Endocrine Terminology Flashcards

Cortisol
Terms Definitions
toxic/o
poison
Repaglinide
Prandin

Meglitinide
ACTH
Adrenocorticotropoic Hormone
Propylthiouracil
PTU

Hyperthyroid Agent
STIMULATE GH
Sleepexercisephysiologic stressfasting/hypoglycemiasex steroidsAlpha-agonists (Norepinephrine)Beta-blockers
Phospholipase C mechansim
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Myxedema
-severe adult hypothyriodism
-Symptoms: enlarged tongue, puffiness of hands and feet
acquired hypertriglyceridemia
diabetes mellitus
obesity
alcohol
beta-blockers
estrogen
resins
retinoids
adenitis
inflammation of a gland
Regulation of GH secretion
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amines are synthesized from
tyrosine
Hypoglycemia
-abnormally low blood sugar
Pramlintide
Symlin

Amylin analog - Diabetes
causes of hypoglycemia
exogenous insuli
insulinoma
EtOH ingestion
Post op complication of gastric surgery
reactive hypoglycemia
liver failure
Apoprotein A-1
Function: Activate LCAT; ABCA-1.Production site: Intestine; LiverLipoprotein location: HDLGets pushed of and cleared by kidney when triglycerides get too high. Loss of A-1 Makes HDL unable to participate in reverse cholesterol transfer
Prolactin (PRL)


Anterior Pituitary hormone regulated by Hypothalamic release of Dopamine (-) inhibitory.
Target Organ: Breast.
Act through JAK/STAT receptors.
siburtamine
sympathomimetic serotonin and norep reuptake inhibitor
Do neurosecretory cells synthesize hormones?
No
Myxedema Coma
Severe, end-stage hypothyroidism
-Tx: maintain airways, meds, corticosteroids (for suppressed adrenal gland), correct BG and electrolyte levels, conserver body heat
hypo/hyper causes..levels of binding proteins
normal
Melanocyte-Stimulating Hormone (MSH)
-From Anterior Pituitary
-Melanotropin
-Targets melanocytes
-stimulates melanocytes to secrete and deposit melanin
antimicrosomal and antithyroglobulin antibodies
Hashimoto thyroiditis
glucose-6-phosphatase
enzyme in glycolysis pathways
found only in hepatic cells and allows them to unphosphorylate glucose which allows glucose into circulation.
Parathryroid hormone
Gland- Parathyroid glandTarget Organ- osteoclastsAction- increase bone break down
Dawn phenomenon
similar early morning hyperglycemia but due to waning of basal insulin effect
pseudopseudohypoparathyroidism
With paternal transmission of a mutated GNAS1 gene, Albright's hereditary osteodystrophy occurs without hypocalcemia, since the normal maternal allele results in the maintenance of renal responsiveness to PTH
thyrotomy
surger perfomed on the thyroid gland
The zona glomerulosa cells constitute 5% of the adrenal and they exclusively synthesize..
Aldosterone
The hormone that stimulates milk production in the mammary gland is:
prolactin
Non-tropic hormones
3- hGH, melanocyte- stimulating hormone, PRL
peptide/protein hormone synthesis
often start as preprohormones
cleaved to prohormone in rough ER and packaged by golgi
cleaved to active hormone
SIADH symptoms
Dilutional hyponatremia
↑ urine Na & urine osmolarity
thyroid major protein molecule
thyroid binding globulin
Antidiuretic Hormone (ADH)
-From Posterior Pituitary
-Targets kidneys
-increases the reabsorption of water in the nephrons
-decreases urine volume
What is ADH also known as?
Vasopressin
What are the mineralocorticoid drugs?
corticosterone
fludrocortisone
Hydrophilic hormone examples
pepties, catecholamines, includes storage, released as active form
glucocorticoid insufficiency
secondary - ACTH is insufficient

primary - adrenal is damaged. all hormones are reduced. includes addison's
GI problems, MSH increase along with ACTH, anorexia, weight loss, nausea, vomiting, diarrhea. reduced cardiac contractility and sodim losses lead to low bp. inability to excrete water.

90% of adrenal cortex needs to be non-functional for clincal syptoms
Pioglitazone
Rosiglitazone
MOA: increase target cell response to insulin
 
Use: monotherapy in T2DM or combined with above agents
 
AEs: weight gain, edema, hepatotoxicity
ACTH adenomas
Are often microadenomas; most appear basophilic with H&E stain. Cause Cushings disease. Diagnostic tests include elevated ACTH, dexamethasone suppression test, ACTH elevation with metyrapone (which blocks cortisol synthesis), and MRI.
Calcium sensing receptor
Activates PLC, PLD, PLA2 Stimulation of PLC leads to activation of PKC and ITP, which releases intracellular calcium CSR is found in parathyroid, renal tubules, bone, GI and c-cells Cell membrane G protein receptor (intra, extra and cell membrane domains Calcium binds to the extracellular domain
BP control in DM
300) use an ARB.
How many amino acids make up Prolactin?
What is the critical cell specific factor that activates PRL gene transcription?
Is PRL secreted in bursts that increase in frequency and amplitude with sleep? 
199.
Pit-1
Yes 
Amine hormones are derived from?
TyrosineThyroid, epi, norep 
Examples of thymic hormones
ThymosinThymic humoral factor (THF)Thymic factorThymopoietin
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ADH secretion by osmolarity & ECF volume
DKA Treatment
-Normalize BG (regulare insulin given IV)
-Replace fluids
-Replace Potassium (unless hyperkalemia or no urine output)
usual first sign of DM in children
infection
Parathyroid Hormone (PTH)
-from the parathyroids
-target bone, kidney, digestive tract
-promote breakdown of bone to increase blood calcium
-promote retention and absorption of calcium in kidneys and digestive tract
What are the normal values for epinephrine?
100
Diagnosis of hyperparathyroidism?
Diagnostic workup for hypercalcemia often includes testing the PTH levels. Ultrasound of the neck area may reveal enlarged glands. Occasionally, scintigraphy with MIBI is necessary to identify adenomas or hyperplastic parathyroids.
pituitary adenomas
- most common cause of hyperpituitarism
- can be functional or nonfunctional
- adults
- 35-60 yo
- soft, well circumscribed lesion
- histologically cells look homogenous
- up to 30% have no capsule and become an invasive adenoma and invade into local structures.
Type I Pseudohypoaldosteronism
hypotension
high renin, angiotensin II and aldosterone
hyperkalemia
catecholamine synthesis
tyrosine (tyrosine hydroxylase - rate limiting) -> DOPA -> dopamine -> NE (glucocorticoid stimulated PNMT) -> epi
glycogen
must be solubilized (3 g water/g glycogen)
4 kcal/g
normal human ~ 80g in liver, 400g in muscle
neurohypophysis description?
small posterior part of pituitary connected to the brain.
Tiny but complex portion of the brain, which is attached to the pituitary by means of the infundibular (hypophyseal) stalk
Hypothalamus
Magnesium deficiency
impairs PTH secretion and PTH action leading to hypocalcemia, Malabsorption, chronic alcoholism, and cisplatintherapy are currently the most common causes of hypomagnesemia
Pheochromocytoma
a tumor of chromaffin cells of the adrenal medullaa. remember 10%: this describes the number of pheos that are malignant, extra-adrenal, part of multiple endocrine neoplasia syndromes, bilateral, and pediatric.
insulin
one of two hormones produced in the pancreas
What is the preferred treatment for IHA?
medical management.
Thymus
A bilobed organ where T cells develop immunocompetence
amino acid derivatives
EPI, NE, DA, T3, T4
derived from tyrosine - thyroid hormones 2 rings; catecholamines 1 ring
(3) signs of gh excess
Overgrowth of tissue
Peripheral neuropathy
Glucose intolerance
Water soluble hormones dissolved in plasma & transported to target tissue via the interstitial space 2
peptide and catecholamines
What indication would make the nurse suspect damage to the laryngeal nerve?
Voice changes
Once treatment has begun, what should the urine look like?
more dilute
pt with weakness, polyuria, polydipsia, lethargy, confusion, convulsions, and coma
hyperosmolar nonketotid coma (HONK)
what does inositol triphosphate do?
decreases release of PTH
TCF7L2
genetic loci with the largest risk of T2DM
gestational diabetes mellitus
caused by metabolic stress of pregnancy causes diabetes in women with an inherent predisposition for diabetes
hyperglycemia results in macrosomia (increased fetal size) and perinatal morbidity
adrenocorticotropic hormone
a polypeptide hormone, produced by the anterior lobe of the pituitary gland, that stimulates the cortex of adrenal glands.
 
Hyperthyroid patients are treated with
Propylthiouracil (PTU), which inhibits the peroxidase enzyme, thereby decreasing thryroid hormone synthesis at oxidation
Primary adrenal insufficiency
– Defect in adrenal gland– Dx: ↓cortisol ↑ ACTH– Treat: glucocorticoids, mineralcorticoids, ± androgens
Clinical Presentation of Cushings disease or syndrome
Caused by elevated glucocorticoids a. hypertensionb. truncal obesity and “moon facies”, buffalo humpc. proximal muscular weakness and atrophy of Type II fibersd. thin skin, capillary fragility, loss of collagene. osteoporosis, often with compressed vertebral fracturesf. hyperpigmentation (if Cushing disease)g. acne, hirsutism, amenorrheah. glucose intolerance (diabetes)i. immune suppressionj. mental status changes, depression
Endocrine Drugs
What are the three major functions they can have?

Replacement Therapy
Antagonists to treat conditions caused by excess production of hormones.
Diagnostic tools for identifying endocrine abnormalities. 
distinguish Addison's from secondary cause
Addison's has hyperpigmentation from MSH from excess ACTH production from POMC
Long: superior hypophysial arteries form capillary network in median eminence (1 capillary plexuses) converge & form it. travel down infundibulum to deliver venous blood to anterior lobe.
Short hypothalamic hypophysial portal blood vessel
treatment for thyroid storm
esmolol IV propranalol, .5 mg increments
hydration
cooling
propylthiouracil
250-500 mg/hr q6 IV or by NG
followed by sodium iodide, I IV/12 hrs
cortisol 100mg q 8 to prevent associated adrenal suppresion
inside the thyroid, iodide is oxidized back to iodine which is bound to
amino acid tyrosine
Trousseau's sign =
occlude brachial artery and get carpal spasm (sign of hypocalcemia)
What is the source of thyroid hormones?
Thyroid follicular cells
Will a pt. with Cushings disease gain or lose wt.?
gain wt
hypoglycemia, high immunoreactivity, insulin, and suppressed plasma C peptide
--> pathognomonic of exogenous insulin administration
Main causes of hyperthyroidism are:
1. Graves disease
2. toxic multinodular goiter
3. functioning thyroid adenoma
palmar and tubo-eruptive xanthomas
occur with remnant accumulation in remnant removal disease
what does vasopressin do?
An antidiuretic with stimulated the reabsorption of fluids at kidney. Also causes vasoconstrition and elevated BP
What does the parenchyma of medulla secrete?
Epinephrine and nor-epinephrine
Somatostatin has what effect on hormone release from the ant. pituitary
Inhibits GH and TSH Release
TESTS FOR GROWTH HORMONE SECRETION
• Basal levels:– GH, IGF-1, IGFBP-3• Stimulated:– Arginine– Insulin– GHRH– Estrogen/beta-blockers; L-DOPA• Suppression:– OGTT
what are the cardinal manifestations of hyperprolactinemia in young adult women?
Inappropriate lactation, together with oligomenorrhea (irregular menses) or amenorrhea (absent menses).
What is the first stage of mitosis?
PROPHASE, metaphas, anaphase, telophase.
Special Considerations for HRT
-May takes weeks to feel better
-Take medications daily
-Tx can speed up body functions causing problems for pts with:
*Corinary Artery Disease
*DM
*Adrenal insufficiency
GH causes growth only when
There is adequate insulin
There is adequate CHO in the diet
17-a-hydroxylase deficiency manifests with:
Low cortisol, low sex hormones, high aldosterone! --> HTN, hypokalemia, phenotypically female but no maturation
Who is more at risk of developing hyperparathyroidism?
Women between 60-70
What is the primary function of mineralocorticoids (aldosterone)?
regulation of sodium balance
what is myxedema coma and how to treat?
long-standing hypothyroidism, untreated. cold exposure/trauma/infxn/CNS depressants --> hypothermia, stupor --> CO2 retention --> respiratory depression --> fatal. tx with very high T3 and T4
Surgery for Cushing's Disease
- usually highly effective, but give low doses of glucocorticoids
How does hypocalcemia manifest itself in sheep and goats?
Mild hyperexcitability in early stages, tetany (stiffness in legs), flaccid paralysis (weak and recumbent)
Zona reticularis physical description
between zona fasciulata and medulla,. They are polyhedral cells, some darker some lighter
What are the parafollicular cells? What is their function?
Cells within the thyroid gland follicles. Also known as C-cells. Synthesize and secrete calcitonin, an inhibitor of bone resorption.
Following a precipitous delivery with substantial blood loss from a placenta previa, a 24-year-old primigravida is in stable condition. However, she is unable to breastfeed the baby. Then, over the next few months she notes a failure to return to normal
post-partum pituitary necrosis led to the loss of pituitary hormones and hypogonadism, hypothyroidism, and finally secondary adrenal insufficiency. e
What is the mechanism by which glucocorticoids mediate lipid metabolism chronic effect (Central fataccumulation with chronic excess of cortisol)?
Uncertain, associated with increased insulin levels which may interactwith cortisol to increase lipogenesis at central sites.
which tissues don't need insulin to take up Glu?
Brain and RBCshave GLUT1 trasporter 
inhibition of gluconeogenesis leads to
↓ amount & activity of liver enzymes
↓ release of amino acids from muscle & other tissues
unlike MH, thyroid storm is not associated with
acidosis, muscle rigidity, elevated CK
What is the major action of Luteinizing hormone LH?
Female: stimulates development of corpus luteum, release of oocyte, production of estrogen and progesterone.
Male: stimulates secretion of testosterone, development of interstitial tissue of testes.
What can be done to manage SIADH?
Eliminate underlying cause, restrict fluid intake, Furosemide (Lasix) - if hyponatremia is present
The parathyroid gland chief cell Ca receptor has 2 signal transducers... what are they?
1. inositol triphosphate --> reduces PTH release
2. cAMP --> increases PTH release
What would a C-cell tumor do to calcium in a bull?
Hypocalcemia d/t increased calcitonin
what does chromophobe cells do?
believe to be inactive form of chromophile cells
What is the order of activation for Vit D? Which form is an accurate predictor of calcium storage?
Synthesized from 7 dehydro-cholesterol and sunlight in skin; 25 hydorxylation in live; 1 hydroxylation in kidney (active form)
 
25(OH) D
what are the signs of ACTH deficiency?
Common symptoms are fatigue, muscle weakness, anorexia and weight loss. Hyponatremia and hypoglycemia may be present, but severe dehydration and hyperkalemia do not occur.
What does "Coupling" refer to during the process of thyroid hormone formation?
“Coupling” refers to a still mysterious process in which TG folds upon itself allowing iodo-tyrosines in its N- and C-regions to come in contact, transferring the iodo-phenyl group of one tyrosine to the phenyl ring of another iodo-tyrosine within TG.
What is the strict definition of hormones?
\"Chemical messengers that travel in the bloodstream\"
why are hyperth pts prone to an exagerated response to induction
because they are chronically vasodilated and hypovolemic
What are some interventions for hyperpituitarism?
Parlodel: reduces tumor size, but can cause hypotension
Hypophysectomy: removal of anterior pituitary to decrease hormone levels.
What signs could the family watch for to notify the dr. that the dose of hormone is to low?
wt. loss , postural hypotension
What does the thyroid do?
The function of the thyroid is to regulate the body's metabolism by making thyroid hormone.
what happens when you lose cortisol?
- catecholamines do not exert their normal vasoconstrictive effects
- inability to readily mobilize energy sources.
what does pars intermedia do?
not sure, but may be involved with melanocyte stimulating hormone
What is his yearly risk of developing diabetes if you have prediabetes
Patients with prediabetes have a vastly increased risk of progressing to type 2 diabetes---5-10% per year
What are some of the drugs that induce aldosterone deficiency or resistance states w/Hyperkalemia?

Inhibition of synthesis/secretion of A (↓PA; ↑PRA)    ACE inhibitors/Ang II receptor blockers    CyclosporineSuppression of renin release (↓PA; ↑PRA)     β-blockers    Cyclooxygenase inhibitors (NSAIDs)Interference with renal actions of A (↑PA; ↑PRA)- MR blockers    Spironolactone     Eplerenone - ENaC blockers    Amiloride     Triamterene
Uterus progesterone down regulates it own receptors & receptors for estrogen (menstration).
Thyroid: T3 decreases senstivity for TRH receptors in anterior pit. High T3 decreases overall response hypothalamus, pitutary and thyroid axis.
What is up-regulation and how does it occur?
What do mineral corticoids do?
They have an effect on F & E balance, specifically aldosterone (controlled by the RAAS system and controls fluid volume)
When is measurment of TSH levels indicated in the elderly?
When pts. have unexplained physical or mental deterioration
What is the function of the parathyroid.
The sole purpose of the parathyroid glands are to regulate the calcium level in our bodies within a very narrow range so that the nervous and muscular systems can function properly.
what is the equation for calculating the LDLs from TGs?
LDL = TC – (TG/5 + HDL)
Which glucose transporter acts as a sensor? Which cells express this transporter?
The liver and beta cells’ GLUT2 has a low affinity for glucose, allowing those tissues to sense and respond to graded levels of serum glucose.
Pituitary dwarfishm. Failure to grow, short tature, mild obesity, delayed puberty. Caused by hypothalamic dysfxn so decrease GHRH, lack of anterior pit GH, Can't generate IGF in liver & GH receptor deficiency/defect.
GH excess in adults causes what and what are the symptoms?
Who is at higher risk of developing Graves' disease?
Women, usually between the second and fourth decades
What are the 2 principal cell types
1) Dark cheif cells 2) light chief cells
If angina is detected in a patient, what is the nurses first action?
Must report finding and treat at once to avoid a fatal myocardial infarction, thyroid hormone administration must be discontinues immediately
What is different in T3 and T4?
T 4 is weak, T3 is 5x stronger than T4.
what to do first if you have pt with solitary nonfunctioning thyroid nodule?
TSH --> if nl TSH, then U/S, then FNA for cytology
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