The Endocrine System, Ch 4 (4.1 & 4.2)

Front 1

this diagnostic test can help diagnose thyroid disorders

Back 1

MRI

Front 2

Provocative diagnostic test

Back 2

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

Front 3

Insulin antagonist that causes hyperglycemia

Back 3

Growth hormone

Front 4

And where is ADH produce and stored

Back 4

Produced by the hypothalamus stored and release by posterior pituitary

Front 5

Decrease ADH leads to

Back 5

Renal tubule's not retaining water

Front 6

Diabetes insipidus causes these qualities

Back 6

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

Front 7

Nephrogenic diabetes insipidus

Back 7

Kidneys are not responding to ADH not a hormone problem

Front 8

Primary diabetes insipidus

Back 8

Defect in pituitary or hypothalamus lack of ADH production or secretion also known as central diabetes insipidus

Front 9

Secondary diabetes insipidus

Back 9

Tumor of pituitary or hypothalamus trauma infection surgery metastatic cancer

Front 10

Drugs that can cause diabetes insipidus

Back 10

Lithium

Front 11

Psychogenic diabetes insipidus

Back 11

Patient in just a large amount of water five leaders are more and interns depresses ADH production and secretion

Front 12

Diagnostic tests of diabetes insipidus

Back 12

Serum sodium increase

Plasma osmolarity increase

Specific gravity of urine decrease

Front 13

Water deprivation test

Back 13

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

Front 14

These tests can help diagnose diabetes insipidus

Back 14

Water deprivation test vasopressin test hypertonic saline test

Front 15

Hypertonic saline test

Back 15

Normal saline followed by 3% saline causes sudden decrease in urine output is a sign of ADH release

Front 16

Which fluids should be used for replacement therapy and diabetes insipidus

Back 16

Hypotonic

Front 17

diabenase

Back 17

Only use it as a partial reduction in ADH increases action of ADH

Front 18

Interventions for diabetes insipidus

Back 18

Daily weights

Fluid and electrolyte balance

Fluid replacement with hypotonic solution

Ddavp

Front 19

What it is retained but there was no edema

Back 19

Syndrome of inappropriate antidiuretic hormone

Front 20

Describe what happens with SIADH

Back 20

Elevation of ACH movies continues even with increased plasma volume and decreased osmolar

Front 21

Causes of SIADH

Back 21

Cancer stroke traumatic brain injury

Front 22

Signs of SIADH

Back 22

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

Front 23

How to treat SIADH I

Back 23

Fluid restriction 500 to 600 24h inns and outs daily weights diuretics

Front 24

Minimum daily requirement of iodine

Back 24

80 µg

Front 25

Because thyroid gland can Store a large amount of iodine four months

Back 25

Signs and symptoms may not. For a long time

Front 26

With thyroid function begin assessment by

Back 26

Inspection looking for lumps puffiness facial expression large tongue change invoice here vision nails

Front 27

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:

Back 27

Hashimoto’s thyroiditis

Front 28

A congenital hypothyroidism in which the thyroid gland is absent or thyroid hormone is not synthesized by the thyroid gland is:

Back 28

Cretinism

Front 29

A deficiency in the release of vasopressin (antidiuretic hormone) by the posterior pituitary gland causes:

Back 29

Diabetes insipidus

Front 30

Adrenal insufficiency, with progressive destruction of the adrenal gland, is called:

Back 30

Addison’s disease

Front 31

A simple or nontoxic goiter results from:

Back 31

Inadequate amounts of iodine in the diet

Front 32

A sure sign of Cushing’s syndrome is:

Back 32

Buffalo humps

Front 33

A thyroid storm or thyrotoxicosis might occur in:

Back 33

Hyperthyroidism

Front 34

Which of the following is NOT a component of metabolic syndrome?

Back 34

Low blood pressure

Front 35

Destruction of the entire anterior lobe of the pituitary gland is termed:

Back 35

Panhypopituitarism

Front 36

Diabetes which has its onset during pregnancy is called:

Back 36

Gestational diabetes mellitus

Front 37

Hormones that stimulate secretion of other hormones are called:

Back 37

Trophic hormones

Front 38

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:

Back 38

Acromegaly

Front 39

Hypersecretion of human growth hormone by the pituitary before puberty resulting in abnormal and accelerated growth is called:

Back 39

Gigantism

Front 40

In which of the following diseases is there usually a bronze color of the skin?

Back 40

Addison’s disease

Front 41

It is NOT possible for a 7 y/o girl in precocious puberty to get pregnant.

Back 41

False

Front 42

Precocious puberty is:

Back 42

*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

Front 43

Somatotropin is also known as the:

Back 43

Growth hormone

Front 44

The master gland of the endocrine system is the:

Back 44

Pituitary gland

Front 45

The most common form of diabetes is:

Back 45

Type II diabetes mellitus

Front 46

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:

Back 46

Cancer of the thyroid gland

Front 47

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:

Back 47

Cushing’s syndrome

Front 48

Which of the following is NOT a type of thyroid cancer?

Back 48

Nodular

Front 49

A part of the brain that also has endocrine functions is the:

Back 49

Hypothalamus

Front 50

Older age, obesity, family history of diabetes are all characteristics of:

Back 50

Type II diabetes

Front 51

The diagnosis of hypoglycemia is defined as a blood glucose level less than:

Back 51

50

Front 52

Body activities, homeostasis, and the response to stress are controlled by the __________ system and the ___________ system.

Back 52

nervous, endocrine

Front 53

Hormones are chemical messengers classified as either ________ _______(proteins) or __________.

Back 53

amino acid, steroids

Front 54

Hormones that stimulate secretion of other hormones are called __________ hormones.

Back 54

tropic

Front 55

What do endocrine diseases result from?

Back 55

They result from an abnormal increase or decrease in the secretion of hormones.

Front 56

The _________ _______ plays a central role in regulating most of the endocrine glands.

Back 56

pituitary gland

Front 57

What causes hyperpituitarism?

Back 57

An excessive production and secretion of pituitary hormones.

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

Front 58

Explain the difference between gigantism and acromegaly.

Back 58

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.

Front 59

*When the hypersecretion of GH (growth hormone, somatotropin) occurs in CHILDREN, BEFORE PUBERTY, result is __________, a proportional overgrowth of ALL body tissue.

Back 59

GIGANTISM

Front 60

*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)

Back 60

ACROMEGALY

Front 61

What is another name for growth hormone?

Back 61

somatotropin

Front 62

____________ _____________ ____________ is often the cause of oversecretion of growth hormone.

Back 62

Anterior pituitary adenoma (aka- pituitary tumor)

Front 63

What bones are usually affected in acromegaly?

Back 63

bones of the face, hands and feet

Front 64

Define hypopituitarism.

Back 64

Is a condition caused by a deficiency or absence of any of the pituitary hormones, especially those produced by the anterior pituitary lobe.

Front 65

When _________ secretion is reduced, the functioning of the thyroid gland is affected and the patient may have hypothyroidism.

Back 65

thyrotropin (thyroid-stimulating hormone [TSH])

Front 66

When the secretion of ________ swindles, salt balance and nutrient metabolism are affected.

Back 66

corticotropin (adrenocorticotropic hormone [ACTH])

Front 67

The cause of hypopituitarism may be a ___________ or a _____________tumor.

Back 67

pituitary, hypothalamus

Front 68

_____________ is when there is destruction of the entire anterior lobe of the pituitary gland.

Back 68

panhypopituitarism

Front 69

__________ is the abnormal underdevelopment of the body, or hypopituitarism, occurring in children.

Back 69

Dwarfism

Front 70

What are the signs and symptoms of dwarfism.

Back 70

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.

Front 71

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.

Back 71

thirst, urine, vasopressin (antidiuretic hormone [ADH])

Front 72

What are the symptoms of diabetes insipidus?

Back 72

*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*

Front 73

What test is given to confirm the diagnosis of diabetes insipidus?

Back 73

water-restriction test

Front 74

Name the most common endocrine gland to produce a disease condition or problem.

Back 74

Thyroid gland

Front 75

Identify the hormone released from the pituitary gland that controls the activity of the thyroid gland.

Back 75

Thyroid-stimulating hormone (TSH)

Front 76

The 2 hormones produced by the thyroid gland are ___________ and _____________.

Back 76

T4 (thyroxine) hormone,T3 (triiodothyronine) hormone

Front 77

The term ______ refers to any enlargement of the thyroid gland usually evidenced by a swelling in the neck.

Back 77

goiter

Front 78

What statement(s) is(are) true about a simple goiter?

Back 78

The patient may notice a swelling of the neck and experience difficulty swallowing. Thyroid ultrasonography can confirm the presence of a thyroid nodule.

Front 79

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

Back 79

Iodine

Front 80

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

Back 80

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

Front 81

What is the incidence of Hashimoto's Thyroiditis in women vs. men?

Back 81

Occurs in women 8 times as often than in men.

Front 82

Hyperthyroidism is also called ___________ ____________.

Back 82

Graves' Disease

Front 83

This occurs when the entire thyroid gland hypertrophies, resulting in a diffuse goiter and an overproduction of thyroid hormones.

Back 83

Hyperthyroidism.

Front 84

Hyperthyroidism is Also Known As:

Back 84

(Graves' Disease) -- A condition of primary hyperthyroidism,

Front 85

Name a condition of the eyes that can be seen with hyperthyroidism.

Back 85

exophthalmos (outward protrusion)

Front 86

A sudden exacerbation of symptoms in hyperthyroidism that may be life-threatening is called ______________.

Back 86

thyrotoxicosis (thyroid storm)

Front 87

True OR False?

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

Back 87

True

Front 88

An increase in ________ and below normal _____ and ______ are indicative of hypothyroidism.

Back 88

TSH, T3, T4

Front 89

Name some symptoms of hypothyroidism.

Back 89

Fatigue, cold intolerance, constipation, and dry, flaky skin

Front 90

___________ 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.

Back 90

Cretinism

Front 91

In Cretinism, the _______ ________ is absent or ___________ __________ is not synthesized by the thyroid gland.

Back 91

thyroid gland, thyroid hormone

Front 92

__________ is a severe hypothyroidism with reduced levels of T4 that has its onset in the older child or adult.

Back 92

Myxedema

Front 93

Name the signs of thyroid cancer.

Back 93

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.

Front 94

True OR False?

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

Back 94

False

Front 95

Name the 4 types of thyroid cancer and give a brief description of each.

Back 95

*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)

Front 96

Which thyroid tumor secretes calcitonin?

Back 96

Medullary thyroid carcinomas

Front 97

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).

Back 97

hyperparathyroidism

Front 98

Hyperparathyroidism increased the breakdown of _______ from the skeletal system, which results in excessive reabsorption of __________ into the blood and _____________ fluid.

Back 98

bone, calcium, extracellular

Front 99

What are some symptoms of hypercalcemia brought on by hyperparathyroidism?

Back 99

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.

Front 100

Is the condition in which the secretion of parathyroid hormone (PTH) by the parathyroid glands is greatly reduced.

Back 100

hypoparathyroidism

Front 101

_________ or severe, sustained muscular contractions, may develop due to hypocalcemia from hypoparathyroidism.

Back 101

Tetany

Front 102

The presence of __________ _________ is a sure indication of hypocalcemia.Your

Back 102

Trousseau's Phenomenon

Front 103

What treatment will reduce hypocalcemia?

Back 103

Calcium replacement therapy with Vitamin D

Front 104

Is a condition of chronic hypersecretion of the adrenal cortex, which results in excessive circulating cortisol levels.

Back 104

Cushing's Syndrome

Front 105

What forms in the scapular area with Cushing's Syndrome?

Back 105

fat deposits called buffalo humps

Front 106

With Cushing Syndrome there is the characteristic _________ face.

Back 106

moon

Front 107

List 3 etiologies for Cushing's Syndrome.

Back 107

*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)]

Front 108

Is a partial or complete failure of adrenocortical function.

Back 108

Addison's Disease

Front 109

What color is the skin of an Addison's disease patient?

Back 109

Bronze

Front 110

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.

Back 110

Addisonian Crisis (Addison's Crisis)

Front 111

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.

Back 111

diabetes mellitus

Front 112

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.)

Back 112

Diabetes type I

Front 113

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)

Back 113

Diabetes type II

Front 114

Ketonuria may lead to ________.

Back 114

acidosis

Front 115

True OR False?

The person experiencing insulin shock requires simple sugar.

Back 115

True

Front 116

Explain the etiology of gestational diabetes.

Back 116

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.

Front 117

When is gestational diabetes usually detected?

Back 117

Between the 24 and 28 weeks of gestation.

Front 118

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.

Back 118

metabolic syndrome

Front 119

What are the 5 components of metabolic syndrome?

Back 119

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

Front 120

It occurs when excessive insulin enters the bloodstream or when the glucose release rate falls below tissue demands:

Back 120

hypoglycemia

Front 121

Hypoglycemia is commonly defined as a blood glucose level of less than ______.

Back 121

50 mg/dl

Front 122

What are the signs and symptoms of precocious puberty in a boy.

Back 122

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.

Front 123

At what age in a boy is puberty considered precocious?

Back 123

an onset before age 9 is considered precocious.

Front 124

What are the signs and symptoms of precocious puberty in a girl?

Back 124

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.

Front 125

At what age in a girl is puberty considered precocious?

Back 125

An onset before age 8 is considered precocious in girls.