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50 Cards in this Set
- Front
- Back
Giantism is caused by
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Too much growth hormone
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Growth hormone deficiency is caused by
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A reduced production of GHRH or GH or by a pituitary tumor.
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Growth hormone deficiency is caused by
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A reduced production of GHRH or GH or by a pituitary tumor.
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Growth hormone replacement requires
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Weekly shots of GH
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Whats the history of GH replacement
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It use to come from cadevers until children started dying from cruetz felt Jacob syndrome. Now synthetic is available
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To determine a GH deficiency you need to know
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How tall the parents are, what are the secondary sex charecteristics, What is the bone age shown in the hand on an xray.
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When does a child need gh replacement
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When the bone is older than the child, once the epiphyseal ends close GH cant be given or acromegaly will develop.
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Giantism is caused by
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Growth hormone deficiency
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What is the mechanism seen in Giantism
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Excess GH occurring before puberty
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What is acromegaly caused by
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Excess Gh secretion in adulthood.
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How do you stop acromegaly or giantism
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By giving somatotrostain, stops GH
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How do you treat acromegaly
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Transphenoidal hypophysectomy (removing tumor) or with somatostatin.
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Antidiuretic hormone when
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arginine vasopressin is released from the posterior pituitary when the supraoptic nuclei in the hypothalamus senses an increase in serum sodium osmolality, or if the aortic arch, carotid arch, or left atrium sense that plasma volume is low they will affect the target organ= the distule tubule of the kidneys collecting to shut down
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Why does ADH release when plasma volume is low
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For fluid retention to stop urine outmust and allow fluid to move into the intracellular space instead of being in the extracellular space for excretion.
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Why are the aortic and carotid vessels the volume sensors and not the peripheral vessels
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Because they sense central core volume for a more accurate reading, peripheral vessels reading are affected by factors like HTN
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Diabetes insipiud is a result of
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Insufficient ADH
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Diabetes insipidus is NOT related to _____ , it is a result of
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NOT related to mellitus. It is caused because there is no balance of adh
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The two types of diabetes insipidus
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Neurogenic or nephrogenic.
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Neurogenic DI is caused by
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ADH not be produced, there is a problem with synthesis, transport or release
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Nephrogenic DI is caused
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by an inadequate response of ADH
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The BIG problem with DI is because ___ can develop
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Hypertonic dehydration and increased serum osmolality with inadequate fluid intake, especially in those unable to say they need water or get it.
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Siadh is a result of
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Excessive adh production
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SIADH can cause
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water retention and dilutional hyponatremia
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What is syndrome of inappropriate antidiuretic hormone secretion a result of
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Negative feed back syptom because it controls adh regulation. Since negative feedback is not working, excessive adh is continuously produced and secrete
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SIADH mechanism
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Water retention even though expansion/increase of intravascular colume is occurring.
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Why does thirst occur with SIADH
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Intravascular cells are dehydrated.
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Why are there GI symptoms with SIADH
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Due to increased volume to the GI tract
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Neuro symtpoms occur in SIADH because
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Electrolytes are diluted, everything will appear hypo even when it is not
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Graves disease is
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State of Hyperthyroidism, occurs more in women, mostly autoimmine b/c TSH stimulated the thyroid absnormally. It may be associated with other autoimmunes like myasthenia gravis or pernicious anemi
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Thyroid stimulating hormone increases what
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The activity of the thyroid gland because TSH in the anterior pituitary gland increases thyroglobulin breakdown and increases the follicle cell numbers and size causing the release of thyroid hormone from the follicles into the bloodstream, activating the iodide pump, increasing the oxidation of iodide and the binding of iodide to tyrosine.
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Actions of Thyroid Hormone
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For growth in children, increase of 60 to 100% of the baseline metabolic rate because of thyroxine secretion, increase of cardiovascular functions (heart rate and contractility), increased GI functioning (appetite),if there is a lot of TH muscles react more vigorously, if there is little amounts of TH muscles are sluggish.
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Altered thyroid functions include
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Hypothyroidism & Hyperthyroidism
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Hypothyroidism is most oftenly seen in
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elderly women especially in winter and those with hyperthyroidism because of thyrotoxicosis
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Which is more problematic hypo or hyperthyroidism
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Hyperthyroidism
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How many thryoid glands are there
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4 glands normally, can function with two though
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How many parathyroid glands
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1- 12
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How is parathyroid horome produces
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When the thyoid gland repsonds to ionized calcium it produces parathyroid.
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Hypoparathyroidism is related to
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Hypocalcemia / hypo or no thyroid
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The adrenal sex hormone ______ serves as a source of _____
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Androgens produce estrogen
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The adrenal cortex produces three types of steroid hormones
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the mineralocorticoids, the glucocorticoioids and the adrenal sex hormones
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Mineralocorticoids include and do what
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Aldosterone which function in sodium, potassium, and water balance
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What is a glucocorticoid & what does it do
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Cortisol, aids in regulating the metabolic functions and controlling the inflammatory reponse. Essential for survival during stress
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The manifestations of primary adrenal cortical insufficiency is related to _____ & _____ deficiency
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Mineralocorticoid deficiency because salt and water regulation is impaired and glucocorticoid deficiency because blood glucose and the inflammatory response cannot be controlled.
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Glucorticocoid cortisol regulates
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Glucose metabolism by stimulating gluconeogenesis and decreasing utilization of gluose which increases breakdown of proteins and causes increased protein levels causing fatty acids to be mobilizes and increases the utilization of fatty acids. Cortisol levels rise when with increased ACTH levels diurnal rhythm to cortisol as an important part of the stress response to regulate inflammation and generation of fever.
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What tests adrenal function
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Dexamethasone suppression test
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How Is the adrenal test done
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By administering dexamethasone (glucosteroid synthetic drug) to measure the HPA (hypothalamic pituitary adrenal system) then seeing if ACTH is produced, levels should be high normally because adrenal and ectopic drugs do not cause acth stimulation.
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What is a primary adrenal insufficiency disease
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Addisons disease
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In primary adrenal insufficiency addisons disease, the symptoms don’t show until when
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Until 90% of the adrenal gland has been destroyed
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Why is primary adrenal insufficiency worse than secondary
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Secondary does not affect the adrenal gland directly while primary does. Secondary can still be regulated because the gland still works.
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The main thing to distinguish between primary and secondary adrenal insufficiency is
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in primary there is hyperpigmentation and blue black oral mucus membranes, hyperkalemia, and autoimmune cause. In secondary there is hypokalemia, secondary deficiencies of testosterone, adh, thyroxine and growth hormone and secondary is not autoimmune.
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