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110 Cards in this Set
- Front
- Back
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What is the primary coordinator of the endocrine system?
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the pituitary gland
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How can hormones be classified?
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according to:
structure gland of origin the effects they have chemical composition |
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What type of hormone (lipid or water soluble) circulates bound to a carrier protein in the bloodstream?
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lipid soluble
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Which type of hormone (lipid or water soluble) diffuses through the plasma membrane and binds to nuclear receptors?
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lipid soluble
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Name 2 examples of lipid soluble hormones.
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steroids
thyroid hormone |
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Name 2 examples of water soluble hormones.
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insulin
parathyroid hormone |
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Which type of hormone (lipid or water soluble) has a short half life?
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water soluble
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Which type of hormone (lipid or water soluble) circulates in the bloodstream free and unbound?
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water soluble
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Which type of hormone (lipid or water soluble) binds to a cell surface receptor to travel through the membrane?
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water soluble
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What are lipid soluble hormones made from?
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cholesterol
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What are the 2 posterior pituitary hormones?
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ADH
oxytocin |
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Which hormone regulates growth and development, cell metabolism, oxygen consumption, and body temperature?
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thyroid hormone
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Which hormone is the primary regulator of calcium?
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parathyroid hormone
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The pancreas is responsible for ___________ in the body.
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metabolism
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The alpha cells of the Islets of Langerhans secrete ________?
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glucagon
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The beta cells in the islets of Langerhans secrete _________?
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insulin
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The D cells in the islets of Langerhans secrete ________ and _________?
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somatostatin
and gastrin |
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The major job of insulin is to:
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decrease blood glucose
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Insulin is synthesized by _________, ___________, and __________.
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liver
muscles fat tissue |
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Somatostatin (produced by the D cells) is thought to inhibit ____________ and __________ secretion.
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glucagon and insulin
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The adrenal cortex secretes three types of hormones:
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glucocorticoids
mineralocorticoids androgens/estrogens |
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The primary type of glucocorticoid is:
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cortisol
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Which type of hormone secreted by the adrenal cortex inhibits the immune/inflammatory response, increases circulating erythrocytes, and increases appetite (promotes fat deposits)?
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glucocorticoids
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When is cortisol secreted?
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during stressful situations
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What is the primary type of mineralocorticoid?
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aldosterone
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Which type of hormone secreted by the adrenal cortex affects ion transport, causing sodium retention and potassium/hydrogen loss?
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mineralocorticoid
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What two hormones are produced by the adrenal medulla?
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epinephrine
norepinephrine |
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What does the hormone oxytocin do?
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controls lactation and uterine contractions
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What does the hormone ADH do?
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controls renal reabsorption of free water
is a powerful vasoconstrictor |
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A low concentration of the hormone increases the number of receptors per cell.
This is called: |
up-regulation
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A high concentration of the hormone lowers the number of receptors per cell.
This is called: |
down-regulation
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Name 4 important anterior pituitary hormones.
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ACTH
MSH GH TSH |
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What is ACTH, its target, and its function?
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Adrenocorticotropic hormone
Targets the adrenal gland Secreted by the anterior pituitary Regulates growth/secretion of the adrenal gland, particularly cortisol and the androgenic steroids |
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What is MSH, its target, and its function?
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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 |
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What is GH, its target, and its function?
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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 |
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What is TSH, its target, and its function?
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Thyroid-stimulating hormone
Targets the thyroid gland Secreted by the anterior pituitary Causes increased production/secretion of thyroid hormone (TH) Causes increased iodine uptake |
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What is the normal range of T3 in the body?
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80 - 200
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What is the normal range of T4 in the body?
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4.5 - 11.5
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What are some effects of aging on the thyroid gland?
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T4 secretion is decreased
T3 levels decline Hypothyroidism is more prevalent TSH secretion is diminished |
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What are some effects of aging on the parathyroid gland?
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It is difficult to detect because of decreased calcium intake and circulating vitamin D, as well as blunted response accompanying aging.
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What are some causes of ADH hypersecretion (SIADH)?
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head trauma
carcinomas (ADH secreting tumors) medications surgery (fluid volume shifts) |
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What are some signs/symptoms of ADH hypersecretion (SIADH)?
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1. Fluid volume retention = weight gain, edema
2. Dilutional hyponatremia -> muscle cramps, weakness, arrhythmias 3. Concentrated urine (decreased urine output) |
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What are some symptoms of a drop in your sodium level from 140 to 130 mEq/L?
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thirst
impaired taste anorexia fatigue |
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What of some symptoms of a drop in your sodium level from 130 to 120 mEq/L?
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Severe gastrointestinal symptoms, such as vomiting and abdominal cramps
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What are some symptoms of a serum sodium level below 115 mEq/L?
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confusion, convulsions, twitching, lethargy
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How would you treat ADH hypersecretion (SIADH)?
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Treat the cause.
Major fluid restriction (600-800 cc/day) Diuretic with cardiac symptoms K+ supplement |
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What is the ADH hyposecretion disorder called?
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diabetes insipidus
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What are some causes of diabetes insipidus?
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Idiopathic (naturally get rid of too much water--no known cause)
Brain tumors Closed head trauma Intracranial surgery |
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What are the signs/symptoms of diabetes insipidus?
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polyuria (5-20 L per day)
nocturia increased serum osmolality (hypernatremia, which causes polydipsia--increased thirst) Weight loss, hypovolemic shock, hypotension, agitation, tachycardia, constipation |
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How would you treat diabetes insipidus?
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Fluid replacement
Give drugs that act like ADH Monitor input and output |
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Gigantism is due to an overproduction of ___________.
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growth hormone
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What age group does gigantism occur in?
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growing children (whose epiphyses have not closed yet)
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Gigantism is a disorder of what endocrine gland?
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anterior pituitary (usually caused by a pituitary adenoma)
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Acromegaly is a disorder of what endocrine gland?
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anterior pituitary (overproduction of GH)
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Acromegaly occurs in what age group?
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adults in their 40s and 50s (caused by tumor on anterior pituitary)
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What are the signs of acromegaly?
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bones become thicker and wider (since epiphyseal closure has occurred)
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What is the most common hyperthyroid condition?
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Graves disease
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What are the signs/symptoms of Graves disease?
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tachycardia
arrhythmias out of breath on exertion diarrhea weight loss muscle weakness fatigue nervousness inattention amennorhea impotence eyeballs look like they are about to pop out of head goiter (thyroid enlargement) |
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How do you treat Graves disease?
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antithyroid drugs
radioactive iodine surgery surgical therapy nutritional therapy |
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What is the acute but rare condition associated with hyperthryoidism?
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thyroid storm (thyrotoxic crisis)
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What is the cause of thyroid storm?
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stressors (infection, trauma, surgery) in a patient with existing hyperthyroidism
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What are the signs of thyroid storm?
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severe tachycardia, heart failure, shock, hyperthermia up to 105.3, seizure, coma
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What are some causes of hypothyroidism?
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- 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) |
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What are the symptoms of hypothyroidism?
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Metabolic activity of the cells decreases, causing:
fatigue/lethargy weight gain cold hands and feet subnormal temp and pulse swelling in hands, feet, and eyelids thinning hair dry skin brittle nails |
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Hypothyroidism is diagnosed on the basis of:
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- low T3 and T4 levels
- elevated TSH in primary hypothyroidism - low TSH in secondary hypothyroidism - heart rate less than 60 bpm |
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How is hypothyroidism treated?
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lifelong thyroid replacement
diet |
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What is myxedema?
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the characteristic sign of severe or long-standing hypothyroidism
causes edema around the eyes, hands, and feet also causes thick, slurred speech and hoarseness |
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What is myxedema coma?
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a medical emergency associated with severe hypothyroidism
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What are the symptoms of myxedema coma?
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decreased level of consciousness
hypothermia without shivering hypoventilation hypotension hypoglycemia |
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How is myxedema coma treated?
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IV thyroid hormone to maintain vital functions
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Hyperparathyroidism = increased secretion of __________?
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parathyroid hormone (PTH)
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Hyperparathyroidism leads to what 2 conditions?
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hypercalcemia
hypophosphotemia |
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What causes primary hyperparathyroidism?
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a benign neoplasm in the parathyroid gland
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What causes secondary hyperparathyroidism?
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problems that causes hypocalcemia
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What causes tertiary hyperparathyroidism?
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hyperplasia of parathyroid gland and loss of feedback mechanism
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What are the signs and symptoms of hyperparathyroidism?
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Same as symptoms of hypercalcemia:
dysrhythmias constipation osteoporosis bone pain hyperreflexia headache confusion decreased attention span kidney stones |
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What causes hypoparathyroidism (inadequate circulating PTH)?
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accidental removal of parathyroids or damage to vascular supply during neck surgery
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What are the signs and symptoms of hypoparathyroidism?
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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 |
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Hypoparathyroidism leads to what 2 conditions?
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hypocalcemia
hyperphosphatemia |
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How is hypoparathyroidism treated?
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IV infusion of calcium salts
Long-term: oral calcium supplements Vitamin D |
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Hyperfunction of the adrenal cortex causes what disease?
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Cushing's disease
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What causes Cushing's disease?
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use of exogenous corticosteriods (Prednisone)
ACTH secreting pituitary tumor adrenal tumor adrenal hyperplasia |
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Cushing's disease is characterized by excess __________?
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corticosteroids, especially glucocorticoids
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What are the signs and symptoms of Cushing's disease?
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weight gain
accumulation of adipose tissue glucose intolerance protein & muscle wasting osteoporosis |
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A tumor of the adrenal medulla which produces excess catecholamines is known as a __________?
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pheochromocytoma
(90% of these are benign) |
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Pheochromocytomas most commonly develop in what age groups?
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men and women ages 40-60
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What are the signs and symptoms of a pheocromocytoma?
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severe episodic hypertension, tachycardia, profuse sweating, anxiety, papitations, headaches
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How is a pheochromocytoma treated?
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by surgically removing it
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Normal glucose range is _____ to _____
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70 to 120
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Normal fasting glucose is less than ____ in the morning
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110
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Impaired fasting glucose (IFG)
Greater than ____ but less than _____ |
greater than 110 but less than 126
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Impaired glucose tolerance (IGT)
Greater than ____ but less than ____ |
greater than 140 but less than 200
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the term used to describe individuals who have plasma glucose levels that are higher than normal but lower than those considered diagnostic for diabetes
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IGT - impaired glucose tolerance
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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
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administration of 75 g of oral glucose after a 10 hour fast
blood is then taken 2 hours later |
oral glucose tolerance test (OGTT)
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Type I diabetes is characterized by a lack of _______ and a relative excess of __________.
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lack of insulin
excess of glucagon |
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Symptoms of Type I diabetes:
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hyperglycemia
loss of glucose in the urine polyuria polydipsia polyphagia weight loss fatigue ketoacidosis (makes breath smell sweet) |
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The most powerful risk factor for type 2 diabetes is:
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obesity
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Type 2 diabetes is characterized by:
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insulin resistance with inadequate insulin secretion
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How is type 2 diabetes treated?
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person is put on a diet and given an oral hypoglycemic agent (pill, not insulin shot)
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Symptoms of type 2 diabetes:
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recurrent infections
prolonged wound healing blurred vision numbness/tingling of the extremities fatigue |
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What are 2 major acute complications of diabetes mellitus?
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hypoglycemia
diabetic ketoacidosis |
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What are some symptoms of hypoglycemia?
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shaking
fast heartbeat sweating anxiousness dizziness hunger impaired vision fatigue headache irritability |
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What are the numbers for newborns and for adults for hypoglycemia?
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below 35 for newborns
45-60 for adults |
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What is the range for diabetic ketoacidosis (diabetic coma)?
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300-700
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What are the symptoms of diabetic ketoacidosis?
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polyuria
dehydration increased thirst polydipsia sugar in urine ketones in urine CNS depression Kussmaul respirations |
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What are the chronic complications of diabetes mellitus?
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diabetic neuropathies
microvascular disease (retinopathy and diabetic nephropathy) macrovascular disease (coronary artery disease, stroke, peripheral vascular disease) |
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the most common complication of diabetes
involves nerve degeneration and delayed conduction sensory deficits and symptoms are more common than motor involvement |
diabetic neuropathy
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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 |
retinopathy
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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
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diabetic nephropathy
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