endocrine

  1. Posterior pituitary

    1. Antidiuretic hormone (ADH): controls plasma osmolality, inc permeability of distal tubules, inc water reabsorption into blood, concentrating urine

    2. oxytocin: uterine contractions + milk ejection in lactating women

  1. anterior pituitary

    1. ACTH, MSH

    2. somatotropic hormones

      1. growth hormone, prolactin

    3. glycoprotein hormones

      1. follicle stimulating hormone, luteinizing hormone, thyroid stimulating hormone

What is positive and negative feedback? 

  1. Positive: increases release

  2. negative: decreases release


What is up-regulation and down-regulation?

  1. Up-regulation: low concentration ↑ # of receptors/cell

  2. Down-regulation: high concentration ↓ # receptors/cell


Describe the neuroendocrine system. (what are the two parts and how are they connected?)

  • the hypothalamic-pituitary axis (HPA) forms the structural and functional basis for the neuroendocrine system

  • The hypothalamus and pituitary gland are connected by nerves and blood vessels. The hypothalamus sends signals through nerves to the back part of the pituitary gland to release hormones. It also sends hormones through blood vessels to the front part of the pituitary gland to control other hormone releases.


The pineal gland secretes: 

  • melatonin


Which gland controls metabolism? 

  • Thyroid gland


What does the parathyroid gland control?

  • The body’s calcium levels


What are the two functions of the pancreas?

  • (Endocrine) produces hormones and (exocrine) produces digestive enzymes

What stimulates insulin secretion? 

  • Blood glucose levels (chemical)


What does amylin do? 

  • It regulates blood glucose concentration by delaying gastric emptying and suppressing glucagon secretion after meals


What does glucagon do? 

  • stimulates glycogenolysis, gluconeogenesis, and lipolysis


What does ghrelin do? 

  • Stimulates GH, controls appetite, regulation of insulin sensitivity


Where are the adrenal glands?

  • Zona glomerulosa, fasciculata, reticularis


What stimulates the adrenals?

  •  The adrenal glands are stimulated by the adrenocorticotropic hormone (ACTH) from the pituitary gland and by the sympathetic nervous system during stress.


Name the three hormones from the adrenal glands:

  • (Sugar) Glucocorticoids, (salt) mineralcorticoids, (sex) androgens


SIADH clinical manifestations, treatment/interventions

  • Clinical manifestation:

    • thirst, impaired taste, anorexia, dyspnea on exertion, fatigue, dulled sensorium

  • treatment:

    • fluid restriction, correct underlying cause, monitor sodium n neuro, hypertonic saline, vasopressin receptor agonists


DI clinical manifestations, treatment/interventions

  • clinical manifestations:

    • polyuria, nocturia, continuous thirst, polydipsia, large bladder capacity, hydronephrosis

  • treatment:

    • neurogenic

      • ADH replacement, fluid, DDAVP

    • nephrogenic

      • comorbidity, d/c meds, correct lyte imbalance


Growth hormone; when do each of the following occur?

  • Gigantism

    • Overproduction of GH during CHILDHOOD before the growth plates close

      • clinical manifestations:

        • Excessive height and growth of long bones

  • Acromegaly 

    • overproduction of GH in ADULTHOOD after the growth plates have closed

    • clinical manifestations:

      • Abnormal growth of hands, feet, facial features, other soft tissues


Hyperthyroidism: clinical manifestations, labs, treatment/interventions

  1. clinical manifestations:

    1. Thin hair, enlarged thyroid, tachycardia, weight loss, diarrhea, warm skin, hyperflexia, pretibial edema

  2. labs: inc T4, inc T3, dec TSH

  3. treatments: control TH prod and secretion; meds: antithyroid; surgery


Hypothyroidism: clinical manifestations, labs, treatment/interventions

  1. Clinical manifestations

    1. loss of hair, normal/small thyroid, bradycardia. Constipation, muscle weakness, edema of the extremities

  2. labs: dec T4, dec T3, inc TSH

  3. tx: meds, replace hormone


What are the clinical manifestations of hyperparathyroidism?

  • hypercalcemia, hypophosphatemia, hypercalciuria (kidney stones), pathologic fractures


What is the most common cause of hypoparathyroidism?

  • parathyroid damage during thyroid surgery 


What is the difference between type 1 and type 2 diabetes?

  • Type 1 diabetes is an autoimmune condition resulting in no insulin production, while type 2 diabetes is characterized by insulin resistance and often reduced insulin production, typically influenced by lifestyle factors.


Review table 20.4 pg 459 focus on the three Ps and increased blood sugar levels that cause them

  • polydipsia: Elevated blood glucose levels cause water to be drawn out of body cells, leading to dehydration and stimulating thirst in the hypothalamus.

  • polyuria: Hyperglycemia causes excess glucose to be excreted in urine along with large amounts of water, leading to glycosuria and increased urine output due to its osmotic diuretic effect.

  • polyphagia: Depletion of cellular stores of carbohydrates, fats, and protein results in cellular starvation and a corresponding inc in hunger


List the acute complications of diabetes

  • hypoglycemia rapid onset

  • diabetic ketoacidosis (DKA)

  • HHNKS


What are the three major clinical manifestations of diabetic ketoacidosis?

  • hyperglycemia, metabolic acidosis, ketonuria


List the microvascular complications of diabetes.

  • Diabetic:

    • retinopathy, nephropathy, neuropathies


List the clinical manifestations of Cushing’s and Addison’s (pg 467). What is the cause? 

Cushings

  • weight gain: accumulation of adipose tissue in the trunk, face, and cervical area

  • Glucose intolerance: cortisol-induced insulin resistance + inc gluconeogenisis + glycogen storage by the liver

  • protein wasting: catabolic effects of cortisol on peripheral tissues

addison’s

  • hypocortisolism and hypoaldosternoism, vitiligo, hyperpigmentation, anorexia, n/v/d