Patho Ch 25 and 9 week 1

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Patho Ch 25 and 9 week 1
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2010-10-02 12:49:00
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pathophysiology
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  1. What 3 things do endocrine glands do?
    • 1. Secrete hormones
    • 2. Goal: regulate metabolism, growth, and homeostasis
    • 3. Works with close coorperation of the nervous system
  2. What are 2 ways hormones are measured?
    • 1. directly by blood tests
    • 2. "inferred" under substances in blood
  3. Proper functioning of endocrine system is vital to? (2)
    • 1. homeostasis
    • 2. Fertility and reproduction
  4. Endocrine instability causes many?
    pathophysiologic changes
  5. Endocrine problems may result from? (3)
    • 1. too much of a hormone being secreted (because of a tumor on a gland)
    • 2. too little of a hormone being secreted (because of a tumor on a gland)
    • 3. insensitivity of the target organ to the hormone
  6. What are some causes of insensitivity of the target organ to the hormone? (3)
    • 1. genetics
    • 2. auto-immune destruction of a target hormone
    • 3. aging/atrophy of the target organ
  7. What are some of the endocrine glands? (4)
    • 1. pituitary glands
    • 2. hypothalamus
    • 3. adrenal glands
    • 4. gonadal
  8. What does the pituitary gland secrete? (6)
    • 1. Somatrophin (GH) Growth Hormone
    • 2. Adrenocorticotropic Hormone (ACTH)
    • 3. Prolactin (PRL)
    • 4. Thyroid-stimulating Hormone (TSH)
    • 5. Follicle-stimulating Hormone (FSH)
    • 6. Luteinizing Hormone (LH)
  9. What is the function of GH?
    • *GROWTH HORMONE (Somatotropin)
    • Growth/Repair
  10. What is the function of ACTH
    • *Adrenocorticotropic Hormone
    • Stimulates adrenals to release cortisol
  11. When the adrenocorticotropic hormone causes the adrenal glands to release cortisol, this reaction causes? (2)
    • 1. decreased immune response
    • 2. anti-inflammatory
  12. What is the function of PRL?
    • *Prolactin
    • 1. stimulates breast milk production
    • 2. inhibits ovulation
  13. What is the function of TSH?
    • *Thyroid-stimulating hormone
    • Stimulates Thyroid>metabolism
  14. What is the function of FSH? (3)
    • *Follicle-stimulating hormone
    • 1. Stimulates follicles in ovary to begin egg development
    • 2. Stimulates estrogen release
    • 3. MALES: stimulates spermatogenesis
  15. What is the function of LH? (3)
    • *Luteinizing hormone
    • 1. Continues egg maturation
    • 2. Continues Ovulation
    • 3. MALES: stimulates testosterone production
  16. What kind of tumors can cause reproductive/fertility problems?
    Pituitary gland tumors
  17. What are the disorders of the pituitary gland? (14)
    • 1. Adenoma
    • 2. dwarfism
    • 3. acromegly
    • 4. gigantism
    • 5. pheochromocytoma
    • 6. Cushing's syndrome
    • 7. Addison's disease
    • 8. Hypothyroidism
    • 9. Goiter
    • 10. hyperparathyroidism
    • 11. hypoparathyroidism
    • 12. Syndrome of inappropriate ADH secretion
    • 13. Diabetes insipidus
    • 14. diabetes mellitus (DM)
  18. 1. What causes pheochromocytoma? 2. What does this disorder cause? 3. What are signs and symptoms of this disorder?
    • 1. A benign tumor on the adrenal medulla
    • 2. Excess release of norepinephrine and epinephrine
    • 3. A. hypertension
    • B. cephalgia
    • C. stressed feeling
  19. What are the ACTH problems? (3)
    • 1. pheochromocytoma
    • 2. Cushing's syndrome
    • 3. Addison's disease
  20. What happens physiologically when a patient has Cushing's syndrome?
    Too much cortisol/glucocorticoids are released by the adrenal cortex.
  21. What are the 4 reasons the too much cortisol or glucocorticoids are released by the adrenal cortex in Cushing's syndrome?
    • 1. pituitary tumor -> increase in ACTH
    • 2. adrenal tumor
    • 3. unknown cause
    • 4. side effects of cortisone/steroid use
  22. What is Cushing Syndromes signs and symptoms?
    • 1. Increase in body fat/ "moon face"
    • 2. depression/mood swings
    • 3. fragile skin/easy bruising
    • 4. decreased immune response-> increased risk of infections
    • 5. stomach ulcers/ GI bleeding
    • 6. increased blood sugar
    • 7.loss of Ca++ in bone-> osteoporosis
  23. What does cephalgia mean?
    headaches
  24. What does ecchymosis mean?
    bruise
  25. Someone with a decreased immune response should not get?
    vaccines
  26. A patient with Cushing's syndrome experiences increased blood sugar (BS) as a symptom, what may be needed?
    insulin injection
  27. What causes the GI bleeding and stomach ulcers for people with Cushing's syndrome?
    Antibiotics
  28. What has the same signs and symptoms as cushing's syndrome?
    steroid treatment
  29. What is important to know when taking a patient off of steroid treatment?
    You must wean them off gradually until the body learns how to produce its own cortisol again.
  30. What is the opposite of cushing's disease?
    Addison's disease
  31. 1. What physiologically causes addison's disease? 2. What is the disease usually secondary to? (2)
    • 1. insufficient gluco-corticoids or mineralo-corticoids
    • 2. Auto-immune response or tumor/infection of the adrenal cortex
  32. What are the signs and symptoms of addison's disease? (3)
    • 1. hypoglycemia
    • 2. fatigue
    • 3. weight loss
    • 4. decrease in Na+ in blood->water loss->hypotension->dizziness, at risk for syncope
    • 5. increase in K+ in blood -> dysrhythmia
  33. What is hyponatremia?
    Decrease in Na+ in blood
  34. What is decreased blood pressure called?
    hypotension
  35. What is syncope?
    fainting
  36. 1. Aldosterone is a type of what? 2. Therefore, when it is low it causes what?
    • 1. mineralocorticoid
    • 2. hyperkalemia
  37. What is dysrhythmia?
    irregular heartbeat
  38. What is the treatment for Addison's disease?
    Supplemental steroids with frequent monitoring
  39. What is adenoma?
    benign endocrine tumor (most common pituitary disorder)
  40. How is adenoma treated? (4)
    • 1. medication
    • 2. surgery
    • 3. radiation
    • 4. simply monitor
  41. What are the 3 GH problems?
    • 1. dwarfism
    • 2. acromegaly
    • 3. gigantism
  42. What are the 2 characteristics of dwarfism?
    • 1. small bones (Usually proportioned)
    • 2. normal IQ
  43. What happens physiologically to cause dwarfism?
    Too little growth hormone
  44. What is the treatment for dwarfism?
    GH supplements in children before epiphyseal plates seal
  45. What physiologically causes acromegaly?
    Too much growth hormone
  46. In acromegaly, what causes too much growth hormone?
    adenoma
  47. What are the characteristics of a person with acromegaly? (3)
    • 1. large bones
    • 2. thickening of skull
    • 3. large jaw&tongue
  48. What can acromegaly lead to and why?
    It can lead to a person becoming diabetic because it causes insulin resisitance
  49. What are the signs and symptoms of acromegaly? (4)
    • 1. insulin resisitance
    • 2. high blood glucose
    • 3. high blood pressure
    • 4. CV disease
  50. What physiologically causes gigantism?
    Too much GH BEFORE puberty (Very large, tall person)
  51. What are the thyroid problems? (6)
    • 1. hypothyroidism
    • FORMS:
    • A2.myxdema
    • B3. Hashimoto's disease
    • C4. Cretinism
    • 5. hyperthyoidism
    • 6. goiter
  52. What is hypothyroidism due too physiologically?
    Low thyroid functioning
  53. In hypothyroidism what is the low thyroid functioning due to? (3)
    • 1. genetics
    • 2. aging (esp in females)
    • 3. auto immune disease
  54. What do lab tests show is someone has hypothyroidism?(2)
    • 1. Increased TSH
    • 2. decreased T3 and T4
  55. If a patient has hypothyroidism what may a thyroid scan reveal?
    Tumor
  56. What is T3?
    Triidothyronine
  57. What is T4?
    Thyroxine
  58. What are the 3 forms of hypothyroidism?
    • 1. myxedema
    • 2. Hashimoto's disease
    • 3. Cretinism
  59. What age group does myxedema effect?
    adults
  60. What kind of disease is Hashimoto's disease?
    Auto-immune
  61. What age group does Cretinism effect?
    infants
  62. What are the signs and symptoms of hypothyroidism? (6)
    • 1. increased weight gain
    • 2. decreased energy
    • 3. menstrual irregularities
    • 4. depression
    • 5. confusion
    • 6. cold intolerance
  63. What are the treatments for hypothyroidism?
    Oral meds (synthetic thyroid hormone) for life. labs tests to monitor
  64. Hyperthyroidism occurs when the thyroid is?
    oversecreting
  65. What is a form of hyperthyroidism?
    Grave's disease
  66. What happens physiologically when a person has Grave's disease?
    • 1. increased T3
    • 2. increased T4
  67. What causes Grave's disease? (2)
    • 1. tumor
    • 2. auto-immune disease
  68. What are the signs and symptoms of hyperthyroidism?
    • 1. exopthalamus
    • 2. decreased weight
    • 3. nervousness
    • 4. palpitations
    • 5. tachycardia
    • IF S&S are SEVERE:
    • "thyroid storm" occurs
  69. What is "thyroid storm"s signs and symptoms? (3)
    • An acute medical emergency:
    • 1. increased body temperature
    • 2. increased pulse
    • 3. possible heart failure
  70. What is exopthalmus?
    bulging eyes
  71. What is tachycardia?
    increased pulse
  72. What are the treatments for hyperthyroidism?
    • 1. partial or total thyroidectomy
    • 2. radioactive iodine injections to kill off some thyroid tissue
    • 3. close monitoring of thyroid levels
    • 4. Monitoring of PTH levels
  73. Why for the treatment of hyperthyroidism does monitoring of PTH levels occur?
    Because treatment may have accidentally injured or removed all of the 4 parathyroid glands.
  74. What is a goiter?
    Enlarged thyroid
  75. What is a goiter due to? (2)
    • 1. hyperthyroidism
    • 2. hypothyroidism
  76. What are the PTH problems? (2)
    • 1. hypoparathyroidism
    • 2. hyperparathyroidism
  77. What is hypocalcemia?
    Decreased Ca levels
  78. What are the causes of hypoparathyroidism? (2)
    • 1. auto-immune disease
    • 2. thyroidectomy
  79. What are the signs and symptoms of hypoparathyroidism? (3)
    • 1. decreased Ca levels
    • 2. weak heart
    • 3. muscle twitches
  80. What is hyperparathyroidism due to? (2)
    • 1. tumor
    • 2. renal failure
  81. What are the signs and symptoms of hyperparathyroidism? (4)
    • 1. increased Ca levels
    • 2. kidney stones
    • 3. dysrhythmia
    • 4. osteoporosis
  82. What is the treatment for hyper/hypo-parathyroidism? (2)
    • Depending on cause:
    • 1. includes surgery
    • 2. supplements of D and Ca
    • (must find reason for calcium imbalance as may be due to a bone tumor)
  83. What are the reproductive hormone problems? (5) (these do not have real names, rather they are just imbalances)
    • IMBALANCES OF:
    • 1. FSH
    • 2. LH
    • 3. PRL
    • 4. estrogen
    • 5. progesterone
  84. What do imbalances of FSH, LH, and/or PRL cause? (2)
    • 1. menstrual and/or ovulatory irregularities in females
    • 2. sperm irregularities in males
  85. What does treatment for imbalances of FSH, LH, and/or PRL depend on? (2)
    • 1. cause
    • 2. age
    • (example: FSH increases in menopause)
  86. What are the general concepts of estrogen and progesterone imbalances? (3)
    • 1. affect ovulation
    • 2. affect cervical mucus
    • 3. affect endometrial growth
  87. What does an IUD cause?
    endometrial inflammation
  88. What does an IUD release?
    exogenous hormones
  89. What are exogenous hormones?
    Hormones from outside the bodies natural production
  90. What are some examples of exogenous hormones? (3)
    • 1. the pill
    • 2. depo-provera
    • 3. norplant
  91. What are 3 things that exogenous hormones do?
    • 1. sometimes inhibit ovulation
    • 2. always make cervical mucus difficult for sperm to traverse
    • 3. thins endometrail lining which fertilized egg needs to implant well
  92. What is a risk when taking exogenous hormones?
    Certain ones can increase the risk of ectopic pregnancy
  93. What is abortifacient?
    A substance or device which induces failure of pregnancy
  94. What is a teratogen?
    substance which causes fetal defects
  95. What is mennorhagia?
    excessive menstrual blood loss
  96. What may mennorhagia lead to?
    anemia
  97. What is oligomenhorrhea?
    short or infrequent menstrual periods
  98. What is mettorrhagia?
    bleeding in between menstrual cycles
  99. What is the treatment for all menstrual related diseases?
    Treatment depends on cause
  100. What does ADH conserve?
    sodium, raising BP
  101. What is excess ADH called?
    Syndrome of inappropriate ADH secretion
  102. What are the signs and symptoms of syndrome of inappropriate ADH seceretion? (3)
    • 1. increased H2O in blood (thus low Na levels)
    • 2. confusion
    • 3. electrolyte imblances
  103. What is the treatments of syndrome of inappropriate ADH secretion? (3)
    • 1. diuretics
    • 2. Na pills
    • 3. salty diet
  104. What is low ADH called?
    Diabetes Insipidus
  105. Why is low ADH called diabetes insipidus?
    Because polyuria (excessive urination) mimics that seen with diabetes mellitus except there is NO glucose in the urine.
  106. What is the sign and symptom of diabetes insipidus?
    severe dehydration
  107. What is the treatment for diabetes insipidus?
    ADH injections
  108. What is type 1 diabetes mellitus?
    insufficient insulin secretion by islets of langerhans in pancreas
  109. What is the treatment for type 1 diabetes?
    insulin injections
  110. What is type 2 diabetes mellitus?
    insensitivity to insulin by target organ cells throughout body
  111. What is the treatment for type 2 diabetes mellitus?
    Pills, if they do not work then insulin injections
  112. What are the causes of both diabetes mellitus? (4)
    • 1. genetics
    • 2. obesity
    • 3. pregnancy
    • 4. auto immune
  113. What is the short hand for gycosylated hemoglobin?
    HbA1c
  114. What is gycosylated hemoglobin?
    An asssessment of the average blood glucose levels within the last 60-90 days before the blood is drawn. Gives a better picture of a patients diabetes control.
  115. What is normal for gycosylated hemoglobin?
    6-7%
  116. What is the normal fasting blood serum glucose for gycosylated hemoglobin?
    70-110 mg/dL
  117. What rely totally on glucose for energy?
    brain cells
  118. 1. What do people with diabetes mellitus lack? 2. What does this cause for cells?
    1. insulin or its ability to work on target cells. 2. This causes the cells to not be able to carry on metabolic processes.
  119. With diabetes mellitus, what is increased?
    BS (blood sugar)
  120. In diabetes mellitus, although BS is increased, what still lack energy?
    intracellular processes
  121. Because intarcellular processes lack energy in diabetes mellitus, what does this cause?
    DKA
  122. What is DKA?
    Diabetic Keto Acidosis
  123. In diabetes mellitus, What can also happen to blood sugar?
    it can get too low
  124. When blood sugar is too low because of diabetes mellitus what does this cause?
    not enough glucose enters the cell
  125. In diabetes mellitus, brain and muscle cells which lack 1.? cause the primary signs and symptoms of 2.?
    • 1.intracellular glucose
    • 2. hypoglycemia
  126. What does diabetic keto acidosis cause physiologically?
    • 1. high blood glucose levels
    • 2. mobilization of lipids
  127. What are the PRIMARY signs and symptoms of hypoglycemia?
    • 1. confusion
    • 2. drunken acting
    • 3. weakness
    • 4. pass out EVENTUALLY
  128. How fast is the onset for hypoglycemia?
    sudden
  129. How fast is the onset for DKA?
    GRADUAL
  130. When in doubt if someone has hypoglycemia or DKA, what do you treat them as?
    hypoglycemic!!!!! NOT DKA
  131. What is the treatment for someone in hypoglycemic shock? (2)
    • 1. Immediate oral glucose (6 lifesavers, 4 oz non-diet pop or juice, cake icing, glucose tablets)
    • 2. glucagon injection (follow up with protein)
  132. What is the cause of gestational diabetes?
    Uncertain cause
  133. What is the signs and symptoms of Gestational DM?
    1. increased maternal BS-> extra glucose available to the fetus->LGA (Large for Gestational Age)
  134. After birth, with Gestational DM, the newborn may show signs of 1.? due to 2.?
    • 1. hypoglycemia
    • 2. sudden drop in supply of glucose from the mother
  135. In gestational DM, does a woman blood sugar turn back to normal after their pregnancy?
    Yes
  136. What is candidiasis?
    Overgrowth of vaginal yeast
  137. Is candidiasis a STD?
    No
  138. What is cervical cancer usually secondary to? (2)
    • 1. herpes simplex virus (HSV)
    • 2. Human Papilloma Virus (HPV)
  139. Is cervical cancer curable?
    Only if caught early
  140. What is the treatments of cervical cancer?(2)
    • 1. removal of abnormal cells or RT(radiation therapy)
    • 2. hysterectomy
  141. What is another name for leiomyoma?
    benign fibroid tumor
  142. What is leiomyoma?
    overgrowth of myometrium of uterus
  143. Is leiomyoma precancerous?
    no
  144. What are the main problems caused by leiomyoma? (SYMPTOMS)
    • 1. pressure
    • 2. bleeding
    • 3. interfere with getting or remaining pregnat
  145. What are the uterine problems?
    1. leiomyoma (benign fibroid tumor)
  146. What is the treatment for leiomyoma?
    Varies with size, but they after skrink after menopause so surgery can be avoided.
  147. What are the problems with the fallopian tube? (3)
    • 1. obstructions
    • 2. salpingitis
    • 3. ectopic pregnancy
  148. What are obstructions to the fallopian tube usually secondary to? (3)
    • 1. infection
    • 2. scarring
    • 3. congenital abnormalities
  149. What do the obstructions of the fallopian tube lead to? (2)
    • 1. infertility
    • 2. ectopic pregnancy
  150. What is salpingitis?
    inflammation/infection of the fallopian tube
  151. What is salpingitis usually caused by? (2)
    • 1. STD
    • 2. vaginal infection migrating upward
  152. How do you figure out the causative organism for salpingitis?
    vaginal/blood cultures
  153. What are the S&S of salpingitis? (5)
    • 1. abdominal pain
    • 2. fever
    • 3. foul-smelling vaginal discharge
    • 4. possibly peritonitis
    • 5. septic shock
  154. What are the treatments for salpingitis? (2)
    • 1. hospitalization for IV antibiotic therapy
    • 2. remove IUD if present
  155. What does sequelae mean? (2)
    • 1. possible infertility
    • 2. ectopic pregnancies
  156. What is a ectopic pregnancy?
    implantation of fertilized egg outside uterus (usually implants in tube)
  157. about 6 weeks after an ectopic pregnancy, what are the S&S? (2)
    • 1. vaginal bleeding
    • 2. abdominal pain
  158. What can a ectopic pregnancy lead to? (2)
    rupture of tube-> hemoperitoneum (blood in peritoneum)
  159. What is hemoperitoneum?
    blood in peritoneum
  160. If ectopic pregnancy is not caught early, what is the treatment?
    surgery
  161. If ectopic pregnancy is caught early, what is the treatment?
    methotrexate (MTX) to dissolve blastocyte
  162. What are the ovary problems? (2)
    • 1. benign cysts
    • 2. ovarian cancer
  163. What are the S&S of benign cysts? (3)
    • 1. pain
    • 2. pressure
    • 3. menstrual irregularities
  164. What are the treatments for benign cysts? (2)
    • 1. hormones
    • 2. surgery
  165. What are the S&S fof ovarian cancer? (6)
    • 1. bloating
    • 2. backache
    • 3. urinary frequency
    • 4. dyspareunia (pain with intercourse)
    • 5. vaginal discharge
    • 6. bowel problems
  166. What are the treatments for ovarian cancer? (3)
    • 1. surgery
    • 2. RT
    • 3. metatases
  167. What is dyspareunia?
    pain with intercourse
  168. What are the pregnancy problems? (3)
    • 1. preclampsia
    • 2. placenta previa
    • 3. abruptio placenta
  169. What is another name for preclampsia?
    toxemia
  170. What is preclampsia?
    excessively high BP OR excessive clotting of blood "disseminated Intravascular Clotting" (DIC)
  171. In preclampsia, if you have the kind with really high BP, what does this high BP lead to?
    kidenys leaking protein into urine
  172. Because the kidenys leak protein into urine (preclampsia), what S&S does this lead to? (4)
    • 1. fluid retention
    • 2. edema
    • 3. headaches
    • 4. "eclampsia" with seizures
  173. When you have the preclampsia with DIC, what does this lead to?
    hemorrhages throughout the body (can be fatal)
  174. What is the treatment of pre-clampsia/eclampsia? (3)
    • 1. meds
    • 2. induce pregnancy
    • 3. rest
  175. What is placenta previa?
    placenta implants too low, completely or partially covering cervix
  176. What are the S&S of placenta previa? (2)
    • 1. painless bleeding
    • 2. miscarriage
  177. What is the treatment for placenta previa?
    rest
  178. What is abruptio placenta?
    placenta seperates from uterus before birth
  179. What are the S&S of abruptio placenta? (2)
    • 1. painful bleeding
    • 2. fetal distress
  180. What is the treatment for abruptio placenta?
    quick delivery

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