis Tendonitis
65
What is the weakness pattern of muscles in those with endocrine disease?
Proximal upper and lower limbs symmetrically
66
Where does tendonitis most often occur in those with endocrine dysfunction?
Shoulders
67
What is chondrocalcinosis called when accompanied by gout like symptoms?
Pseudogout
68
What does the parathyroid hormone do secreted by the parathyroid gland?
Regulates calcium and phosphorus metabolism
69
What does hypoparathyroidism cause?
Hypocalcemia
70
What does hypocalcemia lead to?
Cardiac arrhythmias and neuromuscular irritability
71
What does hyperparathyroidism do?
Elevated parathyroid hormone which releases calcium by bones and accumulation of calcium in the bloodstream (loss of bone density)
72
What are causes of hyperparathyroidism?
Tumors or renal failure
73
What are symptoms of hyperparathyroidism?
Proximal muscle weakness/fatigue Myopathy of respiratory muscles Weight loss Nausea Depression Increased thirst/urination Tendon rupture
74
What are the causes of hypoparathyroidism?
Accidental removal or injury
75
What are symptoms of hypoparathyroidism?
Personality changes Dry/scaly skin Thinning of hair Brittle nails
76
What are the 2 types of fluid imbalance?
Fluid deficit and dehydration
77
How can fluid imbalances occur?
Loss of water without solutes Loss of both water and solutes
78
What are the two forms of fluid excess?
Water intoxication and edema
79
What is water intoxication?
Excess of water without excess of solutes
80
What is edema?
Excess of water and solutes
81
What are the causes of metabolic alkalosis?
Vomiting, upper GI suctioning, diuretic therapy, ingestion of large amounts of base substances
82
What are signs of metabolic alkalosis?
Vomiting, diarrhea, confusion, muscle cramping, paresthesias, eventual coma, and shallow/slow breathing
83
What are some causes of metabolic acidosis?
Renal failure Severe diahrrea Drug/alcohol toxicity Lactic acidosis
84
What are symptoms of metabolic acidosis?
Fatigue, nausea, diarrhea, muscle twitching, coma, rapid/deep breathing
85
What is a gout?
Formation of tiny uric acid crystals that collect in the joints
86
Who is most likely to suffer from gout?
Men age 40-50
87
What are some of the biggest risk factors to get gout?
Menopause, obesity, white people, high intake of purine rich foods
88
What is hemochromatosis?
Genetic abnormality of iron metabolism (increased iron absorption)
89
Who is most likely to suffer from hemochromatosis?
Men older than 50 who have excessive vitamin C or alcohol
90
What is osteomalacia?
Decalcification of bones
91
What are risk factors of osteomalacia?
Lack of UV, lack of vitamin D, renal defect, and receptor site reduction
92
What are the signs of osteomalacia?
Severe bone pain, skeletal deformities, fractures, and severe muscle pain
93
What is Paget’s disease?
Disordered bone remodeling
94
Who is most likely to suffer from Paget’s disease?
Men (70-90% are asymptomatic)
95
What are erythrocytes?
Red blood cells
96
What are leukocytes?
White blood cells
97
What are thrombocytes?
Platelets
98
What are primary hematologic diseases?
Uncommon
99
What medication induced disorders related to hematology are common?
NSAIDs Chemotherapy Thrombocytopenia due to multiple pharmacological agents
100
What are the 2 major PT concerns with hematologic disorders?
Bleeding and clotting
101
What are signs and symptoms of hematologic disease with physical effort?
Dyspnea, chest pain, palpitations, severe weakness, and fatigue
102
What are integumentary signs in hematologic diseases?
Pallor Cyanosis or clubbing Wounds Easy bruising/bleeding
103
What is anemia?
Too few erythrocytes
104
What is polycythemia?
Too many erythrocytes
105
What is poikilocytosis?
Abnormally shaped erythrocytes
106
What is anisocytosis?
Abnormal variations in size of erythrocytes
107
What is hypochromia?
Erythrocytes deficient in Hg
108
What happens in anemia?
Reduction of O2 carrying capacity of the blood due to abnormal quantity of erythrocytes
109
What causes anemia?
Excessive blood loss, destruction of erythrocytes, and decreased production of erythrocytes
110
What are the 4 categories of anemia?
Iron deficiency Chronic diseases or inflammatory diseases Neurological conditions Infectious disease
111
What are the signs of anemia?
Skin pallor Fatigue Chest pain with minimal exertion Decreased diastolic BP
112
What is sickle cell disease?
Clumps of sickle cell can block blood flow to limbs and organs
113
Why does sickle cell disease cause anemia?
Body cannot reproduce enough RBCs to replace dying ones
114
What are signs of sickle cell disease?
Vascular and pulmonary problems Neurological problems Hand foot syndrome Splenic sequestrian syndrome
115
Who is most at risk for polycythemia?
Men older than 60 who are dehydrated
116
What is leukocytosis?
Increase in white blood cells
117
What is thrombocytosis?
Increase in number of platelets with tendency to clotting
118
What is thrombocytopenia?
Decrease in number of platelets
119
What is a venous thromboembolism?
Formation of blood clot in a deep vein (DVT, PE, PTS)
120
What is hemophilia?
Deficiency of a blood clotting factor due to genetic mutation

Differential Diagnosis (6 decks)

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