1
Q
endocrine system
A
regulatory system composed of glands that secrete hormones
directly into the bloodstream
2
Q
hormones are secreted
A
into blood
3
Q
glands detect
A
internal changes or receive input from the brain
4
Q
cells with specific receptors respond by
A
altering function or
activity
5
Q
feedback loops (usually negative
A
regulate further secretion
6
Q
endocrine system 3 steps (?)
A
- hypothalamus
- pituitary gland (anterior or posterior)
- target organ
7
Q
hypothalamus primary hormones
A
releasing/inhibiting hormones
8
Q
hypothalamus function
A
controls pituitary
- link between brain & endocrine system
9
Q
pituitary (master gland) primary hormones
A
GH, ACTH, TSH, ADH, etc
10
Q
pituitary (master gland) functions
A
regulates growth, thyroid, adrenal, + reproductive function
11
Q
thyroid primary hormones
A
- T3
- T4
12
Q
thyroid functions
A
controls metabolism, heart rate, temperature
13
Q
parathyroid primary hormones
A
PTH
14
Q
parathyroid function
A
regulates calcium + phosphate balance
15
Q
adrenal glads primary hormones
A
- cortisol
- aldosterone
- epinephrine
16
Q
adrenal glands function
A
stress response, blood pressure, metabolism, fluid balance
17
Q
pancreas primary hormones
A
- insulin
- glucagon
18
Q
gonads (ovaries/testes) primary hormones
A
- estrogen
- testosterone
18
Q
pancreas function
A
regulates blood glucose
19
Q
gonads (ovaries/testes) function
A
reproduction, muscle mass, fat
20
Q
pineal primary hormones
A
melatonin
21
Q
pineal function
A
regulates sleep/wake cycles
22
Q
hypothalamic-pituitary axis
(HPA axis)
A
- hypothalamus receives signals from brain/body
- signals to pituitary gland to release hormones
- pituitary hormones stimulate target glands (thyroid, adrenals, gonads)
- feedback from those glands tells hypothalamus + pituitary to increase or decrease output
23
Q
stress activates a cascade
A
- hypothalamus -> CHR (corticotropin-releasing hormone)
- pituitary -> ACTH (adrenocorticotropic hormone)
- adrenal cortex -> cortisol
24
stress & hormones cortisol effects
- increase blood glucose
- decrease inflammation
- alters immune response
- affects tissue repair
25
stress & hormones releases
- catecholamines (adrenal medulla): epinephrine, norepinephrine -> increased HR + BP
- endorphins : natural pain suppressors
- growth hormone & prolactin: metabolism + tissue regulation
26
with age the endocrine system
- pituitary, thyroid, adrenal glands shrink or become fibrotic
- decrease hormone output (GH, estrogen/testosterone, thyroid hormones)
27
aging & endocrine system leads to
- decrease bone density
- decrease muscle mass
- sleep disturbances
- slower healing
28
endocrine disorders pathology
- impaired synthesis or release of hormones
- abnormal interactions between hormones + target tissues
- abnormal responses of target organs to their hormones
29
endocrine disorders: MSK signs + symptoms muscles-related
- muscle weakness
- muscle atrophy
- myalgia (muscle pain)
- fatigue
30
endocrine disorders: MSK signs + symptoms connective-tissue
- carpal tunnel syndrome
- synovial fluid changes
- periarthritis
- adhesive capsulitis (esp diabetes)
31
endocrine growth + fluid balance
- excessive or delayed growth
- polydipsia (excessive thirst)
- polyuria (frequent urination)
- dehydration or excessive retention of body water
32
endocrine neurological & mental status changes
- nervousness
- confusion
- depression
33
endocrine hair, skin, body composition
- changes in hair (quality + distribution)
- changes in skin pigmentation
- changes in distribution of body fat
34
endocrine cardiovascular + autonomic responses
- heart palpations
- changes in viral signs:
- elevated body temp
- increased pulse rate
- increased blood pressure
- increased perspiration
- kussmaul's respirations (deep, rapid breathing)
35
endocrine disorders listed :
- pituitary gland disorders
- thyroid glad disorders
- parathyroid gland disorders
- adrenocortical pathologies
- diabetes mellitus
36
anterior pituitary gland
growth hormone (GH)
- stimulates growth of bones, muscles, and tissues; promotes protein synthesis + fat metabolism
thyroid-stimulating hormone (TSH)
- signals the thyroid gland to release T3 and T4, which regulate metabolism
follicle-stimulating hormone (FSH)
- stimulates development of ovarian follicles in females + spermatogenesis in males
adrenocorticotropic hormone (ACTH)
- stimulates the adrenal cortex to release cortisol, which helps regulate stress response, metabolism, + immune function
37
anterior pituitary gland disorders: 2 types
hyperpituitarism
- gigantism
- acromegaly
hypopituitarism
38
gigantism
hypersecretion of growth hormone before growth plates close in childhood
- abrupt onset
- excessive linear bone growth
- up to 9 feet
39
acromegaly
hypersecretion of growth hormone after growth plates have closed in adults
- gradual onset
- increased bone thickness
- hypertrophy of soft tissues
40
posterior pituitary gland
antidiuretic hormone (ADH)
- promotes water reabsorption in kidneys to regulate fluid balance + BP
oxytocin
- stimulates uterine contractions during labor + milk ejection during breastfeeding; bonding behaviors
41
posterior pituitary gland disorders: 2 types
- diabetes insipidus
- syndrome of inappropriate antidiuretic hormone release (SIADH)
42
diabetes insipidus cause + effect
cause: deficiency or insensitivity to ADH , leading to inability to retain water
effect: kindneys excrete large volumes of dilute urine, resulting in dehydration
43
diabetes insipidus presentation
- polydipsia (excessive thirst)
- polyuria ( frequent, excessive urination)
- nocturia (waking at night to urinate)
- dehydration
44
syndrome of inappropriate antidiuretic hormone release (SIADH) cause + effect
cause: excessive release of ADH without appropriate
effect: water retention -> hypoatremia -> cellular swelling (esp brain)
45
syndrome of inappropriate antidiuretic hormone release (SIADH) presentation
- water intoxication
- neurological signs (headache, confusion, seizures)
- neuromuscular symptoms (muscle cramps, weakness)
- weight gain without edema
- decreased urine output
46
thyroid horomones
anterior pituitary
- thyroid stimulating hormone (TSH)
thyroid
- thyroxine (T4)
- triiodothyronine (T3)
47
thyroid disorders
- hyperthyroidism
- graves disease
- thyrotoxicosis/thyroid storm
- hypothyroidism
- primary hypothyroidism
- thyroiditis
48
graves disease
an autoimmune disease where thyroid-stimulating immuniglobulins activate TSH receptors, increasing T3 + T4 production (resulting in hyperthyroidism)
49
graves disease etiology
- autoimmune (graves)
- genetic predisposition
- more common in womens (4:1)
- age 20-40 y/o
50
graves disease pathogenesis
- thyroid-stimulating immunoglobulin (TSI) binds to TSH receptors
- increased T3/T4 -> increased metabolic rate
- systemic upregulation of sympathetic nervous system activity
51
graves disease clinical features
- goiter, nervousness, weight loss
- heat intolerance, palpitations, tremor
- exophthalmos
- bulging eyes
- pretibial myxedema
- thickening, redness, swelling of skin
52
thyrotoxicosis/thyroid storm
severe complications of untreated or poorly managed hyperthryoidism
thyrotoxicosis
- clinical state caused by excess circulating thyroid hormones , leading to an overstimulated metabolism
thyroid storm
- most extreme + life-threatening form of thyrotoxicosis ; medical emergency
53
thyrotoxicosis/thyroid storm triggers
- infection
- surgery
- trauma
- labor + delivery
- acute illness
- stopping antithyroid medications suddenly
54
thyrotoxicosis/thyroid storm signs + symptoms
often develop rapidly + can be severe
- high fever
- tachycardia
- severe hypertension, followed by hypotension
- restlessness, anxiety, delirium, seizures
- nausea, vomiting, diarrhea
- sweating, tremors
- heart failure or arrhythmias
55
hypothyroidism
underproduction of thyroid hormones, often due to hashimotos
56
hypothyroidism etiology
- hashimotos thyroiditis
- thyroid ablation/radiation
- medication-related
- womens > mens
57
hypothyroidism pathogenesis
- decreased T3/T4 -> decreased basal metabolic rate
- increased TSH (in primary type 1) due to loss of negative feedback
58
hypothyroidism clinical features
- fatigue, cold intolerance, constipation
- depression, mild weight gain
- myxedema, bradycardia, slowed DTR
- rheumatologic: arthralgia, myalgia, fibromyalgia-like symptoms
59
thyroiditis
inflammation of thyroid gland, which maybe be acute, subacute, chronic
can lead to either hyper or hypothyroidism , both at different stages of disease
60
every thyroid issue is what in nature
autoimmune
61
thyroiditis clinical features
- pain
- swelling in neck
- fatigue
- palpitations
- weight changes
62
parathyroid hormone disorders: 2 types
hyperparathyroidism
hypoparathyroidism
63
hyperparathyroidism
increased parathyroid hormone (PTH) production causing elevated blood calcium + bone demmineralization
64
hyperparathyroidism etiology
primary: parathyroid adenoma
secondary: chronic renal failure
tertiary: dialysis-related
65
hyperparathyroidism pathogenesis
- increased PTH -> increased osteoclast activity -> bone resorption
- hypercalcemia -> neuromuscular, renal, gi symptoms
66
hyperparathyroidism clinical feautures
- bone pain, fractures, weakness
- kidney stones
- hypercalcemia: paresthesia, abdominal pain, fatigue
67
hypoparathyroidism
insufficient PTH production -> hypocalcemia -> neuromuscular irritability
68
hypoparathyroidism etiology
- latrogenic (surgery)
- idiopathic or autoimmune
- more common in women + children
69
hypoparathyroidism pathogenesis
- decreased PTH -> decreased calcium in kidney + bone
- neuromuscular instability due to hypocalcemia
70
hypoparathyroidism clinical features
- tetany, tingling (lips, fingers, feet)
- muscle cramps, spasms
- chvostek's sign
- twitching of facial muscles when facial n. is trapped
71
adrenocortical pathologies
hyperfunction
- cushings syndrome/disease
- conn's syndrome
hypofunction
- addisons disease
- secondary renal insufficiency
72
cushing's syndrome/disease
excess cortisol production
cushing syndrome: exogenous steroid use or adrenal tumor
cushing disease: pituitary adenoma
-> increased ACTH
73
cushing's syndrome/disease etiology
- pituitary adenoma
- long term corticosteroid use
- ectopic ACTH-producing tumors
74
cushing's syndrome/disease pathogensis
- increased coristol -> protein catabolism, glucose dysregulation, immunosuppression
- abnormal fat deposition
75
cushing's syndrome/disease clinical features
- moon face, buffalo hump
- muscle wasting, central obesity
- purple striae (stretch marks), fragile skin
- hypertension, osteoporosis
76
conn's syndrome
aldosterone-secreting tumor (usually benign adenoma) -> sodium retention + potassium loss
77
conn's syndrome etiology
- adrenal adenoma (primary hyperaldosteronism)
78
conn's syndrome pathogenesis
- increased aldosterone -> increased Na+/H2O retention, decreased K+
- leads to hypertension + hypokalemia
79
conn's syndrome clinical features
- hypertension
- muscle cramps
- fatigue
- metabolic alkalosis
80
addisons disease
- primary adrenal insufficiency
- destruction of adrenal cortex -> decreased cortisol + aldosterone
81
addisons disease etiology
- autoimmune
- infections
- adrenal metastases
82
addisons disease pathogenesis
- decreased cortisol -> decreased gluconeogenesis, increased fatigue
- decreased aldosterone -> hypoatremia, hyperkalemia, hypoetension
83
addisons disease clinical features
- fatigue, anorexia, weight loss
- hyperpigmentation (palmar creases, gums)
- hypotension, salt craving
- risk of addisonian crisis (shock)
84
secondary adrenal insufficiency
- caused by insufficient ACTH from pituitary gland
- results in low cortisol production, but adrenal glands are intact
- due to pituitary disorders, long term corticosteroid therapy
85
secondary adrenal insufficiency clinical features
- arthralgia (joint pain)
- myalgias (muscle pain)
- tendon calcifications
- no hyperpigmentation
86
diabetes mellitus due to + results in
chronic, systemic metabolic disorder marked by abnormal regulation of blood glucose due to:
- insufficient insulin production or
- ineffective insulin action
results in:
- impaired metabolism of carbohydrates, fats, proteins
87
diabetes mellitus
problem: decreases insulin or decreased tissue response
effect: decrease glucose uptake -> hyperglycemia
88
diabetes mellitus
problem: cells starve for energy
effect: body breaks down fat + protein instead
89
diabetes mellitus
problem: fat breakdown -> ketones
effect: risk of ketoacidosis
(mainly type 1)
90
diabetes mellitus
problem: chronic glucose exposure
effect: damages blood vessels + nerves
91
diabetes mellitus
signs & symptoms
polyuria : frequent urination
- due to glucose spilling into urine
polydipsia : excessive thirst
- caused by fluid loss from polyuria
polyphagia : excessive hunger
- cells are starving for energy
92
diabetes mellitus
other symptoms
- fatigue + weakness
- unexplained weight loss (type 1)
- blurred vision
- slow healing wounds
- recurrent infections
- tingling or numbness in hands/feet
93
diabetes mellitus complications
complications develop due to chronic elevated blood sugar + vascular and nerve damage
94
diabetes mellitus
macrovascular complications
- CVD
- cerebrovascular disease (stroke)
- periph. artery disease (PAD)
95
diabetes mellitus
microvascular complications
- retinopathy (vision loss)
- nephropathy (kidney damage)
- neuropathy (nerve damage)
96
diabetes mellitus
neuropathic complications
- sensory : numbness, tingling
- motor : musc. atrophy, weakness
- autonomic : affects HR, digestion, sweating, bladder
97
diabetes mellitus
MSK complications
- adhesive capsulitis
- carpal tunnel
- trigger finger
- osteoporosis
98
diabetes mellitus
medical emergencies
- hypoglycemia (low blood sugar)
- diabetic ketoacidosis (body breaks down fat)
- hyperosmolar hyperglycemic state (severe dehydration + confusion)
99
diabetes mellitus tools
- fasting blood glucose
- A1C test
- self-monitoring
100
type 1 diabetes mellitus treatment
- requires exogenous insulin
- delivered via injections or pump
101
type 2 diabetes mellitus treatment
- lifestyle modifications
- diet changes
- regular exercise
- oral antidiabetic meds
- injectable meds
102
gestational diabetes
glucose intolerance first recognized during pregnancy
- usually 2nd or 3rd trimester
- usually resolves after delivery
103
gestational diabetes
maternal complications
- ketosis + ketoacidosis
- hypoglycemia
- preeclampsia/eclampsia
- increased risk of developing type 2
- accelerated retinopathy + nephropathy
104
UTHSC PATHOLOGY
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