Endocrine

Front 1

How do hormone-receptor interactions work?

Back 1

In a lock & key manner in that only the correct hormone (key) can bind to and activate the receptor site (lock). Binding a hormone to its receptor causes the target tissue to change its activity.

Front 2

What does the thyroid do?

Back 2

The function of the thyroid is to regulate the body's metabolism by making thyroid hormone.

Front 3

Where is the parathyroid gland?

Back 3

Close to, imbedded in or attached to the posterior surface of the thyroid gland.

Front 4

What does the parathyroid gland consist of?

Back 4

4 small glands.

Front 5

What is the function of the parathyroid.

Back 5

The sole purpose of the parathyroid glands are to regulate the calcium level in our bodies within a very narrow range so that the nervous and muscular systems can function properly.

Front 6

What does the pancreas do?

Back 6

The pancreas has two primary purposes: to secrete enzymes into your digestive system that help break down carbohydrates and protein, and to produce hormones that help maintain normal blood sugar levels.

Front 7

What are the Islets of Langerhans?

Back 7

Perform the endocrine functions of the pancreas. Composed of 3 distinct cell types: alpha cells, which secrete glucagon; beta cells, which secrete insulin; and delta cells, which secrete somotostatin.

Front 8

What do glucagon and insulin affect?

Back 8

Carbohydrate, protein and fat metabolism.

Front 9

What is Somotostatin?

Back 9

Secreted not only in the pancrease but also in the gut and the brain, inhibits the release and action of glucagon and insulin from the pancreas.

Front 10

What is the function of the pancreas?

Back 10

-Exocrine function of the pancreas involves the secretion of digestive enzymes through ducts that empty into the duodenum.
-Endocrine function is primarily to regulate blood glucose (sugar).

Front 11

What is insulin?

Back 11

An anabolic hormone (one that stimulates growth), promotes the synthesis and storage of carbohydrate (CHO), protein and fat. Lowers blood glucose levels by enhancing glucose diffusion across cell membranes in many tissues.

Front 12

What are Stimulation Tests?

Back 12

Measured amounts of selected hormones are given to stimulate the target gland to maximal production. Hormone levels are then measured and interpreted against a given norm. Failure of the hormone level to rise with stimulation denotes hypofunction.

Front 13

What are Suppression Tests?

Back 13

Used when hormone levels are high or in the upper range of normal. Failure of hormone production to be suppressed during standarized testing indicates hyperfunction.

Front 14

What is radioimmunoassay?

Back 14

A competetive binding assay in which radioactivily labeled amounts of hormone (antigen) compete with unlabeled hormones from the plasma or serum for antibody sites. Various techniques measure the amount of unbound and bound hormone. the unbound hormone is the active hormone.

Front 15

What do urine test do?

Back 15

Because many of the endocrine hormones are secreted in a pulsatile fashion, measurement of a specific hormone in a 24-hour urine collection better reflects the overall function of certain glands, such as the adrenal gland.

Front 16

What do glucose test do?

Back 16

They help the doctor make a diagnosis of diabetes mellitus. The glycosylated hemoglobin (HbA1c) value reveals the average blood glucose level over a period of 2-3 months.

Front 17

What is hyperthyroidism?

Back 17

(or "overactive thyroid gland") is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. Major causes are: Graves' disease (the most common etiology with 70-80%,
Toxic thyroid adenoma and
Toxic multinodular goitre.

Front 18

What is hypothyroidism?

Back 18

Disease state caused by insufficient production of thyroid hormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism.

Front 19

What is Grave's Disease.

Back 19

AKA toxic diffuse goiter. It is the most common cause of hyperthyroidism. Represents a basic defect in the immune system, causing production of immunoglobulins (antibodies) which stimulate and attack the thyroid gland, causing growth of the gland and overproduction of thyroid hormone. Similar antibodies may also attack the tissues in the eye muscles and in the pretibial skin (the skin on the front of the lower leg).

Front 20

What are the symptoms of Grave's Disease?

Back 20

-Hyperthyroidism
-a goiter (enlargment of the thryoid gland.
-exophthalmos (abnormal protusion of the eyes)
-pretibial myxedema ( dry, waxy swelling of the front surfaces of the lower legs.

Front 21

Age people get Graves?

Back 21

Diagnosed most often in women between the ages of 20 and 40. Toxic multinodular goiter usually occur after the age of 50 and affects women 4X as often as men.

Front 22

What is the hallmark sign of hyperthyroidism?

Back 22

Heat intolerance. May have diaphoresis which means increased sweating when temperature is comfortable for others. Also wears lighter clothing in cold weather.

Front 23

Symptoms of hyperthyroidism?

Back 23

-Heat intolerance
-diaphoresis
-palpitations
-chest pains
-dyspnea
-visual changes
-changes in energy level
-fatigue
-weakness
-insomnia
-irritability
-depression
-decreased menstrual flow
-increased libido

Front 24

What 2 types of opthalmopathy(abnormal eye appearance and function) are common with hyperthyroidism?

Back 24

1. Eyelid retraction (eyelid lag):Upper eyelid fails to descend when patient gazes slowly downward.
2. Globe (eyeball) lag: upper eyelid pulls back faster than the eyeball when patient gazes upward.

Front 25

What is photophobia?

Back 25

Sensitivity to light.

Front 26

What is bruits?

Back 26

Turbulence from increased bloodflow.

Front 27

What are the psychosocial aspects of hyperthyroidism?

Back 27

Lability (mood instability), irritability, decreased attention span, and manic behaviors.

Front 28

What are some interventions for hyperthyroidism?

Back 28

1)Drug therapy - most common are the thioamides, including propylthrouracil (PTU) and methiamazole (Tapazole), which block thyroid hormone production.
2) Radioactive Iodine therapy - most effective treatment, and is used to prevent the thyroid continuing to produce too many hormones.
3) Thyroidectomy - full or partial removal of the thyroid.

Front 29

What does euthryoid mean?

Back 29

A near normal thyroid function.

Front 30

What postoperative care should be provided for a thyriodectomy?

Back 30

-Vital signs every 15 mins until stable and then every 30 minutes.
-Assess level of pain and discomfort.
-Humidification of air to promote easier respirations and to thin respiratory secretions.
-Assist in coughing and deep breathing every 30 mins to 1 hour.
-Suction if neccessary.
-Monitor for hemorage, respiratory distress, hypocalcemia, tetany, laryngeal nerve damage and thyroid storm crises.

Front 31

What is hypocalcemia?

Back 31

the presence of low serum calcium levels in the blood (usually taken as less than 2.2 mmol/L or 9mg/dl or an ionized calcium level of less than 1.1 mmol/L (4.5 mg/dL)). This condition is sometimes confused with hypokalemia.

It is a type of electrolyte disturbance.

Front 32

What is Tetany?

Back 32

The point at which signals from nerves (action potentials) are arriving to skeletal muscle rapidly enough in succession to cause a steady contraction, and not just a series of individual twitches.

Front 33

What is Thyroid Storm?

Back 33

AKA thyroid crises - life threatening - occurs in people with hyperthyroidism and is usuall caused by Grave's Disease. Signs & symptoms include: fever, tachycardia, systolic hypertension, abdominal pain, nausea, vomiting, diarhea, agitation, anxiety, tremors. Is triggered by major stressors such as trauma or infection, vigourous palpatations of the goiter, exposure to iodine and RAI.

Front 34

What is Hashimoto's thyroiditis?

Back 34

Chronic thyroiditis - type of hypothyroidism that affects women more than men, comost commonly 30-50 years old. Is an autoimmune disorder. The thyroid becomes invaded with antithyroid antibodies and lymphocytes causing thyroid tissue destruction.

Front 35

Signs of Hashimoto's?

Back 35

Dysphagia and painless enlargment of the gland.

Front 36

How is Hashimoto's diagnosed?

Back 36

Based on the presence of circulating antithyroid antibodies and needle biopsy findings of the thyroid gland.

Front 37

Treatment for Hashimoto's

Back 37

Thyroid hormones to prevent hypothyroidism and to suppress TSH secretion, thereby decreasing the size of the thyroid gland. Surgery is necessary if the goiter doesn't respond to thyroid hormone, is disfiguring or compresses other structures.

Front 38

What is hyperparathyroidism?

Back 38

Overactivity of the parathyroid glands and excess production of parathyroid hormone (PTH). Consequences are weakness of bone tissue (predisposing for fracture) and hypercalcemia (high calcium levels).

Front 39

Symptoms of hyperparathyroidism?

Back 39

Abdominal pain, lethargy or dysphoria, kidney stones, osteoporosis (and resultant fractures), and depression.

Other symptoms include: headaches, sleep disorders, memory problems, gastroesophageal reflux, decreased sex drive, thinning hair, hypertension, and heart palpitations.

In short-lived hyperparathyroidism, hypercalcemia might be the only sign, sometimes producing such symptoms as nausea, vomiting, lethargy, depression, muscular weakness and an altered mental state.

Front 40

Diagnosis of hyperparathyroidism?

Back 40

Diagnostic workup for hypercalcemia often includes testing the PTH levels. Ultrasound of the neck area may reveal enlarged glands. Occasionally, scintigraphy with MIBI is necessary to identify adenomas or hyperplastic parathyroids.

Front 41

Treatment for hyperparathyroidism?

Back 41

The only definitive treatment is surgery. Surgical techniques for hyperparathyroidism now are much less invasive and much more effective than in the past. The procedure is called parathyroidectomy. Usually, the surgery will only involve one of the glands, and a successful surgery will allow the remaining parathyroids to correctly regulate blood calcium levels.

If hypercalcemia is severe, bisphosphonates may be required to maintain bone. Hyperparathyroidism can be treated medically with cinacalcet (a calcium receptor blocker), which is very expensive.

Front 42

What is hypoparathyroidism?

Back 42

Decreased function of the parathyroid glands, leading to decreased levels of parathyroid hormone (PTH). The consequence, hypocalcemia, is a serious medical condition.

Front 43

Symptoms of hypoparathyroidism?

Back 43

Hypocalcemia is the only real result of parathyroid dysfunction and low PTH levels. This presents with tremor, tetany and, eventually, convulsions.

Front 44

Disgnosis of hypoparathyroidism?

Back 44

Diagnosis is by measurement of calcium, albumin (for correction) and PTH in blood. PTH degrades rapidly at ambient temperatures and the blood sample therefore has to be transported to the laboratory on ice.

If necessary, measuring cAMP (cyclic AMP) in the urine after an intravenous dose of PTH can help in the distinction between hypoparathyroidism and other causes.

Front 45

Treatment of hypoparathyroidism?

Back 45

Severe hypocalcemia, a potentially life-threatening condition, is treated as soon as possible with intravenous calcium (e.g. as calcium gluconate). Generally, a central venous catheter is recommended, as the calcium can irritate peripheral veins and cause phlebitis.

Long-term treatment of hypoparathyroidism is with calcium and Vitamin D3 supplementation (D1 is ineffective in the absence of renal conversion). Teriparatide, a synthetic form of PTH (presently registered for osteoporosis) might become the treatment of choice for PTH supplementation, although further studies are awaited.

Front 46

What is gestational diabetes?

Back 46

A form of diabetes found in pregnant women. It occurs when the pregnant woman's body cannot produce enough insulin, resulting in high blood sugar. Gestational diabetes affects an estimated two to three percent of pregnant women.[1]

Front 47

What are the risk factors for gest. diabetes?

Back 47

-a family history of type 2 (adult-onset) diabetes
maternal age
- a woman's risk factor increases the older she is
-ethnic background (those with higher risk factors include African-Americans, North American native peoples and Hispanics)
-obesity
-gestational diabetes in a previous pregnancy
-a previous pregnancy that resulted in a child with a birth weight of 9 pounds or more.

Front 48

Signs & symptoms of gest. diabetes?

Back 48

Frequently women with gestational diabetes exhibit no symptoms. However, possible symptoms include increased thirst, increased urination, fatigue, nausea and vomiting, bladder and yeast infection, and blurred vision.

Front 49

Treatment for gest. diabetes?

Back 49

Often, gestational diabetes can be managed through a combination of diet and exercise. If that is not possible, it is treated with insulin, in a similar manner to diabetes mellitus.

Front 50

Complications of gest. diabetes?

Back 50

-Large for gestational age (LGA) babies are those whose birth weight lies above the 90th percentile for that gestational age. Macrosomia, also known as big baby syndrome, is sometimes used synonymously with LGA, or is otherwise defined as a fetus that weighs above 4000 grams (8 lb 13 oz) or 4500 grams (9 lb 15 oz) regardless of gestational age.