ch 31 patho

Created by Amy46 

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how does the hypothalamus-pituitary axis work?

releasing hormones from hypothalamus stimulate pituitary to release trophic hormones which stimulate peripheral glands to produce and release their hormones.

tertiary hormone disorder

abnormality in the hypothalamus

secondary hormone disorder

abnormality in the pituitary

primary hormone disorder

abnormality in the actual endocrine gland

what is the difference between the anterior and posterior pituitary gland?

anterior pituitary secretes trophic hormones (hormones that stimulate other organs to secrete hormones) while posterior secretes hormones that don't need to stimulate another organ (ie: oxytocin and ADH).

name some trophic hormones that are released from the anterior pituitary.

FSH, LH (gonadotrophic hormones), TSH (thyroid stimulating hormone), ACTH (adrenocorticotropic hormone)

what stimulates growth hormone (GH) release?

hypoglycemia, fasting, starvation and stress. the hypothalamus releases GHRH (growth hormone releasing hormone) which stimulates the anterior pituitary to release GH.

what inhibits growth hormone (GH) release?

increased glucose levels, free fatty acid release in the blood, obesity, cortisol, and a hormone called somatostatin released by the hypothalamus

what is the predominant effect of excessive growth hormone ?

increased blood glucose levels

growth hormone stimulates production of IGF. what are some functions of IGF-1?

IGF-1 is a hormone produced by the liver. it increases protein synthesis which increases 1) bone and cartilage growth 2) body organ growth 3) lean muscle mass.

how does growth hormone exhibit anti-insulin effects?

increases breakdown of fats (lipolysis) with increased use of free fatty acids (FFA) for fuel. it also increases carbohydrate metabolism which increases blood glucose levels but prevents glucose from being taken up by fat/muscle cells for storage/fuel.

idiopathic GH deficiency

arising from an unknown cause. often lack hypothalamic GHRH.

pituitary tumors or agenesis (incomplete development) of pituitary causes GH deficiency. why?

pituitary does not produce GH

laron-type dwarfism

hereditary defect in IGF production even though GH levels are normal

growth hormone excess (child)

gigantism

growth hormone excess ( adult)

acromegaly (enlargement of soft bones in hands and feet and in the face)

what are the gonadotropins?

FSH and LH released from the anterior pituitary

how does the hypothalamus stimulate release of gonadotropins by the pituitary?

GnRH (gonadotropic releasing hormone)

thyroid hormones

T3 and T4 are secreted by the thyroid, responsible for healthy metabolism.

thyroid insufficiency is due to

lack of iodine (I-)

Hashimoto's thyroiditis

autoimmune disorder where the thyroid is destroyed (symptoms may be the same as hypothroidism). major cause of goiter and predominantly disease of women.

acquired hypothyroidism arises from

thyroidectomy and Hashimoto's thyroiditis

Graves disease manifestations

goiter, fine hair, sweating, tachycardia, weight loss, oligomenorrhea (few periods), tremor

Graves disease

autoimmune hyperthyroidism

hyperthyroidism arises from

Graves disease and thyroid tumor

hormones secreted by adrenal cortex

aldosterone, testosterone, cortisol

what does ACTH do, and where is it secreted from?

it stimulates the adrenal cortex to secrete various hormones (ie: cortisol), is secreted from the anterior pituitary

what components make up major adrenal cortical hormones?

cholesterol and acetate. they are corticosteroids.

cortisol functions

stimulates protein breakdown into amino acids -> amino acids are transported to liver -> liver produces glucose from amino acids

more cortisol functions

1) catabolism increased (muscles, free fatty acids, glucose), stimulates sympathetic nervous system 2) immune system suppression 3) increase plasma proteins

adrenal cortical insufficiency

inability to make aldosterone, testosterone, cortisol.

Addison's disease

primary adrenal cortical insufficiency. (abnormality in adrenal cortex)

Addison's disease manifestations

hyponatremia, hypoglycemia, decreased cardiac output (bc of hypovolemia due to high sodium and water output), hyperkalemia, nausea, vomiting, weight loss, anorexia, lethargy

which disorders arise from excessive adrenal secretion?

Cushing's syndrome (glucocorticoid hormone excess)

Cushing's syndrome manifestations

muscle weakness, thin extremities, problems with glucose metabolism which may cause diabetes, immune suppression

secondary adrenal cortical insufficiency

caused by hypopituitary or removed pituitary gland. could also occur because cortisol was administered (inhibiting the pituitary).

acute adrenal crisis

usually a sudden flare up of Addison's disease which causes severe adrenal insufficiency. symptoms are the same as Addison's.

hyperaldosteronism

oversecretion of aldosterone (which would cause hypernatremia, hypokalemia, hypervolemia)

congenital adrenal hyperplasia

deficiency in the synthesis of cortisol. this increases ACTH which stimulates production of adrenal androgens (makes females gain male characteristics).

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