Alterations in the Endocrine System

Hypothyroidism

decreased thyroid hormone elevated tsh fatigue diminished deep tendon reflexes

Select all diagnostic features associated with HHNKS: Absent urine ketones Serum glucose >600 mg/dL Normal bicarbonate level Elevated urine ketones Elevated serum glucose >250 Elevated serum osmolarity Decreased serum osmolarity Elevated serum bicarbonate level

serum glucose greater 600 normal bicarb level elevated serum osmolarity absent urine ketones

Cortisol secretion is regulated by the hypothalamus and the anterior pituitary. True False

true

Glucagon antagonizes insulin with a resulting increase in blood glucose during periods of fasting, exercise and hypoglycemia True False

true

HHNKS is characterized by increased gluconeogenesis and glycogenolysis. True False

true

Lipid-derived hormones cross the cell membrane and bind to receptors in the cell's cytoplasm. True False

true

Polydipsia results from elevated glucose levels that exert an osmotic diuretic effect. True False

true

The adrenal cortex is stimulated by the adrenocorticotropic hormone (ACTH) from the anterior pituitary. True False

true

The anterior lobe of the pituitary produces its own hormones. True False

true

Treatment of secondary hyperparathyroidism involves calcium replacement, dietary phosphate restriction, phosphate binders and vitamin D replacement. True False

true

Trousseau sign will result in painful, carpal spasm. True False

true

Vitamin D works with parathyroid hormone (PTH) to promote calcium and phosphate absorption in the GI tract and bone True False

true

serum magnesium and urinary calcium excretion will help in diagnosing hypoparathyroidism. True False

true

Select all of the following that are associated co-morbidities of Cushing's syndrome. Hypokalemia Hyperlipidemia Diabetes Hypertension Hyperkalemia Infections Muscle weakness Osteoporosis Psychiatric disorders GI disturbances

diabetes osteoporosis psychiatric disorders muscle weakness hypokalemia infections

Signs of hypocalcemia

dry skin loss of body and scalp hair hypoplasia of developing teeth horizontal ridges on the nails

Type 1 Cause of Polydipsia

elevated glucose levels exert an osmotic effect that pulls water from the body cells resulting in dehydration and thirst

Hyperthyroidism

elevated thyroid hormone suppressed tsh enlarged liver hand tremors

Decreased circulating PTH results in decreased serum calcium levels and decreased serum phosphate levels. True False

false

In Grave's disease, overproduction of thyroid hormone is due to parafollicular cell production of thyroid hormone. True False

false

TSH production is decreased in hypothyroidism. True False

false

The only way for a hormone to reach a target cell is through the blood stream. True False

false

The parathyroid glands are located on the anterior lobe of the thyroid gland. True False

false

The posterior pituitary produces its own hormones. True False

false

To be considered a lipid hormone, it must be bound to a protein and it must bind to receptors inside the cell membrane. True False

false

The effect of catecholamines is vasodilation. True False

false vasoconstriction

Which of the following affect an individual's response to insulin: height blood pressure weight activity level medications abdominal fat amount of food intake

height weight activity level abdominal fat

Select the correct lab values that reflect hypocalcemia: Hight PTH level Low phosphorous level Low PTH level High phosphorous level

high phosphorous low pth

Primary Parathyroid

hyperfunction of parathyroid cells due to adenoma

Metabolic syndrome is characterized by: Normal blood pressure, obesity, hyperlipidemia Hyperlipidemia, obesity, hypertension Cachexia, hypotension, normal cholesterol Hypertension, stroke, peripheral edema

hyperlipidemia, obesity, hypertension

The drug of choice for the treatment of hypothyroidism is: Iodine Prolactin Levothyroxine Indomethacin

levothyroxine

Tertiary Parathyroid

long term stimulation of parathyroid leads to hyperplasia

The two most distinguishing factors of Grave's disease is: Goiter and exophthalmos Lethargy and weight gain Pretibial myxedema and exophthalmos Pretibial myxedema and truncal obesity

pretibial myxedema and exophthalmos

Delta Cells

responsible for secreting gastrin and somatostatin

alpha cells

responsible for secreting glucagon

Beta cells

responsible for secreting insulin and amylin inhibits glucagon secretion

F (PP) Cells

secrete pancreatic polypeptide that stimulates gastric secretions and antagonizes cholecystokinin.

Which of the following is considered an extra adrenal effect of the adrenal cortex? Conversion of cholesterol to pregnenolone Stimulation of melanocytes Secretion of cortisol and adrenal androgens Maintenance of gland size

secretions of melanocytes

Secondary Parathyroid

stimulation of parathyroid in response to hypocalcemia

Identify the symptoms associated with hypoglycemia (select all that apply): tachycardia sweating excessive energy restlessness abdominal pain anxiety polyuria pallor tremors anorexia hunger

tachycardia sweating tremors pallor anxiety hunger restlessness

Which of the following is an example of a steroid hormone? Glucagon. Thyroxine. Insulin. Testosterone.

testosterone

Follicular Cells

thyroxine (T4)

A goiter may appear in hypothyroidism because of the overproduction of TSH. True False

true

Aldosterone promotes sodium reabsorption and potassium excretion in the kidneys. True False

true

An individual who presents with Diabetic Ketoacidosis (DKA) will have a blood glucose level of >250 mg/dL. True False

true

Characteristics of myxedema include non-pitting edema around eyes. True False

true

Chromaffin cells are the site of production for epinephrine and norepinephrine. True False

true

Chvostek sign is elicited by tapping the cheek that will result in twitching of the upper lip. True False

true

The pineal gland is responsible for regulating the sleep-wake cycle. True False

true

Type 2 cause of acanthosis nigricans-brown to black pigmentation in skin folds

Associated with insulin resistance

Secondary Hypocortisolism

Caused by inadequate stimulation of the adrenal glands by ACTH.

Primary Hypocortisolism

Lack of production and secretion of the adrenocortical hormones

Type 1 Cause of Fatigue

Metabolic changes contribute to fatigue.

Type 2 cause of fatigue

Metabolic changes result in poor use of food products, contributing to lethargy and fatigue

Type 2 DM

Usually > 40 years of age Associated with hyperosmolar nonketotic coma Symptoms: weakness, weight loss, infections

zona glomerulosa

aldosterone is produced

zona reticularis

aldosterone is secreted

Which of the following is considered a treatment option for Cushing's disease? Transsphenoidal hypophysectomy Laparoscopy Resection All of the above

all of the above

Which of the following is used in the treatment of hyperthyroidism? Methimazole Radioactive Iodine Propylthiouracil All of the above

all of the above

Which of the following hormones are produced by the hypothalamus? Thyroid stimulating hormone. Antidiuretic hormone. Follicle-stimulation hormone. Luteinizing hormone.

antidiuretic hormone

Parafollicular cells

calcitonin

Tertiary Hypocortisolism

caused when exogenous glucocorticoids are abruptly withdrawn

zona fasciculata

cortisol is secreted

Type 2 Cause of Recurrent Infections and prolonged wound healing

Decline in immune protection because growth of microorganisms is stimulated by increased glucose levels Slow wound healing due to decreased blood supply

Type 1 Cause of Polyphagia

Due to depletion of cellular stores of carbohydrate, fats, and protein resulting in cell starvation

Type 1 Cause of Weight Loss

Due to fluid loss that occurs with osmotic diuresis Insulin deficiency results in fat and protein mobilization to be used as energy

Type 1 Cause of Polyuria

Due to the osmotic diuretic effects of hyperglycemia

Type 2 cause of visual changes-blurred vision

Fluid balance in the eye fluctuates because of elevated blood glucose Diabetic retinopathy is another cause of visual loss

Type 2 cause of genital pruritus

Fungal growthpromoted by hyperglycemia and glycosuria

Select the proper diagnostic tests that are appropriate for Cushing's syndrome. Notable diurnal variation No cortisol diurnal variation. Activation of plasma ACTH Suppression of plasma ACTH by hypercortisolism due to an adrenal nodule. Decreased production of cortisol Suppression of cortisol after dexamethasone Increased production of cortisol. No suppression of cortisol after dexamethasone administration.

No cortisol diurnal variation No suppression of cortisol after dexamethasone administration Increased production of cortisol Suppression of plasma ACTH by hypercortisolism due to an adrenal nodule

Type 1 DM

Onset 1<10-20 years Associated with diabetic ketoacidosis Symptoms: polyuria, polyphagia, polydipsia

Type 2 cause of paresthesia

Paresthesiasare common manifestations ofdiabetic neuropathies