Term
| hypofunction of the endocrine system occurs when ________ hormone is produced |
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Definition
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Term
| hyperfunction of the endocrine system occurs when _______________ hormone is produced. |
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Definition
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Term
| Primary endocrine disorders originate in the ___________________________. |
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Definition
| target gland responsible for producing the hormone. |
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Term
| In secondary endocrine defects, the "target cell" is normal and the defect is in the ___________________. |
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Definition
| stimulating hormones or releasing factors. |
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Term
| Tertiary endocrine disorders results from ____________________. |
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Definition
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Term
| _____ to _____ percent of the anterior pituitary gland must be destroyed before hypopituitarism becomes clinically evident. |
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Definition
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Term
| GH (somatotropin) deficiency can occur at the level of either the ___________ or _________. |
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Definition
| hypothalamus or pituitary |
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Term
| At the hypothalmic level, GH deficiency can be caused by 2 things: |
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Definition
1. the hypothalamus releases too little Growth Hormone Releasing Hormone (GHRH) to stimulate the pituitary or
2. producing too much somatostatin which inhibits GH release by the pituitary. GH deficiency at the pituitary level is seen when a pituitary tumor or other cause prevents the release of adequate GH. |
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Term
| Infants with congenital GH show obvious delays in growth by ____ to ____ years of age. |
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Definition
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Term
| If you see the manifestations of: short stature, obesity w/ immature facial features, delayed skeletal maturation, delayed puberty. What might it be? |
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Definition
| congenital GH deficiency exhibits those |
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Term
| What are adults with growth hormone deficiency at risk for? |
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Definition
| cardiovascular mortality d/t central adiposity, visceral fat, insulin resistance & dyslipidema (can cause Diabetes Mellitus). |
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Term
| GH excess occurring before puberty & fusion of he epiphyses of the long bones results in __________ . |
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Definition
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Term
| GH excess in adults results in __________. 95% of the time it is caused by ________________. |
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Definition
acromegaly,
somatotropic adenoma |
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Term
| Describe the manifestations that appear in the hands, feet & face from GH excess. |
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Definition
| pronounced enlargement of hands & feet, broad & bulbous nose, protruding lower jaw, slanting forehead. |
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Term
| Enlargement of cartilage in the larynx & respiratory tract results in GH excess. |
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Definition
| a deep voice & a tendency for bronchitis |
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Term
| Describe the skeletal changes that occur from GH excess. |
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Definition
| kyphosis (hunch back), arthralgias (joint pain, particularly arthritis), degenerative arthritis of spine, hips and knees |
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Term
| With GH excess, the skin may ________ & there is _______ of sebaceous glands (glands usually in hair covered areas). |
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Definition
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Term
| What are the effects of excessive GH on carbohydrate metabolism & what ca be the subsequent result? |
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Definition
| decrease in glucose uptake by skeletal & adipose tissue. Increase in glucose production in liver, increase insulin secretion ---> Diabetes |
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Term
| Precocious puberty is defined as the appearance of secondary sexual development before age ___ in white girls, age ___ in African American girls and age ____ in boys of either race. |
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Definition
| 6 in white girls, 7 in African American girls & 9 in boys of any race |
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Term
| What is the most common Thyroid disorder? |
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Definition
| primary hypothyroidism. This type results from DESTRUCTION or DYSFUNCTION of the thyroid gland rather than altered hypothalamic or pituitary dysfunction. |
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Term
| The most common cause of the hypothyroidism is ____________________, an _________________ disorder that can completely destroy the thyroid gland. |
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Definition
| hashimoto thyroiditus, autoimmune |
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Term
| Is hypothyroidism primarily in men or women? |
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Definition
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Term
| List the dominant clinical manifestation of hypothyroidism... |
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Definition
| decreased heart rate, muscle weakness, coarse brittle hair, loss of lateral eyebrows, lethargy/impaired eyebrows, edema, puffy face, pallor, large tongue, hoarsness, COLD INTOLERANCE, constipations, skin changes to coarse/dry, "MYXEDEMA" madness, "MYXEDEMA" heart (cardiomegaly) |
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Term
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Definition
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Term
| What is Myxedema & what causes it? |
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Definition
| it is hard nonpitting edema d/t increased mucins trapping water in the interstitial space |
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Term
| What is a myxedematous coma? |
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Definition
| life-threatening, end stage expression of hypothyroidism |
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Term
| What are the clinical manifestations of myxedematous coma? |
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Definition
| coma, hypothermia, cardiovascular collapse, hypoventilation, hyponatremia, hypoglycemia, LACTIC ACIDOSIS |
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Term
| Who does the myxedematous coma occur in most frequently? |
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Definition
| elderly women w/ chronic hypothyroidism |
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Term
| What are the dominant clinical features of Grave's Disease? (a state of hyperthyroidism) |
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Definition
| exophthalmos (bulging eyes), Goiter (swollen thyroid externally), tachycardia, sweating, increased appetite but losing weight, fine hair, hair loss, tremors. Remember, Hyperthyroidism will result in overactivity of the organs of the body... so you'll get increased HR, sweating, weight loss |
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Term
| What is the usual age of onset for Grave's Disease? Does it affect men or women more? |
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Definition
| between 20 & 40 years. It effects women 5 times more often than men. |
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Term
| What is Grave's Disease & what is it characterized by? |
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Definition
| state of hyperparathyroidism accompanied with a goiter, exophthalmos (bulging eyes) or thick skin in pretibial area |
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Term
| Thyroid storm is rarely seen today, but when it is, it is life-threatening & has a high mortality rate. What are the manifestations? |
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Definition
| Increased fever, CV-tachycardia, CHF, angina, CNS-agitation, restlessness, delirium |
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Term
| The principal mineralcorticoid is _________________. Describe its function. |
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Definition
| aldosterone. Sodium, Potassium and Water balance. |
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Term
| What is the principal glucocorticoid? Describe its function? |
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Definition
| Cortisol (hydrocortisone), glucose, fat & protein metabolism, aids in surviving stressful situations, regulates metabolic functions, controls inflammatory response |
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Term
| What are the principal adrenal sex hormones? Describe their function. |
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Definition
| Androgens, the male sex hormone. Most well known androgen is testosterone. (estrogen is the female hormone) |
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Term
| Congenital Adrenal Hyperplasia (CAH) describes a congenital disorder caused by an _____________________ trait. |
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Definition
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Term
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Definition
| Adrenocorticotropic hormone, as its name implies, stimulates the adrenal cortex. More specifically, it stimulates secretion of glucocorticoids such as cortisol, and has little control over secretion of aldosterone, the other major steroid hormone from the adrenal cortex. |
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Term
| A common characteristic of all types of CAH (congenital adrenal hyperplasia) is a defect in the synthesis of cortisol that results in increased levels of ACTH and adrenal hyperplasia. The increased levels of ACTH overstimulates the pathways for production of adrenal androgens. Mineralcorticoids may be produced in excessive or insufficient amounts, depending on the precise enzyme deficiency. Infants of both sexes are effected. Boys seldom are diagnosed at birth, but the excess androgens in girls create _________________ . |
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Definition
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Term
| In infants of both sexes, if aldosterone production is deficient, the _______________________ form of CAH occurs & is manifested by: |
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Definition
| simple virilizing. fluid and electrolyte disorders after the fifth day of life (including hyponatremia, hyperkalemia, vomiting, dehydration and shock). |
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Term
| What is the most common cause of adrenal cortical insufficiency? |
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Definition
| lack of feedback inhibition. This is b/c adrenal cortical hormones are deficient & ACTH levels are elevated). |
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Term
| Addison disease is a disease in which all layers of the _____________________ are destroyed. |
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Definition
| adrenal cortex. So, Addison disease results in adrenal cortical insufficiency. |
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Term
| Addison disease number one cause is by _______________ destruction. |
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Definition
| autoimmune. So the cells in the body do not recognize its own cells and attacks itself by mistake. |
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Term
| Before 1950, TB was the most common cause of Addison disease in the U.S. With the resurgence of TB & the presence of mult-drug & XDR TB what might happen to the incidence of Addison Disease? |
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Definition
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Term
| Addison disease requires life-long _____________ replacement. |
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Definition
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Term
| The manifestations of adrenal cortex insufficiency, lack of androgens in women are: |
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Definition
| sparse axillary & pubic hair. skin looks suntanned in exposed areas (creases esp. dark) blue or black gums |
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Term
| What manifestations are caused by mineral corticoid (aldosterone) deficiency? |
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Definition
| increased urinary sodium, chloride and water, decreased excreted Potassium. So, hyponatremia, hyperkalemia. Decreased cardiac input, loss of ECF, abnormal appetite for Sodium, orthostatic hypotension, dehydration |
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Term
| What manifestations are associated with glucocorticoid (cortisol) deficiency? |
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Definition
| poor tolerance for stress, hypoglycemia, lethargy, weakness, anorexia, nausea, vomiting, weight loss |
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Term
| In persons with Addison disease, what can trigger ACUTE ADRENAL CRISIS & what are the manifestations? |
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Definition
| exposure to illness & stress, causes N/V, muscle weakness, HYPOTENSION, DEYDRATION, VASCULAR COLLAPSE |
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Term
| What disease are we studying that is glucocorticoid hormone excess? |
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Definition
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Term
| The manifestations of Cushing Syndrome result from _______________________ from any cause. |
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Definition
| excess glucocorticoid (cortisol) production |
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Term
| What are the 3 forms of Cushing Syndrome? |
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Definition
| pituitary form, adrenal, ectopic |
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Term
| List the major clinical manifestations of Cushing Syndrome |
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Definition
| emotional disturbance, many are exaggerations of cortisol: altered fat metabolism (protruding abdomen, "BUFFALO HUMP" on back, round "MOON FACE", muscle weakness, extremities are thin b/c of protein breakdown and muscle wasting skin on forearms and legs is thin like parchment paper, get purple stretchmarks, osteoporosis, skin ulcers, obesity, amenorrhea, enlarged sella turcica. Look at pg. 695 figure 31-13 |
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Term
| What famous president had Addison's Disease? |
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Definition
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Term
| What U.S. President, his wife & dog all had Grave's Disease? |
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Definition
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Term
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Definition
| adrenocorticotropic hormone |
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Term
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Definition
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Term
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Definition
| growth hormone releasing hormone |
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Term
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Definition
| insulin like growth factor |
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Term
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Definition
| gonadatropin releasing hormone |
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Term
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Definition
| follicle stimulating homone |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
|
Definition
| thyrotropin releasing hormone |
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Term
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Definition
| thyroid stimulating hormone |
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Term
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Definition
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Term
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Definition
| corticotropin releasing hormone |
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Term
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Definition
| hypothalamic, pituitary, adrenal system |
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Term
| The nurse is caring for a client who has increased serum cholesterol, bradycardia, decreased respiratory rate and cold intolerance. These are manifestations of: a. Addison's Disease B. Cushing's Disease C. hypoparathyroidism D. Hypothyroidism |
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Definition
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Term
| A client with underlying Addison's disease is experiencing an acute adrenal crisis. What manifestations would the nurse expect to see? a. fluid overload b. hypernatremia c. hypokalemia d. hypotension |
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Definition
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Term
| In a client with myxedema, the nurse would expect to see: a. a "buffalo hump" b. a "moon face" c. nonpitting edema d. a protruding abdomen |
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Definition
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