Pathophysiology & Endocrine Review

Question-and-answer flashcards covering liver pathology, endocrine feedback loops, hormone actions, and related disorders.

What pathological changes characterize cirrhosis?

Diffuse hepatic fibrosis with regenerative nodules that distort normal liver architecture and function.

Name two common chronic injuries that can lead to cirrhosis.

Chronic viral hepatitis (e.g., B or C) and chronic alcohol use (fatty liver disease is another).

Which liver cells are activated to produce collagen in cirrhosis?

Hepatic stellate (Ito) cells.

How does cirrhosis produce portal hypertension?

Fibrous tissue disrupts hepatic sinusoids, increasing resistance to portal venous blood flow.

Why do patients with cirrhosis often develop ascites and peripheral edema?

Reduced hepatic protein synthesis lowers serum albumin, decreasing plasma oncotic pressure and allowing fluid to accumulate.

What coagulation problem is common in cirrhosis?

Bleeding tendencies due to decreased synthesis of clotting factors.

Elevated ammonia in cirrhosis can lead to which neurologic complication?

Hepatic encephalopathy.

What causes splenomegaly and esophageal varices in cirrhosis?

Increased portal vein pressure from portal hypertension.

What is the most common cause of acute cholecystitis?

A gallstone obstructing the cystic duct.

How does a gallstone obstruction lead to inflammation in cholecystitis?

Trapped bile causes gallbladder distention and bile stasis, promoting bacterial growth and wall inflammation.

Which physical-exam sign is classically positive in cholecystitis?

Murphy’s sign (inspiratory arrest with right upper-quadrant palpation).

If untreated, cholecystitis may progress to which life-threatening complication?

Gallbladder rupture causing peritonitis.

Give three major etiologic categories for hepatitis.

Viral infection (A, B, C, D, E), alcohol abuse, and drug/toxin or autoimmune injury.

Which liver enzymes are typically elevated in acute hepatitis?

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Chronic untreated hepatitis can progress to what advanced liver condition?

Cirrhosis (fibrosis with regenerative nodules).

Accumulation of what pigment causes jaundice?

Bilirubin.

In pre-hepatic jaundice, which form of bilirubin predominates in blood?

Unconjugated (indirect) bilirubin.

Give one common post-hepatic (obstructive) cause of jaundice.

Choledocholithiasis (common bile-duct gallstone) or pancreatic tumor obstructing the duct.

Which hypothalamic hormone triggers release of FSH and LH?

Gonadotropin-releasing hormone (GnRH).

What ovarian event is precipitated by the LH surge?

Ovulation.

During the luteal phase, which two hormones exert negative feedback on GnRH, FSH, and LH?

Estrogen and progesterone produced by the corpus luteum.

In males, LH acts on which testicular cells to produce testosterone?

Leydig cells.

Which Sertoli-cell hormone selectively inhibits FSH secretion?

Inhibin.

List, in order, the three principal hormones of the HPA axis.

CRH (corticotropin-releasing hormone) → ACTH (adrenocorticotropic hormone) → cortisol.

High cortisol levels produce what type of feedback on CRH and ACTH?

Negative feedback inhibition.

Hyperpigmentation in Addison disease results from excess secretion of which pituitary hormone?

ACTH, which also stimulates melanocytes via MSH effect.

Name two classic physical features of Cushing syndrome.

Central (truncal) obesity with “moon face” and “buffalo hump.”

Excess growth hormone before epiphyseal plate closure causes which disorder?

Gigantism.

Which mediator primarily drives the tissue overgrowth seen in acromegaly?

Insulin-like growth factor-1 (IGF-1) produced by the liver in response to GH.

Severe, long-standing untreated hypothyroidism in adults is called what?

Myxedema.

From where is antidiuretic hormone (ADH) released into the bloodstream?

Posterior pituitary (after being produced in the hypothalamus).

To conserve water, ADH binds to which renal receptors?

V2 receptors on collecting-duct cells, inserting aquaporin-2 channels.

How does ADH affect urine volume and concentration?

Decreases urine volume and makes urine more concentrated.

Which hormone operates by positive feedback to intensify uterine contractions during labor?

Oxytocin.

Name the two primary physiologic actions of oxytocin.

Stimulates uterine contractions during labor and milk ejection (“let-down”) during breastfeeding.

Define enterohepatic circulation.

Recycling of bile salts (and some drugs/bilirubin derivatives) from intestine → portal blood → liver for reuse.

Intestinal bacteria convert conjugated bilirubin into which colorless compound?

Urobilinogen.

Oxidation of residual urobilinogen in the colon yields which pigment that colors stool brown?

Stercobilin.

Elevated urine urobilinogen can indicate which two broad disease categories?

Increased hemolysis or impaired hepatic uptake/conjugation (e.g., hepatitis).

Pheochromocytoma arises from which part of the adrenal gland?

Adrenal medulla (chromaffin cells).

Which two catecholamines are overproduced in pheochromocytoma?

Epinephrine and norepinephrine.

Why must alpha-blockers be administered before beta-blockers in pheochromocytoma treatment?

Unopposed alpha-adrenergic stimulation after isolated beta-blockade can provoke severe hypertensive crisis.

List three classic cardiovascular or autonomic symptoms of pheochromocytoma.

Paroxysmal hypertension, tachycardia/palpitations, and profuse sweating with pallor.