Hormones _____ and _____ are water soluable
Peptides (small proteins),
Catecholamines (dopamine, epinephrine, norepinephrine)
Which catecholamines are water soluble?
Dopamine,
epinephrine,
norepinephrine
These hormones travel freely in solution in the plasma, some are partially protein-bound
Water soluble hormones
These hormones are unable to cross the plasma membrane to enter cells and must exert actions by binding to receptors located on the surface of target cell membranes
Water-soluble hormones
____ and _____ hormones are lipid soluble hormones
Triiodothyronine (T3),
Thyroxine (T4)
Examples of water soluble peptides
Angiotensin II, Glucagon, Oxytocin, Insulin, Parathyroid Hormone, FSH, Growth hormone, LH, Prolactin, TSH
These hormones bind outside of the cell. Once bound they cause a second messenger to become active within the cell.
Water soluble hormones
These hormones are carried inside the cell as their receptors are within the cytoplasm. A combination of protein binding and fat solubility allows entry to the cell.
Lipid soluble hormones
A _____ feedback loop is a mechanism for maintaining hormone activity within a normal range or set point of normal activity
Negative
Physiologic hormone concentrations are _____ in most cases
Low
Pharmacological hormone concentrations are _____ than normal
Greater
When cells are exposed to high concentrations of hormone for a prolonged period, a common result is decreased number of receptors. This is called?
Down-regulation
An increase in the number of receptors in response to chronically low hormone concentrations is called ?
Up-regulation
When hormones increase the number of receptors for other hormones, and enhancing the effect of the second hormone it is called?
Permissiveness
_____ allows cellular events to occur in sequence
Permissiveness
______ work against or block
Antagonists
_____ with with or binds
Agonist
Medications that mimic hormone activity and are frequently given as hormone replacement therapy are _____
Agonists
_____ compete with epinephrine and norepinephrine for receptor sites are used to block cardiac stimulatory properties and decrease cardiac workload
Antagonists
GH targets which organ?
Muscle,
Adipose,
Liver
ACTH targets which organ?
Adrenal cortex
TSH targets which organ?
Thyroid
LH and FSH target which organs?
Gonads
Testosterone in the testes for me,
Estrogen,progesterone in ovaries for women
Prolactin targets which organ?
Breasts
What are the hormones of the anterior-pituitary gland
GH, ACTH, TSH, LH, FSH, Prolactin
The _______ regulates endocrine function of the anterior pituitary gland
Hypothalamus
What are the hormones of the posterior pituitary gland?
Oxytocin,
ADH
Oxytocin targets which organ?
Breasts,
Uterus
ADH targets which organ?
Kidneys,
Liver
Lactotropes secrete ____
Prolactin
Gonadotropins secrete ______
FSH,
LH
Thyrotropes release ____
TSH
Corticotrophes produce ______
ACTH
____% of the circulating thyroid hormone is T4 and ____% is T3
90,
10
______ is released in response to increased serum osmolality and decreased blood pressure
Anti-diuretic hormone
What are the neurocrine hormones?
Oxytocin,
ADH
Idiopathic = ?
Unknown
Neoplastic = ?
Tumor
Iatrogenic = ?
Unintentional side effect
What are the side effects to decreased thyroid hormone?
Weakness, lethargy, cold intolerance, bradycardia, decreased metabolic rate
What is the treatment for decreased thyroid hormone (hypothyroidism)?
Oral levothyroxine
What are the side effects for increased thyroid hormone (hyperthyroidism)?
Heat intolerance, elevated temperature, tachycardia, rhythm abnormalities, restlessness, confusion
What is the treatment for increased thyroid hormone (hyperthyroidism)?
Beta blockers,
Radioactive iodine
_____ disease is a result of decreased cortisol
Addison
What are the early signs of Addison disease?
Anorexia, Weight loss, Weakness, Malaise, Apathy
_____ syndrome is a result of too much cortisol
Cushing
What are the manifestations of Cushing syndrome?
Moon face, Truncal obesity, Thin skin, Impaired wound healing, Dorsocervical fat pad (buffalo hump)
______ may lead to decreased potassium
Hyperaldosteronism
Excess Catecholamine results in ??
Headache,
Tachycardia,
Diaphoresis
Excess of growth hormone in adults is called ______
Acromegaly
Excess of growth hormone in children is called ______
Gigantism
Manifestations of hyperparathyroidism and hypoparathyroidism are related to excessive amounts of serum ______
Calcium
Endocrine diseases characterized as hyper esponsive or clinically similar to hyposecretion of hormones but are due to _______ ______
Tissue resistance
In primary hypothyroidism, the circulating level of thyroid stimulating hormone will be _______
Increased
Are unique feature of graves disease is protrusion of the eyeballs, called ________
Exophthalmos
In adrenocortical deficiency, the most severe manifestations are related to in adequate quantities of the hormone ______
Cortisol
Water soluble hormones produced there a fact by binding to cell membrane receptors that produces these within the cell?
Secondary messengers
Chemical signals secreted by want to sell that affected adjacent cell
Paracrine
Hormones synthesized here travel via nerve axons to the posterior pituitary gland for release
Hypothalamus
Lipid soluble hormones, like thyroid hormone, must be attached to these to be transported in the blood
Proteins
Farm onset are look at soluble and are derived from cholesterol are known as ______
Steroids
Cortisol is an example of a hormone who’s release Gary’s over 24 hour period, called a ______ pattern
Circadian
This circulating thyroid hormone must be converted to its active form to be biologically active
T4
Releasing hormones from the hypothalamus stimulates hormone secretion from the _______
Anterior pituitary
The primary mechanism by which most hormone levels in the blood are controlled is ________
Negative feedback
Drugs that block dopamine activity are likely to increase the secretions of_____
Prolactin
Which hormones are expected to raise blood glucose
Growth hormone,
cortisol,
epinephrine
What is the enzyme that synthesizes thyroid hormones
Thyroid peroxidase
The primary negative feedback for the release of corticotropin releasing hormones is _____
Cortisol
The portal vein transports releasing factors from the hypothalamus to the _______
Anterior pituitary
Diabetes insipidus is characterized by ______
Hypernatremia
Hypothyroidism manifestations include ____
Non-Pitting edema
A patient with hyperparathyroidism would be likely to present with _____
Kidney stones
Potential life-threatening finding in hypoparathyroidism is ______
Laryngospasm
What kind of hormone is cortisol, the body’s primary glucocorticoid
Catabolic
Findings associated with primary adrenal insufficiency/Addison disease include ______
Hypovolemia
Aldosterone promotes reabsorption of sodium and water as well as excretion of potassium by the kidneys. What other hormone also produces these effects?
Glucocorticoid hormone
Pheochromocytoma is rare, life-threatening disease characterized by _____
Profound hypotension
Conn syndrome is characterized by _____
Primary excess of aldosterone
A sign of diabetic nephropathy is _____
Microalbuminuria
Diabetes mellitus is diagnosed when to fasting blood glucose samples are found to be greater than or equal to _____ mg/dL
126
Exercise for a patient with type two diabetes room may result in decreased ____
Insulin resistance
______ is a major concern when hyperglycemia is severe as a result of diabetes complications in children
Dehydration
Parathyroid glands secrete ______ hormones
Parathyroid
_______ glands/hormones have a role in monitoring and managing serum calcium levels
Parathyroid
Decreased levels of parathyroid hormone are typically related to _____
Surgery
Excess amounts of parathyroid home on result in ?
Hypercalcemia, kidney stones, bone demineralization, osteoporosis, pathologic fractures
The ______ secretes Antidiuretic hormone
Posterior pituitary
The _______ is a role in fluid regulation of blood concentration (osmolality)
Posterior pituitary
Insufficient amounts of antidiuretic hormone result in ?
Diabetes insipidus,
dilute urine,
fluid deficit,
serum hyperosmolality
Lexus antidiuretic hormone results in?
Water retention, concentrated urine, weakness, muscle cramps, fatigue, lethargy
What is the treatment for insufficient antidiuretic hormone?
Vasopressin and free access to fluids
What is the treatment for excess amounts of antidiuretic hormone?
Water restriction
ADH decreases _____
Urine flow
Signs and symptoms of diabetes insipidus
Decreased specific gravity, decrease osmolarity, hypovolemia, increased thirst, tachycardia, decreased blood pressure
What is the nursing care for diabetes insipidus
Monitor fluids, replace fluids, neuro status, vital signs, mucous membranes
What are the signs and symptoms of hypothyroidism
Hair loss, lethargy, dry skin, muscle aches and weakness, constipation, intolerance to cold, receding hairline, facial and eyelid edema, brittle nails and hair
Signs and symptoms of hyperthyroidism
Intolerance to heat, fine straight hair, irritability increased, goiter, tachycardia, increased blood pressure, weight loss, increased diarrhea, bulging eyes
What are the three S’s of the adrenal gland hormones
Sugar (glucocorticoids),
salt (mineralocorticoids),
sex (androgens)
What is the blood sugar mnemonic
Hot + dry = sugar high,
cold + clammy = need some candy
What does the TIRED mnemonic related to hypoglycemia
Tachycardia Irritable Restless Excessive hunger Diaphoresis depression..
What are the increased risks for those with diabetes mellitus
Heart disease, end-stage renal failure, blindness, amputation, pregnancy complications
Those with diabetes mellitus have _____ extracellular fluid than within cells
More
_____ is the sympathetic response to hypoglycemia
Glucagon
_____ adds glucose to blood
Glucagon
________ helps glucose leave the body
Insulin
Macrosomia=______
Big baby
With which type of diabetes is diabetic ketoacidosis (no insulin) present
Type 1
Non-ketotic hyperglycemic hyperosmolar syndrome
Some insulin is present metobolic acidosis