Endocrine System Disorders

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Endocrine Gland

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Secretes hormones directly into the bloodstream to act on/In target cells

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Hypothalamus

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Regulates the pituitary

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Steroid hormones

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Need carrier to directly enter cell

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Non-Steroid hormone

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Soluble in blood; acts on the receptors on cell surface. Does NOT need a carrier

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Negative Feedback System

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Deviation from normal values initiates a response (secretion); the response (secretion decreases as values return to normal

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Feedback System

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How internal conditions are kept within set limits

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Positive feedback system

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Moves the controlled condition further away from homeostasis; childbirth and coagulation

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Steps of the feedback system

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1. hypothalamus

2. Pituitary

3. Target gland

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What is an antagonist hormone?

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An antagonist hormone opposes another hormone; if one rises the other lowers

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True or False

Inherent dysfunction of the gland or of the gland that activates it

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TRUE: the problem can be "upstream" that results in the gland not working

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Example of antagonist hormone

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Parathyroid hormone increases blood calcium levels; calcitonin released from the thyroid decreases blood calcium levels

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Are hormones released at a constant?

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Hormone rates vary; some are constant, intermittent/on demand, sleep/wake cycles

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What is an endocrine disorder?

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It is a problem with too much or too little of a hormone

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What is a common cause of endocrine disorders?

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ADENOMAS!!

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Define hypersecrete

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When a gland releases too much of a hormone

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What is a cause of hyposecretion?

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Gland destruction. Initially, because of cell destruction you can have hypersecretion from hormones being liberated from the glands cells. As the gland destruction progresses, the result is hyposecretiom

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What are 3 causes of endocrine disorders?

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1. Adenomas

2. Feedback System failure

3. Ectopic hormone release

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Negative Feedback failure

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Secretes too much; doesn't turn off

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Positive feedback failure

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Secretes too little; doesn't turn on

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An example of ectopic hormone release?

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Some lung cancers secrete ADH

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3 examples of cell surface receptor-associated disorders; target cell failure

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1. Decreased # of receptors

2. Impaired receptors

3. Antibodies present against receptors

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4 types or target cell failure

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1. Cell surface receptor associated disorder

2. intracellular disorder

3. inhibitors

4. Dysfunctional delivery

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What is meant by dysfunctional delivery?

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1. Inadequate carrier proteins for steroid hormones

2. Poor blood supply

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What is meant by intracellular disorders?

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issue with a secondary messenger system for non - steroidal hormones

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Role of hypothalamus

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1.Regulates the pituitary gland

2.ADH and oxytocin are made in the hypothalamus and then STORED in pituitary

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Role of pituitary gland

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"Master Gland"; controls other gland activities

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How many lobes does the pituitary gland have?

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It has 2 lobes; anterior and posterior

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Growth Hormone

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Released by pituitary; stimulates growth within the body

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Prolactin

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Released by the pituitary; milk production

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Follicle Stimulating Hormone (FSH)

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Released by pituitary;

- females: growth and maturity of ovarian follicle

-males: spermatogenesis

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Luteinizing Hormone

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Released from pituitary; Works in conjunction with FSH

-females: follicle maturation (estrogen and progesterone)

- males: increases testosterone; sperm maturation

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Thyroid Stimulating Hormone

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Released from pituitary; controls the releae of thyroid hormone; simulates growth and function of thyroid gland

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Adrenocorticotropic hormone (ACTH)

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Released by pituitary; stimulates growth of adrenal gland cortex and corticosteroid secretion

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What is a common source of pituitary abnormalities?

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ADENOMAS

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What are 3 things that can cause pituitary damage?

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1. damage from trauma

2. tumor

3. infection

* since the pituitary is controlled by the hypothalamus, a dysfunction there can affect the pituitary

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Acromegaly

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Hypersecretion of GH in adulthood

-broader, heavier bones

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Gigantism

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Hypersecretion of GH in children and adolescents

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Proportionate Dwarfism

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Hyposecretion of GH in children and adolescents

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Hypersecretion of PROLACTIN

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-caused by prolactinomas

*hyposecretion and hypersecretion of prolactin affects fertility in both sexes

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Symptoms of hyperprolactinemia

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In both sexes: infertility, decreased sex drive, bone loss

Females: amenorrhea, hirsutism

Males: ED, gynecomastia

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Diabetes Insipidus

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disorder that causes imbalance of water in the body

Symptoms: polydipsia, polyuria

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Where is the parathyroid glands

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The parathyroid glands are nodules on the back of the thyroid gland. They

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Parathyroid Hormone (PTH)

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Increases blood calcium levels; antagonist of thyroid hormone

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Hypoparathyroidism

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Sx

1. Hypocalcemia

-causes decreased heart contractions, and increased muscle and nerve excitability

2. hyperphosphatemia

-PTH decrease phosphate absorption in KIDs

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Hyperparathyroidism

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Sx

1. Hypercalcemia

-increased heart contractions, and decreased muscle and nerve stiulation

2. Hypophostphatemia

3. KID stones

4. Pathologic fractures

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PRIMARY hyperparathyroidism

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PRIMARY; excessive secretion of PTH from the gland itself; typically from adenoma

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SECONDARY hyperparathyroidism

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SECONDARY; ezcessive secretion of PTH from parathyroid glands as a result of a disease like renal failure

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Calcitonin

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Released by the thyroid gland; decreases blood calcium levels

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What are 3 thyroid hormones

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1. T3

2. T4

3. Calcitonin

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The hypothalamus causes TSH secretion from the pituitary gland by what 2 hormones?

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T3 and T4

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Goiter

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Enlargement of the thyroid gland; can be present in hyperthyroidism and hypothyroidism

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Most common cause of hyperthyroidism

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Graves Disease; autoimmune disease

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SX of Graves Disease

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1. Bulging eyes

2. hypermetabolic state

3. thin hair

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Thyrotoxic Crisis/ Thyroid Storm

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Combination of uncontrolled hyperthyroidism, preceded by infection/surgery; life-threatening

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PRIMARY hypothyroidism

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dysfunction of the gland itself

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SECONDARY hypothyroidism

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pituitary dysfunction

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SX of hypo thyroidism

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1. hair loss

2. Puffy face

3. muscle weakness

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thyroiditis

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inflammation of the thyroid

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Adrenal cortex produces what types of hormones

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steroid hormones: aldosterone, cortisol, androgens

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Adrenal medulla produces

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norepinephrine, epinephrine

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Cushing DISEASE

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Increased secretion of ACTH from pituitary (pituitary adenoma) increasing cortisol production in the adrenal cortex

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Cushing SYNDROME

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The SIGNS AND SYMPTOMS related to increased cortisol from adrenal cortex regardless of cause

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Cushing Sx

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1. Moon face

2. Excessive sweating

3. trunk obesity

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Hypersecretion of adrenal cortex gonadocorticoids

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-feminization in males

-virilization in females

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Hyposecretion of adrenal cortex gonadocorticoids

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inferitility in females

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Pheochromocytoma

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RARE benign adrenal medullary tumor

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Sx of pheochromocytoma

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1. HTN

2. headache

3. anxiety

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neuroblastoma

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pediactric malignancy that typically originates in the adrenal glands

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Islets of Langerhans

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endocrine cells of the pancreas

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alpha cells of the pancreas

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glucagon; increase blood glucose

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beta cells of the pancreas

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produce insulin; lowers glucose levels, slows gastric emptying and inhibits glucagon production

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Diabetes Mellitus

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Disease in which your body is unable to produce insulin or has a decreased cellular response to insulin

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Roles of Insulin

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1. allows transport of glucose into the tissues, decreasing blood glucose levels

2. promotes storage of glucose

3. prevents fat breakdown

4. increases protein synthesis

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True of False

ALL cells need a carrier to get insulin in

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False; some tissues do not need a carrier for insulin to enter

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Where does the production of insulin take place

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produced by the pancreatic beta cells in the islets of Langerhans

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Types of Diabetes

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Type 1

Type 2

Insipidus

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Type 1 diabetes

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Juvenile or insulin dependent

-beta cell defect/destruction

-pancreatic atrophy

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Type 2 diabetes

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mature/adult onset, non-insulin dependent

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SX of type 1 diabetes

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1. polydipsia

2. polyuria

3. polyphagia (however, weight-loss due to fat breakdown)

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Risk factors for Type 2 diabetes

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1. obesity

2. age

3. inactivity

4. HTN

5. Family Hx

6. GDM

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SX of type 2 diabetes

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1. fatigue

2. visual changes

3. pruritus

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diabetic ketoacidosis

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MEDICAL EMERGENCY: the body does not produce enough insulin; the liver is unable to keep up with processing the volume of ketones as a result of fats being broken down as an energy source creating ketones

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Sx of diabetic ketoacidosis

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1. polyuria

2. polydipsia

3. nausea and vomitting

4.fruity/acetone breath

5. confusion

6. hyperglycemia

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Neuropathy (damage or disease of the nerves)

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Most common chronic complication of DM

1. impaired sensation

2. weakness

3. paresthesias

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Common complications from DM

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1. infection due to poor perfusion, hyperglycemia, and delayed healing

2. cataracts

3. pregnancy complications