Pathophysiology test 4- Endocrine

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mechanisms of control in the body

Hormonal Control
Neurological control

What is the function of endocrine glands?

secrete hormones into the blood

What is the effect of endocrine glands?

they effect specific target organs

Problems that may occur with endocrine glands:

Hypersecrete
Hyposecrete
Fail to stop secreting
Fail to start secreting

Peexisting conditions

Pituitary tumors
Ratiation therapy of the head and neck
Autoimmune disease
Neurosurgical procedures

Which gland is the master Gland?

Pituitary gland

The Pituitary gland is controled by which part of the brain?

Hypothalamus

What is another name for the pituitary gland?

Hypophysis

Pituitary pathway

Pituitary hormones act as chemical messengers to othe endocrine glands. Only a few hormones have direct action

Pituitary format

have several lobes which produces different hormones

Pituitary Hormones

ACTH, LH , FSH, GH, TSH

TSH

Thyroid Stimulating Hormone
Thyroid growth and secretion

ACTH

adrenocorticotropic hormone
adrenocortical growth and secretion

STH/ GH

Somatotropin/growth hormone
protein biosynthesis, bone and muscle growth

LH

Lutenizing or Interstitial cell stimulating hormone
Ovulation and Lutenization over Ovary follicle/testosterone production

FSH

Folicle Stimulating Hormone

Pituitary=ACTH=Adrenal gland=

Hydrocortisone

Pituitary=LH=Testicles=

testosterone

Pituitary=FSH=Ovaries=

Estrogen and Progesterone

Pituitary=GH=Liver=

IGF

Pituitary=TSH=Thyroid=

T3 and T4

Prolactin

Mammary Gland, development / milk secretion

ADH Vasopressin

antidiuretic Hormone
Water retention and stimulates vascular smooth muscle

Oxytocin

Uterine contractions and milk injection

Pathological condition that can change normal production of pituitary hormones?

Breast cancer or tumors
May require administration of the target organ hormone

What is the Syndrome of inappropriate ADH (SIADH) or non physiological need for ADH?

*Post operative tumor/ cancer producing ADH
*Signs of water retention from kidneys

how is Vasopressin (antidiuretic Hormone) stimulated?

* sympathetic nervous system and osmotic receptors in hypothalamus
* Increased water reabsoption
* Vasoconstriction caused by high dose

Signs of SIADH

Water retention= hyponatremia
Confusion
muscle weakness

Where are ADH and Oxytocin produced?

In the neurosecretory cells in the hypothalamus

Where are ADH and Oxytocin secreted?

Axon endings into the blood stream

Signs of diabetes insipidus

Insufficient ADH resulting in polyuria and polydypsia
High Osmolarity
Opposite of SIADH

Insufficient ADH results in?

polyuria and polydypsia

Signs of Hypopituitary

* complete absence of pituitary hormones to decrese in some hormones
* Dwarfism
* Ages 2-7

Hyperpituitary

* Gigantism
* 8' 11'' weight 490 at death at 22 y

Hyperpituitary - giant

* 8' 11'' weight 490 at death at 22 y

Acromegly

Growth hormone excess adults

Prolactinoma effects in women

galactorrhea and menstrual disturbance

Prolactinoma effects in men

loss of libido and erectile dysfunction

Prolactinoma function

supressess normal gonads

Signs of thyroid Hypofunction

* weight gain
* Growth retardation
*Emotionally subdued
*expressionless
* Slow speech and mental processes
* thick skin/ thin hair
* Sensitive to depressants
*Can be postpartum

Diagram: Hypothalamus

first in diagram

Diagram:Thyroid- releasing hormone=

second in diagram

Diagram:pituitary

third in diagram

Diagram: thyroid stimulating hormone

4th in diagram

Diagram:thyroid gland

5th in diagram

Diagram:
thyroxine(T4)
Triiodothymine (T3)

6th in diagram

Diagram:
thyroxine(T4)
Triiodothymine (T3)

goes back to :
hypothalamus
Thyroid- releasing hormone
pituitary

Signs of Hyperthyroidsm

* weight loss
* High basic temp
*Exopthalmous
* Increased appetite
* Enlarged gland (goiter)
* Nrevousness
*palpitation, tachicardia
*Flushed and perspiration

Characteristics related to Hyperthyroidism

Graves's disease

Characteristics related to Hyperthyroidism

Toxic multinodular goiter

Characteristics related to Hyperthyroidism

Thyroid crisis

Characteristics related to Hyperthyroidism

Excess TSH stimulation

Characteristics related to Hyperthyroidism

Thyroiditis

Thyroid Storm

thyrotoxic crisis

Thyroid Storm: thyrothoxic crisis clinical manifestations:

Bulging eyes
confused

Thyroid Storm: thyrothoxic crisis is associated with what disease?

Grave's disease

Thyroid Storm: thyrothoxic crisis is distinguisehd from?

hyperthyroidism

Thyroid Storm: thyrothoxic crisis precipitating factors

?????

What can Thyroid Cancer cause?

Hyper and post op. hypo condition

Hyperparathyroidism

High level of parathyroid hormones

What does Hyperparathyroidism cause?

elevated calcium

What does Hypoparathyroidism cause?

lower calcium

Hypoparathyroidism

low level of parathyroid hormones

is Hyperparathyroidism or Hypoparathyroidism that requires medical intervention?

Hypoparathyroidism

what is the medication for high level of parathyroidism (PTH)?

Calcitonin and phosphorous

What does high level of parathyroidism (PTH) cause?

Hypercalcemia- may be life threatening

Hypercalcemia crisis is related to:

Malignancy associated hypercalcemia (MAH)

Hypercalcemia crisis is related to:

primary hyperparathyroidism

when does Hypocalcemic crisis happen?

Following surgery for hyperparathyroid tumors

How is Hypocalcemic crisis treated?

I.V. calcium while monitored

what is the medication for low level of parathyroidism (PTH)?

magnesium meds but also must decrease phosphorous levels

What does low level of parathyroidism (PTH) cause?

High phosphorous level

What problems does low level of parathyroidism (PTH) cause?

muscle tetany

Where are adrenal glands located?

on top of kidney

What are the parts of the adrenal gland ?

medulla and cortex
each secrete different hormones

Which hormones are secreted by the adrenal medulla?

epinephrine and norepinephrine

adrenal medulla hormones are also called?

catecholamines

adrenal medulla hormones called catecholamine stimulates what system ?

sympathetis nervous system

what do we give epinephine
(adrenalin) as ?

Beta agonist

Which hormones are secreted by the adrenal cortex?

3S MAG
Sugar- Glucocorticoids hydrocortisone
Salt - Mineralocorticoids- aldosterone
Sex- Androgen- Men

where is the adrenal cortex?

in the adrenal gland

what is the function of the adrenal cortex?

sinthesize and secrete hormones

Which 2 hormones are sinthesized and secreted by the adrenal cortex?

Glucocorticoids and Mineralocorticoids

Which disease is associated with adrenal cortex hyposecretion?

Addison's disease

When a patient is having adrenal cortex hyposecretion, what is treatment?

Replacement of hormones

which hormones are replaced during adrenal cortex hyposecretion treatment?

aldosterone, hydrocortisone and testosterone

When a patient is having adrenal cortex hyposecretion, what should be increased for treatment?

Na intake

Addison's disease signs

*Generalized skin pigmentation (caucasion)
*deposition in the palmer skin creases, nails and gums

Addison's disease signs

deposition in the palmer skin creases, nails and gums

She was treated many years ago for pulmonary TB. What are the other causes of this condition?

???

Signs and symptoms of Adrenal crisis

Cortisol defficiency

Signs and symptoms of Adrenal crisis

Hypoglycemia

Signs and symptoms of Adrenal crisis

Hypercalcemia

Signs and symptoms of Adrenal crisis

Decreased gastric mobility, vascular tone

Signs and symptoms of Adrenal crisis

CHH DV

Which disease is associated with adrenal cortex hypersecretion?

Cushing's Disease

Signs and symptoms of Adrenal Cortex Hypersecretion

Weakness
loss libido
moon face
oily skin

What could be a possible cause of adrenal cortex hypersecretion?

overmedication with exogenous sources of hormone

Signs and symptoms of Adrenal Cortex Hypersecretion

Hyperplasia of cortex

Adrenal Cortex Hypersecretion affects which hormones?

cortisone and androgen

Aldesterone Deficiency with Adrenal crisis

HHHE
Hyperkalemia
Hyponatremia
Hypovolemia
Elevated BUN

What does Glucocorticoids influence?

Glucose metabolism

What is Glucocorticoids stimulated by?

ACTH

What is Glucocorticoids functions?

Provides anti inflamatory response
and suppresses allergic reactions

Glucocorticoids can also be related to ?

elevated blood sugar

what is a Glucocorticoids sources?

Exogenous

what is the Glucocorticoids sources used for?

anti inflamatory (arthritis)
Immunosupressant (lupus)

what does too much or too long cases of Glucocorticoids cause?

Adrenal atrophy
high blood sugar
mask infection
inhibts healing
osteoporosis
peptic ulcer
growth retardation
infertility due to feedback to pituitary

what can Mineralocorticoids (aldosterone) influence?

Electrolytes amd metabolism

what can Mineralocorticoids (aldosterone) cause?

sodium retention and K excretion

Mineralocorticoids (aldosterone) secreted in response to?

angiotensin II or elevated K levels

What is Florinef?

Combination of gluco and mineralocort

Hypoglycemia (TIRED)
- an abnormal decrease of blood in the sugar

T-achycardia
I-rritability
R-estless
E-xcessive Hunger
D-iaphoresis/ Depression

Adrenal Gland Hormones (SSS)

S-ugar (Glucocorticoids)
S-alt (Mineralcorticoids)
S-ex (Androgens)

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