Alterations in the Endocrine System
Hypothyroidism
decreased thyroid hormone elevated tsh fatigue diminished deep tendon reflexes
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
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
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
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
The pineal gland is responsible for regulating the sleep-wake cycle. 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
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
