What is the difference between endocrine and exocrine glands, and what are examples of each?
Endocrine: secretes substances into ductal system onto an epithelial surface
Exocrine: secrete products directly into the bloodsteam for dispersal to the systemic circulation
How does the hypothalamus regulate endocrine function through negative feedback loops?
Hypothalamus does all the measuring, it gives off stimulating hormones based on its measures.
What is the role of positive feedback loops in physiological processes, and how do they differ from negative feedback loops?
A reaction that causes an increase in function, causes the output to be increased. Ex: birth, blood clotting
A reaction that causes a decrease in function, causes output to be lessened so that the feedback can stabilize the system. Ex: Blood glucose
How does the hypothalamus-pituitary-endocrine axis regulate hormone levels in the body?
hypothalamus is always opposite the gland
- the gland and pituitary are always the same
- T3/T4 is gland
- TSH is pit
- TRH is hypothalamus
What are the differences between primary, secondary, and tertiary endocrine disorders
Primary is an issue with the gland
Secondary is pituitary
tertiary is hypothalamus
How do hormone deficiency affect endocrine function, and what are common causes?
- Cells are damaged and cannot create the hormones.
- Due to a gland destruction due to autoimmunity, infection, inflammation, infraction or tumor infiltration
How do hormone excess affect endocrine function, and what are common causes
- Usually due to tumor growth, autoimmune, or genetic mutations that cause cells to increase endocrine function.
How do hormone resistance affect endocrine function, and what are common causes?
Usually due to inherited defects in membrane receptors, making cells unable to utilize the hormone that is present
What are the diagnostic tools used to assess endocrine gland dysfunction, and how do they differ based on the disorder?
Diagnosed via lab, ultrasounds and CT/MRI to see tumors
How does diabetes insipidus differ from the syndrome of inappropriate antidiuretic hormone (SIADH) in pathophysiology and clinical presentation?
DI: low ADH
- dehydrated
- hypernatremia
- Pee but its low USG (nothing in it)
- Desmopressin
SIADH: high ADH
- Hyponatremia
- High USG
- Furosemide
What are the causes, symptoms, and treatments for hypopituitarism?
Cause: Pit hypofunction, not enough ADH
Symptoms: Polyuria and poly dipsia, confusion, seziures, coma
Treatment:
- replacement of the ADH
What are the causes, symptoms, and treatments for hyperpituitarism?
Cause: Brain injury, Too much ADH, SIADH
Symptoms:
Treatments: fluid restriction, furosemide
How do growth hormone deficiencies and excesses manifest differently in children versus adults?
Deficiency:
Child- dwarfism
Adult- rare
Excess:
Childhood it is giantism( GP open)
Adulthood it is acromegaly (GP closed)
What is the role of the thyroid gland in metabolism, and how are T3 and T4 regulated by the hypothalamus and pituitary?
- The thyroid hormones have a wide range of actions- mostly act as the metabolism driver of the body
If T3/T4 is high then hypo is low and pit is low
IF T3/T4 is low then hypo is high and pit is high
What is the significance of a goiter, and how does it relate to thyroid gland dysfunction?
Goiter is an enlarged thyroid gland, can be associated with changes in function
How do autoimmune disorders such as Graves’ disease and Hashimoto’s thyroiditis impact thyroid function?
Graves is Autoimmune hyperthyroidism. The immune system produces TSH receptor antibodies.
Hashimoto’s: Autoimmune hypothyroidism. The immune system attacks and gradually destroys thyroid tissue.
What are the risks and benefits of using levothyroxine for hypothyroidism, and what are the key nursing considerations?
Benefits: TSH naturally stabilizes
Risks:
- Takes 6-8 weeks for TSH to stabilize
- Bioavaliblity differences
Considerations:
- Monitor for cardiac probs
- Administer does in morning before meals and meds
How does methimazole treat hyperthyroidism, and what are the common side effects and precautions associated with its use?
- Inhibits production of new thyroid hormone and reduces immune molecules
- SE: Hypothyroidism as it is not easily managed, Agrenulocytosis, hepatotoxicity, teratogenicity
- NO pregnancy
How do parathyroid glands regulate calcium levels, and what are the consequences of hypoparathyroidism?
PTH promotes calcium reabsorption in the kidneys and osteoclast activity in the bones, releasing calcium from the bones
Consequences: rare, causes low PTH=Low calcium
What are the consequences of hyperparathyroidism?
Caused by andenocacinoma
- Excessive PTH = High calcium
- Bones, stones, psychiatric overtones
What are the functions of cortisol, aldosterone, and adrenal androgens, and how do they respond to stress?
Cortisol: increases BS
Aldosterone: RAAS, increases Na and H2O reabsorption–> Helps maintain BP/volume under stress
Adrenal: libido and hair growth
How does the hypothalamus-pituitary-adrenal (HPA) axis regulate cortisol production?
Once cortisol is high enough, it tells the hypothalamus and pituitary to slow down — so they stop making CRH and ACTH.
What is Addison’s disease, and how does it differ from Cushing’s syndrome in terms of etiology and symptoms?
Cortisol Issue
Addisons:
- Low Cortisol (Low stress)
- Bronze Skin
- weakness, hypotension, lethargy, anorexia, N/V
Cushing’s:
- High cortisol, high stress
- Buffalo hump and moon face
- weight gain, dark neck folds (hyperglycemia), hypertension, stretch marks, bruising
What are the causes and symptoms of an adrenal crisis, and how is it treated?
Low low cortisol levels, due to an autoimmune destruction of adrenal cortex
- Symptoms: Abd pain, fever, weakness, confusion, N/V, hyponatremia
- Treat by IV hydrocortisone, fluids
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