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73 Cards in this Set

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cells that produce effects growth hormone

a) Kupffer Cells
b) Somatotrope Cells
c) Pancreatic Cells
d) Follicular Cells
Somatotropes
T/F

mechanism of GH depends on Somatostatin
F- somatomedin (produced by LV)

Somatostatin inhibits effects
where is somatomedin produced

a) KD
b) LV
c) Thyroid
d) Pituitary
LV
GHRH stimulates GH production and is released from

a) Ant Pituitary
b) Post Pituitary
c) Hypothal
d) None
Hypothal

GH released from Ant Pit
Incorrect Statement about GH

a) increase rate of protein synth
b) uses F.A. as fuel
c) lowers blood sugar
d) a,b
e) b,c
INCREASES blood sugar bc it decreases use of sugar as fuel

instead GH promotes FA mobilization and use of FA for fuel
GH promotes growth of all of the following except

a) Viceral Organs
b) Muscles
c) Skin
d) Connective Tissue
promo linear growth of ALL
when does production of GH Peak?

a) during activity
b) after meals
c) during sleep
d) levels are constant
during sleep- 3-4 hrs after onset
stimulates secretion of GH

a) hyperglycemia
b) decreased blood AA
c) stress
d) all
stress

GH secretion also stim by
hypoglycemia/starving
increased blood AA
inhibits secretion of GH

a) hyperglycemia
b) stress
c) increased blood AA
d) cortisol
Hyperglycemia/obesity
Cortisol

increased free FA
list causes of short stature
genetic
chromosomal
chronic illness/malnutrition/malabsorption
endocrine
psychosocial
T/F

short stature may be idiopathic due to a GH deficiency
T

also may be due to agenesis/tumor/non working pituitary gland
Congenital GH xu can be determined by

a) amniocentesis
b) growth measurement during 1st year
c) delayed puberty
d) all
growth measurement during 1st year

obvious by 1st/2nd years
Congenital short stature may cause

a) delayed puberty
b) delayed skeletal maturation
c) neonate seizure
d) all
ALL
T/F
tall stature that manifests during childhood is called acromegaly
F

Gigantism = childhood
Acromegaly = adulthood (slow onset)
T/F

a person w acromegaly is more likely to have HPB
T

due to cardiomegaly

also likely to be
diabetic- glucose intolerance
HOw will glucose affect lab test results of GH in a px w acromegaly
GH will remain Hi and not be suppressed by GH
which cranial nerve may be compressed in px w acromegaly

a) IV
b) II
c) III
d) V
II- causes visual field defects
list manifestation of tall stature disorders
glucose intolerance/diabetes
HBP/Cardiomegaly
HA
Hyperostosis/neuropathy
Goiter/heat intolerance
CNII compression/visual defect
Hypogonadism- low labido, irreg menses
T/F

Acromegaly may cause hypergonadism
T

Hypogonadism-> lo labido, disturbed menses
Which cell type makes up thyroid hormones


a) Kupffer Cells
b) Somatotrope Cells
c) Pancreatic Cells
d) Follicular Cells
follicular cells make T3 and T$ from tyrosine and I-
______is the active form of thyroid hormones
T3
T/F

thyroid hormones do not need to be bound to proteins in the blood
F

bound to proteins in blood
will signal the hypothal to produce TRH

a) Cold
b) Stress
c) Sleep
d) Heat
Cold (NOT heat)
Stress
Sleep
stim hypothal to produce TRH
TRH signals Ant Pit to secrete TSH to target thrydoid gland
T3/4 travel to target organs/cells
T/F

Thyroid hormones use a + Feedback syst
F
negative feedback

increased production of T3/4 inhibits hypothal from producing TRH which inhibits Ant PIt secretion of TSH
_____ increases metab and protein synth and is necessary for physical and mental development
Thyroid Hormone
Incorrect Statement about Thyroid Hormone

a) vasodilation
b) may cause diarrhea
c) stimulates parasymp
d) catabolism of fat/protein/carbs
Stimulates SYMPathetic

increases metab and protein synth needed for physical and mental dvlpment. Effects BMR, Cardio/Respiratory sys, GI, and Neuromuscular
Thyroid Hormone increases metab in all tissues except
Retina
SP
LU
Testes
Congenital Hypothyroidism

a) myxedema
b) goiter
c) grave's disease
d) cretenism
cretenism: infants appear normal- later evident mental retardation and impaired growth

myxedema= adult hypothyroidism -> goiter
grave's= hyperthyroidism
cause of transient hypothyroidism

a) Lithium tx
b) maternal use of I-
c) Hashimoto's
d) all
maternal use of I-
T/F

Adult hypothyroidism may cause pitting edema
F
non-pitting
myxedema
goiter
T/F

Impaired hypothal is the cause of primary hypothyroidism
F-
primary: thyroidectomy, hashimotos, xs I- ingestion, Lithium tx

secondary: caused by impaired hypothal or pituitary
list causes of hyperthyroidism
graves disease
adenoma
OD thyroid hormone
manifestations of Grave's disease
hyperthryoidism/xs symp activity
goiter
exophthalmos
mechanism of Grave's Disease
autoimmune
abnormal stim of TSH Antibodies act through normal TSH receptors
T/F

Thyroid Storm is likely life threatening
T

-> hi fever, tachycardia/cardiac failure, agitation, delirium
Conjugation of Adreno-cortical hormones takes place in the

a) LV
b) KD
c) SP
d) GB
LV- conjugation

excreted via urine and bile
Route of excretion for adreno cortical hormones

a) urine
b) feces
c) bile
d) all
urine
bile
T/F

Adreno-cortical hormones do not need to be bound to proteins for circulation
F

must be bound to plasma proteins
not a cause of adrenal insufficiency

a) autoimmunity
b) TB
c) infection
d) xs pituitary function
xs pituitary function -> cushings

adrenal insufficiency:
tumor
infection
TB
autoimmune
pathology of adrenal insufficiency
-destruction of all layers of the adrenal gland
-decrease adrenal hormone
-increase ACTH
hyper-pigmentation is a manifestation of _______
adrenal insufficiency

also:
mineral-corticoid xu
gluco-corticoid xu
correct statement

a) transient hypothyroidism will cause abnormal brain devlpmnt
b) xu of TRH is a disorder of the pituitary
c) hashimoto's is the most common cause of primary hypothyroidism
d) all are true
hasimoto's is most common

usually presents in young women
T/F

Graves Disease is an autoimmune condition
T
-> hypermetabolic state w xs symp activity
T/F

the mechanism of Graves disease causes xs TSH to be released
F

This is an auto-immune condition: TS-Ab abnormally stim the thyroid gland and act like normal TSH
Px blood test shows lo levels of TSH but px experiences insomnia, hi fever, irritability and constant hunger along w goiter. what is the diagnosis
Graves- autoimmune disease TSH-Ab -> xs stim of Thyroid
list the 3 layers of the adrenal cortex from the outermost layer to the innermost
Glomerulosa (aldosterone)
Fasciculata (glucocorticoid)
Reticulata (sex hormone)
precursor for steroid hormones
cholesterol -> pregnenolone
list the adrenal cortical steroid hormones produced
DHEA
-> testosterone, estradiol/estrone
Glucocorticoid
Aldosterone
where in the adrenal is Aldosterone synthesized

a) Glomerulosa
b) Fasciculata
c) Reticulars
d) Medulla
Glomerulosa
Where is glucocorticoid synth in the adrenal

a) Glomerulosa
b) Fasciculata
c) Reticulars
d) Medulla
fasciculata
where are DHEA nad sex hormones synthesized in the adrenal

a) Glomerulosa
b) Fasciculata
c) Reticulars
d) Medulla
reticularis

(sex hormones released are not as strong as those released from the ovaries/testes
aldosterone is regulated by

a) renin angiotensin
b) blood K+
c) ACTH
d) FA
renin angiotensin
blood k+

promo Na/K balance
Where is Na retained by Aldosterone
distal tubules
an xs of blood k+ will cause

a) increase aldosterone for Na+ retention and K+ retention
b) decrease aldosterone for Na+ retention and K+ retention
c) Increase aldosterone for Na+ retention and K+ excretion
d) decrease aldosterone for Na+ retention and K+ excretion
increase aldosterone for Na+ retention and K+ excretion
regulation of glucocorticoid occurs by


a) renin angiotensin
b) blood K+
c) ACTH
d) FA
ACTH- negative feedback mech of hypothalamic/pituitary adrenal system (peak 6-8 am to deal w stress of waking)
Glucocorticoid regulation is a ______ feedback system
negative
list the functions of glucocorticoid
increase Blood Sugar
Increase protein breakdown
-> increase plasma protein
increase Fatty Acid mobilization
Anti-inflammatory
Emotional Stability

peaks between 6-8 am
steroid commonly administered in RA treatment
glucocorticoid- cortisol

anti-inflammatory action
True Statement about adrenal sex hormone

a) little effect on sexual function
b) body hair distribution
c) secondary sex characteristics
d) all
All
adrenal genital syndrome is

a) autosomal dominant
b) autosomal recessive
c) impaired translocation
d) none
autosomal recessive
-> xu of any one enzyme necessary for the formation of cortisol
describe the mechanism of adrenal genital syndrome
Congenital Adrenal Hyperplasia:
xu of any enzyme needed for formation of cortisol
-> Increase ACTH
-> Adrenal hyperplasia
-> Increase Androgen
Manifestation of adrenal genital syndrome
baby boy- enlarged genitalia, mineral imbalance

baby girl- virilization syndrome of ambiguous genitalia enlarged clit and fused labia majora (xs testosterone)
Cushing's syndrome

a) adrenal insufficiency
b) hypercortisolism
c) xs testosterone
d) none
hypercortisolism/xs glucocorticoid

(addison's= adrenal insufficiency)
(xs testosteron= drenal genital syndrome)
Causes of adrenal insufficiency
Autoimmune
infection
TB
tumor
adrenal insufficiency affects which layer(s) of the adrenal gland
ALL layers destroyed

->decrease in adrenal hormone
->increase ACTH
px presents w fatigue, muscle twitching, mood swings, and dark patches in the gums of the mouth. likley diagnosis
adrenal insufficiency/addison's

mnieralcorticoid xu- lo Na+, twitching, fatigue
glucocorticoid xu- lo blood sugar, emotions, weightloss
hyperpigmentation- esp mucus membranes due to xs ACTH
causes of cushing's syndrome
xs pituitary fnctn
adrenal cause
ectopic cushing's
iatrogenic (xs Rx of steroids- RA, Lupus)
manifestations of cushing's
Hyperglycemia
muscle wasting, stretch marks
Fat redistribution- moon face, buffalo hump, skinny legs
water/electrolyte imbalance- water retention
prone to infection
Increase ST HCl
Euphoria/psychosis
Hirsutism, Irreg menses
T/F

extra care should be taking when treating a patient w adrenal insufficiency bc they are more prone to infection
F

Cushing's more prone to infection
-xs steroid production decreases immunity
Px has a puffy round face, skinny legs and hump back. what is the likely diagnosis
cushing's
px diagnosed with cushing's but shows hi levels of plasma ACTH indicates

a) dysfunction of pituitary gland
b) dysfunction of adrenal gland
c) dysfunction of pineal gland
d) none
dysfunction of post pituitary
px tests indicate xs excretion of cortisol in the urine and lo plasma levels of ACTH

what does this tell you about the px diagnosis
cushing's due to dysfunction of adrenal gland
dexamethasone suppression test is used to diagnose

a) Addison's disease
b) Grave's Disease
c) Hypothyroidism
d) Cushing's disease
cushing's

if ACTH decreases- the problem is likely to be the adrenal gland
if ACTH increase- problem likely to be the pituitary