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110 Cards in this Set

  • Front
  • Back
What is the primary coordinator of the endocrine system?
the pituitary gland
How can hormones be classified?
according to:
gland of origin
the effects they have
chemical composition
What type of hormone (lipid or water soluble) circulates bound to a carrier protein in the bloodstream?
lipid soluble
Which type of hormone (lipid or water soluble) diffuses through the plasma membrane and binds to nuclear receptors?
lipid soluble
Name 2 examples of lipid soluble hormones.
thyroid hormone
Name 2 examples of water soluble hormones.
parathyroid hormone
Which type of hormone (lipid or water soluble) has a short half life?
water soluble
Which type of hormone (lipid or water soluble) circulates in the bloodstream free and unbound?
water soluble
Which type of hormone (lipid or water soluble) binds to a cell surface receptor to travel through the membrane?
water soluble
What are lipid soluble hormones made from?
What are the 2 posterior pituitary hormones?
Which hormone regulates growth and development, cell metabolism, oxygen consumption, and body temperature?
thyroid hormone
Which hormone is the primary regulator of calcium?
parathyroid hormone
The pancreas is responsible for ___________ in the body.
The alpha cells of the Islets of Langerhans secrete ________?
The beta cells in the islets of Langerhans secrete _________?
The D cells in the islets of Langerhans secrete ________ and _________?
The major job of insulin is to:
decrease blood glucose
Insulin is synthesized by _________, ___________, and __________.
fat tissue
Somatostatin (produced by the D cells) is thought to inhibit ____________ and __________ secretion.
glucagon and insulin
The adrenal cortex secretes three types of hormones:
The primary type of glucocorticoid is:
Which type of hormone secreted by the adrenal cortex inhibits the immune/inflammatory response, increases circulating erythrocytes, and increases appetite (promotes fat deposits)?
When is cortisol secreted?
during stressful situations
What is the primary type of mineralocorticoid?
Which type of hormone secreted by the adrenal cortex affects ion transport, causing sodium retention and potassium/hydrogen loss?
What two hormones are produced by the adrenal medulla?
What does the hormone oxytocin do?
controls lactation and uterine contractions
What does the hormone ADH do?
controls renal reabsorption of free water

is a powerful vasoconstrictor
A low concentration of the hormone increases the number of receptors per cell.

This is called:
A high concentration of the hormone lowers the number of receptors per cell.

This is called:
Name 4 important anterior pituitary hormones.
What is ACTH, its target, and its function?
Adrenocorticotropic hormone

Targets the adrenal gland

Secreted by the anterior pituitary

Regulates growth/secretion of the adrenal gland, particularly cortisol and the androgenic steroids
What is MSH, its target, and its function?
Melanocyte-stimulating hormone

Targets the anterior pituitary

Secreted by the anterior pituitary

Promotes secretion of melanin and lipotropin by the anterior pituitary; makes the skin darker
What is GH, its target, and its function?
Growth hormone

Targets the muscle, bone, and liver

Secreted by the anterior pituitary

Regulates metabolic processes:
- skeletal growth
- muscle growth
- increased protein synthesis
- increased liver glycogenolysis
- increased fat mobilization
What is TSH, its target, and its function?
Thyroid-stimulating hormone

Targets the thyroid gland

Secreted by the anterior pituitary

Causes increased production/secretion of thyroid hormone (TH)

Causes increased iodine uptake
What is the normal range of T3 in the body?
80 - 200
What is the normal range of T4 in the body?
4.5 - 11.5
What are some effects of aging on the thyroid gland?
T4 secretion is decreased

T3 levels decline

Hypothyroidism is more prevalent

TSH secretion is diminished
What are some effects of aging on the parathyroid gland?
It is difficult to detect because of decreased calcium intake and circulating vitamin D, as well as blunted response accompanying aging.
What are some causes of ADH hypersecretion (SIADH)?
head trauma
carcinomas (ADH secreting tumors)
surgery (fluid volume shifts)
What are some signs/symptoms of ADH hypersecretion (SIADH)?
1. Fluid volume retention = weight gain, edema

2. Dilutional hyponatremia -> muscle cramps, weakness, arrhythmias

3. Concentrated urine (decreased urine output)
What are some symptoms of a drop in your sodium level from 140 to 130 mEq/L?
impaired taste
What of some symptoms of a drop in your sodium level from 130 to 120 mEq/L?
Severe gastrointestinal symptoms, such as vomiting and abdominal cramps
What are some symptoms of a serum sodium level below 115 mEq/L?
confusion, convulsions, twitching, lethargy
How would you treat ADH hypersecretion (SIADH)?
Treat the cause.

Major fluid restriction (600-800 cc/day)

Diuretic with cardiac symptoms

K+ supplement
What is the ADH hyposecretion disorder called?
diabetes insipidus
What are some causes of diabetes insipidus?
Idiopathic (naturally get rid of too much water--no known cause)

Brain tumors

Closed head trauma

Intracranial surgery
What are the signs/symptoms of diabetes insipidus?
polyuria (5-20 L per day)
increased serum osmolality (hypernatremia, which causes polydipsia--increased thirst)

Weight loss, hypovolemic shock, hypotension, agitation, tachycardia, constipation
How would you treat diabetes insipidus?
Fluid replacement
Give drugs that act like ADH
Monitor input and output
Gigantism is due to an overproduction of ___________.
growth hormone
What age group does gigantism occur in?
growing children (whose epiphyses have not closed yet)
Gigantism is a disorder of what endocrine gland?
anterior pituitary (usually caused by a pituitary adenoma)
Acromegaly is a disorder of what endocrine gland?
anterior pituitary (overproduction of GH)
Acromegaly occurs in what age group?
adults in their 40s and 50s (caused by tumor on anterior pituitary)
What are the signs of acromegaly?
bones become thicker and wider (since epiphyseal closure has occurred)
What is the most common hyperthyroid condition?
Graves disease
What are the signs/symptoms of Graves disease?
out of breath on exertion
weight loss
muscle weakness
eyeballs look like they are about to pop out of head
goiter (thyroid enlargement)
How do you treat Graves disease?
antithyroid drugs
radioactive iodine surgery
surgical therapy
nutritional therapy
What is the acute but rare condition associated with hyperthryoidism?
thyroid storm (thyrotoxic crisis)
What is the cause of thyroid storm?
stressors (infection, trauma, surgery) in a patient with existing hyperthyroidism
What are the signs of thyroid storm?
severe tachycardia, heart failure, shock, hyperthermia up to 105.3, seizure, coma
What are some causes of hypothyroidism?
- use of radioactive iodine

- destruction, removal, or suppression of all/some of the thyroid tissue during surgery

- dietary iodide deficiency

- atrophy of the thyroid gland (most common cause in U.S.)

- inadequate secretion of TSH from pituitary (secondary hypothyroidism)
What are the symptoms of hypothyroidism?
Metabolic activity of the cells decreases, causing:

weight gain
cold hands and feet
subnormal temp and pulse
swelling in hands, feet, and eyelids
thinning hair
dry skin
brittle nails
Hypothyroidism is diagnosed on the basis of:
- low T3 and T4 levels
- elevated TSH in primary hypothyroidism
- low TSH in secondary hypothyroidism
- heart rate less than 60 bpm
How is hypothyroidism treated?
lifelong thyroid replacement
What is myxedema?
the characteristic sign of severe or long-standing hypothyroidism

causes edema around the eyes, hands, and feet

also causes thick, slurred speech and hoarseness
What is myxedema coma?
a medical emergency associated with severe hypothyroidism
What are the symptoms of myxedema coma?
decreased level of consciousness
hypothermia without shivering
How is myxedema coma treated?
IV thyroid hormone to maintain vital functions
Hyperparathyroidism = increased secretion of __________?
parathyroid hormone (PTH)
Hyperparathyroidism leads to what 2 conditions?

What causes primary hyperparathyroidism?
a benign neoplasm in the parathyroid gland
What causes secondary hyperparathyroidism?
problems that causes hypocalcemia
What causes tertiary hyperparathyroidism?
hyperplasia of parathyroid gland and loss of feedback mechanism
What are the signs and symptoms of hyperparathyroidism?
Same as symptoms of hypercalcemia:

bone pain
decreased attention span
kidney stones
What causes hypoparathyroidism (inadequate circulating PTH)?
accidental removal of parathyroids or damage to vascular supply during neck surgery
What are the signs and symptoms of hypoparathyroidism?
Primarily those of hypocalcemia:
- decreased cardiac contractility
- dysrhythmias
- abdominal cramps
- constricted feeling in the throat

Other S/S:
- dry skin
- hair loss
- horizontal ridges on nails
- cataracts
- bone deformities
Hypoparathyroidism leads to what 2 conditions?

How is hypoparathyroidism treated?
IV infusion of calcium salts

oral calcium supplements
Vitamin D
Hyperfunction of the adrenal cortex causes what disease?
Cushing's disease
What causes Cushing's disease?
use of exogenous corticosteriods (Prednisone)

ACTH secreting pituitary tumor

adrenal tumor

adrenal hyperplasia
Cushing's disease is characterized by excess __________?
corticosteroids, especially glucocorticoids
What are the signs and symptoms of Cushing's disease?
weight gain
accumulation of adipose tissue
glucose intolerance
protein & muscle wasting
A tumor of the adrenal medulla which produces excess catecholamines is known as a __________?

(90% of these are benign)
Pheochromocytomas most commonly develop in what age groups?
men and women ages 40-60
What are the signs and symptoms of a pheocromocytoma?
severe episodic hypertension, tachycardia, profuse sweating, anxiety, papitations, headaches
How is a pheochromocytoma treated?
by surgically removing it
Normal glucose range is _____ to _____
70 to 120
Normal fasting glucose is less than ____ in the morning
Impaired fasting glucose (IFG)

Greater than ____ but less than _____
greater than 110 but less than 126
Impaired glucose tolerance (IGT)

Greater than ____ but less than ____
greater than 140 but less than 200
the term used to describe individuals who have plasma glucose levels that are higher than normal but lower than those considered diagnostic for diabetes
IGT - impaired glucose tolerance
test that measure the amount of hemoglobin A1C in the blood

measure the amount of glucose that RBCs have been in contact with over the past 3 months
glycosylated hemoglobin
administration of 75 g of oral glucose after a 10 hour fast

blood is then taken 2 hours later
oral glucose tolerance test (OGTT)
Type I diabetes is characterized by a lack of _______ and a relative excess of __________.
lack of insulin

excess of glucagon
Symptoms of Type I diabetes:
loss of glucose in the urine
weight loss
ketoacidosis (makes breath smell sweet)
The most powerful risk factor for type 2 diabetes is:
Type 2 diabetes is characterized by:
insulin resistance with inadequate insulin secretion
How is type 2 diabetes treated?
person is put on a diet and given an oral hypoglycemic agent (pill, not insulin shot)
Symptoms of type 2 diabetes:
recurrent infections
prolonged wound healing
blurred vision
numbness/tingling of the extremities
What are 2 major acute complications of diabetes mellitus?

diabetic ketoacidosis
What are some symptoms of hypoglycemia?
fast heartbeat
impaired vision
What are the numbers for newborns and for adults for hypoglycemia?
below 35 for newborns

45-60 for adults
What is the range for diabetic ketoacidosis (diabetic coma)?
What are the symptoms of diabetic ketoacidosis?
increased thirst
sugar in urine
ketones in urine
CNS depression
Kussmaul respirations
What are the chronic complications of diabetes mellitus?
diabetic neuropathies

microvascular disease (retinopathy and diabetic nephropathy)

macrovascular disease (coronary artery disease, stroke, peripheral vascular disease)
the most common complication of diabetes

involves nerve degeneration and delayed conduction

sensory deficits and symptoms are more common than motor involvement
diabetic neuropathy
a response to retinal ischemia resulting from blood vessel changes and RBC aggregation and is influenced by growth hormone and metabolic control

develops more rapidly in type 2 than in type 1 diabetes and occurs in 3 stages
renal tissue injury caused by protein denaturation b/c of high glucose levels, hyperglycemia with high renal blood flow, and intraglomerular hypertension exacerbated by systemic hypertension
diabetic nephropathy