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125 Cards in this Set

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this diagnostic test can help diagnose thyroid disorders

MRI
Provocative diagnostic test
Helps determine and the cream ground to reserve function one test show borderline results

Stimulates under active grounds or suppresses overactive grand


Stimulation confirms hypofunction



Insulin antagonist that causes hyperglycemia
Growth hormone
And where is ADH produce and stored
Produced by the hypothalamus stored and release by posterior pituitary
Decrease ADH leads to
Renal tubule's not retaining water
Diabetes insipidus causes these qualities
Dehydration excessive urine output increased plasma osmolarity stimulates thirst response freewater loss plasma osmolarity increases serum sodium increases urine osmolarity decreases thirst frequent avoiding 4l/ 200ml/hr specific gravity less than 1.005 weight loss fatigue constipation anorexia
Nephrogenic diabetes insipidus
Kidneys are not responding to ADH not a hormone problem
Primary diabetes insipidus
Defect in pituitary or hypothalamus lack of ADH production or secretion also known as central diabetes insipidus
Secondary diabetes insipidus
Tumor of pituitary or hypothalamus trauma infection surgery metastatic cancer
Drugs that can cause diabetes insipidus
Lithium
Psychogenic diabetes insipidus
Patient in just a large amount of water five leaders are more and interns depresses ADH production and secretion
Diagnostic tests of diabetes insipidus
Serum sodium increase



Plasma osmolarity increase


Specific gravity of urine decrease



Water deprivation test
Withhold food and water measure urine output molarity and specific gravity hourly until osmol is consistent then measure sera Osmo get vasopressin and take another measurement
These tests can help diagnose diabetes insipidus
Water deprivation test vasopressin test hypertonic saline test
Hypertonic saline test
Normal saline followed by 3% saline causes sudden decrease in urine output is a sign of ADH release
Which fluids should be used for replacement therapy and diabetes insipidus
Hypotonic

diabenase

Only use it as a partial reduction in ADH increases action of ADH
Interventions for diabetes insipidus
Daily weights

Fluid and electrolyte balance


Fluid replacement with hypotonic solution


Ddavp



What it is retained but there was no edema
Syndrome of inappropriate antidiuretic hormone
Describe what happens with SIADH
Elevation of ACH movies continues even with increased plasma volume and decreased osmolar
Causes of SIADH
Cancer stroke traumatic brain injury
Signs of SIADH
Tachycardia hypertensive water intoxication fluid shifts of the brain causing changes in LOC no edema hyponatremia dilutional hypocalcemia normal bun/creat lowes serum sodium low serum calcium normal kidney function low plasma Osmo elevated urine osmol
How to treat SIADH I
Fluid restriction 500 to 600 24h inns and outs daily weights diuretics
Minimum daily requirement of iodine
80 µg
Because thyroid gland can Store a large amount of iodine four months
Signs and symptoms may not. For a long time
With thyroid function begin assessment by
Inspection looking for lumps puffiness facial expression large tongue change invoice here vision nails
A chronic disease of the immune system that attacks the thyroid gland, causes a goiter and occurs 8 times more often in women than men is:
Hashimoto’s thyroiditis
A congenital hypothyroidism in which the thyroid gland is absent or thyroid hormone is not synthesized by the thyroid gland is:
Cretinism
A deficiency in the release of vasopressin (antidiuretic hormone) by the posterior pituitary gland causes:
Diabetes insipidus
Adrenal insufficiency, with progressive destruction of the adrenal gland, is called:
Addison’s disease
A simple or nontoxic goiter results from:
Inadequate amounts of iodine in the diet
A sure sign of Cushing’s syndrome is:
Buffalo humps
A thyroid storm or thyrotoxicosis might occur in:
Hyperthyroidism
Which of the following is NOT a component of metabolic syndrome?
Low blood pressure
Destruction of the entire anterior lobe of the pituitary gland is termed:
Panhypopituitarism
Diabetes which has its onset during pregnancy is called:
Gestational diabetes mellitus
Hormones that stimulate secretion of other hormones are called:
Trophic hormones
Hypersecretion of hGH that causes overgrowth of the hands and feet, abnormal thickening of the bones of the face, and excessive overgrowth of soft tissue, occurring after puberty, is called:
Acromegaly
Hypersecretion of human growth hormone by the pituitary before puberty resulting in abnormal and accelerated growth is called:
Gigantism
In which of the following diseases is there usually a bronze color of the skin?
Addison’s disease
It is NOT possible for a 7 y/o girl in precocious puberty to get pregnant.

False

Precocious puberty is:
*Defined in boys as the onset of puberty before the age of 9

*Defined in girls as the onset of puberty before the age of 8

Somatotropin is also known as the:
Growth hormone
The master gland of the endocrine system is the:
Pituitary gland
The most common form of diabetes is:
Type II diabetes mellitus
The presence of a painless lump or nodule on the thyroid gland, along with complaints of persistent hoarseness and trouble swallowing, should raise the suggestion of:
Cancer of the thyroid gland
The syndrome caused by hypersecretion of the adrenal cortex, which results in excessive circulating cortisol levels, fatigue, muscular weakness, and changes in body appearance is called:
Cushing’s syndrome
Which of the following is NOT a type of thyroid cancer?
Nodular
A part of the brain that also has endocrine functions is the:
Hypothalamus
Older age, obesity, family history of diabetes are all characteristics of:
Type II diabetes
The diagnosis of hypoglycemia is defined as a blood glucose level less than:
50
Body activities, homeostasis, and the response to stress are controlled by the __________ system and the ___________ system.
nervous, endocrine
Hormones are chemical messengers classified as either ________ _______(proteins) or __________.
amino acid, steroids
Hormones that stimulate secretion of other hormones are called __________ hormones.
tropic
What do endocrine diseases result from?
They result from an abnormal increase or decrease in the secretion of hormones.
The _________ _______ plays a central role in regulating most of the endocrine glands.
pituitary gland
What causes hyperpituitarism?
An excessive production and secretion of pituitary hormones.



(i.e. hGH 'human growth hormone' ---produces one of two distinct conditions, GIGANTISM or ACROMEGALY)

Explain the difference between gigantism and acromegaly.
GIGANTISM - describes an abnormal pattern of growth an stature.*ACROMEGALY - is a chronic metabolic condition of ADULTS caused by hypersecretion of growth hormone (GH) by the pituitary gland.
*When the hypersecretion of GH (growth hormone, somatotropin) occurs in CHILDREN, BEFORE PUBERTY, result is __________, a proportional overgrowth of ALL body tissue.
GIGANTISM
*When the hypersecretion of GH occurs after puberty, __________ (an overgrowth of the bones of the face, hands and feet) occurs, with an excessive overgrowth of soft tissue because here is already epiphyseal closure

* (often in ppl 30-40 yrs. old)

ACROMEGALY
What is another name for growth hormone?
somatotropin
____________ _____________ ____________ is often the cause of oversecretion of growth hormone.
Anterior pituitary adenoma (aka- pituitary tumor)
What bones are usually affected in acromegaly?
bones of the face, hands and feet
Define hypopituitarism.
Is a condition caused by a deficiency or absence of any of the pituitary hormones, especially those produced by the anterior pituitary lobe.
When _________ secretion is reduced, the functioning of the thyroid gland is affected and the patient may have hypothyroidism.
thyrotropin (thyroid-stimulating hormone [TSH])
When the secretion of ________ swindles, salt balance and nutrient metabolism are affected.
corticotropin (adrenocorticotropic hormone [ACTH])
The cause of hypopituitarism may be a ___________ or a _____________tumor.
pituitary, hypothalamus
_____________ is when there is destruction of the entire anterior lobe of the pituitary gland.
panhypopituitarism
__________ is the abnormal underdevelopment of the body, or hypopituitarism, occurring in children.
Dwarfism
What are the signs and symptoms of dwarfism.
Hyposecretion of the pituitary gland hormones, especially GH, results in growth retardation. As a result, the child is extremely short, with abody that is small in proportion. The prepubescent child does not develop secondary sex characteristics. The condition may be linked toother defects and a varying degree of mental retardation.
Diabetes insipidus is a disturbance of water metabolism resulting in extreme _______ and excessive secretion of dilute ____________. With diabetes insipidus there is a deficiency in the release of _____________ by the posterior pituitary gland.
thirst, urine, vasopressin (antidiuretic hormone [ADH])

What are the symptoms of diabetes insipidus?

*Polyuria (excretion of copious amounts of colorless and dilute urine)



*Polydipsia (experiences excessive thirst)Fatigue, dehydration (dry mucous membranes), hypotension, dizziness, poor skin turgor


*Onset of symptoms may be abrupt*

What test is given to confirm the diagnosis of diabetes insipidus?
water-restriction test
Name the most common endocrine gland to produce a disease condition or problem.
Thyroid gland
Identify the hormone released from the pituitary gland that controls the activity of the thyroid gland.
Thyroid-stimulating hormone (TSH)
The 2 hormones produced by the thyroid gland are ___________ and _____________.
T4 (thyroxine) hormone,T3 (triiodothyronine) hormone
The term ______ refers to any enlargement of the thyroid gland usually evidenced by a swelling in the neck.
goiter
What statement(s) is(are) true about a simple goiter?
The patient may notice a swelling of the neck and experience difficulty swallowing. Thyroid ultrasonography can confirm the presence of a thyroid nodule.

Simple or nontoxic goiter results from a shortage of ______ in the diet.

Iodine

What is the outstanding clinical feature of Hashimoto's Thyroiditis?

The gradual and painless lumpy enlargement of the thyroid gland, which causes a feeling of pressure in the neck and difficulty swallowing.

What is the incidence of Hashimoto's Thyroiditis in women vs. men?
Occurs in women 8 times as often than in men.
Hyperthyroidism is also called ___________ ____________.
Graves' Disease
This occurs when the entire thyroid gland hypertrophies, resulting in a diffuse goiter and an overproduction of thyroid hormones.
Hyperthyroidism.
Hyperthyroidism is Also Known As:
(Graves' Disease) -- A condition of primary hyperthyroidism,
Name a condition of the eyes that can be seen with hyperthyroidism.
exophthalmos (outward protrusion)
A sudden exacerbation of symptoms in hyperthyroidism that may be life-threatening is called ______________.
thyrotoxicosis (thyroid storm)
True OR False?



Even with excessive appetite and food consumption, a patient with hyperthyroidism still loses weight.

True

An increase in ________ and below normal _____ and ______ are indicative of hypothyroidism.
TSH, T3, T4
Name some symptoms of hypothyroidism.
Fatigue, cold intolerance, constipation, and dry, flaky skin
___________ is a congenital hypothyroidism developing in infancy or early childhood in which the thyroid gland is absent or thyroid hormone is not synthesized by the thyroid gland.
Cretinism
In Cretinism, the _______ ________ is absent or ___________ __________ is not synthesized by the thyroid gland.
thyroid gland, thyroid hormone
__________ is a severe hypothyroidism with reduced levels of T4 that has its onset in the older child or adult.
Myxedema
Name the signs of thyroid cancer.
Palpation of a hard, painless lump or nodule on the thyroid gland, vocal cord paralysis, obstructive symptoms, and cervical lymphadenopathy, dysphagia or hoarseness resulting from compression of the upper aerodigestive tract. A rapidly enlarging neck mass may be a sign of anaplastic thyroid cancer.

True OR False?




Thyroid cancer is easy to detect and often causes symptoms in the early stages.

False

Name the 4 types of thyroid cancer and give a brief description of each.
*papillary (small nipple-like projections)

*follicular (sac-like balls of cells)


*medullary (affecting the interior portion of the gland)


*anaplastic (loss of differentiation of cells)

Which thyroid tumor secretes calcitonin?
Medullary thyroid carcinomas
Is a condition caused by over-activity of one or more of the four parathyroid glands and results in the overproduction of parathyroid hormone (PTH).
hyperparathyroidism
Hyperparathyroidism increased the breakdown of _______ from the skeletal system, which results in excessive reabsorption of __________ into the blood and _____________ fluid.
bone, calcium, extracellular
What are some symptoms of hypercalcemia brought on by hyperparathyroidism?
Hypercalcemia reduces irritability of nerve and muscle tissue, and this causes the patient to experience muscle weakness & atrophy, gastrointestinal pain, and nausea and vomiting. Low back pain, bone tenderness, arthritis pain.
Is the condition in which the secretion of parathyroid hormone (PTH) by the parathyroid glands is greatly reduced.
hypoparathyroidism
_________ or severe, sustained muscular contractions, may develop due to hypocalcemia from hypoparathyroidism.
Tetany
The presence of __________ _________ is a sure indication of hypocalcemia.Your
Trousseau's Phenomenon
What treatment will reduce hypocalcemia?
Calcium replacement therapy with Vitamin D
Is a condition of chronic hypersecretion of the adrenal cortex, which results in excessive circulating cortisol levels.
Cushing's Syndrome
What forms in the scapular area with Cushing's Syndrome?
fat deposits called buffalo humps
With Cushing Syndrome there is the characteristic _________ face.

moon



List 3 etiologies for Cushing's Syndrome.
*Excessive levels of cortisol

*Iatrogenic conditions (Lg. dosages of glucocorticoids)


*Excessive secretions of corticotropin (ACTH) from pituitary gland


*[others: tumor of adrenal cortex, production of corticotropin in another organ (like cancer cells in lungs)]

Is a partial or complete failure of adrenocortical function.
Addison's Disease
What color is the skin of an Addison's disease patient?

Bronze

Insufficiency or a sudden decrease in adrenocortical hormone levels, such as from a sudden withdrawal o glucocorticoid therapy, can result in this life-threatening emergency.
Addisonian Crisis (Addison's Crisis)
Is a chronic disorder of carbohydrate, fat, and protein metabolism caused by inadequate production of insulin by the pancreas or faulty use of insulin by the cells.
diabetes mellitus
Type 1 (formerly "juvenile onset" diabetes or "insulin-dependent diabetes mellitus" (IDDM) - has a early, abrupt onset, before age 30, w/ little or no insulin being secreted by the patient, and can be difficult to control.(An infection early in life may have triggered an autoimmune process that destroy B Cells of the pancreas.)
Diabetes type I
Type 2 (formerly "adult onset" diabetes or "non-insulin-dependent diabetes mellitus" (NIDDM) - most common form, gradual onset in adults older than 30 yrs., and more often in people over 55yrs. Some pancreatic function remains, permitting control of symptoms by dietary management; in addition, an oral hypoglycemic medication is often prescribed.(Occurs in older, over weight adults)
Diabetes type II
Ketonuria may lead to ________.

acidosis

True OR False?




The person experiencing insulin shock requires simple sugar.

True

Explain the etiology of gestational diabetes.
Increased destruction of insulin by the placenta plays a role in causing GDM. There is a reduced effectiveness of maternal insulin during pregnancy. The fetus takes its glucose from the mother, stressing the balance of glucose production and glucose use. Elevated levels of estrogen and progesterone block the action of insulin. Risk factor include a family history of diabetes, obesity, and age over 25 years.
When is gestational diabetes usually detected?
Between the 24 and 28 weeks of gestation.
aka 'Syndrome X' - is a collection of signs and/or conditions that existing together may increase an individuals potential for Type 2 diabetes and cardiovascular disease.
metabolic syndrome
What are the 5 components of metabolic syndrome?
1. Central Obesity -collection of excess fat around abdomen. Waist over 35" women & over 40" in men, indicates at risk!

2. Increased Blood Pressure - greater than 130/85 in men or women.


3. Abnormal lipid levels


4. Insulin resistance or an increase in the amount of insulin required to control hyperglycemia.


5. Impaired Glucose Tolerance

It occurs when excessive insulin enters the bloodstream or when the glucose release rate falls below tissue demands:
hypoglycemia
Hypoglycemia is commonly defined as a blood glucose level of less than ______.
50 mg/dl
What are the signs and symptoms of precocious puberty in a boy.
Earlier sexual maturity manifested by early development of secondary sex characteristics, gonadal development, and spermatogenesis. The patient's history may include altered growth pattern or emotional disturbances. Pubic hair & beard grow, gonads & penis increase in size & sebaceous gland activity increases. Male puberty normally begins between 13 and 15 yrs., an onset before age 9 is considered precocious.
At what age in a boy is puberty considered precocious?
an onset before age 9 is considered precocious.
What are the signs and symptoms of precocious puberty in a girl?
Earlier sexual maturity is marked by an increased growth rate, breast enlargement, appearance of pubic hair before age 8; onset of menstruation (menarche) may occur before age 10. Ovarian function makes pregnancy a possibility. Emotional problems may occur.
At what age in a girl is puberty considered precocious?
An onset before age 8 is considered precocious in girls.