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Endocrine asses/dia
endocrine assess/diagnostic eval
| Question | Answer |
|---|---|
| 1. What is the function of the endocrine system? | * closely linked w/ nervous & immune system; * exerts control by releasing (chemical substances) hormones into the blood |
| 2. What do hormones do? | affect other endocrine glands or body systems |
| 3. What is the difference between exocrine and endocrine glands | exocrine – (outside) into organs and sweet glands ** endocrine (Inside ) the blood (in circulation to affect other body tissues and systems) |
| 4. Growth and development | |
| 5. Metabolism of energy | thyroid |
| 6. Adipose tissue distribution | |
| 7. Sexual development | progesterone/ testosterone / LH / prolactin |
| 8. Fluid and electrolyte balance | |
| 9. Inflammation and immune responses | |
| 10. What glands make up the endocrine system? | pituitary ; thyroid; parathyroid; adrenal; pancreatic islets; ovaries;; testes |
| 11. 4 categories of hormones | 1- amines and amino acid 2- peptides (protein) act on cell surface 3- steroids – act inside cell 4- fatty acid derivatives |
| 12. Hypothalamus – releasing hormones | (CRH) corticotropin releasing hormone (TRH) thyrotrophic RH ( GHRH) Growth Hormone RH- (GnRH) Gonadotropin RH ((controls the release of pituitary hormone)) |
| 13. Hypothalamus inhibiting hormone | somatostatin – ((inhibits growth hormone and thyroid- stimulating hormone)) |
| 14. Anterior pituitary – releases what hormones | GH- growth hormone; ACTH- adrenocorticotropic hormone; TSH- thyroid stimulating hormone ; FSH follicle stimulating hormone ; LH luteinizing hormone ; prolactin |
| 15. GH – growth hormone | (Anterior Pituitary) stimulates growth of muscle/bone; promotes protein synthesis and fat metabolism. Decreases carbohydrate metabolism |
| 16. ACTH- Adrenocorticotropic hormone | (Anterior Pituitary)stimulates synthesis /secretion adrenal cortical hormones |
| 17. TSH- thyroid stimulating hormone | (Anterior Pituitary)stimulates synthesis /secretion of thyroid hormone |
| 18. FSH- follicle stimulating hormone | (Anterior Pituitary)female: ovarian follicle ; ovulation Male: sperm production |
| 19. LH- luteinizing hormone- | (Anterior Pituitary) Female: corpus luteum, release oocyte; estrogen/ progesterone |
| 20. Prolactin | (Anterior Pituitary) preps female breast for feeding |
| 21. Posterior pituitary release what hormones? | ADH – antidiuretic hormone ; Oxytocin |
| 22. ADH- Antidiuretic hormone | (Posterior Pituitary ) increase water reabsorption by kidney |
| 23. Oxytocin- | (posterior Pituitary ) uterine contractions; milk ejection after birth |
| 24. Hormones released by adrenal cortex? | Mineral corticosteroids (aldosterone); glucocorticosteriods (cortisol) ; adrenal androgens (dehydrpepiandrosterone) DHEA) and andresetedeione |
| 25. Function of Mineral corticosteroids (aldosterone); | increase sodium absorption, potassium loss by kidney |
| 26. Function of glucocorticosteriods (cortisol); | affect metabolism of all nutrients; regulates blood glucose levels. Affects growth, anti-inflammatory action; decrease effects of stress |
| 27. Function of adrenal androgens (dehydrpepiandrosterone) DHEA) and andresetedeione | minimal intrinsic androgenic activity; they are converted to testosterone and dihydrotestosterone in the periphery |
| 28. Hormones released by the adrenal medulla | epinephrine; norepinephrine |
| 29. Function of epinephrine and norepinephrine | neurotransmitters for the sympathetic nervous system (SNS) |
| 30. Hormones released by thyroid (follicular cells) | thyroid hormones (T3- triidothyronine) (T4- thyroxin) |
| 31. Function of thyroid hormones (T3- triidothyronine) (T4- thyroxin) | increase metabolic rate; increase protein and bone turnover; increase responsiveness to catecholamine’s; necessary for fetal growth and development |
| 32. Hormones released by thyroid C cells | Calcitonin |
| 33. Function of calcitonin | (thyroid C cells) lowers blood calcium and phosphate levels |
| 34. Parathyroid glands | parathormone (PTH, parathyroid hormone) regulates serum level |
| 35. Pancreatic Islet cells | Insulin; glucagon ; somatostatin |
| 36. Function of insulin | lowers blood glucose by facilitating blood glucose transport across cell membranes of muscle, liver, and adipose tissue |
| 37. Function of glucagon | increase blood glucose concentration by stimulation of glycogenolysis and glyconeogenesis |
| 38. Function of somatostatin | delays intestinal absorption of glucose |
| 39. Hormones released by kidneys | 1,25 dihydroxyvitamin D; renin; erythropoietin; |
| 40. Function of 1,25 dihydroxyvitamin D | stimulate calcium absorption from intestine |
| 41. Function of renin | activates renin-angiotensin- aldosterone system |
| 42. Function of erythropoietin | increase red blood cell production |
| 43. Hormones released by ovaries | estrogen; progesterone |
| 44. Function of estrogen | development of fetal sex organs; secondary sex characteristic |
| 45. Function of progesterone | menstrual cycle; stimulates growth of uterine wall; maintains pregnancy |
| 46. Hormones released by testes | androgens; (main testosterone) |
| 47. Function of androgens (testosterone) | development of male sex organs – secondary sex characteristics; aid in sperm production |
| 48. Hormones are produced by what type of glands | endocrine glands which have no ducts; they do have a rich blood supply |
| 49. Hormones are responsible for what | maintenance of optimal internal environment; corrective/adaptive responses in crisis |
| 50. Where are most endocrine hormones released? | most are released into the bloodstream, some require a protein carrier |
| 51. neurons release some hormones into the blood stream- | Epinephrine – is one such hormone released by neurons |
| 52. where does the hypothalamus release its hormones? | directly to cells in the posterior pituitary by nerve cell extension |
| 53. health history – family hx | any family members first generation mother, father, siblings, children |
| 54. health hx- energy level – fatigued; easily tire; when did symptoms first appear; duration of symptoms | |
| 55. health hx- tolerance to heat cold- | temp changes and tolerance to changes can reflect certain disorders |
| 56. health hx change in thirst appetite, urination | polyphagia (eating too much) , polydipsia (excessive thirst) , polyuria(excessive urination) , oliguria (no urination) |
| 57. health hx- weight changes | increase or decrease in fluid retention |
| 58. health hx- secondary sexual characteristics | |
| 59. health hx- sexual dysfunction | decreased libido |
| 60. health hx- memory concentration | |
| 61. health hx- sleep pattern | |
| 62. health hx- Physical assessment | |
| 63. physical assessment – vital signs | |
| 64. physical assessment –visual head – to –toe | |
| 65. physical assessment –tactile exam | |
| 66. physical assessment –changes in physical characteristics | Cushing’s (moon face, buffalo hump, facial hair on females) Addison’s (bronze skin) Hyperthyroid ( bulging eyes - xeothalmus ) |
| 67. physical assessment –alterations in skin texture | |
| 68. physical assessment –blood pressure | |
| 69. physical assessment –behavioral changes | extreme changes in behavior can be indicative of a hormonal imbalance |
| 70. what is the natural response of the negative feedback system | try’s to suppress the production of the hormone |
| 71. diagnostic tests- blood test | general test and / or specific to suspected diagnoses- usually a CBC w/ diff |
| 72. diagnostic tests- urine tests- | including 24 hour urine- checks for electrolytes ; hormones can be excreted through the urine |
| 73. diagnostic tests- stimulation and suppression tests | |
| 74. Diagnostic tests- radioimmunoassay: RIA | special type of invitro procedure –combines the use of radio chemicals and antibodies to measure the levels of hormones, vitamins, drugs in pts. /. Blood |
| 75. diagnostic tests- CT scans; | |
| 76. diagnostic tests- MRI | |
| 77. diagnostic tests- PET | |
| 78. diagnostic tests- DEXA | bone density scan- for bone structure |
| 79. Thyroid Diagnostic test: TSH | |
| 80. Thyroid Diagnostic test: serum free T4 | |
| 81. Thyroid Diagnostic test: T3 and T4 | |
| 82. Thyroid Diagnostic test: T4 resin uptake | |
| 83. Thyroid Diagnostic test: Thyroid antibodies | |
| 84. Thyroid Diagnostic test :Radioactive iodine uptake | |
| 85. Thyroid Diagnostic test: fine needle biopsy | |
| 86. Thyroid Diagnostic test: Thyroid scan ; radio scan; scintscan | |
| 87. Thyroid Diagnostic test: serum thyroglobulin | |
| 88. Hypothalamus | master gland extension of the pituitary, controls the release of pituitary hormones ; CHR (corticotropin), THR Thyrotrophic, GHRH (growth hormone) GnRH ( gonadotropin ) |
| 89. Pituitary | 1 cm in diameter (size of pea); In sella turcica (depression in sphenoid bone) connected to hypothalamus by slender stalk |
| 90. Location of pituitary in relation to optic chiasm | Blurred vision |
| 91. Posterior pituitary (neurohypophysis)- | extension of hypothalamus; stores /releases 2 hormones Produced in hypothalamus (ADH/ Oxytocin) ; controlled by nerve stimulation; |
| 92. Posterior pituitary (neurohypophysis)- ADH | ADH – anti diuretic hormone (vasopressin) – inhibits urine production by kidney; reabsorbs water& returns to the bloodstream (controls “pee” ) |
| 93. Posterior pituitary (neurohypophysis)- oxytocin (Pitocin) | stimulates urine contraction in pregnancy;, milk ejection from breast after childbirth |
| 94. Anterior pituitary (adenohypophysis) | controlled by releasing hormones of hypothalamus GH; ACTH; TSH; FSH; LH; MSH; PRL |
| 95. Anterior pituitary (adenohypophysis) GH | growth hormone (somatotropin) |
| 96. Anterior pituitary (adenohypophysis) ACTH | adrenocorticotropic |
| 97. Anterior pituitary (adenohypophysis) LH | luteinizing hormone |
| 98. Anterior pituitary (adenohypophysis) MSH | melanocyte stimulating hormone (melanin in skin, appetite, sleep cycles, sexual function |
| 99. Anterior pituitary (adenohypophysis) PRL | prolactin (lactogenic hormone) |
| 100. What causes hyper function of the anterior pituitary | usually caused by benign tumor (adenoma) or hyperplasia (too cells or cells that have grown too big) |
| 101. What is the effect of excessive adrenocorticotropic hormone? | Cushing’s syndrome |
| 102. What is the effect of excessive growth hormone (after the epiphyseal plate “growth plate” closes) and who does it affect | Acromegaly – occurs only in adult hood |
| 103. What is the effect of excessive growth hormone (before the epiphyseal plate “growth plate” closes) and who does it affect | Gigantism – occurs only in childhood |
| 104. What can result is Cushing’s syndrome | *- long term steroid therapy *Cancer malignancy (ectopic production) – tumors of the pituitary /adrenal cortex *- over production of ATCH |
| 105. Cushing’s disease (manifestations/classic signs) | * fatty “buffalo hump” in neck; * Moon faced appearance; * thin fragile kin; * weakness, sleep disturbance; * kyphosis, backache* |
| 106. Cushing’s has a higher prevalence for which category | women 20-40 yrs. of age\ |
| 107. What is Hirsutism- | presentation of masculine traits in women (facial hair) |
| 108. Cushing’s disease diagnostic test | is very time precise |
| 109. Cushing’s disease diagnostic test overnight dexamethasone suppression test | given orally –specific time with blood draw at specific time |
| 110. Cushing’s disease diagnostic test overnight dexamethasone suppression test results | increase in serum sodium and blood gas; decrease in serum potassium, reduction in eosinophil’s; disappearance of lymphoid tissue; 24 hour urinary free cortisol level; CT; MRI,US |
| 111. Cushing’s syndrome treatment | depends on the cause |
| 112. Cushing’s syndrome treatment pituitary tumor | transphenoidal hypphysectomy ; radiation |
| 113. Cushing’s syndrome treatment adrenal cortex | adrenalectomy ; replacement therapy to tx symptoms of adrenal insufficiency |
| 114. Cushing’s syndrome treatment corticosteroid medications | reduce or taper to the minimum dosage( DO NOT STOP STEROIDS ABRUPTLY ) |
| 115. Cushing syndrome nursing interventions: | decrease risk of injury; decrease risk of infection; prep for surgery ( insulin “decreased Blood glucose” Tx peptic ulcers “) encourage rest, activity; promote skin integrity (thin /fragile) education |
| 48. Hormones are produced by what type of glands | endocrine glands which have no ducts; they do have a rich blood supply |
| • Acromegaly | bone and connective tissues continue to grow; in adults only ; caused by the release of too much GFH; congenital dysfunction |
| • Physical characteristics of acromegaly | enlarged forehead. Lengthened maxilla, enlarged tongue, deep voice, large hands and feet |
| • Physiological characteristics of acromegaly | peripheral nerve damage, headache, HTN, CHF, seizures, visual disturbances, diabetes |
| • Hyperpituitarisim occurs when | only in adults- extremities |
| • Anterior pituitary under secretion | ACTH adrenocortical insufficiency (can be caused by tumors) |
| • Growth hormone before epiphyseal plate closes is known as | Dwarfism- (normal body parts- just small) |
| • Anterior Pituitary Under secretion caused by: | congenital dysfunction, tumors, surgical removal of pituitary glands, radiation, pituitary infarction, infection or trauma |
| • Hypopituitarism | Not enough (or none) hormone, can be anterior/posterior or both (panhypopituitarism) |
| • Simmonds’s disease | RARE- total absence of all pituitary secretions- very rare- non-secreting pituitary tumor |
| • Sheehan’s syndrome | postpartum pituitary necrosis: severe blood loss & hypotension; DIC (disseminated intravascular coagulation) |
| • Hypopituitarism can result from | disease of gland itself; disease of hypothalamus; radiation to head and neck; trauma, tumor or vascular lesion ((brain tumors- health tissue being destroyed) |
| • Pituitary tumors are generally | benign |
| • What is the biggest complication for tx of pituitary tumors | location is the problem (located in the sela turcia of the sphenoid bone- entry is generally through the nasal cavity) |
| • Problems in relation to location of the pituitary gland can manifest other complications such as | @ visual disturbances, visual fields color, diplopia |
| • Diagnostic test for pituitary includes | CT. MRI, pituitary hormone levels |
| • How are pituitary removed | thru trans-spheroidal approach (nasal) and stereotactic radiation therapy |
| • Medication for pituitary tumors | used to improve clinical condition |
| • Medication for pituitary tumors- bromocriptine meslylate (parlodel)- | amenorrhea, infertility , hypogonadism, Parkinson’s & acromegaly |
| • Medication for pituitary tumors – octreotide (sandostatin) | inhibits growth hormone; second line drug when no response to surgery of parlodel |
| • Medication for pituitary tumors cabergoline (dostinex) | hyperprolactinemia |
| • Medication for pituitary tumors pegvisomant (somavert) | analog of human growth hormone block of endogenous GH from cell receptors |
| • Pituitary tumors | several approaches to surgical removal of pituitary glands (no menstruation / replacement therapy needed) |
| • How does surgical removal of pituitary gland affect acromegaly? | they are unaffected by surgical removal of the tumor |
Created by:
Kyn269
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