Endo Wrap Up

50 flashcardsby Madi
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1
The Anterior Pituitary gland (adenohypophysis) _______ & _______ hormones
- Produces and releases
2
The Posterior pituitary gland (neurohypophysis) _____ & _____ hormones
- Stores and releases
3
The 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)
4
The Posterior Pituitary gland store & releases which hormones?
antidiuretic hormone (ADH), oxytocin (OXT)
5
Endocrine Gland Hormones include...
Thyroxine (T4), cortisol, epinephrine, parathyroid hormone (PTH), antidiuretic hormone (ADH)
6
Downregulation -> prolonged excessive stimulation -> reduced response (lower sensitivity, fewer receptors)
......
7
Upregulation -> reduced stimulation -> attempted increased response (higher sensitivity, more receptors)
......
8
Primary Endocrine Disorder – dysfunction of the _______
endocrine gland
9
Secondary Endocrine Disorder – dysfunction of ______ caused by abnormal ______ activity
- other organs
- pituitary
10
Endocrine Disorders are disorders involving _____, _______, or _______
Hypothalamic, Pituitary, or Gland Level
11
Tertiary Endocrine Disorder – dysfunction caused by _______ origin
- Hypothalamic
12
Growth hormone treatment/dosing
- Usually dosed 6x/wk
- Dosed in mg/kg/wk
- Physiologic dosing: 0.3mg/kg/wk
13
Hydrocortisone 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
14
Fludrocortisone treatment/dosing
Typical dose is 0.1mg PO daily
15
Levothyroxine treatment/dosing
Dosed daily in mcg
Typically ~ 1-2 mcg/kg/day
Titrated based on labwork
16
Estrogen or Testosterone treatment/dosing
Assist in bringing the patient through puberty
Titrate based on labwork and clinical picture
17
DDAVP (Desmopressin) treatment/dosing
Can be given orally, intranasally or subcutaneously
Titrated based on labwork
18
Most common cause of Hyperpituitarism
Pituitary adenoma
19
Hyperpituitarism presentation in children
gigantism (>7ft), large hands/feet, hypogonadism
20
Early: 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
21
Late (Delayed) or Absent (Hypogonadal Hypogonadism) puberty teat with _________; ______ or _______
- HCG/Testosterone; testicular implants
- Estrogen/Progesterone: Start slow and titrate up
22
Antidiuretic Hormone (ADH) Compels the kidneys to......
reabsorb water back into circulation (i.e. makes you hold onto water)
23
Central DI is the _______. It can be caused by _____, ______, or ______
- Lack of secretion of ADH
- Brain tumors: head trauma, infection
24
Nephrogenic 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
25
Syndrome 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
26
Cerebral 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
27
T4 (thyroxine) – regulates _______ and effects almost EVERY organ system
Metabolism
28
Hypothyroidism- Underactive, nonfunctional, or absent thyroid gland: will have _____ levels of T3 & T4; Measured by _____
- Decreased
- FreeT4
29
Central 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
30
Congenital Hypothyroidism occurs when _______; TSH levels are _____ & FreeT4 levels are _____
- absent or nonfunctional thyroid gland
- Elevated
- Low
31
Autoimmune Hypothyroidism occurs when _______; TSH levels are _____ & FreeT4 levels are _____
- antibodies fighting the gland, causing it not to work
- Elevated
- Low
32
In Subclinical Hypothyroidism TSH levels are _____ & FreeT4 levels are _____
- Elevated
- Normal
33
Hashimoto’s Thyroiditis is the Most common cause of _____
- Hypothyroidism
34
Hashimoto’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
35
Myxedema is severe _____ crisis d/t _______. It causes life-threatening _______, _______, & ______
- Hypothyroidism
- untreated hypothyroidism
- SIADH, hypoglycemia, hyponatremia
36
Congenital hypothyroidism needs to be treated within _____ days of life or sooner
- 14
37
Most common cause of Hyperthyroidism is ________ = ________
- autoimmunity
- Grave’s Disease
38
Grave’s Disease- Thyroid-stimulating immunoglobulins (TSI) antibodies activate _____ receptors resulting in ______
- thyrotropin
- continuous synthesis of thyroid hormones
39
Thyrotoxic Crisis: Thyroid Storm is a medical emergency leading to ______ & ______
heart failure and pulmonary edema
40
Thyroid Storm Treatment – __________, ________, and surgery
- PTU (anti-thyroid med)
- Radioactive iodine treatment
41
Single thyroid nodule= _______ Multiple nodules = _______
- increased risk of malignancy
- often benign
42
Increased Risk of Malignancy of thyroid nodules seen with ______, _______, ______, ______, _______
male, dysphagia/dysphonia, hx of radiation, firm/hard/immobile nodule, cervical lymphadenopathy
43
PTH breaks down _____ to increase ______
- bone
- free calcium
44
Hypoparathroidism 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)
45
Hyperparathyroidism leads to ______; The main cause is _____
- Hypercalcemia
- Adenoma
46
General Lipid guidlines: LDL >160 means likely ________; LDL >190 means ______
- familial hypercholesterolemia (FH)
- consistent with heterozygous FH
47
Diabetic 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
48
Hypoparathyroidism leads to ______
Hypocalcemia
49
Chvostek sign
twitching of the facial muscles in response to tapping over the area of the facial nerve
50
Trousseaus sign
carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes.
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