Patho Ch 25 and 9 week 1
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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
What are 2 ways hormones are measured?
- 1. directly by blood tests
- 2. "inferred" under substances in blood
Proper functioning of endocrine system is vital to? (2)
- 1. homeostasis
- 2. Fertility and reproduction
Endocrine instability causes many?
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
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
What are some of the endocrine glands? (4)
- 1. pituitary glands
- 2. hypothalamus
- 3. adrenal glands
- 4. gonadal
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)
What is the function of GH?
- *GROWTH HORMONE (Somatotropin)
What is the function of ACTH
- *Adrenocorticotropic Hormone
- Stimulates adrenals to release cortisol
When the adrenocorticotropic hormone causes the adrenal glands to release cortisol, this reaction causes? (2)
- 1. decreased immune response
- 2. anti-inflammatory
What is the function of PRL?
- 1. stimulates breast milk production
- 2. inhibits ovulation
What is the function of TSH?
- *Thyroid-stimulating hormone
- Stimulates Thyroid>metabolism
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
What is the function of LH? (3)
- *Luteinizing hormone
- 1. Continues egg maturation
- 2. Continues Ovulation
- 3. MALES: stimulates testosterone production
What kind of tumors can cause reproductive/fertility problems?
Pituitary gland tumors
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)
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
What are the ACTH problems? (3)
- 1. pheochromocytoma
- 2. Cushing's syndrome
- 3. Addison's disease
What happens physiologically when a patient has Cushing's syndrome?
Too much cortisol/glucocorticoids are released by the adrenal cortex.
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
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
What does cephalgia mean?
What does ecchymosis mean?
Someone with a decreased immune response should not get?
A patient with Cushing's syndrome experiences increased blood sugar (BS) as a symptom, what may be needed?
What causes the GI bleeding and stomach ulcers for people with Cushing's syndrome?
What has the same signs and symptoms as cushing's syndrome?
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.
What is the opposite of cushing's disease?
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
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
What is hyponatremia?
Decrease in Na+ in blood
What is decreased blood pressure called?
What is syncope?
1. Aldosterone is a type of what? 2. Therefore, when it is low it causes what?
- 1. mineralocorticoid
- 2. hyperkalemia
What is dysrhythmia?
What is the treatment for Addison's disease?
Supplemental steroids with frequent monitoring
What is adenoma?
benign endocrine tumor (most common pituitary disorder)
How is adenoma treated? (4)
- 1. medication
- 2. surgery
- 3. radiation
- 4. simply monitor
What are the 3 GH problems?
- 1. dwarfism
- 2. acromegaly
- 3. gigantism
What are the 2 characteristics of dwarfism?
- 1. small bones (Usually proportioned)
- 2. normal IQ
What happens physiologically to cause dwarfism?
Too little growth hormone
What is the treatment for dwarfism?
GH supplements in children before epiphyseal plates seal
What physiologically causes acromegaly?
Too much growth hormone
In acromegaly, what causes too much growth hormone?
What are the characteristics of a person with acromegaly? (3)
- 1. large bones
- 2. thickening of skull
- 3. large jaw&tongue
What can acromegaly lead to and why?
It can lead to a person becoming diabetic because it causes insulin resisitance
What are the signs and symptoms of acromegaly? (4)
- 1. insulin resisitance
- 2. high blood glucose
- 3. high blood pressure
- 4. CV disease
What physiologically causes gigantism?
Too much GH BEFORE puberty (Very large, tall person)
What are the thyroid problems? (6)
- 1. hypothyroidism
- B3. Hashimoto's disease
- C4. Cretinism
- 5. hyperthyoidism
- 6. goiter
What is hypothyroidism due too physiologically?
Low thyroid functioning
In hypothyroidism what is the low thyroid functioning due to? (3)
- 1. genetics
- 2. aging (esp in females)
- 3. auto immune disease
What do lab tests show is someone has hypothyroidism?(2)
- 1. Increased TSH
- 2. decreased T3 and T4
If a patient has hypothyroidism what may a thyroid scan reveal?
What is T3?
What are the 3 forms of hypothyroidism?
- 1. myxedema
- 2. Hashimoto's disease
- 3. Cretinism
What age group does myxedema effect?
What kind of disease is Hashimoto's disease?
What age group does Cretinism effect?
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
What are the treatments for hypothyroidism?
Oral meds (synthetic thyroid hormone) for life. labs tests to monitor
Hyperthyroidism occurs when the thyroid is?
What is a form of hyperthyroidism?
What happens physiologically when a person has Grave's disease?
- 1. increased T32. increased T4
What causes Grave's disease? (2)
- 1. tumor
- 2. auto-immune disease
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
What is "thyroid storm"s signs and symptoms? (3)
- An acute medical emergency:
- 1. increased body temperature
- 2. increased pulse
- 3. possible heart failure
What is exopthalmus?
What is tachycardia?
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
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.
What is a goiter?
What is a goiter due to? (2)
- 1. hyperthyroidism
- 2. hypothyroidism
What are the PTH problems? (2)
- 1. hypoparathyroidism
- 2. hyperparathyroidism
What is hypocalcemia?
Decreased Ca levels
What are the causes of hypoparathyroidism? (2)
- 1. auto-immune disease
- 2. thyroidectomy
What are the signs and symptoms of hypoparathyroidism? (3)
- 1. decreased Ca levels
- 2. weak heart
- 3. muscle twitches
What is hyperparathyroidism due to? (2)
What are the signs and symptoms of hyperparathyroidism? (4)
- 1. increased Ca levels
- 2. kidney stones
- 3. dysrhythmia
- 4. osteoporosis
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)
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
What do imbalances of FSH, LH, and/or PRL cause? (2)
- 1. menstrual and/or ovulatory irregularities in females
- 2. sperm irregularities in males
What does treatment for imbalances of FSH, LH, and/or PRL depend on? (2)
- 1. cause
- 2. age
- (example: FSH increases in menopause)
What are the general concepts of estrogen and progesterone imbalances? (3)
- 1. affect ovulation
- 2. affect cervical mucus
- 3. affect endometrial growth
What does an IUD cause?
What does an IUD release?
What are exogenous hormones?
Hormones from outside the bodies natural production
What are some examples of exogenous hormones? (3)
- 1. the pill
- 2. depo-provera
- 3. norplant
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
What is a risk when taking exogenous hormones?
Certain ones can increase the risk of ectopic pregnancy
What is abortifacient?
A substance or device which induces failure of pregnancy
What is a teratogen?
substance which causes fetal defects
What is mennorhagia?
excessive menstrual blood loss
What may mennorhagia lead to?
What is oligomenhorrhea?
short or infrequent menstrual periods
What is mettorrhagia?
bleeding in between menstrual cycles
What is the treatment for all menstrual related diseases?
Treatment depends on cause
What does ADH conserve?
sodium, raising BP
What is excess ADH called?
Syndrome of inappropriate ADH secretion
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
What is the treatments of syndrome of inappropriate ADH secretion? (3)
- 1. diuretics
- 2. Na pills
- 3. salty diet
What is low ADH called?
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.
What is the sign and symptom of diabetes insipidus?
What is the treatment for diabetes insipidus?
What is type 1 diabetes mellitus?
insufficient insulin secretion by islets of langerhans in pancreas
What is the treatment for type 1 diabetes?
What is type 2 diabetes mellitus?
insensitivity to insulin by target organ cells throughout body
What is the treatment for type 2 diabetes mellitus?
Pills, if they do not work then insulin injections
What are the causes of both diabetes mellitus? (4)
- 1. genetics
- 2. obesity
- 3. pregnancy
- 4. auto immune
What is the short hand for gycosylated hemoglobin?
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.
What is normal for gycosylated hemoglobin?
What is the normal fasting blood serum glucose for gycosylated hemoglobin?
What rely totally on glucose for energy?
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.
With diabetes mellitus, what is increased?
BS (blood sugar)
In diabetes mellitus, although BS is increased, what still lack energy?
Because intarcellular processes lack energy in diabetes mellitus, what does this cause?
What is DKA?
Diabetic Keto Acidosis
In diabetes mellitus, What can also happen to blood sugar?
it can get too low
When blood sugar is too low because of diabetes mellitus what does this cause?
not enough glucose enters the cell
In diabetes mellitus, brain and muscle cells which lack 1.? cause the primary signs and symptoms of 2.?
- 1.intracellular glucose
- 2. hypoglycemia
What does diabetic keto acidosis cause physiologically?
- 1. high blood glucose levels
- 2. mobilization of lipids
What are the PRIMARY signs and symptoms of hypoglycemia?
- 1. confusion
- 2. drunken acting
- 3. weakness
- 4. pass out EVENTUALLY
How fast is the onset for hypoglycemia?
How fast is the onset for DKA?
When in doubt if someone has hypoglycemia or DKA, what do you treat them as?
hypoglycemic!!!!! NOT DKA
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)
What is the cause of gestational diabetes?
What is the signs and symptoms of Gestational DM?
1. increased maternal BS-> extra glucose available to the fetus->LGA (Large for Gestational Age)
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
In gestational DM, does a woman blood sugar turn back to normal after their pregnancy?
What is candidiasis?
Overgrowth of vaginal yeast
What is cervical cancer usually secondary to? (2)
- 1. herpes simplex virus (HSV)
- 2. Human Papilloma Virus (HPV)
Is cervical cancer curable?
Only if caught early
What is the treatments of cervical cancer?(2)
- 1. removal of abnormal cells or RT(radiation therapy)
- 2. hysterectomy
What is another name for leiomyoma?
benign fibroid tumor
What is leiomyoma?
overgrowth of myometrium of uterus
Is leiomyoma precancerous?
What are the main problems caused by leiomyoma? (SYMPTOMS)
- 1. pressure
- 2. bleeding
- 3. interfere with getting or remaining pregnat
What are the uterine problems?
1. leiomyoma (benign fibroid tumor)
What is the treatment for leiomyoma?
Varies with size, but they after skrink after menopause so surgery can be avoided.
What are the problems with the fallopian tube? (3)
- 1. obstructions
- 2. salpingitis
- 3. ectopic pregnancy
What are obstructions to the fallopian tube usually secondary to? (3)
- 1. infection
- 2. scarring
- 3. congenital abnormalities
What do the obstructions of the fallopian tube lead to? (2)
- 1. infertility
- 2. ectopic pregnancy
What is salpingitis?
inflammation/infection of the fallopian tube
What is salpingitis usually caused by? (2)
- 1. STD
- 2. vaginal infection migrating upward
How do you figure out the causative organism for salpingitis?
What are the S&S of salpingitis? (5)
- 1. abdominal pain
- 2. fever
- 3. foul-smelling vaginal discharge
- 4. possibly peritonitis
- 5. septic shock
What are the treatments for salpingitis? (2)
- 1. hospitalization for IV antibiotic therapy
- 2. remove IUD if present
What does sequelae mean? (2)
- 1. possible infertility
- 2. ectopic pregnancies
What is a ectopic pregnancy?
implantation of fertilized egg outside uterus (usually implants in tube)
about 6 weeks after an ectopic pregnancy, what are the S&S? (2)
- 1. vaginal bleeding
- 2. abdominal pain
What can a ectopic pregnancy lead to? (2)
rupture of tube-> hemoperitoneum (blood in peritoneum)
What is hemoperitoneum?
blood in peritoneum
If ectopic pregnancy is not caught early, what is the treatment?
If ectopic pregnancy is caught early, what is the treatment?
methotrexate (MTX) to dissolve blastocyte
What are the ovary problems? (2)
- 1. benign cysts
- 2. ovarian cancer
What are the S&S of benign cysts? (3)
- 1. pain
- 2. pressure
- 3. menstrual irregularities
What are the treatments for benign cysts? (2)
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
What are the treatments for ovarian cancer? (3)
- 1. surgery
- 2. RT
- 3. metatases
What is dyspareunia?
pain with intercourse
What are the pregnancy problems? (3)
- 1. preclampsia
- 2. placenta previa
- 3. abruptio placenta
What is another name for preclampsia?
What is preclampsia?
excessively high BP OR excessive clotting of blood "disseminated Intravascular Clotting" (DIC)
In preclampsia, if you have the kind with really high BP, what does this high BP lead to?
kidenys leaking protein into urine
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
When you have the preclampsia with DIC, what does this lead to?
hemorrhages throughout the body (can be fatal)
What is the treatment of pre-clampsia/eclampsia? (3)
- 1. meds
- 2. induce pregnancy
- 3. rest
What is placenta previa?
placenta implants too low, completely or partially covering cervix
What are the S&S of placenta previa? (2)
- 1. painless bleeding
- 2. miscarriage
What is the treatment for placenta previa?
What is abruptio placenta?
placenta seperates from uterus before birth
What are the S&S of abruptio placenta? (2)
- 1. painful bleeding
- 2. fetal distress
What is the treatment for abruptio placenta?
What would you like to do?
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