Pathophysiology Exam 2: Endocrine, Neurologic, Reproductive, and Renal Systems

Comprehensive vocabulary flashcards covering key definitions, pathophysiology, clinical presentations, and diagnostic signs for Pathophysiology Exam 2.

Primary function of endocrine system

Regulate homeostasis through release of hormones

Hormones act on what kind of cells?

Target cells

Syndrome of Inappropriate ADH Secretion (SIADH)

An alteration characterized by the autonomous release of antidiuretic hormone (ADH) in the absence of normal stimuli, resulting in renal free water retention, hypotonic and euvolemic hyponatremia, and urinary hyperosmolality.

Diabetes Insipidus

A condition caused by insufficient ADH activity that leads to an inability to concentrate urine, clinically presenting with polyuria, continuous thirst, nocturia, and polydipsia.

Graves Disease

A primary autoimmune hyperthyroid disorder linked to type II cytotoxic hypersensitivity, associated with hyperthyroidism, decreased TSH, pretibial edema, exophthalmos, and diplopia.

Thyroid Storm

A severe, life-threatening crisis caused by a dramatic rise in thyroid hormone (TH) levels, manifested by hyperthermia, tachycardia, heart failure, agitation or delirium, nausea, vomiting, diarrhea, and hypertension.

Myxedema Coma

A medical emergency marked by decreased level of consciousness caused by severe hypothyroidism, presenting with hypothermia without shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis, and bradycardia.

Hashimoto's Disease

The most common cause of hypothyroidism, characterized by gradual autoimmune-mediated inflammatory destruction of thyroid tissue.

Chvostek Sign

A clinical sign of hypocalcemia and neuromuscular excitability demonstrated by twitching of the lip or facial muscles when tapping over the facial nerve.

Trousseau Sign

A clinical sign of latent tetany and hypocalcemia manifested by carpal spasm elicited by inflating a blood pressure cuff above systolic pressure.

Type 1 Diabetes Mellitus

A metabolic disease caused by autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency, elevated glucagon secretion, polyuria, polydipsia, weight loss, and increased risk for DKA.

Type 2 Diabetes Mellitus

A chronic metabolic disorder characterized by progressive loss of beta-cell insulin secretion accompanied by insulin resistance and chronic low-grade systemic inflammation.

Diabetic Ketoacidosis (DKA)

An acute, rapid-onset complication of diabetes mellitus (primarily type 1) characterized by absolute or relative insulin deficiency, hyperglycemia, metabolic acidosis, ketonuria, and compensatory Kussmaul respirations.

Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNKS)

A severe metabolic complication of type 2 diabetes mellitus characterized by marked hyperglycemia in the absence of significant metabolic acidosis.

Cushing Syndrome

A condition resulting from chronic exposure to excess cortisol (hypercortisolism), manifested by truncal obesity, moon face, buffalo hump, glucose intolerance, thin skin, easy bruising, and muscle wasting.

Addison Disease

Primary adrenal insufficiency caused by autoimmune destruction of adrenal cortical cells by autoreactive T cells, manifested by weakness, fatigue, hyperpigmentation, vitiligo, weight loss, hypotension, and potential adrenal crisis.

Primary Hypothyroidism

Inadequate production of thyroid hormone d/t loss of thyroid gland function

T3/T4 levels are low, TSH is high d/t pituitary compensation

Glaucoma

An optic neuropathy characterized by increased intraocular pressure greater than $12\text{--}20\,\text{mmHg}$, leading to irreversible visual field deficits and loss of central and peripheral vision.

Retinal Detachment

A medical emergency occurring when the retinal pigment epithelium separates from the neural photoreceptors, clinically presenting with dark floaters, flashes of light, and a dark curtain over the visual field.

Conductive Hearing Loss

Auditory impairment occurring when conditions of the outer or middle ear (such as cerumen impaction or otitis media) interfere with the mechanical transmission of sound vibrations to the inner ear.

Presbycusis

The most common form of sensorineural hearing loss in older adults, characterized by bilateral loss of sound clarity and progressive inability to hear high-frequency sounds due to cochlear impairment.

Meniere Disease

A chronic episodic inner ear disorder characterized by recurring vertigo with severe nausea and vomiting, fluctuating sensorineural hearing loss, tinnitus, and aural fullness.

Central Hypothyroidism

Inadequate synthesis of TSH by pituitary

Low TH and TSH levels

Symptoms of Hypothyroidism

Cold intolerance, weight gain, low energy, low basal metabolic rate, lethargy

Hyperthyroidism

Excess TH

Increased metabolic rate, weight loss, heat intolerance, diarrhea, exopthalmos, pretrial edema, diplopia, anxiety

Multiple Sclerosis

A chronic autoimmune-mediated demyelinating disease of the central nervous system involving injury to oligodendrocytes, preventing remyelination and causing axonal loss, paresthesias, weakness, gait ataxia, and optic neuritis.

Guillain-Barré Syndrome

An acute immunologic reaction against peripheral nerve myelin typically occurring about 4 weeks after a respiratory or gastrointestinal infection, presenting with areflexia and ascending motor weakness.

Myasthenia Gravis

A chronic type II autoimmune hypersensitivity disease characterized by autoantibodies blocking or destroying acetylcholine receptors at the neuromuscular junction, resulting in characteristic fatigable muscle weakness.

Excess thyroid hormone enhances sensitivity to what

catecholamines

Epidural Hematoma

An arterial bleed collecting between the inner surface of the skull and the dura mater, characterized by initial loss of consciousness, a temporary lucid interval, and rapid subsequent neurological decline.

Subdural Hematoma

A collection of blood between the dura mater and the arachnoid membrane, commonly caused by tearing of bridging cortical veins, categorized clinically as acute, subacute, or chronic.

Hormone that regulates calcium

Parathyroid hormone

Glasgow Coma Scale (GCS)

A clinical scale used to assess neurological status and coma severity based on eye opening ($1\text{--}4$), verbal response ($1\text{--}5$), and motor response ($1\text{--}6$), categorizing TBI as mild ($13\text{--}15$), moderate ($9\text{--}12$), or severe ($3\text{--}8$).

Condition caused by excess parathyroid hormone

Hyperparathyroidism — leads to elevated calcium levels

Kidney stones, increase risk for fractures, osteoporosis, constipation, bone resorption, psychiatric disturbances

Status Epilepticus

A neurological emergency defined by continuous tonic-clonic seizure activity lasting longer than $5\,\text{min}$, recurring seizures without return to baseline consciousness between episodes, or a single prolonged seizure lasting longer than $30\,\text{min}$.

Hypoparathyroidism leads to

Hypocalcemia — muscle spasms and tetany

Type 1 DM caused by

Autoimmune destruction of pancreatic B cells — leads to absolute insulin deficiency

Polycystic Ovary Syndrome (PCOS)

An endocrine syndrome defined by hyperandrogenism, persistent anovulation, and polycystic ovarian morphology, manifested clinically by irregular menses, hirsutism, infertility, and insulin resistance.

Leiomyoma (Fibroid)

A benign, smooth-muscle tumor originating from the myometrium that is estrogen- and progesterone-sensitive, presenting with abnormal uterine bleeding, heavy menstrual bleeding, pelvic pressure, and pain.

Adenomyosis

A benign gynecological condition characterized by the presence of ectopic endometrial glands and stroma embedded within the uterine myometrium that does not respond to cyclic hormonal changes.

Endometriosis

The presence of functional endometrial tissue outside the uterine cavity that responds to cyclic ovarian hormones by bleeding, leading to local inflammation, fibrosis, scarring, adhesions, infertility, and hallmark pain with defecation.

Varicocele

Abnormal tortuosity and dilation of the pampiniform venous plexus draining the testis, frequently described on palpation as feeling like a 'bag of worms' and associated with male infertility.

Hydrocele

An abnormal collection of fluid around the scrotum, presenting as a smooth, tense mass that transilluminates on examination.

Testicular Torsion

A surgical emergency

obstructs testicular blood flow, resulting in sudden acute unilateral scrotal pain, swelling, and ischemia requiring intervention within $6\,\text{hours}$.

Benign Prostatic Hyperplasia (BPH)

Nonmalignant enlargement and hyperplasia of prostate tissue compressing the prostatic urethra, leading to lower urinary tract symptoms such as weak stream, hesitancy, nocturia, and incomplete bladder emptying.

Signs and Symptoms of Type 1 Diabetes

Polyuria, polydipsia, weight loss

Nephrotic Syndrome

A glomerular disorder characterized by urinary protein excretion exceeding $3.5\,\text{g/day}$ due to increased capillary membrane permeability, resulting in hypoalbuminemia, generalized peripheral edema, hyperlipidemia, and foamy urine.

Nephritic Syndrome

A condition caused by acute immune-mediated inflammation of the glomerular capillaries, characterized by hematuria with dysmorphic red blood cells and RBC casts, mild-to-moderate proteinuria, oliguria, and hypertension.

Chronic Kidney Disease (CKD)

Progressive, irreversible destruction of renal nephrons defined by a sustained decrease in glomerular filtration rate below $60\,\text{mL/min}/1.73\,\text{m}^2$ for longer than 3 months, leading to uremia, anemia, and mineral imbalances.

DKA

Associated with Type 1 DM

Rapid onset — hyperglycemia, metabolic acidosis, ketonuria

Kussmaul respirations

Hyperosmolar Hyperglycemia Nonketotic Syndrome

Affects individuals with T2DM

Hyperglycemia without metabolic acidosis

Mechanism of T2DM

Insulin resistance d/t persistent state of hyperglycemia driven by obesity and inflammatory adipokines

Signs and symptoms associated with T2DM

Recurrent infections, visual changes, neuropathy

Chronic conditions associated with T2DM

Neuropathy, retinopathy, nephropathy, MI, stroke

Most common cause of hypothyroidism

Hashimoto’s disease — causes gradual destruction of thyroid tissue

Myxedema Coma

Emergency associated with severe hypothyroidism

Hypothermia w/o shivering, hypotension, bradycardia, hypoglycemia, decreased LOC

Thyroid Storm

Emergency associated with hyperthyroidism d/t dramatic rise is TH levels

Hyperthermia, tachycardia, agitation/delirium, HTN

Hyperthyroidism is associated with what condition

Graves disease — autoimmune disorder linked to type II hypersensitivity (cytotoxic)

Diabetes Insipidus

Caused by insufficient ADH secretion

polyuria and polydipsia

inability to concentrate urine

ability to maintain urine output despite hydration

Hyperfunction of Adrenal Cortex leads to

Cushing syndrome d/t increased secretion of cortisol

Cardinal signs of Cushing Syndrome

Weight gain — truncal obesity, moon face, buffalo hump

Easy bruising

Addison disease

Autoimmune disease involving attack on adrenal cells

Weakness, frailty, weight loss, fatigue

Adrenal Crisis

Caused by cortisol deficiency

Hypotension that progresses to vascular shock

When does memory consolidation occur

Non-REM sleep

Coup injury

Injury at site of impact

Contrecoup injury

Injury from brain rebounding and hitting opposite side of skull

Brain injury from widespread axonal shearing from traumatic forces

Diffuse axonal injury

“whiplash”

Causes of secondary brain injuries

Cerebral edema, inflammation, increased intracranial pressure

Secondary Brain Injury

Indirect consequence of primary brain injury

Leads to decreased cerebral perfusion and worsening ischemia

Worst Headache of My Life

Subdural hematoma

venous “slow” bleed

Mild TBI

No LOC or LOC for less than 30min

GSC 13-15

Moderate TBI

LOC 30min - 6h

GSC 9 - 12

Severe TBI

GSC <9

What shouldn’t be used with TBI

corticosteroids

Herniated disc

Displacement of nucleus pulpous beyond intervertebral space compressing the nerve root

Pain from herniated disc

Radicular pain

Focal seizure

Originates in one part of the brain

What kinds of seizure are not associated with loss of consciousness

Focal

Atonic and Myoclonic

Seizure that originates from both sides of brain

Generalized seizure

Cause of ischemia stroke

Thrombus or embolus

In an ischemic stroke, the failure of ATP production leads to dysfunction of what cellular structures?

Ion pumps

Mechanism of hemorrhagic stroke

Ruptured blood vessel — bleeding in the brain — hematoma formation

How does hemorrhagic stroke damage brain tissue

Hematoma compresses brain tissue and can lead to ischemia, edema, IICP, resulting in brain herniation

Pathological event that causes seizures

Neurons firing in a hyper-synchronous manner

Mirgaines and Cluster HA involve activation of what system

Trigemiovascular system — leads to the release of vasoactive peptides with cause pain and neurogenic inflammation

Mechanism of Tension HA

Sensitization of myofascial nociceptors and central pathways without vascular changes