Patho Ch 40-42
Pendred syndrime
patients with goiter and congenital deafness
Amylin
produce inhibition of gastric emptying and glucagon secretion
Cushing syndrome
refers to the manifestations of hypercortisolism from any cause
growth
several hormones are essential for normal body ____ and maturation, including growth hormone, insulin, thyroid hormone, and androgens
hypoglycemia
severe and prolonged ____ can cause brain death
Graves disease
the most common cause of hyperthyroidism is this, which is accompanied b ophthalmopathy (or dermopathy) and diffuse goiter
Glucose
the primary source of energy for the body
proteins
these are essential for the formation of all body structures including genes, enzymes, contractile structures in muscle, bone matrix, and hemoglobin of RBCs
adrenal cortex
this forms the bulk of the gland and is responsible for secretng three types of hormones: glucocorticoids mineralocorticoids adrenal androgens
fasting
this plasma glucose has been suggested as the prefered diagnostic test because of ease of administration, convenience, patient acceptability, and cost
aldosterone
this secretion is regulated by the renin-angiotensin mechanism and by blood levels of potassium
growth hormone
this secretion is stimulated by hypoglycemia, fasting, starvation, increased blood levels of amino acids, and stress conditions such as trauma, excitement, emotional stress, and heavy exercise
congenital
this type of defect results in endocrine hypofunction due to the absence or impaired development of the gland or the absence of an enzyme needed for hormone synthesis
Type 1
this type of diabetes mellitus is characterized by destruction of the pancreatic beta cells
Gestational
this type of diabetes mellitus refers to any degree of glucose intolerance that is first detected during pregnancy
thyroid
this type of hormones are bound o thyroxine binding globulin and other plasma proteins for transport in the blood
precocious
this type of sexual development may be idiopathic or may be caused by gonadal, adrenal, or hypothalamic disease
triglyceride
three fatty acids linked by a glycerol molecule
metabolism and protein
thyroid hormone has two major functions: it increases _______ and _____ synthesis and it is necessary for growth and development in children
insulin
type 1 diabetes mellitus always requires treatment with this and many people with type 2 require similar therapy
Glycogenolysis
when blood glucose levels fall below normal (as they do between meals) this process breaks down glycogen and glucose is released
acromegaly
when growth hormone excess occurs in adulthood or after the epiphyses of the long bones have fused, the condition is referred to as this
autocrine and paracrine
when hormones act locally rather than being secreted into the bloodstream, their actions are termed this
glucocorticoid
when produced as part of the stress response, this type of hormone aids in regulating the metabolic functions of the body and in controlling the inflammatory response
Epinephrine
This neurotransmitter can also act as a hormone
glycogen
glucose that is not needed for energy is removed from the blood and stored as this or converted to fat
casual; 200
A ____ plasma glucose concentration that is unequivocally elevated ( >200 mg/dL) is the presence of classic symptoms of diabetes such as polydipsia polyphagia polyuria and blurred vision, is a diagnostic of diabetes mellitus at any age
< 100 mg/dL; 140 mg/dL
A fasting glucose of ___ or a 2 hour oral glucose tolerance test result of ____ is normal
Hypopituitarism
Decreased secretion of pituitary hormones
Panhypopituitarism
Deficiency of all pituitary derived hormones
Autocrine
Hormones exert this action on the cells from which they were produced
high-affinity receptors
Hormones produce their effects through interaction with these, which in turn are linked to one or more effector systems within the cell
free; bound
Hormones that are released into the bloodstream circulate either as ____ molecules or as hormones ___ to transport carriers
Cretinism
Manifestations of untreated congential hypothyroidism
Addison disease
Primary adrenal insufficiency; caused by destruction of the adrenal gland
preventable mental retardation
congenital hypothyroidism is a common cause of this
metabolites or hormone levels
The easiest way to measure hormone levels during a specific period are y either blood samples or urine tests to measure this
Hypophysis
The hypothalamus and the pituitary
glycogenolysis and gluconeogenesis
The most dramatic effect of glucagon is its ability to initiate _____ and ____________
Master gland
The pituitary gland has been called this because its hormones control the functions of many target glands and cells
insulin
The secretion of growth hormone normally is inhibited by this and increased levels of blood glucose
hypothalamus
The synthesis and release of anterior pituitary hormones is regulated by the action of releasing or inhibiting hormones from this Also the coordinating center of the brain for endocrine, behavioral, and autonomic nerous system funciton
hypofunction and hyperfunction
The two categories of disturbances of endocrine function
metabolism
Thyroid hormone increease this of all body tissues except the retina, spleen, testes, and lungs
Urine samples are easily obtained
What is an advantage of measuring hormone levels through a urine sample as opposed to a blood sample?
Thyroid scan
What is an example of isotopic imaging?
Radioimmunoassay methods
What is used today to measure plasma hormone levels?
Paracrine
When hormones act locally on cells other than those that porduced the hormone, the action is called this
Bile and urine
Where adrenal and gonadal steroid hormones are excreted
obesity
a major factor in persons with the metabolic syndrome that leads to type 2 diabetes is this
hormone response element
activate or suppress intracellular mechanisms such as gene activity
secretagogues
agents that cause or stimulate secretion
obesity and physical inactivity
although the insulin resistance is seen in persons with type 2 diabetes cand be caused by _____ and _______
advanced glycation end products
are thought to produce structural defects in the basement membrane of the microcirculation and to contribute to eye, kidney, and vascular complications
Somogyi effect
cycle of insulin induced posthypoglycemic episodes
fatty acids; proteins
because ____ cannot be converted to glucose, the body must break down ________ and use the amino acids as a major substrate for gluconeogenesis during periods when metaboic needs exceed food intake
glucose transporter
because cell membranes are impermeable to glucose, they require this secial carrier to move glucose from the blood into the cell
brain
because this can neither synthesize nor store more than a few minutes' supply of glucose, normal cerebral function requires a continuous supply from the circulation
diabetic retinopathy
characterized by abnormal retinal vascular permeability, microaneurysm formation, neovascularizationand associated hemorrhage, scarring, and retinal detachment
hyperosmolar hyperglycemic
characterized by hyperglycemia (blood glucose over 600 mg/dL) hyperosmolarity (plasma osmolarity over 310 mOsm/L) and dehydration, the absence of ketoacidosis and depression of the sensorium
constitutional tall stature
describes a child who is taller than his or her peers and is growing at a velocity that is within the normal range for bone age
constitutional short stature
describes children (particularly boys) who have moderately short stature, thin build, delayed skeletal and sexual maturation, and the absence of other causes of decreased growth
ketoacidosis
diabetic ________ most commonly occurs in a person with type 1 diabetes in whom the lack of insulin leads to mobilization of fatty acids from adipose tissue because of the unsuppressed adipose cell lipase activity that breaks down triglycerides into fatty acids and glycerol
myxedema
dry skin and swelling around lips and nose as wel as mental retardation
goiter
increase in the size of the thyroid gland
Incretin effect
increase insulin release after an oral nutrient load
Dawn phenomenon
increased levels of fasting blood glucose without precursor hypoglycemia
macrovascuar disease
multiple risk factors for this inculd obesity, hypertension, hyperglycemia, hyperinsulinemia, hyperlipidemia, altered platelet function, endothelial dysfunction, systemic inflammation, and elevated fibrinogen levels, frequently found in people with diabetes
Glococorticoid
stimulate gluconeogenesis by the liver
cortisol
stimulates glucose production by the liver, promotes protein breakdown, and causes mobilization of fatty acids
thyrotoxicosis
the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormone
hypophyseal portal system
the hypophysis is a unit formed by the pituitary and hypothalamus. These two glands are connected by the blood flow in what system?
diabetic nephropathy
used to describe the combination of lesions that often occur concurrently in the diabetic kidney
idiopathic type 1B diabetes
used to describe those cases of beta cell destruction in which no evidence of autoimmunity is present
gigantism
growth hormone excess occurring before puberty and the fusion of the epiphyses of the long bones results in this
somatotropes
growth hormone secreting cells
overstimulation
long-term elevation of growth hormone results in ____ of the beta cells causing them to burn out
Glucagon
maintains blood glucose between meals and during periods of fasting
Hashimoto thyroiditis
Autoimmune disorder in which the thyroid gland may be totally destroyed
insulin-like growth factors
Growth hormone cannot directly produce bone growth; instead it acts indirectly by causing the liver to produce this
9, 4
Fat is most efficient form of fuel storage providing __ kcal/g of stored energy compared with the __ kcal/g provided by carbohydrates and proteins
Laron-type dwarfism
Growth hormone levels are normal or elevated, but there is a hereditary defect in insulinlike growth factor production
oxygen, metabolic
Many of the manifestations of hyperthyroidism are related to the increase in _________ consumption and use of _________ fuels associated with the hypermetabolic state, as well as to the increase in sympathetic nervous system activity that occurs
immunoassay
Measures of T3, T4, and thyroid-stimulating hormone have been made available through _____________ methods
Type 2
This type of diabetes mellitus is heterogeneous condition that describes the presence of hyperglycemia in association with relative insulin deficiency
PPAR-y
Nuclear receptor that leads to the regulation of genes controlling free fatty acids (FFA) levels and glucose metabolism
Lipid soluble
This type of hormone attaches to intracellular receptors and form a hormone-receptor complex that travels to the cell nucleus
Half life of a hormone
Time it takes for the body to reduce the concentration of the hormone by 1/2
hormones
The endocrine system uses these chemical substances as a means of regulating and integrating body functions
nervous system and the immune system
The functions of the endocrine system are closely linked with these two body systems
Negative feedback loop
The hormone levels in the body need to be kept within an appropriate range. How is this accomplished for many of the hormones in the body?
hormone receptors
The structure of this varies in a manner that allows target cells to respond to one hormone and not to others
diabetes
a disorder of carbohydrate, protein, and fat metabolism resulting rom an imbalance between insulin availability and insulin need
Ophythalmopathy
eyelid retraction, bulging eyes, light sensitivity, discomfort, double vision, vision loss
androgens and estrogens
hormones can be synthesized by both vesiclel mediated pathways and nonvesicle mediated pathways. What hormones are synthesized by nonvesicle-mediated pathways?
myxedema
implies the presence of a non-pitting mucus type edema caused by the accumulation of hydrophobic extracellular matrix substances in the connective tissues of a number of body tissues
gluconeogenesis
in addition to mobilizing its glycogen stores the liver synthesizes glucose from amino acids, glycerol, and lactic acid in this process
A growth horone suppresion test
in an adult with acromegaly, a growth hormone secreting tumor is suspected. What diagnostic test would be used for this client?
glycated hemoglobin
in uncontrolled diabetes or diabetes with hyperglycemia, there is an increase in the level of this in circulation
Adiponectin
increases tissue sensitivity to insulin
Somatostatin
inhibit the release of insulin and glucagon
Epinephrine
inhibits insulin release and promotes glycogenolyssis
insulin resistance
initially stimulates an increase in insulin secretion ,often to a level of modest hyperinsulinemia as the beta cells attempt to maintain a normal blood glucose level
second messenger
intracellular signal
thyroid storm
is manifested by a very high fever, extreme cardiovascuar effects, and severe CNS effects
GLUT-4
is the insulin dependent glucose transporter for skeletal muscle and adipse tissue