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