Endocrine System Overview Quiz
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Questions and Answers

Which of the following statements accurately describes the relationship between insulin and cortisol in regulating glucose metabolism?

  • Insulin and cortisol are both primarily responsible for stimulating glucose production in the liver.
  • Insulin and cortisol work synergistically to increase glucose levels in the blood.
  • Both insulin and cortisol primarily target the liver to regulate glucose metabolism.
  • Insulin promotes glucose uptake into cells, while cortisol encourages glucose release from storage, creating an antagonistic relationship. (correct)
  • Based on the information provided, which of the following hormone types is most likely to be transported in the blood bound to a transport protein?

  • Peptide hormones
  • Steroid hormones
  • Amino acid derivative hormones
  • All of the above, but to varying degrees depending on the specific hormone. (correct)
  • Based on the information provided, which of the following statements is TRUE about the regulation of thyroxine (T4) and triiodothyronine (T3)?

  • T4 and T3 are regulated primarily by the body's temperature, increasing production when it's cold.
  • Both T4 and T3 are mainly regulated by the levels of insulin in the blood.
  • T4 and T3 production is mainly influenced by the level of stress hormones like cortisol.
  • Metabolic demand, such as during periods of growth or increased physical activity, regulates the production of T4 and T3. (correct)
  • Which of the following hormones DOES NOT directly contribute to the regulation of blood glucose levels during periods of stress?

    <p>Thyroxine (T4) (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the primary function of the hypothalamic-pituitary axis in relation to glucose regulation?

    <p>The anterior pituitary, under hypothalamic control, releases hormones that indirectly regulate glucose metabolism in target tissues like the liver and skeletal muscle. (B)</p> Signup and view all the answers

    What type of feedback regulation is primarily involved in the hypothalamic-pituitary axis for managing hormone secretion?

    <p>Negative feedback, where the presence of a hormone inhibits further release of that same hormone. (D)</p> Signup and view all the answers

    Which of the following is NOT a primary hormone released by the anterior pituitary?

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

    If an individual has a deficiency in the production of thyroid-stimulating hormone (TSH) by the anterior pituitary, which of the following is a likely consequence?

    <p>Hypothyroidism, characterized by low thyroid hormone levels. (D)</p> Signup and view all the answers

    Which of the following examples illustrates a classic negative feedback loop involving an anterior pituitary hormone?

    <p>Elevated cortisol levels inhibit the release of adrenocorticotropic hormone (ACTH) from the anterior pituitary. (A)</p> Signup and view all the answers

    The hormone vasopressin (ADH) is primarily released by the ______________ pituitary.

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

    Which of the following hormones is directly involved in stimulating milk production in the mammary glands?

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

    Based on the information provided, which of the following would likely be considered a target tissue for the effects of growth hormone?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of cortisol in the body?

    <p>Cortisol is a major stress hormone that helps the body cope with challenging situations by increasing blood glucose levels and suppressing the immune system. (A)</p> Signup and view all the answers

    What is the primary function of corticotropin-releasing hormone (CRH)?

    <p>CRH stimulates the release of adrenocorticotropic hormone (ACTH) from the anterior pituitary. (A)</p> Signup and view all the answers

    How does cortisol exert its negative feedback on the hypothalamic-pituitary-adrenal (HPA) axis?

    <p>Cortisol directly inhibits the release of both CRH and ACTH. (D)</p> Signup and view all the answers

    What is the main difference between long-loop and short-loop negative feedback in the HPA axis?

    <p>Long-loop feedback involves the inhibition of CRH release, while short-loop feedback involves the inhibition of ACTH release. (B)</p> Signup and view all the answers

    What is the effect of exogenous cortisol administration on the HPA axis?

    <p>Exogenous cortisol suppresses the release of CRH and ACTH, decreasing endogenous cortisol production. (A)</p> Signup and view all the answers

    Which of the following scenarios would likely lead to an increase in cortisol levels?

    <p>Exposure to a mild stressor, such as a public presentation. (B)</p> Signup and view all the answers

    What is the significance of the short-loop negative feedback in the HPA axis?

    <p>It ensures that cortisol levels remain within a normal range by directly inhibiting the release of ACTH from the anterior pituitary. (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the interaction between the adrenal cortex and the anterior pituitary in the HPA axis?

    <p>The anterior pituitary releases ACTH, which stimulates the adrenal cortex to produce cortisol. (B)</p> Signup and view all the answers

    Which of the following is NOT a physiological function of cortisol as described in the table?

    <p>Muscle growth and development (C)</p> Signup and view all the answers

    Which of the following correctly describes the relationship between thyroid hormone and reproductive hormones, based on the text?

    <p>Thyroid hormone has a permissive effect on reproductive hormones. (D)</p> Signup and view all the answers

    Based on the text, what is the primary effect of repeated sympathetic stimulation in the context of psychological stress?

    <p>Development of chronic conditions like hypertension and atherosclerosis (C)</p> Signup and view all the answers

    What is the central concept illustrated by the Permissive and Synergy terms in the text?

    <p>Hormones often interact to amplify or modify their effects. (D)</p> Signup and view all the answers

    Which of the following is NOT a key learning objective for the section on the Thyroid Gland?

    <p>Examining the role of thyroid hormone in maintaining body temperature. (A)</p> Signup and view all the answers

    Based on information provided in the text, what is the most likely consequence of a prolonged deficiency in thyroid hormone?

    <p>Disruption of metabolism and potential developmental delays (B)</p> Signup and view all the answers

    What principle BEST explains how thyroid hormone regulation is depicted in the provided figures?

    <p>Negative feedback loop, where the product inhibits its own production. (C)</p> Signup and view all the answers

    In the context of the text, what is the primary implication of the 'mind-body connection' discussed?

    <p>Psychological stress can directly influence physical health and disease. (B)</p> Signup and view all the answers

    In the case of primary hypersecretion due to a problem with the adrenal cortex, what is the status of ACTH levels?

    <p>ACTH levels are low (C)</p> Signup and view all the answers

    A patient presents with high levels of CRH, ACTH, and cortisol. Which of the following is the most likely cause of this hypersecretion?

    <p>A tumor in the hypothalamus (D)</p> Signup and view all the answers

    Which of the following scenarios exemplifies the concept of negative feedback in the hypothalamic-pituitary-adrenal (HPA) axis?

    <p>Increased cortisol levels reduce CRH and ACTH secretion (C)</p> Signup and view all the answers

    A patient presents with elevated ACTH levels, but normal cortisol levels. Which condition is most likely to be the underlying cause?

    <p>Secondary hypersecretion due to pituitary problem (C)</p> Signup and view all the answers

    Exogenous cortisol administration has been shown to suppress the secretion of both CRH and ACTH. This observation supports which of the following principles?

    <p>Negative feedback mechanism (D)</p> Signup and view all the answers

    A doctor suspects a patient has a tumor in the anterior pituitary gland. Which of the following tests would be most helpful in confirming this diagnosis?

    <p>Performing an MRI scan of the pituitary gland (A), Measuring ACTH levels (D)</p> Signup and view all the answers

    What is the primary role of CRH in the regulation of the HPA axis?

    <p>CRH stimulates the release of ACTH from the anterior pituitary (B)</p> Signup and view all the answers

    Which of the following statements accurately reflects the role of cortisol in the regulation of the HPA axis?

    <p>Cortisol directly inhibits CRH and ACTH production (D)</p> Signup and view all the answers

    What is the primary difference between primary and secondary hypersecretion of cortisol?

    <p>Primary hypersecretion is due to a problem in the adrenal cortex, while secondary hypersecretion is due to a problem in either the pituitary or hypothalamus (D)</p> Signup and view all the answers

    A patient presents with low levels of CRH, low levels of ACTH, and high levels of cortisol. Which of the following is the most likely diagnosis?

    <p>Primary hypersecretion due to an adrenal cortex problem (A)</p> Signup and view all the answers

    Which of the following hormones directly stimulates cell division during growth?

    <p>Insulin-like Growth Factors (IGF) I and II (B)</p> Signup and view all the answers

    Which hormone is responsible for the rapid bone growth during puberty, ultimately leading to the closure of the epiphyses?

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

    Which of the following pairs of hormones have a similar role in regulating growth, specifically stimulating protein synthesis?

    <p>Thyroid Hormones &amp; Growth Hormone (C)</p> Signup and view all the answers

    Which of the following statements accurately describes the influence of environmental factors on growth?

    <p>Prenatal and postnatal nutrition, disease and other environmental factors can all significantly impact growth. (C)</p> Signup and view all the answers

    Which of the following best describes how peptide growth factors regulate growth?

    <p>They mainly act locally, either on the same cells or nearby cells, influencing growth. (D)</p> Signup and view all the answers

    Which of the following accurately reflects the role of aldosterone in maintaining sodium and potassium homeostasis?

    <p>Aldosterone directly promotes sodium reabsorption and potassium secretion in the distal tubules of the kidneys, contributing to blood pressure regulation. (C)</p> Signup and view all the answers

    A patient presents with symptoms of fatigue, muscle weakness, and low blood pressure. Laboratory tests reveal low levels of cortisol and high levels of ACTH. Based on this information, which of the following conditions is most likely to be diagnosed?

    <p>Secondary adrenal insufficiency (due to pituitary dysfunction) (D)</p> Signup and view all the answers

    The statement "The effect of exogenous cortisol administration on the HPA axis is to suppress the secretion of both CRH and ACTH" is based on which of the following concepts?

    <p>Negative feedback regulation (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of the adrenal medulla in the stress response?

    <p>The adrenal medulla releases catecholamines, such as epinephrine and norepinephrine, which contribute to the &quot;fight-or-flight&quot; response during stressful situations. (B)</p> Signup and view all the answers

    A patient presents with high levels of cortisol, but low levels of ACTH. Which of the following scenarios is most likely to explain these findings?

    <p>A tumor in the adrenal cortex, leading to autonomous cortisol production (B)</p> Signup and view all the answers

    What is the most likely cause of Cushing's syndrome in a patient presenting with high levels of ACTH and cortisol, but no apparent tumor in the pituitary gland?

    <p>Ectopic ACTH syndrome, where a non-pituitary tumor secretes ACTH (B)</p> Signup and view all the answers

    Which of the following BEST describes the physiological mechanism by which cortisol exerts its negative feedback on the hypothalamic-pituitary-adrenal (HPA) axis?

    <p>Cortisol directly inhibits the release of CRH from the hypothalamus and ACTH from the anterior pituitary. (B)</p> Signup and view all the answers

    A patient presents with low levels of ACTH and cortisol, but normal levels of CRH. Which of the following is the most likely diagnosis based on the information provided?

    <p>Secondary adrenal insufficiency due to a problem with the pituitary gland (D)</p> Signup and view all the answers

    A doctor suspects a patient has a tumor in the adrenal cortex, causing ACTH-independent hypercortisolism. Which of the following would be the most helpful diagnostic test to confirm this suspicion?

    <p>Measurement of ACTH levels in the blood (B)</p> Signup and view all the answers

    In the context of Cushing's syndrome, what is the primary mechanism by which excess cortisol contributes to the development of hypertension?

    <p>Excess cortisol increases sodium retention and potassium excretion, leading to increased blood volume and subsequent hypertension. (A)</p> Signup and view all the answers

    A patient presents with symptoms suggestive of Cushing's syndrome. The doctor suspects a pituitary adenoma causing ACTH-dependent hypercortisolism. Which of the following tests would be most helpful in confirming this diagnosis?

    <p>Dexamethasone suppression test (C)</p> Signup and view all the answers

    A patient presents with low cortisol levels and low ACTH levels, but normal CRH levels. The doctor suspects primary adrenal insufficiency (Addison's disease). Which of the following statements BEST explains why ACTH levels are low in this scenario?

    <p>The adrenal cortex is unable to produce cortisol, leading to the suppression of ACTH release. (A)</p> Signup and view all the answers

    Which condition is characterized by low levels of ACTH while maintaining an intact HPA axis?

    <p>ACTH independent adrenal adenoma (A)</p> Signup and view all the answers

    What clinical manifestation is most likely associated with prolonged corticosteroid excess?

    <p>Central obesity (B)</p> Signup and view all the answers

    Which of the following mechanisms explains the link between cortisol and osteoporosis?

    <p>Cortisol increases RANKL and decreases OPG production. (B)</p> Signup and view all the answers

    What is the primary distinguishing feature between ectopic ACTH secretion and Cushing's disease?

    <p>Ectopic secretion consistently presents with high ACTH levels. (D)</p> Signup and view all the answers

    Which of the following clinical features is often more challenging to diagnose in the early stages of Cushing's syndrome?

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

    What is the primary mechanism by which cortisol regulates its own production in the HPA axis?

    <p>Direct inhibition of CRH and ACTH synthesis and release at the hypothalamus and pituitary, respectively. (A)</p> Signup and view all the answers

    A patient presents with high levels of both CRH and ACTH but low levels of cortisol. Which of the following is the most likely diagnosis?

    <p>Primary adrenal insufficiency (Addison's disease) (D)</p> Signup and view all the answers

    Which of the following statements correctly describes the role of dopamine in the regulation of prolactin secretion?

    <p>Dopamine acts as an inhibitory factor, suppressing prolactin release from the anterior pituitary. (B)</p> Signup and view all the answers

    Which of the following scenarios would NOT be considered a typical physiological response to stress?

    <p>Increased insulin sensitivity, leading to greater glucose uptake by cells. (C)</p> Signup and view all the answers

    A patient with a history of prolonged stress is experiencing a persistent increase in cortisol levels. What is the most likely consequence of this chronic cortisol elevation?

    <p>Suppression of the immune system and increased risk of infections and other health complications. (D)</p> Signup and view all the answers

    A patient presents with symptoms of fatigue, weight loss, and muscle weakness. The doctor suspects adrenal insufficiency. Which of the following would be the most appropriate initial step in the diagnostic process?

    <p>Performing a blood test to measure ACTH and cortisol levels. (B)</p> Signup and view all the answers

    If a patient is diagnosed with a tumor in the anterior pituitary that is secreting excessive amounts of ACTH, what is the expected consequence on the adrenal glands and the overall HPA axis?

    <p>The adrenal glands will become hypertrophied and increase cortisol production, leading to Cushing's syndrome. (D)</p> Signup and view all the answers

    Which of the following statements BEST describes the role of the renin-angiotensin-aldosterone system (RAA) in mineralocorticoid production?

    <p>The RAA system directly stimulates the zona glomerulosa of the adrenal cortex to produce aldosterone. (D)</p> Signup and view all the answers

    What characterizes secondary adrenal insufficiency compared to Addison’s disease?

    <p>Reduced glucocorticoid production due to decreased ACTH (A)</p> Signup and view all the answers

    Which symptom is least likely to be associated with secondary adrenal insufficiency?

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

    What is the primary cause of an adrenal crisis?

    <p>Acute withdrawal of chronic glucocorticoids (B)</p> Signup and view all the answers

    Which of the following is a common symptom of adrenal crisis?

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

    In secondary adrenal insufficiency, what remains unaffected?

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

    What is a potential contributing factor to secondary adrenal insufficiency?

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

    Which of these factors is NOT typically associated with the etiology of secondary adrenal insufficiency?

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

    How does dehydration manifest differently in secondary adrenal insufficiency compared to primary adrenal insufficiency?

    <p>It is less prominent and less severe (B)</p> Signup and view all the answers

    What is the primary cause of easy bruising in conditions involving fibroblast/collagen synthesis inhibition?

    <p>Thinning of the skin due to fat deposition (C)</p> Signup and view all the answers

    Which of the following is NOT a treatment option for hypercortisolism?

    <p>Hormone replacement therapy (B)</p> Signup and view all the answers

    What commonly accompanies Addison's disease due to the destruction of adrenal cortex layers?

    <p>Elevated CRH and ACTH levels (B)</p> Signup and view all the answers

    Which factor is most commonly associated with the development of Addison's disease in developed countries?

    <p>Autoimmune dysfunction against adrenal cortex (C)</p> Signup and view all the answers

    Which of the following treatments is indicated as third-line in managing hypercortisolism?

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

    What underlying condition primarily leads to the destruction of all layers of the adrenal cortex in Addison's disease?

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

    What psychological effects can be seen in patients with conditions of hypercortisolism?

    <p>Labile mood and depression (B)</p> Signup and view all the answers

    In cases of Addison's disease, which hormone levels are typically elevated as a compensatory mechanism?

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

    A patient presents with high levels of T4 and T3, but low TSH levels. They also have a history of radiation therapy to the head. Considering the information provided, which of the following would be the most likely diagnosis?

    <p>Secondary hyperthyroidism due to hypothalamic disease (B)</p> Signup and view all the answers

    A patient presents with symptoms of fatigue, weight gain, and cold intolerance. Their TSH levels are very high, and their free T4 and T3 levels are very low. Which of the following is the most likely diagnosis, considering the information provided?

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

    A patient is experiencing symptoms of hyperthyroidism, including palpitations, weight loss, and increased appetite. Their thyroid function tests show high levels of T4, T3, and TSH. Which of the following is the most likely cause based on this information?

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

    Which of the following is NOT a potential etiology of hypothyroidism, as identified in the provided text?

    <p>Excessive intake of thyroid hormone medications (C)</p> Signup and view all the answers

    According to the information provided, which of the following conditions is LEAST likely to be associated with a decrease in thyroid hormone production?

    <p>Graves' disease (A)</p> Signup and view all the answers

    A patient presents with a goiter, high levels of T4 and T3, and very low levels of TSH. Considering the information provided, which of the following is the most likely diagnosis?

    <p>Graves' disease (B)</p> Signup and view all the answers

    A patient presents with symptoms of hypothyroidism, but their TSH level is normal. Which of the following is the most likely cause of their hypothyroidism, based on the information provided?

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

    A patient is diagnosed with hyperthyroidism and is found to have high levels of T4, T3, and TSH. They are also noted to have a pituitary tumor. Which of the following is the most likely diagnosis based on this information?

    <p>Secondary hyperthyroidism related to a pituitary tumor (D)</p> Signup and view all the answers

    What is the most likely consequence of a prolonged deficiency in thyroid hormone, based on the information provided?

    <p>Slowed metabolism and weight gain (A)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of hypothyroidism, as described in the text?

    <p>It primarily affects males more than females. (A)</p> Signup and view all the answers

    What is the underlying mechanism by which Hashimoto's disease, an autoimmune thyroiditis, disrupts thyroid hormone production?

    <p>Inhibition of thyroid peroxidase by autoantibodies. (A)</p> Signup and view all the answers

    Which of the following laboratory tests is considered the gold standard for diagnosing and monitoring thyroid function?

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

    A patient presents with symptoms of fatigue, weight gain, and slowed metabolism. Lab tests reveal elevated TSH levels and low free T4 levels. What is the most likely diagnosis?

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

    How does the thyroid hormone regulate its own secretion, as described in the text?

    <p>Negative feedback loop, where elevated T4 inhibits TSH and TRH secretion. (B)</p> Signup and view all the answers

    Which of the following is the most common cause of hypothyroidism worldwide?

    <p>Iodine deficiency (B)</p> Signup and view all the answers

    What is the primary reason for the use of the free T4 test in diagnosing thyroid disorders?

    <p>It measures the biologically active, unbound form of T4, reflecting thyroid function more accurately. (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of thyroglobulin in thyroid hormone synthesis?

    <p>It is a protein that stores and releases iodinated tyrosine residues for T3 and T4 production. (C)</p> Signup and view all the answers

    What is the implication of the statement "Sensitivity: 98%, specificity: 92%" in the context of the TSH test?

    <p>TSH test correctly identifies 98% of individuals with thyroid disease and 92% of those without thyroid disease. (B)</p> Signup and view all the answers

    A patient presents with an enlarged thyroid gland, a rapid heartbeat, and excessive sweating. Blood tests reveal elevated levels of thyroid hormone. What is the most likely diagnosis?

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

    Which of the following statements correctly describes the relationship between TSH and thyroid hormone levels in a patient with iodine deficiency?

    <p>TSH levels will be high, leading to increased thyroid hormone production (C)</p> Signup and view all the answers

    Which of the following treatments would be most appropriate for a patient experiencing a thyroid storm?

    <p>Propylthiouracil and iodide (B)</p> Signup and view all the answers

    Which of the following is the most common cause of goiter worldwide?

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

    If a patient presents with a goiter but normal thyroid hormone levels, what is the most likely explanation?

    <p>The goiter is a result of a benign tumor and does not affect thyroid hormone production (B)</p> Signup and view all the answers

    Which of the following physiological processes are slowed in hypothyroidism?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient presents with fatigue, weight gain, constipation, and a slow heart rate. Which of the following laboratory tests would be most helpful in confirming a diagnosis of hypothyroidism?

    <p>TSH levels (B)</p> Signup and view all the answers

    Which of the following statements about thyroid hormone regulation is FALSE?

    <p>Thyroid hormone levels are primarily regulated by the hypothalamus. (C)</p> Signup and view all the answers

    Which of the following cell types is NOT directly involved in the production and release of thyroid hormones?

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

    Based on the text, which of the following BEST represents the primary function of thyroid hormones in adult humans?

    <p>Maintaining metabolic stability and energy balance (B)</p> Signup and view all the answers

    Which of the following is a potential consequence of prolonged deficiency in thyroid hormone, as suggested by the text?

    <p>Impaired cognitive function and delayed development in children (A)</p> Signup and view all the answers

    Based on the provided text, which of the following statements BEST exemplifies the concept of 'mind-body connection' in relation to thyroid disorders?

    <p>Psychological stress can trigger the release of hormones that directly impact thyroid hormone production (A)</p> Signup and view all the answers

    Which of the following is NOT a primary function of the thyroid gland, as directly stated or implied in the provided content?

    <p>Direct control of glucose metabolism and insulin sensitivity (D)</p> Signup and view all the answers

    Which of the following is NOT a direct consequence of the coupling of two iodinated tyrosine molecules in the thyroid hormone biosynthesis pathway?

    <p>Oxidation of iodide to iodine (D)</p> Signup and view all the answers

    Based on the provided information, which of the following represents a key difference between thyroxine (T4) and triiodothyronine (T3) regarding their production and function?

    <p>T4 is produced exclusively in the thyroid gland, while T3 is primarily derived from the peripheral conversion of T4. (D)</p> Signup and view all the answers

    Which of the following statements BEST describes the role of thyroid peroxidase in the biosynthesis of thyroid hormones?

    <p>Thyroid peroxidase catalyzes the coupling of two iodinated tyrosine molecules to form T4 or T3. (A)</p> Signup and view all the answers

    If an individual has a deficiency in the production of thyroid hormone, which of the following is a plausible consequence based on information provided?

    <p>Enhanced sensitivity to cold temperatures and potential weight gain. (A)</p> Signup and view all the answers

    Given the information on protein binding provided, which of the following statements is most likely TRUE regarding the biological activities of T4 and T3?

    <p>T3's lower protein binding allows for more free, active form in the blood, explaining its greater potency. (B)</p> Signup and view all the answers

    Considering the information about the formation and conversion of T4 and T3, which of the following statements is TRUE?

    <p>T3 can be produced directly in the thyroid gland but is more commonly formed in the peripheral tissues from T4. (B)</p> Signup and view all the answers

    Which of the following options BEST represents the order of events in the thyroid hormone biosynthesis pathway, based on the information provided?

    <p>Uptake of iodide → Oxidation of iodide to iodine → Iodination of thyroglobulin → Coupling of iodinated tyrosine residues → Proteolysis → Hormone secretion (C)</p> Signup and view all the answers

    Given the concept of protein binding described for T4 and T3, which of the following scenarios would likely have the most significant impact on the free, active form of T3 in circulation?

    <p>An increase in the rate of peripheral conversion of T4 to T3. (A)</p> Signup and view all the answers

    Which of the following statements CORRECTLY describes the relationship between the formation of T3 and T4 and their respective protein binding?

    <p>T4's higher protein binding is linked to its longer half-life, providing a sustained supply of T3 via conversion. (B)</p> Signup and view all the answers

    Based on the information provided, what is the primary function of the 'Proteolysis' step in thyroid hormone biosynthesis?

    <p>The liberation of free T3 and T4 from thyroglobulin. (D)</p> Signup and view all the answers

    A patient presents with hyperglycemia, polydipsia, and polyphagia, but laboratory tests reveal normal insulin levels. Which of the following is the most likely underlying condition?

    <p>Type 2 Diabetes Mellitus (B)</p> Signup and view all the answers

    A patient with poorly controlled Type 1 Diabetes develops severe metabolic acidosis, hyperkalemia, and a fruity odor on their breath. Which of the following is the most likely diagnosis?

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

    A patient with newly diagnosed diabetes is experiencing frequent urinary tract infections. Which of the following is the most likely explanation for this phenomenon?

    <p>Increased urine output due to hyperglycemia (B)</p> Signup and view all the answers

    A patient with uncontrolled diabetes develops blurred vision, slow-healing wounds, and tingling sensations in their feet. Which of the following complications is most likely occurring?

    <p>Microvascular Disease (B)</p> Signup and view all the answers

    Which of the following pairs of hormones BEST represents the counter-regulatory response to hypoglycemia? (Select all that apply)

    <p>Epinephrine (A), Cortisol (B), Glucagon (C)</p> Signup and view all the answers

    A patient presents with persistent hypoglycemia despite normal insulin levels. Which of the following counter-regulatory hormones is most likely to be deficient in this patient?

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

    A patient with severe pancreatitis is experiencing significant malabsorption of nutrients. Which organ system is MOST likely to be primarily affected by this malabsorption, leading to further complications?

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

    A patient with long-standing diabetes is experiencing retinopathy and neuropathy. These complications are directly related to which of the following pathophysiologic mechanisms?

    <p>Increased oxidative stress (A)</p> Signup and view all the answers

    A patient undergoing surgery is administered general anesthesia. Which of the following mechanisms is MOST likely to contribute to the patient's temporary hypoglycemia during the procedure?

    <p>Inhibition of gluconeogenesis (C)</p> Signup and view all the answers

    A patient with a history of alcohol abuse presents with elevated liver enzymes and ascites. Which of the following is the MOST likely pathophysiologic mechanism contributing to the ascites?

    <p>Increased hydrostatic pressure in the portal vein (A)</p> Signup and view all the answers

    A patient with type 1 diabetes is experiencing episodes of ketoacidosis. Which of the following BEST explains the underlying pathophysiologic mechanism?

    <p>Increased breakdown of fat for energy production (A)</p> Signup and view all the answers

    A patient with chronic kidney disease (CKD) is experiencing anemia. Which of the following is the MOST likely pathophysiologic mechanism underlying this anemia?

    <p>Impaired production of red blood cells due to decreased erythropoietin (B)</p> Signup and view all the answers

    A patient presents with signs of hyperthyroidism. Which of the following is the MOST likely pathophysiologic mechanism underlying this condition?

    <p>Increased production of thyroid-stimulating hormone (B)</p> Signup and view all the answers

    A patient with advanced liver disease has developed hepatic encephalopathy. Which of the following is the MOST likely pathophysiologic mechanism contributing to this condition?

    <p>Increased production of ammonia (B)</p> Signup and view all the answers

    A patient with heart failure is experiencing pulmonary edema. Which of the following is the MOST likely pathophysiologic mechanism underlying this condition?

    <p>Decreased cardiac output leading to increased pressure in the pulmonary capillaries (A)</p> Signup and view all the answers

    What is the relationship between HgA1C and mean blood glucose with a HgA1C of 10%?

    <p>Mean blood glucose is 240 mg/dL (C)</p> Signup and view all the answers

    Which statement best describes the pathophysiology associated with Type I Diabetes Mellitus?

    <p>It involves autoimmune destruction of pancreatic beta cells. (B)</p> Signup and view all the answers

    In Type II Diabetes Mellitus, what is primarily altered in the pathophysiologic characteristics?

    <p>Relative insulin deficiency due to beta cell dysfunction. (C)</p> Signup and view all the answers

    Which type of diabetes is specifically described as related to pregnancy?

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

    What percentage of beta cell loss is significant for glucose dysregulation to occur in Type I Diabetes Mellitus?

    <p>60% (C)</p> Signup and view all the answers

    Which of the following conditions fall under miscellaneous causes related to diabetes?

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

    What is the primary cause of decreased incretin effect in Type II Diabetes Mellitus?

    <p>Decreased beta cell mass (A)</p> Signup and view all the answers

    Which characteristic is NOT associated with Type II Diabetes Mellitus?

    <p>Absolute insulin deficiency (B)</p> Signup and view all the answers

    What is a primary contributor to beta cell dysfunction in individuals with chronic obesity?

    <p>Chronic elevation of free fatty acids (A)</p> Signup and view all the answers

    Which characteristic is typically associated with type I diabetes mellitus compared to type II?

    <p>Onset often before 20 years of age (B)</p> Signup and view all the answers

    What is the typical threshold for glucose elimination in the renal tubule in individuals with diabetes?

    <p>180 mg/dl (A)</p> Signup and view all the answers

    Which symptom is more common in type I diabetes than type II diabetes?

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

    What chronic complication is associated with diabetic retinopathy?

    <p>Increased retinal vascular permeability (D)</p> Signup and view all the answers

    What is a common microvascular complication of diabetes that leads to a specific type of nerve damage?

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

    Which hormone secretion is typically increased during episodes of diabetic ketoacidosis?

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

    What characterizes hyperglycemic hyperosmolar syndrome compared to diabetic ketoacidosis?

    <p>Absence of acidosis (B)</p> Signup and view all the answers

    What is the primary clinical presentation of diabetic ketoacidosis?

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

    Which factor contributes to increased cardiovascular risk in diabetes?

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

    What role does hyperglycemia play in causing polyuria?

    <p>Exceeds renal glucose reabsorption capacity (D)</p> Signup and view all the answers

    What is the likely consequence of impaired insulin sensitivity in adipose tissues?

    <p>Worsening of hyperglycemia (D)</p> Signup and view all the answers

    Which of the following complications is a hallmark of chronic microvascular damage in diabetes?

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

    What is the most likely cause of high cortisol levels in a patient with a normal ACTH level and no apparent tumor in the pituitary gland?

    <p>A tumor in the adrenal cortex (B)</p> Signup and view all the answers

    A patient presents with symptoms of fatigue, muscle weakness, and low blood pressure. Laboratory tests reveal low levels of cortisol and high levels of ACTH. Which of the following is the most likely explanation for these findings?

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    Which of the following is the primary function of the adrenal medulla in the stress response?

    <p>Secrete epinephrine and norepinephrine (B)</p> Signup and view all the answers

    Which of the following statements accurately describes the role of the adrenal medulla in the stress response, considering its primary function?

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    What is the primary factor contributing to the increase in sebum production in acne vulgaris?

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    Which of the following accurately describes the pathophysiology of atopic dermatitis?

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    Which of the following statements BEST describes the role of topical corticosteroids in the treatment of atopic dermatitis?

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    Which of the following accurately describes the pathophysiologic mechanism of Dupilumab in the treatment of atopic dermatitis?

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    Which of the following clinical manifestations is MOST likely to be observed in an adolescent or adult with atopic dermatitis?

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    Which of the following is NOT a typical characteristic of atopic dermatitis in infants and children?

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    Which of the following is the MOST accurate description of the term 'lichenified skin' in atopic dermatitis?

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    Which of the following accurately describes the mechanism of action of topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, in the treatment of atopic dermatitis?

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    Which type of acne lesion is characterized by a raised lesion smaller than 5mm?

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    What is the primary effect of androgens on sebaceous glands?

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    Which of the following factors is least likely to contribute to the development of acne vulgaris?

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    What initiates the inflammatory process that leads to acne lesions?

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    Which statement accurately describes the characteristics of closed comedones?

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    Which of the following statements accurately describes the mechanism by which filaggrin mutation contributes to skin barrier disruption in atopic dermatitis?

    <p>Filaggrin mutation leads to decreased crosslinking of keratin filaments, resulting in a thinner and more permeable skin barrier. (A)</p> Signup and view all the answers

    A patient with atopic dermatitis is experiencing intense itching. Which of the following mechanisms is MOST directly responsible for the pruritis associated with the condition?

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    Which of the following statements accurately describes the relationship between atopic dermatitis and other allergic conditions?

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    Which of the following best describes the key alteration in the immune system that contributes to the development of atopic dermatitis?

    <p>The immune system produces excessive levels of IgE antibodies, which trigger mast cell degranulation and inflammation. (A)</p> Signup and view all the answers

    Why is the pruritis (itching) associated with atopic dermatitis considered a key symptom of the condition?

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    Which of the following is NOT a characteristic feature of atopic dermatitis in infants?

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    How does the disruption of the skin barrier contribute to the development of atopic dermatitis?

    <p>It reduces the skin's natural barrier to allergens, leading to increased inflammation. (A)</p> Signup and view all the answers

    In the context of atopic dermatitis, how does the disruption of the skin barrier contribute to microbial dysbiosis?

    <p>It alters the composition of the skin microbiome, allowing some bacteria to thrive and others to be suppressed. (B)</p> Signup and view all the answers

    A patient presents with itchy, scaly skin lesions predominantly on the elbows and knees. The lesions are well-demarcated and exhibit a silvery-white scale. Upon gently scraping the scales off, pinpoint bleeding is observed. Based on this information, which of the following is the most likely diagnosis?

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

    A 25-year-old patient presents with psoriasis for the first time. He complains of frequent bouts of intense itching and burning sensations on his scalp, and has noticed some hair loss in the affected areas. Which of the following is the most likely contributing factor to the hair loss?

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    A patient with psoriasis has been experiencing a significant increase in the severity of their lesions after a recent viral infection. Which of the following types of psoriasis is most likely to present with this trigger?

    <p>Guttate psoriasis (B)</p> Signup and view all the answers

    A patient with severe psoriasis is experiencing widespread inflammation and shedding of skin, encompassing a significant portion of their body surface area. Which type of psoriasis is most likely the cause of this severe presentation?

    <p>Erythrodermic psoriasis (B)</p> Signup and view all the answers

    A child presents with a sudden onset of multiple small, red, scaling lesions on their trunk and limbs. The child also reports having a sore throat and a fever recently. Which of the following is the most likely diagnosis?

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

    A patient with plaque psoriasis is being treated with a topical corticosteroid cream. The patient reports that the cream has been effective in reducing the inflammation and scaling of their lesions, but they are concerned about long-term use. Which of the following is a potential risk associated with prolonged use of topical corticosteroids?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with psoriasis is undergoing treatment with a TNF-alpha inhibitor. The patient develops an unusual exacerbation of their psoriasis shortly after starting the medication. Which of the following is a possible explanation for this paradoxical response?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with psoriasis exhibits a nail pitting and onycholysis (nail separation) in multiple fingernails. Which of the following is TRUE about this nail involvement?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with psoriasis is being evaluated for psoriatic arthritis. The patient exhibits asymmetrical joint pain and swelling, with predominant involvement of the distal interphalangeal joints. Which of the following is the most likely explanation for the pattern of joint involvement?

    <p>Psoriatic arthritis commonly presents with asymmetrical joint involvement, specifically affecting the distal interphalangeal joints. (D)</p> Signup and view all the answers

    A patient with psoriasis develops a new lesion on the skin after receiving a minor cut. Which of the following describes this phenomenon?

    <p>Koebner phenomenon, indicating the tendency for psoriasis to develop at sites of skin trauma. (B)</p> Signup and view all the answers

    A patient with psoriasis is experiencing both skin lesions and joint inflammation. Which of the following is the most likely diagnosis?

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

    A patient with psoriasis is being treated with a combination of topical corticosteroids and phototherapy (UV light exposure). Which of the following is a potential concern regarding this combination therapy?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with psoriasis is experiencing a significant decrease in the severity of their lesions after making lifestyle changes, including weight loss, reduced alcohol intake, and stress management. Which of the following is MOST likely to be the primary factor contributing to this improvement?

    <p>All of the above (D)</p> Signup and view all the answers

    A patient with psoriasis is asking about the potential long-term consequences of their condition. Which of the following is a possible concern that should be discussed?

    <p>All of the above (D)</p> Signup and view all the answers

    A doctor is explaining to a patient with psoriasis about the importance of managing their condition. Which of the following statements BEST describes the current understanding of psoriasis?

    <p>Psoriasis is a chronic condition that can be managed effectively, but there is no cure. (A)</p> Signup and view all the answers

    Flashcards

    Adipocytes

    Fat cells in the body that store energy as fat.

    Hypothalamic-Pituitary Axis

    A system involving the hypothalamus and pituitary gland that controls hormones.

    Anterior Pituitary

    The front part of the pituitary gland that releases various hormones.

    Posterior Pituitary

    The back part of the pituitary gland, responsible for releasing hormones like oxytocin.

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    Negative Feedback

    A regulatory mechanism where a change triggers a response that counteracts the initial change.

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    Trophic Hormones

    Hormones that stimulate other glands to release hormones.

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    Oxytocin

    A hormone released from the posterior pituitary involved in childbirth and bonding.

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    Vasopressin (ADH)

    A hormone released from the posterior pituitary that regulates water balance in the body.

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    Rapid Bone Growth

    Increased formation of bone tissue, occurring notably in the first two years of life and during puberty.

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    Growth Hormone

    A hormone that stimulates post-natal growth and protein synthesis, essential for normal growth patterns.

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    Insulin-like Growth Factors (IGF-I & II)

    Hormones that stimulate cell division and contribute to growth, working closely with growth hormone.

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    Thyroid Hormones

    Hormones that regulate fetal and post-natal growth and are important for protein synthesis.

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    Environmental Factors Influencing Growth

    Factors such as nutrition, disease, and environmental conditions that affect growth development.

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    Cortisol

    A steroid hormone produced by the adrenal cortex, regulating metabolism and stress response.

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    Hypothalamus

    A brain region controlling the release of hormones via the pituitary gland.

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    ACTH

    Adrenocorticotropic hormone, stimulates cortisol release from the adrenal cortex.

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    CRH

    Corticotropin-releasing hormone, stimulates the release of ACTH from the anterior pituitary.

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    Long-loop negative feedback

    A regulatory mechanism where high levels of a hormone inhibit its own production.

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    Short-loop negative feedback

    A feedback mechanism where a hormone inhibits its own releasing hormone.

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    Adrenal cortex

    The outer layer of the adrenal glands, primarily secreting cortisol and other hormones.

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    Target tissue

    Specific organs or cells that respond to a particular hormone.

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    Hormones

    Chemical messengers that regulate body functions.

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    Insulin

    A peptide hormone from pancreas regulating glucose levels.

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    Thyroxine (T4)

    A hormone from thyroid gland regulating metabolism and growth.

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    Hormone Classification

    Types include peptide, steroid, and amino acid derivatives.

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    Cortisol Functions

    Regulates various physiological functions, including metabolism and immune response, with a circadian rhythm pattern.

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    Synergy in Hormones

    The combined effect of hormones is greater than their individual effects.

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    Permissive Effects

    One hormone allows another to exert its full effects, such as thyroid hormone on reproductive hormones.

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    Thyroid Hormone Role

    Maintains homeostasis, metabolism, and growth and development in the body.

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    Thyroid Hormone Synthesis

    The process by which the thyroid gland produces thyroid hormones using iodide and amino acids.

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    Thyroid Regulation

    Control of thyroid hormone levels through feedback mechanisms involving the hypothalamus and pituitary gland.

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    Psychological Stress Effects

    Stress affects the immune system and can lead to conditions like hypertension and atherosclerosis.

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    Circadian Rhythm

    Biological processes that display an endogenous, entrainable oscillation of about 24 hours, like cortisol secretion patterns.

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    Hypersecretion

    Excess hormone production in the body.

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    Primary Hypersecretion

    Excess cortisol due to adrenal cortex issues.

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    Secondary Hypersecretion

    Excess hormone from pituitary or hypothalamic issues.

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    Symptoms of Cortisol Excess

    Indicators like high cortisol but low CRH and ACTH in primary.

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    Fibroblast Inhibition

    Inhibition of fibroblast function leads to thin skin and striae.

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    Psychiatric Changes

    Mood swings, concentration issues, and anxiety related to hormonal imbalances.

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    Immune Suppression

    Reduced function of the immune system affecting cytokines and T-lymphocytes.

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    Addison's Disease

    Primary adrenal insufficiency caused by adrenal cortex destruction.

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    Etiology of Addison's

    Causes include tuberculosis and autoimmune dysfunction, common in different regions.

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    CRH and ACTH Levels

    Compensatory increase in CRH and ACTH due to low adrenal hormones.

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    Treatment of Addison's Disease

    Includes hormone replacement and addressing underlying causes like surgery.

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    Cortisol Effects

    Cortisol regulates metabolism, immune response and experiences a daily rhythm.

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    HPA Axis

    The hypothalamic-pituitary-adrenal axis regulates stress response and hormone secretion.

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    Adrenal Medulla

    Part of the adrenal gland that secretes catecholamines like adrenaline.

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    Aldosterone

    A hormone produced by the adrenal cortex that regulates sodium and potassium balance.

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    Primary vs Secondary Insufficiency

    Primary results from adrenal gland damage, while secondary is from pituitary dysfunction.

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    ACTH Secretion in Cushing

    Variable and random ACTH levels, ranging from normal to high, with impaired stress response.

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    Ectopic ACTH Syndrome

    Characterized by variable and random high ACTH levels due to ectopic production.

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    ACTH Independent

    Low ACTH levels with an intact HPA axis indicating ACTH-independent causes.

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    Clinical Presentation Spectrum

    Clinical manifestations of Cushing's disease range from mild, difficult to diagnose to severe, easier to diagnose.

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    Cushing Symptoms

    Central obesity, hypertension, glucose intolerance, muscular weakness, and andronergic effects.

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    Corticotropin-Releasing Hormone (CRH)

    A hormone released by the hypothalamus that stimulates the release of ACTH from the anterior pituitary.

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    Adrenocorticotropic Hormone (ACTH)

    A hormone released by the anterior pituitary that stimulates the adrenal cortex to produce cortisol.

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    Cortisol Negative Feedback

    A mechanism where cortisol inhibits the release of CRH and ACTH, preventing overproduction.

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    HPA Axis Hormones

    Involves CRH, ACTH, and cortisol in its regulation framework for stress response.

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    Cortisol Binding Globulin (CBG)

    A protein that binds cortisol, regulating its availability in the bloodstream.

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    Regulation of ACTH Secretion

    ACTH is stimulated by CRH and inhibited by high cortisol levels through negative feedback.

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    Mineralocorticoids and RAA System

    Mineralocorticoid production is mainly controlled by the renin-angiotensin-aldosterone (RAA) system.

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    Secondary Adrenal Insufficiency

    Reduced glucocorticoid production due to low ACTH levels, affecting adrenal glands mildly or not at all.

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    Etiology of Secondary Insufficiency

    Causes include exogenous steroids, hypopituitarism, and radiation therapy, leading to suppressed HPA axis.

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    Clinical Features of Addison’s Disease

    Include hyperpigmentation, weight loss, dehydration, and electrolyte imbalances due to aldosterone loss.

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    Hyperpigmentation in Addison's

    Skin darkening, especially in areas like flexures, caused by increased ACTH stimulating melanocytes.

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    Adrenal Crisis Symptoms

    Includes hypotension, myalgias, malaise, anorexia, and fever during acute adrenocortical insufficiency.

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    Causes of Adrenal Crisis

    Triggered by abrupt glucocorticoid withdrawal or severe stress like surgery or infections.

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    Management of Secondary Insufficiency

    Focus on gradual steroid tapering and treating underlying conditions to prevent adrenal crisis.

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    Minor Symptoms of Secondary Insufficiency

    Can include mild changes in Na and K levels, weakness, and mild dehydration, less pronounced than in primary.

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    Cushing's Syndrome

    A disorder caused by excess cortisol production.

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    Addison’s Disease

    A disorder due to insufficient production of adrenal hormones.

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    Epidemiology of Cushing's Syndrome

    Affects 1-2 cases per 1 million, more common in women (8:1).

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    Iatrogenic Cushing's

    Cushing's due to external glucocorticoid administration.

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    Hypoaldosteronism

    A condition of insufficient aldosterone production.

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    Cushing's Disease

    Specific type of Cushing's due to an ACTH-producing pituitary adenoma.

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    Thyroid Gland

    The largest endocrine gland that produces thyroid hormones.

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    Follicular Cells

    Cells in the thyroid that produce thyroxine (T4) and triiodothyronine (T3).

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    Parafollicular Cells

    Cells in the thyroid that produce calcitonin to regulate calcium levels.

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    Hyperthyroidism Symptoms

    Signs include weight loss, rapid heartbeat, and anxiety due to excess thyroid hormones.

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    Thyroid Hormones (T4 and T3)

    Hormones released by the thyroid that control metabolism and growth.

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    Negative Feedback Loop

    A mechanism where increased T4 reduces TSH and TRH release.

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    Hypothalamic-Pituitary-Thyroid Axis

    A system that regulates thyroid hormone levels via feedback.

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    TSH (Thyroid Stimulating Hormone)

    A hormone from the anterior pituitary that stimulates T4 production.

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    Free T4

    Direct measure of active thyroxine in the blood, important for diagnosing thyroid conditions.

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    Primary Hypothyroidism

    Condition due to inadequate thyroid hormone secretion; most common thyroid disorder.

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    Etiology of Hypothyroidism

    Causes include autoimmune diseases, iodine deficiency, and certain treatments.

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    Hashimoto’s Disease

    An autoimmune disorder causing thyroid gland inflammation and reduced hormone production.

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    Symptoms of Hyperthyroidism

    Includes weight loss, rapid heartbeat, and anxiety due to excess thyroid hormone.

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    Thyroid Hormone Regulation

    Control of T4 and T3 levels through a feedback system.

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    Secondary Pituitary Disease

    Pituitary dysfunction caused by tumors, surgery, or radiation.

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    Hypothalamic Disease

    Disease affecting the hypothalamus, causing TRH deficiency.

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    Myxedema Coma

    A rare, life-threatening complication of untreated hypothyroidism.

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    Levothyroxine

    The primary medication for treating hypothyroidism, T4 form.

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    Hyperthyroidism

    Excessive production of thyroid hormones, more common in women.

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    Graves’ Disease

    The most common cause of hyperthyroidism, autoimmune in nature.

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    Thyroid Cancer

    Malignant growth in the thyroid gland that can cause hyperthyroidism.

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    Medication-Induced Thyroid Dysfunction

    Thyroid issues caused by certain medications like amiodarone and lithium.

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    Triiodothyronine (T3)

    A thyroid hormone that is four times more potent than T4 and has a shorter plasma half-life of 1.5 days.

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    Thyroid Hormone Formation

    Thyroid hormones are formed primarily in the thyroid gland, with T3 also produced from T4 conversion.

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    Thyroid Hormone Protein Binding

    Both T4 and T3 are tightly bound to proteins, with T4 at 99.96% and T3 at 99.6%.

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    Thyroid Hormone Conversion

    T3 is synthesized from T4, with about 80% of T3 coming from this conversion.

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    Thyroid Hormone Biosynthesis Steps

    The production process includes iodination, oxidation, and coupling of iodinated tyrosine.

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    Iodination of Tyrosine

    A crucial step in thyroid hormone synthesis where iodide is added to tyrosine residues.

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    Coupling of Tyrosine

    The reaction where iodinated tyrosine residues combine to form T3 and T4.

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    Hormone Secretion

    The release of T3 and T4 into circulation after proteolysis of thyroglobulin.

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    Thyroid Peroxidase

    An enzyme that catalyzes the coupling of iodinated tyrosine to form thyroid hormones.

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    Thyroid Storm

    A life-threatening condition caused by excessive thyroid hormone release, leading to severe hypermetabolic state.

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    Goiter

    An enlargement of the thyroid gland, often due to iodine deficiency leading to increased thyroid hormone production.

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    Symptoms of Thyrotoxicosis

    Symptoms include weight loss, rapid heartbeat, and anxiety due to excess thyroid hormone production.

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    Hypothyroidism vs Hyperthyroidism

    Hypothyroidism features slower physiological processes, while hyperthyroidism features faster processes.

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    Diagnosis of Thyroid Disorders

    Based on clinical presentation and lab values, primarily TSH and T4 levels.

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    Treatment for Thyroid Storm

    Includes propylthiouracil, iodide, beta-blockers, steroids, and cooling methods.

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    Causes of Goiter

    Most commonly caused by iodine deficiency, leading to increased TSH and thyroid cell hyperplasia.

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    Diabetes Mellitus

    A group of diseases involving high blood sugar levels due to insulin deficiencies or resistance.

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    Type I Diabetes

    An autoimmune condition where the pancreas produces little to no insulin, often diagnosed in children or young adults.

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    Type II Diabetes

    A condition characterized by insulin resistance, usually developing in adults, often associated with obesity.

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    Polydipsia, Polyuria, Polyphagia

    Symptoms of diabetes: excessive thirst, frequent urination, and increased hunger.

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    HgA1C

    Average blood glucose levels over 2-3 months, expressed in percentage.

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    Gestational Diabetes

    Diabetes that develops during pregnancy and typically resolves after delivery.

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    Autoimmune destruction

    Immune system mistakenly attacks the body's own cells, such as pancreatic beta cells in Type I Diabetes.

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    Incretin Effect

    The increase in insulin secretion in response to eating, primarily mediated by hormones like GLP-1.

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    Islet Cell Autoantibodies

    Antibodies that indicate immune-mediated destruction of insulin-producing cells in type 1 diabetes.

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    Absolute Insulin Deficiency

    Condition where the pancreas produces little to no insulin, characteristic of Type I Diabetes.

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    Pancreas Functions

    The pancreas has both exocrine and endocrine functions, producing enzymes and hormones.

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    Insulin Role

    Insulin promotes glucose uptake in tissues and inhibits gluconeogenesis.

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    Glucagon Function

    Glucagon raises blood glucose levels by stimulating glycogenolysis and gluconeogenesis.

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    Counter-Regulatory Hormones

    Hormones like epinephrine and cortisol that oppose insulin actions.

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    Epinephrine Effects

    Epinephrine increases glycogen breakdown and inhibits insulin release during stress.

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    C-Peptide

    A byproduct of insulin production, indicating the amount of insulin made.

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    Fasting Blood Glucose Threshold

    Diagnostic threshold for diabetes is fasting blood glucose ≥126 mg/dl.

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    Oral Glucose Tolerance Test

    Measures blood glucose after ingestion of glucose, used for diabetes diagnosis.

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    Hemoglobin A1C

    A lab test that indicates average blood glucose levels over the past 2-3 months.

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    Diabetes Symptoms

    Excessive thirst, frequent urination, fatigue, and blurred vision are common symptoms.

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    Insulin Resistance

    A condition where cells fail to respond effectively to insulin, leading to high glucose levels.

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    Central Obesity

    Accumulation of fat around the waist, associated with higher health risks than peripheral obesity.

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    Free Fatty Acids

    Increased levels can disrupt insulin signaling, leading to diabetes.

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    Type II Diabetes Mellitus

    A chronic condition affecting the way the body processes glucose, often linked with obesity.

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    3 Ps of Diabetes

    Polyuria, polydipsia, and polyphagia are common symptoms of diabetes.

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    High Blood Glucose Effects

    Results in decreased cellular uptake of glucose and increased liver production of glucose.

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    Diabetic Ketoacidosis (DKA)

    A severe condition characterized by high blood sugar and buildup of ketones, common in Type I diabetes.

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    Hyperglycemic Hyperosmolar Syndrome (HHS)

    A serious condition resulting from high blood sugar without significant ketoacidosis, more common in Type II.

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    Microvascular Complications

    Complications like nephropathy, retinopathy, and neuropathy caused by diabetes.

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    Macrovascular Complications

    Serious cardiovascular issues linked to diabetes, including heart disease and stroke.

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    Diabetic Neuropathy

    Nerve damage associated with diabetes, leading to pain or loss of sensation.

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    Glycogenolysis

    The process of breaking down glycogen to release glucose, increased in diabetes.

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    Gluconeogenesis

    The synthesis of glucose from non-carbohydrate sources, promoted by insulin resistance.

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    Keratinocytes

    Skin cells responsible for forming the outer protective layer.

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    Melanocytes

    Cells that produce melanin, giving color to the skin and protecting against UV light.

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    Langerhans Cells

    Immune cells in the skin that help detect and fight pathogens.

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    Skin Appendages

    Structures like hair follicles, nails, and sweat glands that are associated with the skin.

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    Psoriasis

    A chronic skin disorder characterized by red, scaly patches caused by accelerated skin cell turnover.

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    Stratum Corneum

    The thickest layer of the epidermis, consisting of dead cells.

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    Dermis

    The collagen-based layer beneath the epidermis, providing nutrients and immune support.

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    Sebaceous Glands

    Glands that produce sebum to lubricate skin and hair.

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    Sweat Glands

    Glands that regulate body temperature through sweat production.

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    Th1 and Th17 Cells

    Type of T-lymphocytes involved in the immune response of psoriasis.

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    Auspitz Phenomenon

    Bleeding that occurs with mild disruption of psoriatic patches.

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    Psoriatic Arthritis

    Arthritis that may develop 10 years after psoriasis diagnosis.

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    Corticosteroid Therapy

    Common treatment for managing inflammation in psoriasis.

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    Mental Health Issues

    Common co-morbidities associated with psoriasis, impacting quality of life.

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    Koebner Phenomenon

    Development of psoriasis lesions at the site of skin trauma.

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    Nail Involvement

    Common in psoriasis, noticeable symptoms include pitting and separation.

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    Microbial Dysbiosis

    A condition characterized by decreased microbial diversity, often dominated by Staphylococcus aureus.

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    Th2 Activation

    Increased activation of Th2 helper cells associated with allergic responses and inflammation.

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    Pruritis Mechanism

    Itching caused primarily by IL-31 and IL-4, more significant than histamine's role.

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    Atopic Dermatitis in Infants

    Characterized by weeping vesicles, pruritis, and erythma, usually starting on the cheeks.

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    Atopic Dermatitis in Adults

    Presents as dry, red patches that are pruritic and can lead to lichenification.

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    Acne Vulgaris

    An inflammatory disorder of the pilosebaceous unit, primarily affecting the face, back, and chest.

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    Sebum Composition

    Sebum consists of mono-, di-, triglycerides, sterol/wax esters, and squalene.

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    Topical Treatments for Atopic Dermatitis

    Includes emollients, topical corticosteroids, and calcineurin inhibitors like tacrolimus.

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    Atopic Dermatitis

    An inflammatory skin disorder associated with IgE, often linked to asthma and allergies.

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    Key Symptoms of Atopic Dermatitis

    Characterized by pruritis (itching) and dry skin, leading to lesions.

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    Skin Barrier Disruption

    Involves increased H2O loss, decreased lipids, and higher permeability affecting skin health.

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    Filaggrin Mutation

    A genetic mutation causing decreased binding of keratin, leading to skin barrier disruption.

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    Th2 Cytokines

    Cytokines produced by helper T cells that downregulate skin barrier genes in atopic dermatitis.

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    IL-17 Inhibitors

    Biologics like Secukinumab that block IL-17 to treat autoimmune skin diseases.

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    Pruritis Role in Atopic Dermatitis

    Histamine release causes itching, prompting further skin lesions and irritation.

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    Comedones

    Non-inflammatory acne lesions, which can be open (blackheads) or closed (whiteheads).

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    Inflammatory Acne Lesions

    Includes papules, pustules, and nodules associated with acne inflammation.

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    Precipitating Factors of Acne

    Factors like hormones, heat, stress, and diet that can trigger acne development.

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    Sebum Production

    Oil production by sebaceous glands, increased by androgens, leading to acne.

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    Study Notes

    Endocrine System Overview

    • The endocrine system is a complex network of glands and hormones that regulate various bodily functions.
    • Key components include hormones, their classifications, regulation, and interactions.
    • Learning objectives include understanding hormone classifications, metabolism, and endocrine system regulation.

    A Tale of Three Hormones

    • Insulin: A peptide hormone produced by the beta cells of the pancreas, regulating carbohydrate and fat metabolism.
    • Insulin Regulation: Controlled by blood glucose levels.
    • Insulin Metabolism: Primarily metabolized in the liver and kidneys.
    • Cortisol: A steroid hormone from the adrenal cortex, regulating glucose, immune response, and metabolism of fats, proteins, and carbohydrates.
    • Cortisol Regulation: Controlled by stress levels, but also by various factors including blood volume, electrolytes, fever, and even circadian rhythms.
    • Cortisol Metabolism: Primarily metabolized in the liver.
    • Thyroxine (T4) and Triiodothyronine (T3): Amino acid derivative hormones produced by the thyroid gland, affecting basal metabolic rate, protein synthesis, growth, neural maturation, and various metabolic functions.
    • T3/T4 Regulation: Controlled by metabolic demand, negative feedback loops (involving TSH and TRH), and iodine availability.
    • T3/T4 Metabolism: Metabolized in the liver and kidneys.

    Hypothalamic-Pituitary Axis

    • The hypothalamus and pituitary interact to regulate the endocrine system.
    • The hypothalamus secretes trophic hormones that trigger the anterior pituitary.
    • The anterior pituitary releases hormones that target various tissues.
    • The posterior pituitary is an extension of the neural tissue of the hypothalamus and releases hormones directly into the blood.
    • Learning objectives focus on describing the relationship between the hypothalamus and anterior/posterior pituitary, identifying hormones and their targets, and illustrating regulatory feedback loops (including negative feedback loops).

    Endocrine System Diagrams (Figures 7-11, 7-12, 7-13, and other figures mentioned)

    • These diagrams show the pathways and interactions within the endocrine system, displaying the relationships between the hypothalamus, pituitary gland, and target organs/glands/tissues, including the specific roles of hormones and negative feedback loops. They illustrate the detailed interactions and responses in the different endocrine pathways.

    Regulating Hormone Action

    • The actions of hormones may involve synergy (sum of effects greater than individual parts) or permissiveness (one hormone allowing another to have a full effect).
    • Different hormones and factors, like stress, can affect the secretion and permissive effects of other hormones. Feedback loops constantly adjust hormone levels, both increasing and decreasing them in response to changes in levels of other hormones, or conditions of the body.

    Endocrine Disorders

    • Hypersecretion and hyposecretion can result from problems with the adrenal cortex, hypothalamus, or anterior pituitary, often due to tumors or autoimmune disorders.
    • These conditions can cause varying symptoms associated with Cushing's syndrome (excess cortisol), Addison's disease (insufficient cortisol and aldosterone), and hyper/hypoaldosteronism. Dysfunctions in other regions of the HPA axis, such as non-functioning pituitary adenomas causing insufficient levels of hormones, can also lead to disease.

    Thyroid Gland

    • Learning objectives include describing synthetic thyroid hormone, regulatory pathways, and roles in homeostasis, metabolism, and development.
    • The thyroid gland produces thyroid hormone (T3/T4), which affects metabolism, growth, and development.
    • The hypothalamic-pituitary-thyroid axis regulates thyroid function, with negative feedback loops, via TSH and TRH. Iodine is crucial for thyroid hormone production.

    Adrenal Glands and Stress

    • The adrenal glands secrete cortisol in response to various stimuli, including stress, infections, trauma, and sudden withdrawal of glucocorticoids.
    • Cortisol plays various metabolic and immunoregulatory roles, impacting blood pressure regulation, electrolytes, carbohydrate metabolism, and the immune response.

    Cortisol Secretion (Regulation)

    • Cortisol secretion is primarily regulated by the hypothalamic-pituitary-adrenal (HPA) axis, but can be affected by other factors such as stress, circadian rhythms, and even electrolytes or blood volume.
    • Stress triggers a cascading effect in the HPA axis leading to cortisol secretion; other factors, including fever and hypotension, can also trigger a cortisol response.

    Actions of Thyroid Hormones

    • Thyroid hormones regulate a wide range of activities in tissues: stimulating metabolism, protein synthesis, carbohydrate absorption, fatty acid release, and have a permissive effect on other hormones, like those affecting growth and development.

    Regulation of Growth

    • Growth is regulated by endocrine factors, genetics, environment, and nutrition.
    • Related hormones like growth hormone (GH), insulin, and thyroid hormones, and related growth factors, play essential roles in growth. Growth is controlled by hormones that stimulate or inhibit various cellular processes related to growth and development.

    Calcium & Calcium Balance

    • Calcium homeostasis is maintained by negative feedback loops involving parathyroid hormone (PTH), calcitonin, vitamin D, and hormones affecting the renal and GI systems. The RAA system plays a role. The hormones work across bone, kidneys, and gut to maintain calcium homeostasis.

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    Related Documents

    Adrenal Disorders PDF
    Diabetes Mellitus PDF
    Dermatologic Disorders PDF

    Description

    Test your knowledge of the complex network of glands and hormones that make up the endocrine system. This quiz covers key hormones such as insulin, cortisol, and thyroid hormones, including their regulation and metabolism. Understand how these hormones interact to maintain bodily functions.

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