Term
| What is the hypothalmus Pit axis? |
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Definition
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o Releasing hormones from hypothalamus tell the pituitary what to release into the blood
o Trophic hormones from the pituitary tell specific peripheral glands to grow and produce their hormones |
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Term
| What are the 3 hormone disorders? |
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Definition
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o Tertiary- abnormality in stimulation from the hypothalamus- (can’t fix this one)
o Secondary- abnormality in stimulation from the pituitary
o Primary- abnormality in the gland |
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Term
| What are the 4 Pituitary Hormones? |
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Definition
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o Growth hormone
o FSH and LH- stimulate glands
o TSH- stimulate thyroid
o ACTH- stimulate adrenal cortex |
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Term
| Explain how growth hormone wrks? |
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Definition
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o Released or inhibited from Pituitary depending on message from hypothalamus
o GHRH stimulation d/t hypoglycemia, fasting, starvation, adult metabolism
o Somatostatin inhibits d/t increased glucose levels, free fatty acids release, & obesisty, Glucocorticoids |
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Term
| What are the 2 functions of growth hormone? |
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Definition
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. 1. Growth- promoting actions
2. Anti- insulin effects
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Term
| Explain growth promoting actions |
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Definition
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o Increased Protien Synthesis
§ Bone & cartilage>increased linear growth
§ Body organs> Increased size and fuction
§ Muscle> Increased lean muscle mass |
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Term
| Explain anti insuline effects |
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Definition
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Adipose tissue> increase lipolysis, break down fat and get rid of
Carbohydrate metabolism> decreased glucose use>increased blood glucose |
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Term
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Growth Hormone Defiency in Children |
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Definition
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o Idipotathis GH deficiency- Tertiary Problem
o Hypothalmus does not know how the make GHRH
o Pituitary tumors, agenesis of the Pituitary- Secondary Problem
o Can’t produce GH
o Laron- type dwarfism- Primary Problem
o Hereditary defect in IGF production
o My Hypothalmus and Pituitary are Ok but there is some kind of metabolic event that is not happening correctly
o In adults lack of GH is due to hypopituitaryism
o Replace GH best we can |
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Term
| What is growth hormone deficiency/ Excess and explain s/s |
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Definition
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o Deficiency (Dwarfism)
Craniofacial abnormalities
Hypoglycemia
Over wt as they age
o Excess
o Children- gigantism- epishyseal plate closure(Proportinal)
§ Extreme ht, organmegaly, cardiomegaly
§ Treat with surgery d/t most time it is a tumor |
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Term
In adults what is growth hormone exess?
What are s/s
How do you stop? |
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Definition
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o acromegaly
§ Coase features, organomegaly, cardiomegaly, arthritis, neuropathy, sexual dysfunction(Not Proportional)
§ Give Octrotide/Somatostin to stop production |
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Term
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Achondroplasia- dwarfism s/s
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Definition
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o Large head
o Short arms and Legs especially upper arms and thighs
o Prominent forehead protruding jaw
o Crowded and misaligned teeth
o Forward curvature of lower spine
o Bowed Legs
o “Double jointedness” |
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Term
What does the Thyroid do?
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Definition
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· Does everything, motor for everything, steroid hormone |
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Term
| Explain Thyroid Hormone Control? |
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Definition
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· *T3 stimulates all metabolism, has short life
· * T4 inactive hangs around in tissues , T4 gets used up and then is converted into T3 so that we always have a constant supply of T3
· *Both exert negative feedback on the hypothalamus
· * Carried by binding proteins |
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Term
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Definition
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· Hypothyroidism
o Congenital born with
o Aquired –(causes)
§ Hashimotos thyroiditis(autoimmune)- shuts thyroid hormone down
§ Thryoidectomy- remove d/t cx ex
· |
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Term
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Definition
Hyperthyroidism
o Graves disease- increase T3 & T4, autoimmune
o Thyroid Tumors.- Greats too much thyroid hormone
§ 1% Despirate Aplastic Kill you within 6 months
§ 99% slow growing tumors, that you can cut out or kill with radiactive iodine |
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Term
| Why is Iodine so important? |
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Definition
- · Iodine is essential for all T3&T4 production must have just correct amount
- · There is no neg feed back if no iodine
- · Hypothalamus relases huge amount of TRH
- · Pituitary releases huge amount of TSH, d/t it is a tropic hormone it goes to thyroid telling it to grow and release.
- · However the thyroid will not be able to release any hormone because it won’t have iodine to make it d/t their was a halt production of T3 & T4
· Now your patient will have a Goitor |
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Term
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Definition
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· Metabolic Rate
· Cardiovascular
· Gastrointentional
· Neuromuscular |
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Term
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Hypothyroidism
Adult vs Child
S/s
Causes
Treatment
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Definition
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· Myxedema/ adults
· Cretnism/ Children
o DECREASED METABOLISM- Pale puffy face, cold skin, brittle hair, decreased hr, fatigue, lethargy, wt gain, hypotension
· Causes
o Hashimoto’s- chronic autoimmune thyroiditis
o Low iodine in diet, radioactive iodine, surgery
· Treatment
o Replace T4- synthroid
o 10% Women need T3 as well |
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Term
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Hyperthyroidsm
Assesment characteristic
Treatment
S/s |
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Definition
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· Graves( autoimmune)
· Assessment characterists- exopthlalmos- cytokine-mediated activation of fibroblasts in orbital tissue
o Exopthlamos patient will have increase scar tissue behind eyes and eyes will look like they are budlgeing out
· Treatment
o Block T3 & T4 production measure levels
o Treatment for 2yrs then stop 40% will go back to normal after treatment is stoped
o Radioactive Iodine (iodine 131)
o Surgery- take out
· S/s
o INCREASE MET- Fine hair, exopthalamos, Goiter, sweating, tachycardia, wt loss, olgomenorrhea, tremor |
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Term
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Toxic Hyperthyroidism
S/S
Treatment
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Definition
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· Thyroid storm.. d/t not treated
· S/S
o Excessive metabolic rate, patient acts like they are on Cocaine
o Dysthmias, CNS Stimulation, skeletal muscle weakness, increased metabolic rate, mental processes, fast speech, progress to fatigue, coma, death
· Treatment
o Initial treatment with potassium iodine or other iodine salts.. flood with iodine to shut off thyroid, High iodine decreases uptake and suppresses release of thyroid hormone
o Give a Beta Blocker |
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Term
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Major Adrenal Cortical Hormone |
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Definition
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· Hypothalmus
· Corticotropin- releasing hormone (CRH)
· Anterior Pituitary
· Adrenal Cortocotropic Hormone (ACTH)
· Adrenal Cortex- controls
o Glucocorticoids-Sugar
o Mineralcorticods-Salt
o Sex Hormone- sex |
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Term
| What is major part of Adrenal Hormones? |
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Definition
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Term
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Mineralocorticoids
· Aldosterone |
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Definition
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o Promote salt and water balance
o Na+ rention and K+ excretion at distal tubules
o Regulated by rennin- angiotension system in kidney
o Resonds to renal perfusion and k+ levels |
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Term
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Definition
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· Common with people who have tumors of the adrenal gland
· Patient will have Sodium and water retention
o Causes fluid and electrolyte problems, edema and increase BP
· Patient will lose K and this will lead to problems with the heart.
· Treatment
o Get tumor out |
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Term
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Glucocorticoids
· Cortisol |
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Definition
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· Catabolic hormone breaks down my resourses and puts pieces parts out their in order to allow me to have plenty of resourses for what ever is going on.
o Plasma Protiens increase
o Muscle Break down
o Free fatty acids increased
o Blood glucose increased
o SNS response increased
o Immune inflammatory system suppressed
§ Patient will have mental and emotional concerns
§ Inflam system suppressed so much more likely to get an infection. |
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Term
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Definition
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· Stress, Pain, Infection, Hypoglycemis, Sleep, hemorrhage, Trauma |
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Term
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Adrenal Insufficiency- Primaary
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Definition
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o Chronic Addison
§ Disease of the adrenal cortex
§ Could be caused by Idiopathic, autoimmune, trauma
o Acute- Addisonian Crisis
§ Severe clinical surgery |
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Term
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Adrenal Insufficiency- Secondary
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Definition
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· Secondary- MOST COMMON
o Hypothalamic or Pituitary insufficiency
§ CRH and or ACTH, not as likely
o Iatrogenic- Steriod therapy- Caused by treatment by something else
§ Will see this daily , Run risk of Chronic
§ Steroid therapy caused, flood body with cortisol, CRH and ACTH drop off, hypothamlas monitors, more steroids less cortisol produced, problem lies with Ant Pituitary.
· Must wean cortisol and steroids slowly, so hypothalamus can start back up. |
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Term
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Adrenal Insufficiency- S/S
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Definition
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· Hypglycemia
· Muscle wasting
· Fat storage
· HyperKalemia
· Hyptension
· Hyperpigmentation of skin
o Increased production melanocyte stimulating hormone- Black and Brown Pigment
o Precursor common with ACTH
§ No neg feed back |
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Term
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Definition
· Addisonian Crisis
o Cortisol-glucose metabolism
§ And protein and fat exhausted fatigued feel sick
o Aldosterone- dehydration, salt craving electrolyte imbalance, happens very quickly
o Decreased Vascular tone, Hypovolemia reduced cardiac output- clinical emergency
§ Long term steroid therapy leads to Adrenal insufficiency
§ Not haveing Cortisol and Aldosteron leads to Crisis
§ Get Iv Steroids |
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Term
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Adrenal Insufficiency
· Treatment |
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Definition
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o Replacement
· Hydocorisone BID to mimic the Diurnal release, give IV
· Next after feel better, Fludrocrotisone/ Florinef-Aldosterone Oral
o Stress can bring about crisis require IV administration
o Always need xtra steroids incase there is an increase in stress |
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Term
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AdrenalCortical HyperFunction
Primary
Secondary
Tiertiary
Cushing Syndrome
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Definition
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· Primary-adrenal adeoma- Tumorn in Adrenal Gland
· Secondary- Anterior Pit- Tumor of Pit that keeps cranking ACTH
o Called Cushing disease
· Tertiary- hypothalamus Increase in CRH
o Treatment based on cause if Hypothlamus prob you are out of luck
· Crushing syndrome- Clinical feature of Hypercortisolism
o 2much Cortisol caused by steroids of me |
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Term
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Definition
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· Caused by chronic steroid therapy
· Emotional disturbances, enlarged sella turica, moon face, osteroporosis, cardiac hypertrophy, buffalo hump, obesity, adrenal tumor or hyperplasia, thin wrinkled face, abd stria, amenorrhea, muscle weakness, purpura, skin ulcers.
· Hold H20 Fat development in areas |
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Term
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Adrenal Medulla
· Pheochromocytoma |
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Definition
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o Tumor of cells that produce catecholamine
o Excess production of catecholamine
o Excessive sympathetic response
§ HTN, Increased Heart Rate, dysrhythmia, Stroke, headache, diaphoresis
o Treatment
§ Surgery
§ Metyrosine- stops production |
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