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Ch. 25 Patho

Ch. 25 Endocrine Disorders

What are the two categories of endocrine problems? An excessive amount of hormones and a defecit of a hormone.
What can cause an excess amount of hormones? Tumor produces high levels, Excretion by liver or kidney is impaired, and a congenital condition produces excess hormone
What can cause a defecit of a hormone? Tumor produces too little hormone, Inadequate tissue receptors present, Antagonistic hormone production is increased, Malnutrition, Atrophy, surgical removal of gland, and congenital defects
Diagnostic used for Endocrine Disorders Blood tests, Urine tests, Stimulation or Suppression tests, Scans, Ultrasounds, and MRI's.
Treatment for a hormone defecit is? Replacement Therapy
Treatment for an excess amount of a hormone is? Medications, Surgery, and Radiation
Diabetes Mellitus basic problem is? Inadequate insulin effects in receptor tissues.
Diabetes Mellitus is caused by? Deficit of insulin secretion, Production of insulin antagonists
Diabetes results in? Abnormal carbohydrate, protein, and fat metabolism.
Type 1 Diabetes is caused by? An autoimmune destruction of beta cells in pancreas.
Type 1 Diabetes is found more commonly in? Children and Adolescents
Treatment for Type 1 Diabetes requires? Insulin replacement
Type 1 Diabetes is? Insulin Dependent Diabetes Mellitus
Type 2 Diabetes is? Non Insulin Dependent Diabetes Mellitus
Type 2 Diabetes is caused by? A decrease effectiveness of insulin, a relative defecit of insulin, decrease insulin production from beta cells, increased resistance to insulin and increased production of glucose
Type 2 Diabetes is found more commonly in? Elders, and obese people.
Treatment for Type 2 Diabetes requires? Oral hypoglycemic medication
General Manifestations of Diabetes include Polyphagia, Polydipsia, Polyuria, Glucosuria, and Hyperglycemia
Insulin defecit results in? Decreased transportation and use of glucose in many cells of the body
Polyuria An abnormally large volume of urine excreted
Polydipsia Dehydration
Polyphagia Increased appetite from a lack of nutrients that enter the cells and stimulate your appetite
Diabetes Diagnostic Tests include? Fasting blood glucose levels, glucose tolerance tests, Glycosylated hemoglobin test
The most important way to treat Diabetes is? To maintain normal blood glucose levels in order to minimize the complications
The three ways to control blood glucose are? Diet and excersize, Oral medication, and insulin replacement
Diet and Excersize results in? Reduced blood glucose as skeletal muscles use glucose
Oral Medication results in? Increase insulin secretion, and reduced blood glucose levels
Insulin replacement results in? Increased amount of insulin that meets the required amount the body needs
The metabolic changes of Type 1 Diabetes are? Catabolism of fats and proteins, Ketonuria, and decompensated metabolic acidosis
Catabolism of fats and proteins causes? Excessive amounts of fatty acids and metabolites, and ketones in the blood
Ketonuria causes? Decreased serum bicarbonate; decrease in pH of body fluids
Complications of Diabetes are related to? The duration and extent of abnormal blood glucose levels
The factors lead to fluctuations in serum glucose levels are? Variations in diet and alcohol use, change in physical activit, infection and vomitting
Acute complications include? Hypoglycemia, Diabetic Ketoacidosis, and Hyperglycemic Hyperosmolar Non-Ketotic coma
Hypoglycemia is? Insuling Shock
Hypoglycemia is more common with? Insulin replacement therapy
Hypoglycemia occurs when? There is an excess amount of insulin in circulation
Hypoglycemia can be caused by? A glucose defecit in the blood, strenuous excersize, a dosage error, vomitting, and skipping a meal after taking insulin
Signs and Symptoms for Hypoglycemia include? Disorientation and change in behavior May appear impaired Anxiety or decreased responsiveness Decreased blood glucose Decreased BP, increased heart rate Decreasing level of consciousness
Diabetic Ketoacidosis results from? An insufficient amount of insulin the blood which leads to high blood glucose levels and mobilization of lipids
Diabetic Ketoacidosis is more commonly found in? Insulin-Dependent clients
Diabetic Ketoacidosis can be caused by? Infection or stress, an error in dosage, infection, change in diet, alcohol intake, or exercise
Signs and Symptoms for Diabetic Ketoacidosis include? Dehyrdration Metabolic Acidosis Electrolyte Imbalances Rapid - Deep respirations Acetone breath ( sweet and fruity)
Dehydration Thirst, dry, rough oral mucosa Warm, dry skin
Rapid, deep respiration – acetone breath Lethargy and decreased respoviness
Metabolic acidosis May lead to a loss of consciousness
Electrolyte Imbalances Abdominal cramps, nausea, vomiting; lethargy, weakness
Hyperglycemic Hyperosmolar Non-Ketotic Coma (HHNC) results in? Severe dehydration and electrolyte imbalances
HHNC is more commonly found in? Type 2 diabetics and elders
Signs and Symptoms for HHNC include? Hyperglycemia, Severe Dehydration, and Electrolyte Imbalances
Electrolyte imbalances result in? Neurologic deficits Muscle weakness Difficulties with speech Abnormal reflexes
Chronic complications include? Vascular problems, Microangiopathy, Macroangiopathy, Peripheral neuropathy, Infections, Cataracts, and Pregnancy
Vascular problems inlcude? Increased risk of atherosclerosis, and changes in small and large arteries
Microangiopathy Changes in microcirculation due to an obstruction or rupture of small capillaries and arteries
Microangiopathy leads to? Tissue necrosis and loss of function Neuropathy and loss of sensation Retinopathy – leading cause of blindness Chronic renal failure – degeneration in glomeruli of kidney
Macroangiopathy Affects large arteries
Macroangiopathy leads to? High incidence of heart attacks, strokes, peripheral vascular disease May result in ulcers on feet and legs – slow healing Frequent infections and gangrenous ulcers Amputation may be necessary.
Peripheral neuropathy is? Common complication due to ischemia in microcirculation to peripheral nerves
Peripheral neuropathy leads to? Impaired sensation, numbness, tingling, weakness, muscle wasting
Infections include Infections in feet and legs due to vascular and neurologic impairment Fungal infections Urinary tract infections Dental caries Gingivitis and periodontitis
Ways to control type 2 diabetes are? Diet containing an increased amount of fiber and a reduction of lipids and simple carbohydrates Regular exercise to reduce glucose levels Reduce insulin resistance by reducing BMI to normal range. Monitoring blood glucose levels
Ways to control type 2 diabetes are? Medications to stimulate the beta cells Proper administration of insulin Routine Follow up
Hypoparathyroidism is caused by? Tumor Congenital lack of parathyroid Surgery or radiation in neck region Autoimmune disease
Hypoparathyroidism leads to? Hypocalcemia
Hypocalcemia causes? Weak cardiac muscle contractions Increased excitability of nerves Spontaneous contractions of skeletal muscle
Hyperparathyroidism is caused by? Tumor Secondary to renal failure Paraneoplastic syndrome
Hyperparathyroidism leads to? Hypercalcemia
Hypercalcemia causes? Forceful cardiac contractions Osteoporosis Predisposition to kidney stones
What is the most common cause for pituitary disorders? Benign Adenomas
The two different effects are? The effect of the mass The effect on hormone secretion
The effect of the mass may cause? Pressure in the skull causing Headaches, seizures, drowsiness, visual deficits
The effect on hormone secretion may cause? An excessive or decreased release of hormones
Dwarfism Deficit in growth hormone production/release
Gigantism Excess GH prior to puberty and fusion of epiphysis
Acromegaly Excess GH secretion in adults Often associated with adenoma Bones become broader and heavier
Diabetes Insipidus Defecit of ADH and may orignate in the neurohypophysis
Inappropriate ADH syndrome Excess ADH and may be temporary
Diabetes Insipidus results from? Head injury or surgery Possible genetic problem
What kind of treatment is required for Diabetes Insipidus? Replacement Therapy
Inappropriate ADH syndrome results from? Stress Ecess secretion from a tumor
What kind of treatment is required for Inappropriate ADH syndrome? Diuretics and Sodium supplements
Thyroid disorders include Goiter, Hyperthyroidism and Hypothyroidism
Goiter Enlargement of thyroid gland
What are the three different types of goiters? Endemic goiter, Goitrogens and Toxic goiters
Endemic Goiter Hypothyroid condition in regions with low iodine levels in soil and food
Goitrogens Foods that contain elements to block synthesis of T3 and T4
Toxic Goiters Results from hyperactivity of thyroid gland
Hyperthyroidism is? Graves Disease and is related to an autoimmune factor
Signs and Symptoms for hyperthroidism are? Hypermetabolism Increased body temperature Sweating Soft silky hair and skin Reduced BMI Insomnia Hyperactivity Toxic Goiter Exophthalmos
Exophtalmos is? Presence of protruding, staring eyes, decreased blink and eye movement Result of increased tissue mass in the orbit May result in visual impairment
Different types of hypothyroidism include? Hashimoto thyroiditis Myxedema Cretinism
Cretinism Results in short stature and severe cognitive deficits Untreated congenital hypothyroidism May be related to iodine deficiency during pregnancy
Signs and Symptoms for Hypothyroidism are? Intolerance to cold Increased BMI Lethargy and fatigue Decreased appetite Myxedema in severe untreated hypothyroidism
Myxedema Non-pitting edema in face, thickened tongue
Myexedema Coma Results in hypotension, hypoglycemia, hypothermia and is life threatening
An Adrenal Medulla disorder is? Pheochromocytoma
Pheochromocytoma is? A benign tumor of the adrenal medulla that secretes epinephrine, norepinephrine, and possibly other substances
Signs of pheochromocytoma are? Headache, heart palpations, sweating, intermittent or constant anxiety
An Adrenal Cortex disorder is? Cushings Syndrome and Addisons Disease
Cushings syndrome is caused by? An excessive level of glucocorticoids
An excessive level of glucocorticoids results from? Adrenal adenoma Pituitary adenoma Ectopic carcinoma Iatrogenic conditions Substance abuse
What changes occur with cushings syndrome? Round face with ruddy color Truncal obesity with fat pad between scapulae Thin limbs Thin hair Fragile skin
Cushings Syndrome causes? Retention of sodium and water Suppression of the immune response Stimulation of erythrocyte production Emotional lability and euphoria Increased catabolism of bone and protein Delayed healing Increased insulin resistance
Addisons Disease is? A deficiency of adrenocorticoid secretions from an autoimmune reaction causing the gland to be destroyed by hemmorage or infection
Signs and Symptoms for Addisons Disease include? Decreased blood glucose levels Inadequate stress response Fatigue Weight loss; frequent infections Low serum sodium concentration
Created by: cdanella