Term
| One of the body's two major communication systems. It consists of all the glands that secrete hormones and target cells which are influenced by a particular hormone. |
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Definition
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Term
| Name the 3 ways in which endocrine disorders are classified. |
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Definition
1. Hypersecretion
2. Hyposecretion
3. Hyper/Hypo responsiveness of the target cell |
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Term
| Where the defect is in the cells that secrete the hormones. |
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Definition
| Primary Endocrine Disorders |
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Term
| Where there is too much or too little tropic hormone. |
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Definition
| Secondary Endocrine Disorders |
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Term
| An alteration in the receptors of the hormone, disordered post- receptor events, or failure of normal metabolic activation of the hormone in cases requiring such activation. |
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Definition
| Hyper or Hypo Responsiveness |
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Term
| Can be distinguished by lab measurements of the hormone and any tropic hormones under both basal conditions and during experimental stimulation of the hormone's secretion. |
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Definition
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Term
| Generally caused by pituitary adenomas that are benign tumors of the anterior pituitary. Associated with excessive production of anterior pituitary hormones, especially growth hormone. |
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Definition
| Hyperpituitarism (ant pit neoplasms) |
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Term
| Occurs when excess growth hormone is secreted during the pre-pubertal period |
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Definition
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Term
| Excess growth hormone secretion that occurs after linear growth has stopped. It results in bone thickening and metabolic derangements. |
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Definition
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Term
| Name 2 disorders that are associated with hyper-secretion of growth hormone |
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Definition
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Term
| Disorders associated with hyper-secretion of prolactin. In men and women. |
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Definition
Women - causes amenorrhea and infertility
Men - Causes impotence |
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Term
| Due to the presence of a tumor with hyperpituitarism, there is compressio of the surrounding structures an this cause cause symptoms. Name 2 |
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Definition
Visual Disturbances
Headache |
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Term
| What are the treatments for Hyperpituitarism. |
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Definition
1. Tumor removal by surgery or radiation therapy; drug therapy
2. Hormone replacement therapy may be necessary after pituitary surgery and/or radiation therapy
3. PT - pay attention to side effects and complications of treatment |
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Term
| A condition due to diminished activity of the anterior lobe of the hypophysis, with inadequate secretion of one or more of the 6 anterior pituitary's vital hormones. |
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Definition
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Term
| Caused by hypophysectomy, nonsecreting pituitary tumors, postpartum hemorrhage, and reversible functional disorders (starvation, anorexia) |
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Definition
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Term
| With hypopituitarism, if you had decreased melanocyte stimulating hormone, what would be the S&S? |
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Definition
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Term
| With hypopituitarism, if you had decreased TSH secretion, what would be the S&S? |
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Definition
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Term
| With hypopituitarism, if you had decreased prolactin, what would be the S&S? |
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Definition
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Term
| With hypopituitarism, if you had decreased ACTH, what would be the S&S? |
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Definition
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Term
| With hypopituitarism, if you had decreased FSH and LH, what would be the S&S? |
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Definition
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Term
| A total failure of anterior pituitary function |
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Definition
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Term
| Panhypopituitarism developed postpartum as a result of pituitary necrosis. Commonly caused by ischemia resulting from a hypotensive episode due to severe blood loss during childbirth. |
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Definition
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Term
| Name the treatments for Hypopituitarism |
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Definition
1. Removal of causative factors, such as tumor
2. Lifetime replacement of missing hormones.
3. PT - pay attention to side effects and complications of treatments |
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Term
| Disease of the posterior pituitary gland, results from inadequate output of pituitary ADH. Characterized by an inability to concentrate urine resulting in polyuria. |
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Definition
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Term
| Name 4 etiologies of Diabetes Insipidus |
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Definition
Idiopathic
Tumors
Trauma
Hypophysectomy |
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Term
| What are the signs and symptoms of Diabetes Insipidus |
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Definition
1. Polyuria
2. Dehydration
3. Extreme thirst
4. Hypernatremia |
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Term
| Very large amounts of pale urine with low specific gravity |
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Definition
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Term
| What are the treatments for Diabetes Insipidus |
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Definition
ADH replacement
PT - be alert for serious side effects of ADH administration |
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Term
| Increases the metabolic rate, and thus promotes consumption of calories (calorigenic effect). This results in heat production. |
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Definition
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Term
| The actions of the SNS are potentiated by __. This is called the permissive action of __ |
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Definition
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Term
| Essential for normal growth and development particularly of the nervous system during fetal life and childhood. |
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Definition
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Term
| Another term for Hyperthyroidism |
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Definition
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Term
| An abnormality of the thyroid gland in which secretion of thyroid hormone is usually increased and is no longer under regulatory control of hypothalamic - pituitary centers |
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Definition
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Term
| Hyperthyroidism is more common in what sex? |
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Definition
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Term
| Where plasma contains anti-TSH receptor antibodies. The antibodies act like TSH and stimulate the thyroid gland causing hypertrophy and increased TH |
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Definition
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Term
| Hyperthyroidism can be characterized by a hypermetabolic state which includes what 7 characteristics. |
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Definition
1. Weight loss
2. Heat Intolerance
3. Tremor
4. Irritability
5. Anxiety
6. Goiter
7. Exophthlamia |
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Term
| Hyperthyroidism does what to heart rate? |
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Definition
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Term
| Can be a very serious pathology because of its cardiovascular effects, largely secondary to its permissive actions on catecholamines. |
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Definition
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Term
| What will lab values reveal with hyperthyroidism? |
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Definition
| Elevated plasma levels of thyroxin and/or T3, and low TSH |
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Term
| What are the possible treatments for hyperthyroidism? |
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Definition
1. Pharmacology (drugs to inhibit TH synthesis)
2. Surgical removal of thyroid gland
3. Radioiodine therapy
4. Thyroid replacement therapy after surgery or radiotherapy is needed |
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Term
| Ingest radioactive iodine to destroy thyroid gland |
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Definition
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Term
| What is a PTs role for a pt with hyperthyroidism |
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Definition
| Observe for signs of hypoparathyroidism for post-op patient who has thyroid gland removed |
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Term
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Definition
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Term
| Most commonly results from autoimmune destruction of all or part of the thyroid, such as in Hashimoto's disease. More common in women. |
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Definition
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Term
| Insufficiency of TH replacement after thyroidectomy or insufficiency of iodine |
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Definition
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Term
| What are some S&S of hypothyroidism |
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Definition
Weight Gain
Fatigue
Cold Intolerance
Changes in skin tone
Changes in mentation
Goiter
Myxedema |
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Term
| A chronic enlargement of the thyroid gland |
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Definition
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Term
| Nonpitting waxy edema of the skin, often most pronounced in the face and shins. |
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Definition
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Term
| What are the CNS effects of hypothyroidism |
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Definition
Slow mental function
Depression |
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Term
| What are the cardiovascular effects of hypothyroidism |
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Definition
Decreased CO
Slow pulse rate
Poor peripheral circulation |
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Term
| Neuromuscular symptoms are among the most frequent manifestation of hypothyroidism seen in PT practice. Name 5. |
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Definition
1. Proximal ms weakness, myalgia
2. Flexor tenosynovitis with stiffness and CTS (carpal tunnel syndrome)
3. Paresthesias
4. Muscular and joint edema
5. Back pain |
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Term
| What are some treatments for the cause or to correct TH deficiency in hypothyroidism patients |
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Definition
1. Destruction of thyroid: TH (T4) replacement
2. Iodine deficiency: iodine supplementation
3. Insufficiency of TH replacement after thyroidectomy: increase T4 dose |
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Term
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Definition
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Term
| The parathyroid gland secretes PTH in response to what? |
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Definition
| Levels of ionized Ca and Mg in the blood |
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Term
| Promotes the release of Ca from bone, increases renal reabsorption of Ca, promotes intestinal absorption of Ca and lowers serum phosphate levels |
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Definition
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Term
| Responsible for 30% of cases of hypercalcemia |
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Definition
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Term
| What are the causes of primary hyperparathyroidism? |
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Definition
Parathyroid adenomas
Parathyroid carcinoma
Primary parathyroid hyperplasia |
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Term
| What are the causes of secondary hyperparathyroidism |
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Definition
1. Chronic renal insufficiency, with associated phosphate retention, impaired vitamin D synthesis, and chronic hypocalcemia
2. This produces compensatory hypersecretion of PTH, secondary hyperplasia of the parathyroids and the osseous manifestations of hyperparathyroidism (called renal osteodystrophy)
3. Other causes include vitamin D deficiency and intestinal malabsorption syndromes |
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Term
| What are the S&S of Hyperparathyroidism |
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Definition
1. Elevated serum PTH levels, hypercalcemia, hypophosphatemia
2. Fatigue, weakness, hypertension
3. Bone pain and pathologic fractures
4. NS effects: mental changes, memory defects and hyperactie reflexes
5. Renal stones, gallstones, pancreatitis, pseudogout |
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Term
| Why might a person with hyperparathyroidism have pathologic fractures? |
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Definition
| Excessive reabsorption of Ca from bone causing demineralization |
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Term
| Calcium pyrophosphate deposits causing joint disease |
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Definition
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Term
| What are the treatments for primary hyperparathyroidism |
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Definition
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Term
| Most often due to surgical resection of the parathyroid glands during a thyroidectomy |
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Definition
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Term
| What are the S&S of hypoparathyroidism |
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Definition
1. Increased NM activity: tetany
2. Cardiac conduction abnormalities: arrhythmia
3. Neuropsychiatric manifestations such as depression, paranoia, and psychoses |
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Term
| What do lab values show in patients with Hypoparathyroidism |
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Definition
Hypocalcemia
Hyperphosphatemia
Decreased PTH |
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Term
| How do you treat hypoparathyroidim |
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Definition
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Term
| The adrenal gland is actually two functional glands. Name them |
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Definition
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Term
| Stimulated to release mineralocorticoids (primarily aldosterone) and glucocorticoids (primarily cortisol) by the action of ACTH |
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Definition
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Term
| Acts as an extension of te SNS, releasing both Epi and NE in response to sympathetic stimulation |
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Definition
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Term
| Released from the adrenal cortex upon stimulation with ACTH |
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Definition
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Term
| Stimulated by the release of CRH from the hypothalamus |
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Definition
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Term
| What are the physiological functions of cortisol? |
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Definition
| To maintain the responsiveness of target cells to Epi and NE, to provide a "check" of the immune system, to participate in energy homeostasis, and to promote normal differentiation of tissues during fetal life. |
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Term
| Insufficient cortisol release from the adrenal glands causing a wide range of problems |
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Definition
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Term
| Another term for primary adrenal insufficiency |
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Definition
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Term
| This results from adrenal destruction. Primary forms of adrenal insufficiency are uncommon, usually as the result of idiopathic atrophy or destruction of both adrenal glands by tuberculosis, an autoimmune process, or other diseases |
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Definition
| Primary adrenal insufficiency (addison's dz) |
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Term
| Hyposecretion of ACTH. Suppression of ACTH by steroid therapy or secondary to opportunistic infections related to HIV |
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Definition
| Secondary adrenal insufficiency (hyposecretion of ACTH) |
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Term
| What are the S&S of adrenal insufficiency |
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Definition
1. Decreased ability to maintain BP (due to loss of aldosterone) and blood sugar (lack of cortisol)
2. Adrenal crisis requires immediate hospitalization and treatment
3. Fatal if untreated |
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Term
| What are the treatments of Adrenal Insufficiency |
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Definition
Treat the cause
Treat aggressively with corticosteroids
Fluids, electrolytes, glucose |
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Term
| What is another term for Cushin's Syndrome |
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Definition
| Adrenocortical Hyperfunction |
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Term
| Hypercortisolism as the result of chronically elevated plasma cortisol concentration |
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Definition
| Adrenocortical Hyperfunction |
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Term
| What are the primary causes of Cushing's Syndrome? |
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Definition
| Chronic administration of hyperphysiologic doses of adrenocorticosteroids (for treatment of immunologic and/or inflammatory conditions) and adrenocortical tumors |
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Term
| The cause of the increased cortisol is secondary to an ACTH secreting pituitary's tumor, which secretes an excess of ACTH causing overstimulation of a normal adrenal gland. |
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Definition
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Term
| A common sign of Cushing's is a redistribution of body fat. What does this look like? |
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Definition
Truncal obesity
Moon face
Buffalo Hump
Thin extremeties |
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Term
| What are some S&S of Adrenocortical Hyperfunction? |
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Definition
1. Redistribution of body fat
2. Skin atrophy - thin skin where underlying veins are visible, sometimes accompanied by hyperpigmentation
3. MS symptoms: increased bone reabsorption inducing osteoporosis with compression fractures of the vertebrae, fractures of ribs and sometimes of long bones and proximal muscle wasting (steroid myopathy)
4. Hypertension
5. Secondary sexual characteristics |
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Term
| What are some secondary sexual characteristics of adrenocortical hyperfunction? |
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Definition
| Females tend to exhibit increased facial hair, decreased scalp hair, acne, and decreased menses. Men often exhibit impotence. Both sexes have decreased libido |
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Term
| What are the treatments for adrenocortical hyperfunction? |
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Definition
Depends on the underlying cause
-tumor resection or radiation
-drug therapy
-for patients with ms wasting or at risk for ms atrophy : high-protein diet |
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Term
| The most common neoplams of the adrenal medulla. |
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Definition
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Term
| About 1 in 1,000 patients with HTN has a __ or __, both secrete excess catecholamines |
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Definition
Pheochromocytoma
Paraganglioma |
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Term
| What are teh S&S of Pheochromocytomas |
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Definition
| HTN - can be sustained or paroxysmal which means is rises suddenly and dramatically as the result of the release of a large amount of catecholamine, which can be precipitated by exercise, stress, change in body position, or pressure on the tumor. |
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Term
| Hypertensive episodes are characterized by what? |
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Definition
| Spasms of severe HTN, chest and ab pain, palpitation, headache, nausea, dyspnea, anxiety, pallor, diaphoresis |
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Term
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Definition
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Term
| What should a PT do with a patient with Pheochromocytomas? |
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Definition
Check vitals
Medical referral of HTN pts
Seek medical attention when hypertensive episodes occur |
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