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Alterations of Hormonal Regulation Patho Exam 4
Terms in this set (35)
What is adrenal hypofunction?
Low levels of cortisol secretion
Inadequate stimulation of adrenals by ACTH
Who is more likely to get addison's disease?
Adults ages 30-60 yrs old
What causes Addison's disease?
-Autoimmune disorder that destroys adrenal cortical cells which results in decreased amounts of cortisol and aldosterone
CM's of Addison's disease?
-Skin changes (Bronze pigmentation)
-Severe hypotension leading to circulatory collapse as a result of decreased aldosterone
-Changes in distribution of body hair
CM's of adrenal crisis
-Vascular collapse (Dec BP)
-Renal shut down (Dec NA and Dec K)
Chronic exposure to excess cortisol
(hypercortisolism or hyperadrenocorticism)
Excess endogenous secretion of ACTH usually due to pituitary tumors or small cell cancer of the lung.
___________ is released from the anterior pituitary gland and causes production of cortisol by the adrenal cortex.
ACTH (Adrenocorticotropic hormone)
________ is a steroid hormone and is released in response to stress and low blood glucose concentrations
S&S of cushing's
-Abdominal obesity with thin arms and legs
-Reddish stretch marks (stirations)
-Round red face (moon face with red cheeks)
-Fat lump in between shoulders (buffalo hump)
-Weak muscles and bones
-Fragile skin that heals poorly
Women with cushion's may have more hair and have irregular menstruations; change in mood, headaches, and chronic fatigue
Slowly progressive autoimmune T cell mediated disease that destroys the beta cells of the pancreas.
Diabetes mellitus Type 1
Non-insulin dependent diabetes mellitus
Which is more common? Type 1 or Type 2 diabetes mellitus?
Who is more affected by type 2 diabetes mellitus?
Adults ages 45-65
What causes type 2 diabetes mellitus?
CMs of metabolic syndrome (Type 2 DM)
-Dyslipidemia (high cholesterol/lipid levels)
-Elevated FBS that results in increased risk of development of DM
CM's of type 1 diabetes mellitus
-Polydipsia (extreme thirst)
-Polyuria (extreme urination)
-Polyphagia (excessive hunger)
-Paresthesias (tingling; prickling)
CM's of type 2 diabetes mellitus
-Tend to just be fatigue
What lab tests can be performed to monitor diabetes mellitus?
-Fasting blood glucose
-Oral glucose tolerance test
-Post - prandial glucose (ratio of pre and post glucose levels)
-Hemoglobin A1C 4.5-6% normal
Chronic complications of diabetes mellitus
-Macrovascular disease (coronary artery disease, stroke, peripheral aerial disease)
-Microvascular disease (retinopathy and diabetic nephropathy)
Early morning rise in glucose with NO hypoglycemia. Caused by nocturnal elevation of GH and increased insulin clearance.
High morning sugars preceded by an episode of low blood sugar, with night sweats being a sign.
Increased levels of TH caused by Grave's disease (50-80% of cases)
What type of autoimmune hypersensitivity is hyperthyroidism?
S&S of hyperthyroidism
-Goiter (enlarged thyroid)
-Increased metabolic rate
-Increased sensitivity to sympathetic nervous stimulation
Autoimmune thyroiditis that causes inflammatory destruction of thyroid tissue by infiltration of lymphocytes and auto-antibodies.
S&S of hypothyroidism
-Myxedema around eyes, hands, feet, and supra clavicular fossae
Condition of severely stunted physical and mental growth due to untreated congenital hypothyroidism usually due to maternal hypothyroidism.
Excess secretion of PTH from 1 or more parathyroid glands.
Hallmarks of hyperparathyroidism
High levels of ADH without normal physiologic stimuli for its release
SIADH (syndrome of Inappropriate ADH secretion)
What most commonly causes SIADH (syndrome of Inappropriate ADH secretion)?
-Tumors such as small cell carcinomas of major organ systems (GI, GU, endocrine, lung)
What other factors can cause an increase in ADH secretion?
-Surgery causes increased ADH secretion for up to 1 week post-op related to amount and type of IVFs and narcotics
In SIADH (syndrome of Inappropriate ADH secretion) ADH increases renal collecting duct permeability to water by inserting ___________ into the tubular membrane which increases water reabsorption by the kidneys.
Aquaporin - 2 (a water channel protein)
S&S of SIADH (syndrome of Inappropriate ADH secretion)
-DOE (dyspnea on exertion)
-Dulled sensorium (when Na rapidly drops form 140-130mEq/L)
-Severe GI symptoms occur with a Na drop from 130-120 mEq/L (ab cramping, diarrhea, etc)
-Na levels < 110-115 mEq/L causes lethargy, confusion, seizures, muscular twitching, and irreversible damage
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