Clinical Chemistry Exam 2 Hormone Disorders and Tests

pituitary adenoma

hypersecretion of any or multiple of the pituitary hormones

hyposecretion of growth hormone

children- dwarfism

adults normally asymptomatic

provocative testing required to diagnose in adults

hypersecretion of growth hormone

children- gigantism

adults- acromegaly

diagnosed using insulin- like growth factor 1 (IGF-1)

IGF-1 will be elevated even after being administered glucose

stalk effect

a phenomenon where the pituitary gland if effectively cut off from the communication with the hypothalamus

prolactin is the only hormone that will still be produced because it is inhibited by dopamine

diabetes insipidus

central or nephrogenic

inadequate ADH action

polyuria and polydipsia

low urine osmolality, hypernatremia

central DI

a decrease in secretion of ADH from the pituitary gland

nephrogenic DI

the renal tubules are unresponsive to ADH

overnight water deprivation and then administration of ADH

how to differentiate between central DI and nephrogenic DI

the nephrogenic DI urine will never change in concentration

syndrome of inappropriate ADH secretion

too much ADH secretion increasing water retention in the body

decreases plasma sodium levels which triggers RAAS

increased urine sodium and osmolality

primary hyperthyroidism

overproduction of T3 and T4 with a decrease in secretion of TSH and TRH

the thyroid cannot be shut off

Graves Disease

a primary hyperthyroidism- overproduction of T3 and T4

induced by Thyroid Stimulating Immunoglobin (TSI) binding to the TSH receptor in the thyroid

thyroid storm

major complication of Graves Disease that is life threatening

primary hypothyroidism

thyroid is NOT secreting T3 and T4

portrays elevated TSH and low free T4

Hashimotos Thyroiditis/ Chronic Lymphocytic Thyroiditis

primary hypothyroidism- autoimmune damage to thyroid gland from lymphocytic infiltration

thyroperoxidase antibody (Anti-TPO) binds to thyroperoxidase decreasing iodination of thyroglobulin

congenital hypothyroidism

can be permanent or transient

caused by defect in thyroid hormone synthesis or thyroid dysgenesis

decreased T3 and T4 synthesis

diagnosed by the measurement of free T4 during the newborn screening

myxedema

secondary disease state from severe hypothyroidism

results in enlarged thyroid and thick skin

euthyroid sick syndrome

nonthyroidal illness syndrome

acute serious disease sometimes uses up thyroid hormones faster for tissue repair/ fight illness

can result in abnormal thyroid test results