1The Anterior Pituitary gland (adenohypophysis) _______ & _______ hormones
- Produces and releases
2The Posterior pituitary gland (neurohypophysis) _____ & _____ hormones
- Stores and releases
3The Anterior Pituitary gland produces/secretes which hormones?
Growth Hormone (GH), Prolactin (PRL), Adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH)
4The Posterior Pituitary gland store & releases which hormones?
antidiuretic hormone (ADH), oxytocin (OXT)
5Endocrine Gland Hormones include...
Thyroxine (T4), cortisol, epinephrine, parathyroid hormone (PTH), antidiuretic hormone (ADH)
6Downregulation -> prolonged excessive stimulation -> reduced response (lower sensitivity, fewer receptors)
......
7Upregulation -> reduced stimulation -> attempted increased response (higher sensitivity, more receptors)
......
8Primary Endocrine Disorder – dysfunction of the _______
endocrine gland
9Secondary Endocrine Disorder – dysfunction of ______ caused by abnormal ______ activity
- other organs
- pituitary
10Endocrine Disorders are disorders involving _____, _______, or _______
Hypothalamic, Pituitary, or Gland Level
11Tertiary Endocrine Disorder – dysfunction caused by _______ origin
- Hypothalamic
12Growth hormone treatment/dosing
- Usually dosed 6x/wk
- Dosed in mg/kg/wk
- Physiologic dosing: 0.3mg/kg/wk
13Hydrocortisone treatment/dosing
- Until growth is complete- 3-4 times per day
- Dosed in mg/m2/day
- Typical dose is 8-12 mg/m2/day
- Stress dosing: 2-3x; IM solucortef for emergencies
14Fludrocortisone treatment/dosing
Typical dose is 0.1mg PO daily
15Levothyroxine treatment/dosing
Dosed daily in mcg
Typically ~ 1-2 mcg/kg/day
Titrated based on labwork
16Estrogen or Testosterone treatment/dosing
Assist in bringing the patient through puberty
Titrate based on labwork and clinical picture
17DDAVP (Desmopressin) treatment/dosing
Can be given orally, intranasally or subcutaneously
Titrated based on labwork
18Most common cause of Hyperpituitarism
Pituitary adenoma
19Hyperpituitarism presentation in children
gigantism (>7ft), large hands/feet, hypogonadism
20Early: Central Precocious Puberty diagnosis is __________ testing; Treat with _____ agonist including _____, ______, or _____; Developmental delay allow then _____, _____, or ______
- Leuprolide Stimulation Testing
- GnRH agonists
- Lupron, Triptodur, Supprelin
- OCP, Depo, IUD
21Late (Delayed) or Absent (Hypogonadal Hypogonadism) puberty teat with _________; ______ or _______
- HCG/Testosterone; testicular implants
- Estrogen/Progesterone: Start slow and titrate up
22Antidiuretic Hormone (ADH) Compels the kidneys to......
reabsorb water back into circulation (i.e. makes you hold onto water)
23Central DI is the _______. It can be caused by _____, ______, or ______
- Lack of secretion of ADH
- Brain tumors: head trauma, infection
24Nephrogenic DI is when the kidneys ______. It can be caused by _______, ______, _______, or ______
- Don’t respond to ADH
- Nephrotoxic drugs (lithium, vancomycin)
- Urinary obstruction (leading to kidney ischemia)
- Hypokalemia, or Hypocalcemia
25Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is _______ leading to ______; It is caused by ______, ______, or ______
- Inc. ADH
- Increased retention of water
- Acute brain injury, stroke, or meningitis
26Cerebral Salt Wasting is when a ________ leads to inappropriate & excessive _______ secretion leading to ______ & _____. Usually occurs ______. Tx includes _____
- neurosurgical procedure
- natriuretic peptide
- natriuresis and diuresis
- around post-operative day 3
- replace sodium and fluid
27T4 (thyroxine) – regulates _______ and effects almost EVERY organ system
Metabolism
28Hypothyroidism- Underactive, nonfunctional, or absent thyroid gland: will have _____ levels of T3 & T4; Measured by _____
- Decreased
- FreeT4
29Central Hypothyroidism occurs when _________; TSH levels are _____ & FreeT4 levels are _____
- the brain is not sending signals to make the thyroid work
- High, low, or normal
- Low
30Congenital Hypothyroidism occurs when _______; TSH levels are _____ & FreeT4 levels are _____
- absent or nonfunctional thyroid gland
- Elevated
- Low
31Autoimmune Hypothyroidism occurs when _______; TSH levels are _____ & FreeT4 levels are _____
- antibodies fighting the gland, causing it not to work
- Elevated
- Low
32In Subclinical Hypothyroidism TSH levels are _____ & FreeT4 levels are _____
- Elevated
- Normal
33Hashimoto’s Thyroiditis is the Most common cause of _____
- Hypothyroidism
34Hashimoto’s Thyroiditis will have _____ & _____ present indicating _____. Common in children with _____
- Anti-thyroglobulin (anti-Tg) antibodies &
Anti-thyroperoxidase (anti-TPO) antibodies
- autoimmune destruction
- other autoimmune disease
35Myxedema is severe _____ crisis d/t _______. It causes life-threatening _______, _______, & ______
- Hypothyroidism
- untreated hypothyroidism
- SIADH, hypoglycemia, hyponatremia
36Congenital hypothyroidism needs to be treated within _____ days of life or sooner
- 14
37Most common cause of Hyperthyroidism is ________ = ________
- autoimmunity
- Grave’s Disease
38Grave’s Disease- Thyroid-stimulating immunoglobulins (TSI) antibodies activate _____ receptors resulting in ______
- thyrotropin
- continuous synthesis of thyroid hormones
39Thyrotoxic Crisis: Thyroid Storm is a medical emergency leading to ______ & ______
heart failure and pulmonary edema
40Thyroid Storm Treatment – __________, ________, and surgery
- PTU (anti-thyroid med)
- Radioactive iodine treatment
41Single thyroid nodule= _______ Multiple nodules = _______
- increased risk of malignancy
- often benign
42Increased Risk of Malignancy of thyroid nodules seen with ______, _______, ______, ______, _______
male, dysphagia/dysphonia, hx of radiation, firm/hard/immobile nodule, cervical lymphadenopathy
43PTH breaks down _____ to increase ______
- bone
- free calcium
44Hypoparathroidism leads to ______; Treatment includes _____ & ______
- Hypocalcemia: Cramping, irritability, tetany, Trousseau’s sign, Chvostek’s sign
- Calcium (Dosed 4-5 times daily)
- Calcitriol (active form of Vit D)
45Hyperparathyroidism leads to ______; The main cause is _____
- Hypercalcemia
- Adenoma
46General Lipid guidlines: LDL >160 means likely ________; LDL >190 means ______
- familial hypercholesterolemia (FH)
- consistent with heterozygous FH
47Diabetic Lipid guidelines: LDL >160 in T1DM: _____; LDL >130 in T1DM + risk factor: _______; LDL >130 in T2DM: _______
- lipid lowering medication
- lipid lowering medication
- lipid lowering medication
48Hypoparathyroidism leads to ______
Hypocalcemia
49Chvostek sign
twitching of the facial muscles in response to tapping over the area of the facial nerve
50Trousseaus sign
carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.