Endocrine System and Hypothyroidism Quiz
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Questions and Answers

Which of these is NOT a possible cause of hypothyroidism?

  • Surgery that affects the thyroid
  • Increased activity and exercise (correct)
  • Autoimmune disease
  • Overmedication for hyperthyroid disease
  • What is the effect of hypothyroidism on the cardiovascular system?

  • Increased heart rate
  • Increased blood pressure
  • Improved blood flow
  • Increased risk of heart attack (correct)
  • Which of these is NOT a musculoskeletal effect of hypothyroidism?

  • Increased bone density
  • Myalgia
  • Joint hypermobility (correct)
  • Proximal hip weakness
  • What is the typical pattern of thyroid hormone levels in hypothyroidism?

    <p>TSH elevated, T3 decreased, T4 decreased (C)</p> Signup and view all the answers

    How does hypothyroidism affect neurological function?

    <p>Slowed speech and decreased short-term memory (A)</p> Signup and view all the answers

    What is the primary treatment for hypothyroidism?

    <p>Synthetic thyroid hormones (C)</p> Signup and view all the answers

    What is the relationship between hypothyroidism and fibromyalgia syndrome (FMS)?

    <p>The link between hypothyroidism and FMS is not fully understood (A)</p> Signup and view all the answers

    What is the recommended approach to exercise for individuals with hypothyroidism?

    <p>Gentle and regular exercise (C)</p> Signup and view all the answers

    What is the primary mechanism by which hormones travel throughout the body?

    <p>Through the bloodstream (C)</p> Signup and view all the answers

    Which of the following is NOT a primary function of the endocrine system?

    <p>Regulation of blood pressure (B)</p> Signup and view all the answers

    The endocrine system plays a crucial role in the development of which of the following during fetal development?

    <p>The reproductive system and the central nervous system (D)</p> Signup and view all the answers

    Which of these is a major function of the endocrine system related to the internal body environment?

    <p>Maintenance of the internal environment (C)</p> Signup and view all the answers

    Which of the following glands is NOT part of the endocrine system?

    <p>Salivary gland (C)</p> Signup and view all the answers

    Which hormone, released by the pituitary gland, contributes to fluid retention by the kidneys?

    <p>Antidiuretic Hormone (ADH) (B)</p> Signup and view all the answers

    What is a common physiological response to stress that involves the release of catecholamines?

    <p>Elevated heart rate and blood pressure (C)</p> Signup and view all the answers

    What is the primary function of cortisol when released from the adrenal cortex during the stress response?

    <p>To regulate proteins, carbohydrates, and lipids to increase blood glucose (C)</p> Signup and view all the answers

    Which of the following is a common musculoskeletal manifestation of endocrine disorders?

    <p>Proximal muscle weakness without pain (D)</p> Signup and view all the answers

    Which of the following hormones is NOT secreted by the anterior lobe of the pituitary gland?

    <p>Antidiuretic hormone (ADH) (B)</p> Signup and view all the answers

    A patient presents with headaches, visual disturbances, and endocrine abnormalities. These symptoms are MOST indicative of what condition?

    <p>Pituitary tumor (adenoma) (D)</p> Signup and view all the answers

    What condition is a result of excessive growth hormone (HGH) secretion in adults?

    <p>Acromegaly (C)</p> Signup and view all the answers

    Which of the following is a characteristic sign of Cushing's disease due to excessive cortisol?

    <p>Moon face and abdominal striae (A)</p> Signup and view all the answers

    Which condition is characterized by symptoms including amenorrhea, gynecomastia, and decreased libido?

    <p>Excessive Prolactin (B)</p> Signup and view all the answers

    Why is early ambulation and exercise encouraged post-surgery for hyperpituitarism?

    <p>To reduce the risk of deep vein thrombosis and ileus (A)</p> Signup and view all the answers

    What is a significant cause of acquired hypopituitarism?

    <p>Destruction of the pituitary gland through surgery or radiation (A)</p> Signup and view all the answers

    A deficiency in growth hormone (HGH) in children can lead to which of the following conditions?

    <p>Delayed skeletal maturation and delayed puberty (C)</p> Signup and view all the answers

    Which of the following best describes the symptoms associated with hypopituitarism?

    <p>Muscle weakness, fatigue, and weight loss (C)</p> Signup and view all the answers

    If a child has a congenital growth hormone (HGH) deficiency, what is a typical physical manifestation?

    <p>Drop off the height growth curve by age 1-2 years (B)</p> Signup and view all the answers

    Which of the following is a medical treatment option for hyperpituitarism?

    <p>Surgery and radiation for benign tumors (A)</p> Signup and view all the answers

    What is a potential cause of secondary adrenal insufficiency?

    <p>Rapid taper of corticosteroids (A)</p> Signup and view all the answers

    Which of the following are symptoms commonly associated with Cushing Syndrome?

    <p>Thin skin (C), Increased hair growth (D)</p> Signup and view all the answers

    How does the body respond to increased temperature and humidity in a pool environment according to the content?

    <p>It requires more cortisol. (A)</p> Signup and view all the answers

    What is a treatment approach for secondary adrenal insufficiency?

    <p>Replacement of ACTH (A)</p> Signup and view all the answers

    Which adverse effect is NOT associated with corticosteroid treatment in Cushing Syndrome?

    <p>Decreased blood sugar levels (B)</p> Signup and view all the answers

    What is a common symptom associated with hyperthyroidism?

    <p>Heat intolerance (D)</p> Signup and view all the answers

    Which hormone is primarily deficient in diabetes insipidus?

    <p>Antidiuretic hormone (ADH) (D)</p> Signup and view all the answers

    Which physical therapy implication may be observed in a patient with hypopituitarism?

    <p>Extreme weakness (A)</p> Signup and view all the answers

    What condition is associated with increased secretion of ADH leading to water retention?

    <p>Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) (A)</p> Signup and view all the answers

    What is one of the main treatments for hyperthyroidism?

    <p>Radioactive iodine therapy (B)</p> Signup and view all the answers

    Which symptom would NOT typically be associated with gonadotropin deficiency in hypopituitarism?

    <p>Excessive body hair (D)</p> Signup and view all the answers

    What hormonal treatment is essential for patients with hypopituitarism?

    <p>Steroid hormone replacement (B)</p> Signup and view all the answers

    What is a potential complication of untreated SIADH?

    <p>Cerebral edema (C)</p> Signup and view all the answers

    Which of the following tests is NOT typically performed for hypopituitary disorders?

    <p>Ultrasound of the abdomen (C)</p> Signup and view all the answers

    What is a common effect of hyperthyroidism on physical performance?

    <p>Decreased muscle strength (C)</p> Signup and view all the answers

    What is the primary hormone deficiency observed in hypoparathyroidism?

    <p>Parathyroid hormone (B)</p> Signup and view all the answers

    Which electrolyte imbalance is primarily associated with hypoparathyroidism?

    <p>Hypocalcemia (C)</p> Signup and view all the answers

    Which of the following is a common diagnosis method for hypoparathyroidism?

    <p>Electrolyte evaluation (C)</p> Signup and view all the answers

    What is the most common cause of iatrogenic hypoparathyroidism?

    <p>Thyroidectomy (C)</p> Signup and view all the answers

    In Addison disease, which hormone is primarily deficient that leads to hypotension?

    <p>Aldosterone (A)</p> Signup and view all the answers

    What symptom may be observed due to adrenal insufficiency in Addison disease?

    <p>Emotional lability (C)</p> Signup and view all the answers

    Which of the following treatments is typically necessary for managing Addison disease?

    <p>Corticosteroids (D)</p> Signup and view all the answers

    What is a serious potential complication of untreated Addison disease?

    <p>Death from respiratory involvement (D)</p> Signup and view all the answers

    Which of the following effects is associated with the adrenal medulla's secretion of epinephrine?

    <p>Increased heart contractility (D)</p> Signup and view all the answers

    What is a common systemic effect of hypoparathyroidism related to the respiratory system?

    <p>Spasm of respiratory musculature (D)</p> Signup and view all the answers

    Flashcards

    Endocrine System

    A group of glands that produce and secrete hormones into the bloodstream. Hormones act as chemical messengers, affecting various bodily functions.

    Hormones

    Chemical messengers produced by glands in the endocrine system. They travel through the bloodstream to target organs and regulate their functions.

    Pituitary Gland

    A gland located in the brain that secretes hormones that control other glands in the endocrine system. Also plays a role in growth, metabolism, and reproduction.

    Parathyroid Glands

    Two small glands located near the thyroid that regulate calcium levels in the blood.

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    Adrenal Glands

    Two glands located on top of the kidneys that secrete hormones involved in stress response, blood pressure regulation, and metabolism.

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    Hypothyroidism

    A condition where the thyroid gland doesn't produce enough thyroid hormones which slows down metabolic processes.

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    Type I Hypothyroidism

    The thyroid gland is not able to produce enough hormones despite normal levels of TSH (thyroid stimulating hormone).

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    Type II Hypothyroidism

    The thyroid gland produces enough hormones, but the body cannot use them effectively. The pituitary gland does not generate enough TSH to stimulate the thyroid.

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    Slowed Digestion in Hypothyroidism

    A common symptom of Hypothyroidism is the slowing of the digestive system, which can lead to weight gain.

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    Proximal Hip Weakness in Hypothyroidism

    Weakness primarily in the muscles near the hips, which is a common symptom of Hypothyroidism.

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    Myalgia in Hypothyroidism

    Hypothyroidism can cause pain and tenderness in muscles.

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    Increased Bone Density in Hypothyroidism

    Hypothyroidism can increase bone density, making bones denser and heavier.

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    Carpal Tunnel Syndrome in Hypothyroidism

    Hypothyroidism can lead to inflammation and pain in the wrist, a common symptom.

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    Central adiposity

    Increased amount of fat around the organs in the abdomen.

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    Insulin resistance

    A condition where the body's cells don't respond properly to insulin, making it difficult for glucose to enter cells.

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    Hypopituitarism

    The body's inability to produce sufficient amounts of hormones from the pituitary gland.

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    Amenorrhea

    The lack of menstrual cycles, a common symptom in hypopituitarism due to gonadotropin deficiency.

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    Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

    A condition where the pituitary gland produces an excess of antidiuretic hormone (ADH), leading to increased water retention.

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    Thyroxine (T4)

    The thyroid gland secretes this hormone, which plays a key role in regulating the body's metabolism.

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    Graves Disease

    An autoimmune disease where the body attacks the thyroid gland, causing it to overproduce thyroid hormones.

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    Exophthalmos

    A symptom of hyperthyroidism, where the eyes protrude from the sockets.

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    Periarthritis

    A condition that may occur in hyperthyroidism, characterized by pain and decreased range of motion in tendons, ligaments, and joint capsules.

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    Antithyroid medication

    Medication that inhibits the synthesis of thyroid hormones, used to treat hyperthyroidism.

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    Body's response to heat/humidity

    The body's response to stress and heat, involving increased cortisol release to regulate blood pressure and cool the body down.

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    Secondary Adrenal Insufficiency

    A condition where the adrenal glands can't produce enough cortisol to regulate body temperature, often caused by tumors or steroid withdrawal.

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    Cushing Syndrome

    High levels of cortisol in the body, often caused by adrenal gland tumors or long-term steroid use.

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    Muscle breakdown in Cushing Syndrome

    Loss of muscle protein due to high cortisol levels, leading to various symptoms like stretch marks, thin skin, muscle weakness, and osteoporosis.

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    Corticosteroid Side Effects

    Potential side effects of corticosteroid treatment, including sleep disturbances, mood changes, gastrointestinal issues, and fluid retention.

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    Hypoparathyroidism

    A condition marked by low levels of parathyroid hormone, leading to hypocalcemia (low calcium in the blood), increased phosphate levels, tetany (muscle spasms), and decreased bone reabsorption.

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    Iatrogenic Hypoparathyroidism

    Accidental removal of parathyroid glands during thyroid or neck surgery.

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    CNS effects of Hypoparathyroidism

    Symptoms of Hypoparathyroidism affecting the central nervous system, characterized by irritability, anxiety, and agitation.

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    Musculoskeletal effects of Hypoparathyroidism

    Symptoms of Hypoparathyroidism affecting the musculoskeletal system, including increased osteoclast activity, tetany (muscle spasms), and spasms of respiratory muscles.

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    Cardiac effects of Hypoparathyroidism

    Symptoms of Hypoparathyroidism affecting the heart, often resulting in irregular heart rhythms (dysrhythmia).

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    Hypoparathyroidism Diagnosis

    A test to diagnose Hypoparathyroidism by measuring electrolyte levels (e.g., calcium, phosphate) and finding a decreased parathyroid hormone (PTH).

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    Emergency Treatment for Tetany

    Emergency treatment for Hypoparathyroidism involving immediate intravenous calcium administration.

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    Endocrine Dysfunction

    A condition where the endocrine system, which regulates growth and development, is not functioning properly. This can be due to either hyperfunction (overactivity) or hypofunction (underactivity) of the endocrine glands.

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    Hypoparathyroidism Treatment

    Long-term management of Hypoparathyroidism involving supplementation with vitamin D and medications to regulate calcium levels.

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    Adrenal Cortex

    The outer layer of the adrenal glands, responsible for producing hormones like aldosterone, cortisol, and androgens.

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    Neuroendocrine Response to Stress

    The body's response to stress involving the nervous system and the endocrine system working together.

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    Adrenal Medulla

    The inner layer of the adrenal glands, responsible for producing epinephrine (adrenaline) and norepinephrine.

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    Catecholamines

    Hormones released by the adrenal glands in response to stress. They include epinephrine, norepinephrine, and dopamine.

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    Cortisol

    A crucial steroid hormone produced by the adrenal cortex that plays a significant role in stress response. It helps regulate glucose levels, protein synthesis, and inflammation.

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    Anterior Lobe (Adenohypophysis)

    A section of the pituitary gland responsible for secreting various important hormones, including ACTH, TSH, LH, FSH, HGH, and prolactin. These hormones regulate various bodily functions.

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    Posterior Lobe (Neurohypophysis)

    A section of the pituitary gland responsible for storing and releasing ADH and oxytocin.

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    Pituitary Tumors (Adenomas)

    Abnormal growths in the pituitary gland. These tumors can cause headaches, vision problems, and hormone imbalances.

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    Acromegaly

    A condition caused by the overproduction of HGH, usually due to a benign tumor. It leads to excessive growth, particularly in the hands, feet, and face.

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    Cushing’s disease

    A condition caused by the overproduction of ACTH, often due to a tumor or exposure to glucocorticoids. It leads to a variety of symptoms including muscle wasting, obesity, and high blood glucose.

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    Prolactin Excess

    An overproduction of prolactin from the anterior pituitary gland. This can lead to various symptoms including amenorrhea, gynecomastia, lactation, decreased libido, and impotence.

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    HGH Deficiency

    A type of HYPOpituitarism involving a deficiency in HGH, leading to decreased growth, delayed puberty, and other issues.

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    LH/FSH Deficiency

    A type of HYPOpituitarism involving deficiencies in LH and FSH, leading to sexual and reproductive problems.

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    Study Notes

    Endocrine System Overview

    • Comprised of numerous glands that synthesize hormones
    • Hormones travel through bloodstream to target organs, affecting function
    • The endocrine system is responsible for:
      • Fetus development (reproductive system and CNS)
      • Growth and development (childhood/adolescence)
      • Reproductive system coordination
      • Maintaining internal environment
      • Responding to emergency situations

    Primary Function

    • Secretion of hormones

    Glands

    • Pituitary
    • Thyroid
    • Parathyroid
    • Adrenal
    • Pancreas
    • Pineal
    • Thymus
    • Ovaries/Testes

    Endocrine System Overview

    • A diagram displays the location of the major glands in the body.
    • The hypothalamus and pituitary gland are central to the endocrine system.

    Endocrine Glands: Secretion, Target, and Action

    • Information is presented in a table format outlining various glands, their hormones, and their targets, along with the basic actions of those hormones.

    Endocrine Dysfunction

    • Dysfunction causes alterations in the musculoskeletal system.
    • Results from hyperfunction or hypofunction.

    Neuroendocrine Response to Stress

    • Immune and endocrine systems are intimately related.
    • Stress increases activation of the sympathetic nervous system, triggering the adrenal glands to release catecholamines.
    • The pituitary gland releases ADH, prolactin, GH, and ACTH.

    Neuroendocrine Response to Stress(exercise, emotional stress, changes in body temperature)

    • Cortisol, released from the adrenal cortex, regulates proteins, carbohydrates, and lipids to increase blood glucose.
    • Inhibits fibroblast proliferation (poor wound healing, increased infection risk).
    • Helps with the fight or flight response.
    • Reduces inflammation.

    Pituitary Gland

    • Master gland
    • Anterior lobe (Adenohypophysis): Secretes ACTH, TSH, LH, FSH, HGH, Prolactin
    • Posterior lobe (Neurohypophysis): Stores ADH and oxytocin

    Pituitary Tumors (Adenomas)

    • Signs/symptoms include headaches, increased ICP, decreased drainage from the 3rd ventricle.
    • Visual disturbances: optic chiasm, bilateral temporal hemianopsia.
    • Endocrine abnormalities (can be present)

    Anterior Pituitary Gland Disorders

    • HGH → acromegaly (adults): Excessive growth (often benign tumor):
      • Overgrowth of long bones
      • Hypertrophy of soft tissues
      • Widened joint spaces (children can grow to >7ft)
      • Increased jaw bone, hand/foot size in adults
    • ACTH → Cushing's disease: Symptoms include muscle wasting, osteopenia, moon face, easy bruising, abdominal striae, acne, 5:1 women to men, childbearing years, obesity, glucose intolerance.

    Prolactin

    • High prolactin levels can result in amenorrhea, gynecomastia, lactation, decreased libido, and impotence in both men and women.

    HYPERpituitarism Medical/Surgical Treatment

    • Benign tumors: surgery and/or radiation.
    • Medications to decrease or stunt hormone production.

    HYPERpituitarism Physical Therapy Implications

    • Ambulation/exercise encouraged 24 hrs post-op.
    • Monitor for changes in consciousness/vision, pulse, blood pressure (indicative of increased ICP—report).
    • Observe for meningitis symptoms (headache, irritability, neck rigidity).

    HYPOPituitarism

    • Diminished secretion (>70%) by the anterior lobe.
    • Etiology: congenital, surgery/medication/radiation, postpartum hemorrhage, anorexia, anemia, or GI dysfunction.
    • Gradual onset of symptoms and signs.

    HYPOPituitarism (cont.)

    • HGH→decreased growth and delayed puberty
    • Impaired cartilage, skeletal bone and muscle growth
    • Skin has affected fatty production for energy
    • LH (Luteinizing Hormone)/FSH→sexual/reproductive disorders.

    HYPOPituitarism – Signs and Symptoms

    • Fatigue, muscle weakness, weight loss, poor appetite, joint stiffness, low blood pressure, headaches, erectile dysfunction, irregular menstruation, delayed growth in children.

    Congenital HGH Deficiency

    • Normal birth length
    • Height curve drops by 1-2 years of age
    • Normal intelligence, obesity, delayed skeletal maturation, delayed puberty, and shortness.
    • HGH replacement therapy (daily or during growth periods)

    Acquired HGH Deficiency

    • Tumor or treatment for tumor
    • ? increased cardiac disease
    • Central adiposity
    • Insulin resistance
    • Poor lipid profile

    HYPOPituitary Disease: Gonadotropin deficiency

    • Amenorrhea, breast atrophy, testicular atrophy, diminished libido, minimal pubic/axillary hair, hypothermia, hypotension, and hypoglycemia.

    HYPOPituitary Disorders: Tests & Measures

    • Blood work (cortisol, prolactin, thyroxine TSH, testosterone, estrogen, LH/FSH, HGH)
    • MRI of hypothalamus/pituitary
    • Radiographs of hands in children

    HYPOPituitary Disease Medical Treatment

    • Removal of causative factor (surgical tumor removal)
    • Lifelong hormone replacement therapy
      • Steroids (replace adrenal hormones)
      • Synthroid (correct TSH loss)
      • Sex hormones
      • Growth hormones

    HYPOPituitarism – Implications for Physical Therapy

    • May observe weakness, fatigue, lethargy, apathy, and orthostatic hypotension.
    • Prevent infections.
    • Impaired vision (bilateral hemianopia) possible

    Posterior Pituitary Lobe Disorders

    • Diabetes Insipidus: Rare; caused by damage to hypothalamus or posterior pituitary.
      • Antidiuretic hormone (ADH) deficiency → kidneys don't reabsorb enough water.
      • Copious diluted urine (dehydration, dizziness, fatigue, polydipsia, etc.)
      • Treatment: ADH replacement.
    • Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): Increased ADH secretion→ increased water retention (hyponatremia).
      • Signs: lethargy, weakness, coma
      • Treatment: Correct sodium balance (surgery/chemo/radiation if tumor), restrict fluid intake, diuretics.

    Thyroid Gland

    • Located inferior to larynx
    • Secretes thyroxine (T4) and triiodothyronine (T3), calcitonin
    • Regulates basal metabolism, enhances fat, promotes growth and development; regulates electrolyte, protein exchange

    Thyroid Disorders

    • More prevalent in women 4:1
    • Affect many body systems (nails, hair, eyes, GI tract, lungs, heart, nervous tissue, bones, muscles)

    HYPERthyroidism

    • Graves Disease: Autoimmune disease.
      • Enlargement of thyroid and increased secretion.
    • Accounts for 85% of hyperthyroidism cases.
      • Typically between 20-40 years old; predominantly women (4:1).
      • Can occur during pregnancy.
    • Symptoms (Hyperthyroidism): Increased thyroid size (goiter), heat intolerance, weight loss, sweating, tremor, tachycardia, irritability, poor concentration, diarrhea, mood swings, exophthalmos (eye protrusion)
    • Diagnosis: Decreased/normal TSH, elevated T3/T4, increased radioactive iodine uptake
    • Treatment: Medication to inhibit synthesis, radioactive iodine (RAI) treatment (followed by thyroid medication), surgery.
    • Hyperthyroidism and Exercise: Associated with exercise intolerance and reduced capacity; proximal muscle weakness. Graves disease muscle weakness/myopathy.
      • Can worsen existing heart conditions, leading to atrial fibrillation and worsening angina pectoris, and increasing risk of myocardial infarction.
    • MS Signs and Symptoms (Hyperthyroidism): Periarthritis (tendons, ligaments, joint capsule, ROM, pain), Calcification in joints (limited ROM "hard end feel"), proximal muscle weakness, and decreased coordination

    HYPOthyroidism

    • Decreased thyroid hormones → slow metabolism
    • Causes: Autoimmune (Hashimoto's thyroiditis), surgery affecting thyroid, overmedication for hyperthyroidism, diet, congenital
    • More prevalent in women (30-60 years)
    • Type I (hormone deficient): Caused by loss of thyroid tissue
    • Type II (hormone resistant): Result from pituitary gland failure to produce adequate TSH
    • Pathology: Thyroid tissue destruction → decreased thyroid hormone secretion → increased TSH secretion from anterior pituitary.
    • Symptoms (Hypothyroidism): Slowed metabolism (decreased GI tract mobility, weight gain), bradycardia, slowed neurological functioning (slow speech, decreased short-term memory, headache, cerebellar ataxia, mood changes), increased cholesterol/triglycerides, anemia.
    • Musculoskeletal Effects (Hypothyroidism): Proximal hip weakness, myalgia, stiffness in small joints, paresthesia without objective findings, joint edema, increased bone density, carpal tunnel
    • Diagnosis: Elevated TSH, normal/low T3/T4, elevated CPK-MB
    • Treatment: Synthetic thyroid hormones (Synthroid)
    • Prognosis: Untreated hypothyroidism can lead to severe CAD, increased triglycerides/cholesterol.
    • Hypothyroidism and Physical Therapy: Correlation with fibromyalgia syndrome (FMS) continues investigation. Thyroid dysfunction commonly seen with rheumatoid arthritis in women. Increased activity/exercise helpful for constipation secondary slowed metabolism/decreased peristalsis.

    Thyroid Cancer

    • Rare, usually slow-growing
    • More prevalent in women (20-60 years old).
    • Risk factors include low iodine, radiation exposure.
    • Types: Papillary carcinoma (develops in one lobe and spreads to lymph nodes), Follicular carcinoma (spreads to lungs and bones).
    • Treatment: Surgery, radioactive iodine, chemotherapy, radiation

    Parathyroid Glands

    • Two glands on each lobe of thyroid.
    • Secrete parathyroid hormone (PTH) to manage calcium levels.
      • If blood calcium levels are low, PTH causes the bones to release calcium and/or increase calcium absorption from the GI tract.

    HYPERparathyroidism

    • Too much PTH is produced, causing hypercalcemia (high calcium levels).
    • Causes: Benign tumor in the glands (most common).
    • Symptoms (mild hypercalcemia): Thirst, frequent urination, HTN, heartburn, mental confusion, kidney stones, and joint pain
    • Secondary HYPERparathyroidism: Caused by low blood calcium levels, stimulating parathyroid glands to produce more PTH; often low vitamin D or kidney disease.
    • Diagnosis: PTH measurement, electrolyte measurement, X-ray of bones.
    • Treatment: Parathyroidectomy, IV hydration to lower calcium levels.
    • Physical Therapy Implications: Early ambulation is essential as weight-bearing speeds up recalcification of bones. Use of light ankle weights or light weight-resistance can accomplish similar results.

    HYPOparathyroidism

    • Decreased secretion of parathyroid hormone (PTH) results in hypocalcemia (low calcium levels).
    • Increased phosphate, tetany (muscle spasms), reduced bone reabsorption.
    • Causes: Iatrogenic (most common); accidental removal during surgery (especially thyroidectomy or neck surgery), hypovolemia, infarction of parathyroid, scar tissue, tumor, or low vitamin D.
    • Symptoms: Irritable, anxiety, agitation, increased osteoclast activity, spasms (esp. resp. muscle), and dysrhythmias.
    • Diagnosis: Electrolyte evaluation, decreased PTH
    • Treatment: Emergency IV calcium; Vitamin D supplementation, airway management, medications
    • Late results: Potential for cataracts, basal ganglia calcification, and respiratory issues, potentially leading to death.

    Adrenal Gland

    • Located above each kidney
    • Outer cortex:
      • Mineralocorticoids (Aldosterone): regulates blood pressure by managing sodium and potassium.
        • Reabsorption of sodium
        • Excretion of potassium
      • Glucocorticoids (Cortisol): metabolism, responses to stress, and reduces inflammation.
      • Androgens (sex hormones) (testosterone, estrogen, progesterone)
    • Inner medulla: Catecholamines (Epinephrine):
      • Increased heart rate
      • Increased heart contractility
      • Increased blood pressure through vasoconstriction
      • Increased blood glucose

    Adrenal Insufficiency

    • Primary Adrenal Insufficiency (Addison's Disease): Insufficient corticosteroid production.

      • Causes: TB complication, autoimmune, radiation, neoplasm, or infections
      • Risk factors: Surgery, pregnancy, trauma, infections
      • Pathogenesis: Drop in production of aldosterone, poor coordination etc. and of cortisol
        • Hypoglycemia: weakness, hypotension, nausea, emotional lability, paranoia
        • Increased skin pigmintation on extensor surfaces
      • Diagnosis: Cortisol levels
      • Treatment: Corticosteroids
      • Prognosis: Untreated → fatal
      • **Physical Therapy Implications: **Aquatic therapy may be contraindicated; heat/humidity increases cortisol need.
    • **Secondary Adrenal Insufficiency: **Causes: tumors, rapid tapering of corticosteroids, symptoms: arthralgia, myalgia, tendon calcification; treatment: replacement ACTH, manage fluid/electrolyte balance

    Cushing Syndrome

    • High levels of cortisol.
    • Causes: Adrenal gland tumor, high-dose steroid treatments.
    • Effects: Loss of amino acids (protein) → stretch marks, decreased wound healing, thin skin, muscle weakness, osteoporosis, fractures, Cushingoid face, increased weight, hair growth, buffalo hump
    • **Physical Therapy Implications: **Adverse effects from corticosteroid treatment (sleep/mood changes, GI irritation, hyperglycemia, fluid retention).

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    This quiz tests your knowledge on hypothyroidism and the endocrine system. It covers key concepts including causes, effects on the cardiovascular and musculoskeletal systems, and treatment options. Assess your understanding of hormone functions and the role of the endocrine system during fetal development.

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