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Target cell number can determine target cell _____ to a hormone |
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refers to an increase # of receptors in response to low hormone concentration.
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refers to a ¯ in # of receptors in response to high hormone concentration |
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Hormonal alterations may be due to: |
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usually due to secreting tumors or excessive stimulation of the gland by tropic signals |
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Definition
•may be due to:
•Failure of glandular tissue
•Congenital absence of glandular tissue
•Surgical removal of gland
•Lack of normal tropic signals
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Definition
•may be due to:
•Receptor-associated disorders
•Intracellular signaling pathway disorders
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Primary endocrine disorders |
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Definition
•result from intrinsic defects within the hormone-secreting gland
•Primary hyposecretion = low target gland hormone, high pituitary hormone
•Primary hypersecretion = high target gland hormone, low pituitary hormone
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Secondary endocrine disorders |
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Definition
•result from abnormal pituitary secretion of tropic signals.
•Both pituitary & target-gland hormone levels are low in hyposecretion and both are high in hypersecretion
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Growth hormone deficiency |
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Definition
GH deficiency in childhood results in dwarfism
•GH deficiency in adulthood is usually due to a traumatic head injury or resection of a pituitary tumor
•Without GH replacement therapy, the result is:
•¯ed lean body mass
•¯ed bone density
•Hypercholesterolemia
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Definition
•GH excess in childhood results in gigantism
•GH excess in adulthood (after closure of bone epiphyses) results in ed bulk and acromegaly
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Syndrome of inappropriate ADH secretion (SIADH) |
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Definition
Serum hyponatremia (dilutional)
Urine hyperosmolality
•Clinical manifestations are due to hyponatremia and become more severe with ¯ing Na+
•[Na+] of 130-136 (mild)
•[Na+] of 120-130 (moderate)
•[Na+] < 115 (severe)
• Symptoms:
•GI symptoms occur early:
•Anorexia, nausea, vomiting
•Most of symptoms are neuropsychiatric in nature:
•Headaches, blurred vision, lethargy, apathy, disorientation, agitation, irritability, seizures
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Definition
•always involves a deficiency in ADH function.
•Urine cannot be concentrated and free water is lost. (due to a large diuresis of very dilute urine)
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4 types of diabetes insipidus |
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Definition
1.Neurogenic (inability to ® and/or release ADH)
2. Nephrogenic (inability of kidney tubules to respond to ADH)
3. Gestagenic
4. Primary polydipsia has 2 subtypes
•Dipsogenic polydipsia (thirst-center abnormality)
•Psychogenic polydipsia (compulsive water drinking)
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Untreated diabetes insipidus can produce |
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Definition
•Hypovolemia
•Hyperosmolality
•Circulatory collapse
•Loss of consciousness
•CNS damage
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Term
myxedema
(not myxe-dean-a!!) |
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Parathyroid hormone (PTH) increases ____ through its effects on bone, renal tubules, & intestine.
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causes high serum Ca++ and bone demineralization.
High serum Ca++ ¯s neuromuscular excitability, leading to muscle and bone weakness. High serum Ca++ also can lead to cardiac arrhythmias and renal calculi.
Treatment is to remove abnormal gland
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Definition
causes low serum Ca++ levels, which neuromuscular excitability, leading to tetany and seizures
Treatment involves Ca++ supplementation rather than hormone replacement |
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3 Classes of adrenal cortical steroid hormones |
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Definition
Glucocorticoids
Mineralocorticoids
Sex steroids (androgens)
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Term
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Definition
1.Glucocorticoids are stress management hormones.
2.The primary glucocorticoid is cortisol. Cortisol helps the body respond to stress. Cortisol helps maintain BP and CV function, suppresses the immune system inflammatory response, stimulates gluconeogenesis, increases protein breakdown, and increases mobilization of FFA.
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1.Mineralocorticoids function to maintain salt and water balance by promoting sodium retention (and potassium secretion) at the DCT and collecting duct.
2.The primary mineralocorticoid is aldosterone. Aldosterone helps maintain blood pressure and water and salt balance in the body by helping the kidney retain Na+ & excrete K+ .
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| 1.The adrenocortical androgens play a minor role in development and maintenance of secondary sex characteristics except in children with adrenogenital syndromes. |
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Addison Disease is _____ adrenocortical insufficiency |
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Definition
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•Primary adrenal insufficiency
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Definition
a disorder of the adrenal glands themselves. (patients display high levels of ACTH)
•Most common cause is autoimmune destruction of gland
•Aldosterone deficiency is common |
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Term
•Secondary adrenal insufficiency
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Definition
is due to inadequate secretion of ACTH by pituitary gland. (i.e. low ACTH)
•Because ACTH has little control over aldosterone secretion, hypoaldosteronism is generally not present in secondary adrenal insufficiency.
•A temporary form of secondary adrenal insufficiency may occur when a person who has been taking a glucocorticoid hormone such as prednisone for a long time abruptly stops or interrupts the medication.
• Hence the gradual weaning off glucocorticoid meds |
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Term
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Definition
•Chronic, worsening fatigue
•Muscle weakness
•Loss of appetite
•Weight loss
•Blood pressure that falls further when standing
•Skin changes with areas of hyperpigmentation
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Symptoms of adrenal insufficiency
usually begin gradually and progress slowly
•Symptoms are usually ignored until a stressful event causes them to become worse.
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Symptoms of addisonian crisis include |
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Definition
1.Sudden penetrating pain in lower back, abdomen, or legs
2.Severe vomiting and diarrhea
3.Hypovolemia
4.Hypotension
5.Loss of consciousness
1.2.During an addisonian crisis, standard therapy involves intravenous injections of hydrocortisone, saline, and Hydrocortisone (cortisol substitute) and dextrose. Fludrocortisone acetate or Florinef (aldosterone sub.)
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Definition
Excess cortisol production due to pituitary hyperstimulation of the adrenal cortex
Cushing disease is most commonly due to an ACTH-secreting pituitary adenoma
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Clinical manifestations of Cushing disease/syndrome |
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Definition
1.Weight gain
2.Muscle weakness
3.Fatigue
4.Buffalo hump
5.Thinning extremities with muscle wasting & fat mobilization
6.Thin, fragile skin
7.Moon face & ruddy complexion
8.Hirsutism
9.Truncal obesity
10.Broad purple striae
11.Bruising & impaired wound healing
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Common clinical findings of Cushing syndrome |
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Definition
Regardless of the cause, hyperaldosteronism results in sodium/water retention and potassium excretion. This results in:
1.Hypervolemia
2. Hypertension
3. Hypokalemia
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Definition
Hyperfunction of the adrenal medulla is caused by a tumor that is responsible for excessive catecholamine release causing:
•Hypertension
•Headache
•Tachycardia
•Diaphoresis |
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Term
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Definition
(formerly IDDM)
•b cells in pancreas are destroyed.
•In the idiopathic type 1 disease, patients have a permanent insulin deficiency with no evidence of autoimmunity.
•In the immune-mediated type 1 disease, a local or organ-specific deficit may induce an autoimmune attack on b cells |
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Definition
(formerly NIDDM) may be caused by:
•Resistance to insulin in target tissues
•Abnormal insulin secretion
•Inappropriate hepatic gluconeogenesis |
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1.Chronic complications of diabetes
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Definition
Diabetic neuropathies-axonal and schwan cell degen-impaired motor nerve conduction, pain
Microvascular disaese-retinopathy, neuropathy, capillary basement membrane thickening, ischemia, HTN
Macrovascular disease-CHD, CVA, periph. vascular disease, proliferation of fibrous plaques, ischemia, atherosclerosis related to high serum lipids
Infection-sensory impairment, atherosclerosis, ischemia, hypoxia, leukocytic impairment |
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1.Acute complications of DM
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Definition
Insulin shock/hypoglyc- s/s:weak, anxious, confused, tachycard, diaphoresis @ risk:Type1&2 Sugar level: 30mg or less in infants, 60 in adults treat:fast acting carbohydrate
DKA-s/s:N/V, Polyuria,polydips,polyphagia, HA @ risk: type 1 (insulin omission) Sugar level:300-750mg treat:low-dose insulin, fluid replacement
HHNKS-s/s:similar to DKA, sz, stupor, dehydration @ risk:elderly &young w/type 2 DM, hyperosmolar diuresis Sugar level:600-4800mg treat:crystaloid/colloid fluid replacement |
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