Unit 3: Chapter 41

Question 1

General Aspects of Altered Endocrine Function

Answer 1

affects all aspects of body function, including growth and development, energy metabolism, muscle and adipose tissue distribution, sexual development, fluid and electrolyte balance, and inflammation and immune responses.

Question 2

Hypo/Hypofunction

Answer 2

Disturbances of endocrine function usually are related to either hypofunction or hyperfunction of an endocrine gland or to hormone resistance of the target cells.

Question 3

Hypofunction of Endocrine Glands

Answer 3

Occur for a variety of reasons:
absence or impaired development of a gland or deficiency of an enzyme needed for hormone synthesis.
The gland may be destroyed by a disruption in blood flow, infection, inflammation, autoimmune responses, or neoplastic growth.
Decline in function occur with aging, or atrophy as a result of drug therapy or for unknown reasons.
A gland may produce a biologically inactive hormone, or circulating antibodies may destroy an active hormone before it can exert its action.

Question 4

Hyper function of Endocrine Gland

Answer 4

usually is due to excessive hormone production. This can result from excessive stimulation and hyperplasia of the endocrine gland or from a hormone-producing tumor. A
tumor can produce hormones that are not normally secreted by the tissue from which the tumor is derived (ectopic hormone production

Question 5

Endocrine Dysfunction

Answer 5

because of hormone resistance may be associated with receptor defects at the target cells.
Hormone receptors may be absent or the receptor binding of hormones may be defective.

Question 6

Endocrine Disorders

Answer 6

onsidered as primary, secondary, and tertiary disorders, related to the cascade of hormonal responses regulated through the hypothalamic–pituitary–target endocrine gland axis.

Question 7

Primary Disorders

Answer 7

Primary disorders of endocrine function originate in the target endocrine gland responsible for producing the hormone.

Question 8

Secondary Disorders

Answer 8

The target endocrine gland is essentially normal; however, the gland is not producing appropriate levels of hormone because it is not receiving appropriate stimulation from the pituitary gland. The actual source of dysfunction is at the level of the pituitary gland.

Question 9

Tertiary Disorders

Answer 9

results from hypothalamic dysfunction (as may occur with craniopharyngiomas or cerebral irradiation).
Thus, both the pituitary and target organ are understimulated.

Question 10

ACTH Function

Answer 10

Produced by the pituitary gland
Controls the release of cortisol from the adrenal glands

Question 11

TSH Function

Answer 11

Produced by the pituitary gland
Controls the secretion of thyroid horome from the thyroid gland

Question 12

LH Function

Answer 12

Produced by the pituitary gland
Regulates sex hormones int he ovaries and testes

Question 13

FSH Function

Answer 13

Produced by the pituitary gland
Regulates fertility in the ovaries and testes

Question 14

Growth Hormone

Answer 14

also called somatotropin, is a 191-amino acid polypeptide hormone synthesized and secreted by special cells in the anterior pituitary called somatotropes.
Rate of GH production in adults is almost as great as it is in children.
GH is necessary for growth and contributes to the regulation of metabolic functions.
GH stimulates all aspects of cartilage growth, linear bone growth.

Question 15

Acromegaly

Answer 15

When GH excess occurs in adulthood or after the epiphyses of the long bones have fused.

Question 16

Adenomas

Answer 16

clinical manifestations associated with acromegaly are related to pituitary adenomas, as this is the etiologic cause of most cases of acromegaly.
As the pituitary adenoma grows, it causes further dysfunction of the pituitary gland and surrounding brain structures.

Question 17

Thyroid Function

Answer 17

Stimulation by TSH from the pit art gland serves as the stimulus for the thrips glad to secrete T3 and T4 thyroid hormones into the blood.

Question 18

Thyroid Hormone

Answer 18

Increases the metabolism and protein synthesis in nearly all of the tissues of the body.

Question 19

Causes of Low Thyroxine Binding Globulin

Answer 19

alterations of TBG function have been identified, including an X-linked TBG deficiency associated with a gene on the long arm of the X chromosome.
Glucocorticoid medications and systemic disease conditions such as protein malnutrition, nephrotic syndrome, and cirrhosis can decrease TBG concentrations of the thyroid-binding proteins.
Drugs, such as phenytoin, salicylates, and diazepam, can affect the binding of thyroid hormone to normal concentrations of binding proteins or disrupt thyroid metabolism in other ways.

Question 20

Graves Disease

Answer 20

is a state of hyperthyroidism, goiter, and ophthalmopathy.
Affects population under 40 years of age. Autoimmune disorder characterized by abnormal stimulation of the thyroid gland by thyroid-stimulating antibodies (TSH receptor antibodies) that act through the normal TSH receptors.
It may be associated with other autoimmune disorders such as myasthenia gravis.

Question 21

Hypothyroidism

Answer 21

Occurs as congenital or an acquired defect.
Congenital: develops prenatal and is presen at birth
Acquired: primary disease of the thyroid gland or secondary disorder to disorder of hypothalamic or pituitary origin

Question 22

Congenital Hypothyroidism

Answer 22

In the infant may result from a congenital lack of the thyroid gland or from abnormal biosynthesis of thyroid hormone or deficient TSH secretion. With congenital lack of the thyroid gland, the infant usually appears normal and functions normally at birth because hormones have been supplied in utero by the mother.

Question 23

Adrenal Cortex Function

Answer 23

The cortex forms the bulk of the adrenal gland (approximately 80%) and is responsible for secreting three types of hormones—the glucocorticoids, the mineralocorticoids, and the adrenal androgens.
Essential for life and is fatal if not treated

Question 24

Adrenal Cortical Insufficiency

Answer 24

two forms of adrenal insufficiency—primary and secondary.
1. Primary adrenal insufficiency, or Addison disease, is caused by destruction of the adrenal gland.
2. Secondary adrenal insufficiency results from a disorder of the HPA system.

Question 25

Clinical Findings of Adrenal Insufficiency

Answer 25

Anorexia and weight loss Fatigue and weakness GI symptoms, nausea, diarrhea Myalgia,, arthralgia, Abd pain Orthostatic hypothesis on Hyponatremia Hyperkaleia Hyperpigmentation Associated autoimmune conditions

Question 26

Addison Disease

Answer 26

primary adrenal insufficiency (i.e., originating in the adrenal glands) in which adrenal cortical hormones are deficient and ACTH levels are elevated because of lack of feedback inhibition.

Question 27

Addison Disease Manifestations

Answer 27

adrenal cortex has a large reserve capacity, and the manifestations of adrenal insufficiency usually do not become apparent until approximately 90% of the gland has been destroyed. Related primarily to mineralocorticoid deficiency, glucocorticoid deficiency, and hyperpigmentation resulting from elevated ACTH levels.

Question 28

Glucose Metabolism

Answer 28

Efficient fuel, when metabolized in the presece of O2, breaks down to form CO2 and water. Brain relies exclusively on glucose as a fuel. Body tissues obtain glucose from the blood.

Question 29

Insulin

Answer 29

insulin is the only hormone that acts to lower blood glucose levels. The active form of insulin is produced in the beta cells of the pancreas from a larger molecule called proinsulin. formed by cleaving away the C-peptide of the proinsulin molecule, leaving the A and B polypeptide chains, which form the active insulin molecule

Question 30

Insulin Action

Answer 30

The actions of insulin include: 1. Promoting glucose uptake by target cells and storage of glucose as glycogen (in liver and muscles) or fat (in adipose tissue) 2. Inhibiting fat and glycogen breakdown 3. Inhibiting gluconeogenesis and increasing protein synthesis

Question 31

DM

Answer 31

efers to a group of common metabolic disorders characterized by hyperglycemia resulting from imbalances between insulin secretion and cellular responsiveness to insulin. 4 classification of types

Question 32

Pre diabetes

Answer 32

This classification is used when the blood glucose levels are elevated but do not meet the diagnostic criteria for diabetes.

Question 33

Type 1 DM

Answer 33

Characterized by insufficient insulin production, typically because of autoimmune destruction of pancreatic beta cells and frequently leading to absolute insulin deficiency. There is also a subtype that is idiopathic in which no autoimmune antibodies are detected.

Question 34

Type 2 DM

Answer 34

Characterized by a state of insulin resistance and progressive decline in pancreatic beta-cell secretion of insulin. Commonly accompanied by co-occurring clinical manifestations called the “metabolic syndrome.”

Question 35

Gestational DM

Answer 35

Abnormalities of glucose regulation presenting initially during pregnancy, primarily during the second or third trimester.

Question 36

Diabetes Due to Other Causes

Answer 36

cludes monogenic diabetic syndromes (such as neonatal diabetes and maturity-onset diabetes of the young [MODY]), as well as diabetes related to conditions such as cystic fibrosis and organ transplantation.

Question 37

Criteria for DM

Answer 37

Fasting plasma glucose ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 hours. OR 2-h PG ≥ 200 mg/dL (11.1 mmol/L) during OGTT. OR Hemoglobin A1C ≥ 6.5% (48 mmol/L) Repeat testing should be done to confirm the results in the absence of unequivocal hyperglycemia. OR A random plasma glucose of ≥200 mg/dL (11.1 mmol/L) in a person with classic symptoms of hyperglycemia or hyperglycemic crisis.

Question 38

Hyperosmolar Hyperglcyermic Stat

Answer 38

characterized by hyperglycemia, hyperosmolarity with dehydration, the absence of ketoacidosis, and depression of the sensorium. Occurs frequently in people with type 2 diabetes.

Question 39

Hyperosmolar Hyperglycemic State Manifestations

Answer 39

prominent manifestations of HHS are weakness, dehydration, polyuria, neurologic alterations, and excessive thirst. Neurologic alterations include hemiparesis, seizures, and coma; these symptoms may be mistaken for a stroke.

Question 40

Hashimoto Thyroiditis

Answer 40

Most common cause of acquired hypothyroidism Autoimmune disorder in which the thyroid gland may be totally destroyed by an immunology process. Predominately disease in women Onset: goiter may be present

Question 41

Hypothalamic-Pituitary- Adrenal System Function

Answer 41

Communication between 3 organs. Critical for stress management Create a feedback loop of hormones to enact and regulate your body stress reaction