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Endocrine & GI
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73
Physiology
Graduate
05/12/2012

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Term
ACTH
Definition
excreted from pituitary by stimulation from CRH from hypothalmus,
Term
Fulminant Hepatitis
Definition
severe impairment or necrosis of liver cells. complication of hep C or B compounded with delta virus. Tylenol overdose leading cause of acute liver failure in US
Term
Evaluation & Treatment of Hepatitis
Definition
dx: A- presence of anti HAV, as is the dx of HCV
B-HBsAG
D- antibody & antigen anti-HDV
E- no test yet
A low fat, high carbohydrate diet is beneficial if bile flow is obstructed
Term
Recovery phase hepatitis
Definition
begins with resolution of jaundice about 6-8 wks. Liver function test return to normal within 2-12 wks. after onset of jaundice. Chronic hepatitis assoc. with HBV & HCV. Liver function test remain abnormal for longer than 6 months & HBsAG persistant. Chronic active hepatitis constitutes a carrier state.
Term
Icteric Phase hepatitis
Definition
begins 1-2 wks. after prodromal phase, last 2-6 wks. jaundice caused from hepatocellular destruction & intrapepatic bile stasis. Urine dark & foamy, stools clay colored before jaundice from conjugated hyperbilirubinemia. This phase actual phase of illness. GI & respiratory symptoms subside, but fatique & abd pain may persist or become more severe. Serum bilirubin levels increase to 5-10 mg. (<1.5 normal). Jaundice may last 2-6 wks. Itching accompanies jaundice.
Term
Prodromal Phase Hepatitis
Definition
preicteric (jaundice) 2 wks. after exposure & ends with appearance of jaundice. Fatigue, anorexia, malaise, nausea, vomiting, HA, hyperalgia (pain), cough, & low grade fever that procede onset of jaundice. HBV & HCV may cause nephritis related to glomerular immune complex deposition. Right upper abd pain is common & wt. loss of 2-4 kg. Highly transmissible during this phase.
Term
Incubation Stages of Hepatitis
Definition
Hep A- 30 days
Hep B- 60-180 days
Hep C- 35-72 days
Hep D- 30-180 days
Hep E- 15-60 days
Hep G- unknown
Term
Hepatitis clinical manifestations
Definition
s/s of all similar
AST & ALT increased
4 phases:
incubation
prodromal- initial stage of disease
icteric-jaundice
recovery
Term
Hepatitis Patho
Definition
similar to other viral infections
Hepatic cell necrosis, scarring, Kupffer cells hyperplasia, & infiltration by mononuclear phagocytes occur with vary severity. Cellular injury is promoted by cell-mediated immune mechanism. Regeneration of hepatic cells begins within 48 hrs. of injury. The inflammatory process can damage & obstruct bile canaliculi, leading to cholestasis & obstructive jaundice.
Term
Hepatitis B
Definition
transmitted thru contact with infected blood, body fluids, or contaminated needles, sex. People receiving hemodialysis, multiblood transfusions, immunosuppressive drugs have greater risk of exposure or less resistance. Mother-infant transmission if mother becomes infected during 3rd trimester. Major cause of chronic hepatitis, cirrhosis & hepatocellular carcinoma. Assoc. with acute fulminating hepatitis.
Term
Hepatitis G
Definition
recently discovered parenterally & sexually transmitted virus. May decrease HIV viral load, increase CD4+ T cell levels, & slow down HIV disease progression.
Term
Hepatitis E
Definition
most common in developing countries. transmitted fecal-oral. usually by contaminated water. Animal reservoirs include: domestic pigs, wild boars, & deer. More prevalant in adults & highest mortality n PG women. Clinically resembles HAV.
Term
Hepatitis D
Definition
occurs in individuals with hep B. Delta virus depends on HBV for replication HBsAg molecules (which Delta depends on) are on the surface of HBV. Parenteral drug users have a high incident. Clinical course same as A & B, sometimes more severe. Antiviral drugs used for treatment.
Term
Hepatitis C
Definition
parenterally transmitted flavivirus. 40% involve IV drug users. Coinfetion with HBV prevalant. Most common cause of chronic liver disease. No vaccine. s/s persistant infection with increase aminotransferase.
Term
Hepatitis A
Definition
fecal-oral route, also by blood transfusion. incubation period 4-6 wks. fecal shedding of virus is greatest for 10-14 days before onset of symptoms. Antibodies develop about 4 wks. after infection. serum IgM increases initially & followed by increase serum IgG which remains elevated for years.
Term
Chronic Pancreatitis
Definition
ETOH abuse most common cause. Fibrosis, strictures, calcification, ductal obstruction, pancreatic cysts. coninuous or intermittent abd pain, wt. loss, steatorrhea & DM accompany disease progression. Risk factor for Pancreatic Cancer
Term
Acute Pancreatitis
Definition
acinar cells metabolizes ethanol with the generation of toxic metabolites, disruption of acinar cells permit leakage of pancreatic enzymes. s/s: epigastric or mid abd. pain is cardinal sign. pain caused by edema. Fever & increased WBC, N & V, hypotension & shock. In hemorrhagic, some develop flank or periumbilical ecchymosis (sign of poor prognosis) increased serum amylase & lipase (lipase more specific) Serum transferrin-- marker for ETOH pancreatitis.
Term
Pancreatitis
Definition
inflammation of pancreas. can be acute or chronic assoc with other clinical conditions. ETOH, obstructive biliary tract disease, peptic ulcers, trauma, hyperlipidemia & drugs.
Term
Vomiting
Definition
assoc with nausea & follows retching. The duodenum & antrum of the stomach produce retrograde peristalsis while the body of the stomach & esophagus relax. Spontaneous vomiting that is not proceded by nausea or retching is projectile vomiting. The vestibular system initiates vomiting (8th cranial nerve)
Term
Constipation
Definition
decrease in the # of BM's per week, hard stools, & difficult evacuation. assoc with Hirschsprung, acquired megacolon, hypothyroidism, pelvic hiatal hernia, MS, spinal cord trauma, cancer, CVA, IBS. Weakness can interfere with the generation of adequate intra-abdominal pressure. Anticholinergic drugs block parasympathetic impulses to GI tract, which impaires motility. Rome III criteria: straining, hard stools, sensation of incomplete evacuation, manual maneuvers, sensation of blockage, fewer than 3 a week.
Term
3 basic secretion patterns of hormones
Definition
1. circadian or diurnal
2. pulsatile & cyclic patterns
3. patterns that depend on levels of circulating substrates
Term
All Girls Feel Loose To Me Anterior pituitary hormones
Definition
ACTH
GH
FSH
LH
TSH
MSH (melanocyte)
Term
Secretory Phase
Definition
glands begin to secrete a thin glycogen-containing fluid.
Term
Follicular/proliferative phase
Definition
maturation of the ovarian follicle & proliferation of the endometrium
Term
luteal/secretory phase of menstrual cycle
Definition
ovulation marks the beginning
Term
Secreted by thyroid
Definition
thyroid hormone
Term
Absence of ACTH
Definition
weight loss, anorexia, muscle weakness, nausea, vomiting, low blood pressure, low blood sugar, low blood sodium level, high blood potassium, sparse female pubic hair, sparse female armpit hair depression,
Term
Absence of TSH
Definition
cold intolerance, dry skin, mild myxedema, lethargy, decreased metabolic rate. hypothyrioidism,
Term
vaginits infections
Definition
commonly caused by candida ablicans or glabrata.
Cardinal symptom: itching, white curd like discharge
Term
bactereial vaginosis
Definition
disturbance in the normal flora of vaginia
cardinal symptom: fishy odor especially occurs after intercourse causes grey thin homogenus type discharge
each person should be assessed with a wet prep to determine what type of infection is going on.
Term
Mechanisms of Hormonal Regulation
Definition
Hormones are either excreted directly by the kidneys or metabolized by the liver, which inactivates them & renders the hormone more water soluble for renal excretion.
Term
Ovarian Cycle
Follicular Phase
Definition
starts when previous cycle has ended.
1. GnRH released from hypothalamus
2. GnRH stimulates release of FSH & LH from pituitary gland (low levels)
3. FSH stimulates follicle growth, aided by LH
4. Cells in follicle secreting estradiol slow rise in estradiol during follicular phase (oocyte grows & mature, low levels of estradiol inhibits secretion FSH & LH (still secreted but in low levels)
5. Estradiol secretion rises steepley (negative feedback)
6. FSH & LH increase, high levels of estradiol-stimulates GnRH production, effects LH production more
Term
Luteal Phase
Definition
8. LH stimulates follicular tissue, transforming it into corpus luteum
corpus luteum secretes progesterone & estradiol
Negative feedback on hypothatlmus reduces GnRH & indirectly negative feedback n pituitary gland reducing FSH, LH secretion
Term
Thyroid Feedback
Definition
Hypothalamus
}
TRH
}
Anterior pituitary
}
TSH
}
Thyroid
tyrosine
+ }
iodine

thyroxine
negative feedback
Term
GnRH
Definition
inhibited by combination of estradiol & progesterone
stimulated by high levels of estradiol
FSH & LH- inhibited by low levels of estradiol
Term
Ovarian Cycle
Definition
Follicular phase (end with ovulation)
Luteal phase (end with degeneration of corpus luteum)
Uterine Cycle
Proliferative phase (coordinates with follicular phase)
Secretory phase (coordinates with luteal phase)
Term
Anorexia Nervosa
Definition
fear of becoming obese despite progressive wt. loss, distorted body image, body wt. 15% less than normal for age & height because of refusal to eat.
absence of 3 consecutive menstrual periods.
Term
Ulcerative colitis
Definition
lesions limited to mucosa
chronic inflammatory condition that is common in Jewish or European descent.
lesions usually begin appearing between 20-40 years.
Lesions located from rectum to colon proximally.
assoc. with mouth ulcers, epicleritis, anterior uveitis, primary sclerosing cholangitis in the liver, gallstones, alterations in coag & migratory polyarthritis.
Term
Chronic gastritis
Definition
Fundal is more rare & severe (type A)
antral- occurs most frequently in older adults (type B)
Term
Hiatal hernia
Definition
sliding-most common & reverses with standing. It moves into the thoracic cavity with sitting, bending, tight clothing, ascites & obesity.
Paraesophageal-caused by herniation of the greater curvature of the stomach thru a second opening in the diaphragm.
Term
Ferritin
Definition
protein to which iron is bound in epithelial cells
Initially it is bound to intestinal transferrin.
Term
Calcium phosphate & phosphoproteins
Definition
bind iron in the intestinal lumen & reduce absorption
Term
Transcobalamin
Definition
protein carrier for vitamin B12 to enter plasma
Term
Carboxpeptidases
Definition
responsible for breaking the end amino acids away from the ingested protein.
Term
Cephalic phase of gastric juice secretion
Definition
smelling
seeing
tasting
chewing
swallowing food
Term
Function of the stomach acid
Definition
intrinsic factor is secreted from parietal cells within the stomach.
Acid is responsible for dissolving food fibers & acts against bacteria.
Also cleaves pepsinogen to pepsin.
Term
Enterchromaffin-like cells
Definition
secrete histamine in the stomach
Term
G Cells
Definition
secrete gastrin in the antrum of the stomach
Term
Chief Cells
Definition
secrete pepsinogen in the stomach
Term
Parietal cells stomach
Definition
secrete hydrochloric acid & intrinsic factor
Term
Cholescystokinin
Definition
causes relaxation in the esophagus
Term
Motlin
Definition
increases contraction of stomach by lowering the threshold potential of muscle fibers.
Term
Gastrin
Definition
increase contraction of stomach by lowering the threshold potential of muscle fibers.
Term
Secretin
Definition
hormone that causes inhibition of stomach contractions by raising the threshold potential
Term
esophagus
Definition
The upper third is striated muscle & innervated by motor neurons
The middle third is striated & smooth muscle
The lower third is smooth muscle innervated by preganglionic fibers from the vagus nerve.
Term
Salivation
Definition
cholinergic fibers stimulate the salivary glands
Term
Buboe
Definition
abscess near a lymph node, usually inguinal node
Term
Primary syphilis Skin
Definition
chancre that is painless & ulcerated lesion
Term
Condyloma acuminatum
Definition
assoc with HPV & is soft, skin colored, whitish-pink to red-brown, discrete growth.
Term
Condyloma lata
Definition
assoc with syphilis & consist of wart-like lesions that are flat, moist, & hypertrophied.
Term
Epididymitis
Definition
unilateral pain in the scrotum
Red & swollen area on the scrotum
pyuria (pus in the urine)
bacteriuria
Term
Sertoli Cells
Definition
provide nutrients & the hormonal signals they need to develop into sperm
Term
Follistatin
Definition
suppress FSH activity
Term
Activin
Definition
stimulates FSH release
Term
Luteinizing hormone
Definition
stimulates the ovary to release the ova & secrete progesterone
Term
Inhibin
Definition
inhibits follicle-stimulating synthesis & secretion
Term
Luteal/Secretory phase
Definition
ovulation marks the beginning
Term
Secretory Phase
Definition
glands begin to secrete a thin glycogen-containing fluid
Term
Follicular/Proliferative Phase
Definition
represents the maturation of the ovarian follicle & proliferation of the endometrium
Term
SIADH
Definition
syndrome of increased ADH activity inspite of reduced plasma osmolarity,
hyponatremia
urine osmolarity > serum
urine Na>30
normal BUN/Cr
Term
Treatment SIADH
Definition
fluid restriction
Na replacement
diuretics (Lasix)
Term
DI
Definition
cause: lesion in pituitary, head trauma
s/s: polydipsia, (thirst)polyuria 2.5-6 L/d.
incr. urine volume
urine osmo<200
S.G. <1.005
hypernatremia
water deprivation test
DI if plasma osmo>295, urine osmo<500
Term
DI treatment
Definition
DDAVP
Na restriction
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