Test 4

Significantly Altered hormone levels are due to...

1) Inappropriate amounts of *HORMONE* delivered to *Target Cell*
2) Inappropriate responses by the target cell !!!!

Inappropriate Amounts of hormones can result from....

1) Disorders of *ENDOCRINE GLANDS*
2) Failure of feedback systems
3) Dysfunctional Hormones
4) Defects in *HORMONE DELIVERY* !!!!

Inappropriate responses by the Target Cell are due to....

1) Abnormalities in receptors
-To *many* or to *few* !!!!
2) Intracellular disorders !!!!
-Ex: inadequate synthesis of *second messengers* !!!!

Interruption and or damage to the *Pituitary Stalk* can be caused by...

1) Destructive Lesions
2) Rupture after head surgery
3) Surgical Transection
4) Tumor

Loss of *Hypothalamic Hormones* causes....

Pituitary to release *inadequate amounts* of hormones !!!!

What are the *Hormones* released by the *Anterior* Pituitary !?!?!

1) FSH
2) LH
3) TSH
4) ACTH
5) Prolactin
6) Growth Hormone

FSH

Follicle-stimulating hormone

LH

Luteinizing Hormone

TSH

Thyroid Stimulating Hormone

ACTH

Adrenocorticotropic Hormone

With *Decreased Hypothalamic Function*, all hormones released by the Anterior Pituitary Gland decrease... *except for one*, which is it !?!?

Prolactin !!!!

Syndrome of Inappropriate Antidiuretic Hormone Secretion is a disease of the...

Posterior Pituitary Gland

Syndrome of Inappropriate Antidiuretic Hormone Secretion is *characterized by*...

*HYPERSECRETION* of *ADH* !!!!

Syndrome of Inappropriate Antidireutic Secretion is caused by...

*ECTOPIC PRODUCTION* of ADH by tumors, pulmonary of CNS disorders, surgery, or medications !!!!

ADH

Antidiuretic Hormone

The *Clinical Manifestations* of Syndrome of Inappropriate Antidiuretic Hormone Secretion result from...

Hyponatremia and is determined by its *severity* and *rapidity of onset* !!!!

Hyponatremia

*LOW SODIUM* in blood !!!!

What can happen if the *SODIUM* level in urine is *NOT CONCENTRATED* !??!?!

Sodium Levels go low in body since we are giving out *MORE SODIUM THAN WHAT WE ARE TAKING IN* !!!!

Diabetes Insipidus is a disease of the...

*POSTERIOR* pituitary gland !!!!

Diabetes Insipidus

Insufficiency of *ADH* causing loss of *too much water in urine* !!!!

What are the two forms of *Diabetes Insipidus* !?!?!

1)Neurogenic (central)
2) Nephrongenic

*Neurogenic* Diabetes Insipidus

*Insufficient* secretion of ADH !!!!!

*Nephrogenic* Diabetes Insipidus

*INADEQUATE RESPONSE* of the RENAL TUBES to ADH !!!!

*Clinical Manifestations* of Diabetes Insipidus include...

1) Polyuria
2) Nocturia
3) Continuous Thirst

Polyuria

Frequent Urination!!!!

Nocturia

Urination at night !!!!

*Hypopituitarism* is a disorder of the...

*ANTERIOR* pituitary gland !!!!

Hypopituitarism

*ABSENCE* or *FAILURE* of Anterior Pituitary Hormones !!!!

Panhypopituitarism

ALL hormones are deficient !!!!!

What *causes* Hypopituitarism !?!?!

1) Pituitary Infarction
2) Space-occupying lesions
3) TBI
4) *Removal* or *destruction* of gland
5) Infections
6) *AUTOIMMUNE* hypophysitis

Hypophysitis

*INFLAMMATION* of the pituitary Gland !!!!

Concerned with *HYPOPITUITARISM*, the *symptoms* are related to...

*CORTISOL* Insufficiency !!!!

Hyperthyroidism is a symptoms of...

Panhypopituitarism !!!!!

What causes *Panhypopituitarism* !?!?!

Being born without a full brain !!!!

Hypersecretion of *Growth Hormone* is what type of disorder !?!?!

*Anterior* Pituitary !!!!

What are the different types of of diseases caused by *Hypersecretion of Growth Hormone* !?!?!

1) Acromegaly
2) Giantism

Acromegaly

Hypersecretion of Growth Hormone *DURING CHILDHOOD* !!!!

Giantism

Hypersecretion of Growth Hormone in children whose *EPIPHYSEAL PLATES* have *NOT YET CLOSED* !!!!

What is the reason people with *Giantism* do not live very long !?!?

Organs do not match size !!!!
-Resulting in *congestive Heart Failure* due to poor circulation around the body !!!!

*Prolactinoma* is what type of disorder !?!?

*Anterior* pituitary !!!!

Prolactinoma

Pituitary tumors that cause the *HYPERSECRETION OF PROLACTIN* !!!!!

What are the *MANIFESTATIONS* of *Prolactinoma* in Females !?!?!

1) Amenorrhea
2) Glactorrhea
3) Hirsutism
4) Osteopenia

Amenorrhea

Abnormal absence of menstruation !!!!

Galactorrhea

Nonpuerperal Milk production !!!!
-Milk production occurring when not pregnant !!!!

Hirsutism

Excessive hair growth !!!!

The *MANIFESTATIONS* of *Prolactinoma* in Males !!!

1) Gynecomastia
2) Hypogonadism
3) Erectile Dysfunction

Gynecomastia

Development of breast tissue in males !!!!

Hypogonadism

Diminished functional activity of the gonads (testes or ovaries) !!!!

What are some examples of *Primary Thyroid Disorders* !?!?!

1) Dysfunction or Disease in Thyroid !!!!
2) Increased or Decreased Thyroid Hormone
3) Idiopathic, caused by *AUTOIMMUNE MECHANISMS* !!

A *majority* of Primary Thyroid Disorders are what? and are caused by what !?!?!

Are *IDIOPATHIC* and are Caused by *AUTOIMMUNE MECHANISMS*!!!!

Central (Secondary) Thyroid Disorders

Disorders of Pituitary gland Thyroid Stimulating Hormone (TSH) Production !!!!

How is *HYPERthyroidism* caused !?!!

Increase in Thyroid Stimulating Hormone

How is *HYPOthyroidism* caused !?!?!

When Thyroid Stimulating Hormone *GOES UP* and *T3* and *T4* go down !!!!

Thyrotoxicosis

Condition due to any cause of *INCREASED TH LEVELS* !!!!

Hyperthyroidism is a form of...

Thyrotoxicosis !!!!

Hyperthyroidism

Increased *THYROID HORMONES* from the Thyroid Gland !!!!

Hyperthyroidism is caused by...

1) Graves Disease
2) Toxic multi nodular goiter
3) Solitary Toxic Adenoma

Central (Secondary) Hyperthyroidism is caused by...

Pituitary Adenomas !!!!!

What are the *MANIFESTATIONS* for *Thyrotoxicosis* !?!?!

1) Increased metabolic rate
2) Heat intolerance
3) Tissue Sensitivity

Graves Disease

*AUTOIMMUNE* disease caused by stimulation of *Thyroid* by *autoantibodies* directed against the *Thyroid Stimulating Hormone RECEPTOR* !!!!!

Small number of individuals with *Graves Disease*, who have very high levels of TSI will experience...

Pretibial myxedema !!!!

Pretibial myxedema

Subcutaneous swelling on anterior portions of the legs and by *indurated* and *erythematous* skin !!!!

Hyperthyroidism that results from *NODULAR THYROID DISEASE* can be the result of...

1) Toxic Multinodular goiter (multiple)
2) Toxic adenoma (one)

Thyrotoxic Crisis (Thyroid Storm)

Thyroid Hormone rise *DRAMATICALLY*, and can be fatal !!!!!

Hypothyroidism results from....

Deficient production of Thyroid Hormone by the Thyroid Gland !!!!!

*Primary* Hypothyroidism is the...

Loss of Thyroid Function

*Primary* Thyroidism is caused by....

1) Autoimmune thyroiditis
2) Loss of Thyroid Tissue
3) Medications
4) Endemic Iodine deficiency

*Central (Secondary)* Hypothyroidism is the...

Failure of *PITUITARY* to synthesize *ADEQUATE THYROID STIMULATING HORMONE* !!!!

*Central (Secondary)* Hypothyroidism is caused by...

Pituitary tumors and associated treatments to these tumors !!!!!

What are the *MANIFESTATIONS* of Hypothyroidism !?!?!

1) Decreased metabolic rate
2) Cold intolerance
3) Lethargy

What are the different *HYPOTHYROID* conditions !?!?!

1) Hashimoto disease
2) Congenital hypothyroidism
3) Subacute thyroiditis
4) Postpartum thyroiditis

Hashimoto Disease

*AUTOIMMUNE* disease causing gradual destruction of Thyroid Tissue

Congenital Hypothyroidism can occur when...

1) Thyroid Tissue is absent
2) Hereditary defects in *Thyroid Hormone* synthesis !!!

What is the most common *Endocrine Malignancy* !?!?!

Thyroid Carcinoma

What is the *MOST COMMON* cause of Thyroid Carcinoma !?!?

Ionizing Radiation

How is *Thyroid Carcinoma* treated !?!?!

1) Thyroidectomy
2) Suppression Therapy
3) Radiation
4) Chemotherapy

Hyperparathyroidism

Increased secretion of *PARATHYROID HORMONE* !!!!

Hyperparathyroidism is classified as...

1) Primary
2) Secondary
3) Tertiary

*Primary* Hypeparathyroidism

Excess secretion of Parathyroid Hormone from one (1) or more parathyroid glands !!!!

*Secondary* Hyperparathyroidism

Increase in Parathyroid Hormone *secondary* to *CHRONIC HYPOCALCEMIA* !!!!

*Tertiary* Hyperparathyroidism can develop after...

Long period of *HYPOCALCEMIA* !!!!

What are the *MANIFESTATIONS* of Hyperparathyroidism !?!?!

1) Hypercaclcemia
2) Hypophosphatemia

Parathyroid Hormone has to deal with...

Calcium production !!!!

Hypoparathyroidism

Abnormally *LOW* Parathyroid levels !!!

What causes *Hypoparathyroidism* !?!?!

Parathyroid damage in Thyroid surgery !!!!

What are the *MANIFESTATIONS* of Hypoparathyroidism* !?!?

Hypocalcemia !!!!!

Diabetes Mallitus

Group of *METABOLIC DISEASE* characterized by *HYPERGLYCEMIA* !!!!!

Diabetes Mellitus results from defects in....

1) Insulin Secretion
2) Insulin Action
*OR BOTH* !!!!

What are the *DIFFERENT CATEGORIES* in Diabetes Mellitus !?!?

1) Type 1
2) Type 2
3) Gestational

Why is *INSULIN* so important !?!?

Unlocks cells to let *glucose* in !!!!

What is the most common *PEDIATRIC CHRONIC DISEASE* !?!?!

Type 1 Diabetes Mallitus

Type 1 Diabetes

Body produces *NO INSULIN* !!!!
-The *pancreas* shuts off or the *immunologically* mediated *BETE CELL* destruction and apoptosis !!!!

Concerned with *Type 1 Diabetes*, in addition to the decline in insulin secretion, there is also decreased secretion of...

Amylin

Concerned with *Type 1 Diabetes*, the decrease in *amylin* leads to...

An increase in *GLUCAGON* !!!!

Concerned with *Type 1 Diabetes*, due to no insulin being produced resulting in no glucose being taken in by ones body, what does this result in !?!?!

Body has to work hard to break down *FAT*, resulting in *WEIGHT LOSS* and *DEHYDRATION* !!!!

Type 1 Diabetes is a disease of the...

PANCREAS !!!!

Concerned with *Type 1 Diabetes*, what are the *MANIFESTATIONS* that result from the *INSULIN DEFICIENCY* !?!??!

1) Hyperglycemia
2) Polydipsia
3) Polyphagia
4) Weight Loss n
5) Fatigue
6) Recurrent Infections
7) Prolonged Wound Healing

Those who are *Type 2 Diabetic* will have *RECURRENT INFECTIONS* because ...

Not enough oxygen is reaching the tissues !!!!

Type 2 Diabetes

*Insulin Resistance* and decreased insulin secretion by *BETA CELLS* !!!!
-Body does not like its own insulin!!!
-Insulin is produced by pancreas, but body builds resistance to it !!!!

Concerned with *Type 2 Diabetes*, the *target cells* ignore the body's own insulin because...

Have to much weight around the midsection !!!!