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78 Cards in this Set
- Front
- Back
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Hormones |
chemical messengers which are made by endocrine glands and are released into the blood stream. can only affect target cells which express a specific receptor for that hormone |
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most common dysfunctions associated with hormonal regulation |
1. production of too much or too little hormone 2. improper feedback 3. ectopic production of hormone |
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Neurons in the supraoptic and paraventricular nuclei of hypothalamus project axons which terminate in the posterior pituitary. These neurons make? |
oxytocin and anti-diuretic hormone (ADH) |
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2 different type of cells based on staining characteristics |
chromophobes(non-secretory) chromophils(secretory) |
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chromophobe adenoma |
the most overt symptoms of these begin tumors are due to the compression on the optic nerve and headaches due to increase in intracranial pressure. |
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bitemporal heminoplasia |
defect in visual field on separate sides |
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where is ADH normally synthesized |
in hypothalamic nuclei and axonally transported, stored and released from the posterior pituitary |
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ADH is released |
in response to increased blood osmolarity in times of dehydration |
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ADH targets |
the cells of the distal tubule and collecting duct of the kidney to promote water reabsorption from the filtrate or to produce a concentrated urine |
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Diabetes insipidus |
insufficiency of ADH. loosing fluid, and increasing sodium |
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neurogenic diabetes insipidus |
occurs due to interruption of the synthesis, transport or release of ADH due to hypophysectomy, tumors, inflammation, vascular lesions |
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nephrogenic diabetes insipidus |
occurs when renal tubes fail to respond to ADH |
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psychogenic diabetes insipidus |
caused by extremely large intake of water producing decreased ADH levels |
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clinical manifestations of diabetes insipidus |
polyuria polydipsia hypoosmolar urine;dilute urine hyperosmolar plase; increased osmolarity in blood hydronephrosis; enlarged kidneys |
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treatment for diabetes insipidus |
oral hydration desmioressin (vasopressin analog) |
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SIADH: syndrome of Inappropriate ADH secretion |
excessive ADH secretion. hanging onto fluid and decreases sodium. dark urine usually due to an ectopic problem |
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effects of excessive ADH |
increased water reabsorption by the kidneys hemodilution hypervolemia; lots of fluid hyponatremia; low sodium in blood |
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clinical manifestation of hyponatremia |
140-130 impared taste; fatigue 130-120 muscle and GI cramping 115 confusion, lethargy, seizue |
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treatment for hyponatremia |
correct underlying problem hypertonic saline fluid restriction |
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diseases of the anterior pituitary |
GH-growth hormone ACTH-adrenocorticotropic hormone TSH-thyroid stimulating hormone |
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Child giantism |
adenoma that produces excess amounts of GH large tumor on pituitary gland |
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adult acromegaly |
increased connective tissue and bone growth and deposition increased insulin resistance leading to diabetes mellitus Features: enlarged tongue jaw and forehead, hyperosteosis of vertebrae, enlarged sella turcica due to adenoma, enlarged hands and feet, increased sebaceous and sweat gland activity |
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child and adult dwarfism |
in children short stature from birth give GH to kids for treatment, has potential for tumors. in adults no symptoms occur with lack of only GH |
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Thyroid Gland |
2 differnt endocrine cells: follicular cells and parafollicular cells |
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atrophy of thyroid gland |
decrease in mass of gland due to lack of TSH. hypothyroidism |
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hypertrophy/hyperplasia of thyroid gland |
increase in mass of gland due to excess TSH, or tumorous condition |
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goiter |
enlarged thyroid gland due to a variety of causes |
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endemic goiter |
lack of iodine in diet |
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neoplasms of thyroid |
can cause hypertrophy/hyperplasia of gland |
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adenoma of pituitary gland |
excess TSH which over stimulates thyroid gland |
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hyperthyroidism |
thyroid gland dysfunction resulting in excessive TH production |
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primary hyperthyroidism |
increased T3/T4 levels decreased TSH levels in thyroid gland |
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secondary hyperthyroidism |
increased T3/T4 levels increased TSH production in anterior pituitary |
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Hypothyroidism |
thyroid gland dysfunction resulting in decreased TH production |
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primary hypothyroidism |
decreased T3/T4 levels increased TSH levels in thyroid gland |
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secondary hypothyroidism |
decrease T3/T4 decrease TSH levels in anterior pituitary |
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graves disease |
hyperthyroidism an autoimmune disease antibodies that bind to and stimulate thyroid gland |
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what does a person with graves disease display |
increased BMR, tachycardia, nervous, sweating, rapid weight loss, warm in the touch, loose stools. bulging eyes |
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exophthalmos |
protrusion of eyeball from socket increased extracellular infiltrate of extra ocular eye muscles lids do not close properly leading to corneal erosions/ulcerations |
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thyroid "storm" |
a rapid, sudden urge of TH symptoms of thyrotoxicosis worsen leading to death due to high output failure of the heart |
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given to block thyroid hormone synthesis |
propylthiouracil |
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hypothyroidism |
patients with low levels of TH are usually very lethargic, cool, low BMR, and with myxedema |
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myxedema |
edematous condition of connective tissue surrounding the eyes, skin, limbs and in the tongue |
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autoimmune thyroiditits |
immunoglobulins inhibit thyroid gland and provoke immune mediated destruction |
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what happens to the gland after autoimmune thyroiditis? |
become fibriotic, infiltrated with lymphocytes, enlarged, eventually destroyed |
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cretinism |
lacking TH during fetal development and immediately following birth. child is slow to reach major milestones, lethargic, sleepy, slow pulse, cold, stunted skeletal growth (dwarf) and mentally retarted. can be treated with supplemental TH |
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insulin |
hormone naturally produced by the pancreatic beta cells in the islets of langerhan functions to increase glucose transport into cells and lower blood glucose levels |
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diabetes mellitus |
systemic condition that arises due to a lack of insulin |
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3 cardinal signs of diabetes mellitus |
polyuria polyphagia polydipsia |
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type 1 diabetes mellitus |
insulin dependent juvenile onset B-cells in pancreas destroyed no insulin made risk factor: HLA-DR3/ HLA-DR4 10% of cases |
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type 2 diabetes mellitus |
non-insulin dependent adult onset B-cells make insulin insulin receptors decreased or desensitized risk factor: obesity 90% of cases |
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test used to measure blood sugar levels |
fasting blood glucose: >126 random blood glucose: >200 glycated hemoglobin: elevated levels of hemoglobin A1C |
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diabetic ketoacidosis |
insulin defieciency metabolic enzymes don't work as efficiently, so energy failure then shock direct relationship between volume and pressure. as volume increases, pressure increases |
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adrenergic response to insulin excess |
anxiety sweating tremor tachycardia weakness |
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brain deprived of glucose in insulin excess |
disorientation convulsions unconsciousness insulin shock |
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hormones that increase blood sugar |
growth hormone epinephrine cortisol glucagon |
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hormone that decrease blood sugar |
insulin |
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chronic complications of diabetes mellitus |
arise from the hyperglycemic state over many years. neuropathies, vascular disease, infections |
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Neuropathies complication of DM |
sensory>motor axonal degeneration pain and other problems related to peripheral neuropathy |
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vascular disease complication of DM |
microvascular: retinal arteries, renal arteries macrovascular: atherosclerosis, coronary artery disease/ stroke, peripheral vascular disease, gangrenous necrosis/ amputation |
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infection complication of DM |
increased risk due to: impaired sensorium sugar rich body fluids impaired immune response due to abnormal blood supply/chemotaxis/phagocytosis |
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zona glomerulosa |
secretes mineralocorticoids aldosterone-promots sodium retention and potassium excretion |
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zona fasciculata |
secrets glucorticoids largest layer cortisol: increases blood glucose by stimulating gluconeogenesis and inhibiting glucose uptake increases blood amino acid levels by promoting protein degradation increases blood fatty acid levels by stimulating lipolysis |
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zona reticularis |
secretes gonadocorticoids androgens: stimulate masculinizing effects |
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cushing's disease |
overactivity of adrenal cortex increased ACTH production and release from anterior pituitary or elsewhere which stimulates the adrenal cortex and raising production and release of cortisol. tumor |
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cushings syndrome |
refers specifically to the clinical condition caused by hypercortisolism which can arise from a variety of causes-cushing disease being one of them |
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hypercortisolism effect on proteins |
muscle wasting in extremities poor wound healing skin breakdown:less collagen synthesis, purple striae protein matrix of bone breakdown |
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hypercortisolism effects on carbohydrate metabolism |
increase gluconeogenesis insulin resistance |
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hypercortisolism effects on adipose tissue |
moon face truncal obesity buffalo hump |
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primary hyperaldosteronism (Conns disease) |
hypertension and hypokalemia |
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hypertension |
high levels of aldosterone on blood levels with some contribution from excessive sodium absorption and expansion of the extracellular fluid. kidney tubules demonstrate a sodium escape phenomenon in which they possess an intrinsic ability to release excess sodium into urine |
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hypokalemia |
hypokalemic alkalosis: sodium increases and potassium decreases tetany and muscle weakness EKG abnormalities and other cardiac changes less H+ ions in ecf, and more in ICF |
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hypersecretion of androgens from the zone reticularis |
adrenogenital syndrome: development of masculine features in a female body |
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addisons disease |
primary adrenal insufficiency due to: infectious organism, autoimmune disorder, HLAB8/HLADR3 |
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clinical manifestations of addisons disease |
hypocortisolism and hypoaldosteronism |
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hypoaldosteronism |
blood sodium levels fall, drop in blood volume and pressure increased blood potassium levels |
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hypocortisolism |
loss of permissive effects of catecholamine stimulation to blood vessels creating possible hypotensive crisis decreased glucocorticoid effect producing hypoglycemia muscle weakness weight loss GI upset bronzing of the skin(hyper pigmentation of ACTH levels are high and stimulates melanocytes) |
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pheochromocytoma |
tumor of the adrenal medulla which synthesizes excessive catecholamines (adrenalin) hypertension diaphoresis tachycardia and palpitations elevation in basal metabolic rate |
