Endocrine System Quiz
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Questions and Answers

What is the primary method by which hormones are transported throughout the body in the endocrine system?

  • The bloodstream (correct)
  • Lymphatic system
  • Direct nerve pathways
  • Diffusion across cell membranes

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

  • Controlling bone remodeling and calcium deposition. (correct)
  • Coordinating reproductive systems, including maturation and gamete production.
  • Regulating development of the reproductive system and the central nervous system in the fetus.
  • Adjusting responses to stress, injuries and emergency situations.

    • Which of the following is a paired endocrine gland?

  • Thyroid gland
  • Adrenal gland (correct)
  • Pituitary gland
  • Pancreas

    • Which of the following structures is NOT a gland of the endocrine system?

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

    Besides the reproductive system, what other system does the endocrine system influence during fetal development?

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

    Which of the following is a risk factor for thyroid cancer?

    <p>Low iodine intake (D)</p> Signup and view all the answers

    What is the most common cause of primary hyperparathyroidism?

    <p>A tumor in the parathyroid glands (A)</p> Signup and view all the answers

    What is the primary function of parathyroid hormone (PTH)?

    <p>Manage calcium levels in the body (D)</p> Signup and view all the answers

    Which of the following is NOT a symptom of hypercalcemia?

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

    What is the most common type of thyroid cancer?

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

    Which of the following is a treatment option for thyroid cancer?

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

    What is the recommended treatment for hyperparathyroidism?

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

    Which of the following conditions can lead to secondary hyperparathyroidism?

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

    What is the primary function of the endocrine system in relation to the musculoskeletal system?

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

    Which of the following is a common effect of catecholamines released during a stress response?

    <p>Increased heart rate and elevated blood glucose (C)</p> Signup and view all the answers

    What is a typical effect of cortisol release from the adrenal cortex during stress?

    <p>Reduced inflammation and increased blood glucose (C)</p> Signup and view all the answers

    A patient presents with bilateral carpal tunnel syndrome. What other condition should a physical therapist consider in their differential diagnosis?

    <p>An issue arising from the pituitary gland (A)</p> Signup and view all the answers

    Which hormone is secreted by the anterior lobe of the pituitary gland that stimulates the adrenal cortex?

    <p>ACTH (Adrenocorticotropic Hormone) (C)</p> Signup and view all the answers

    A patient with a pituitary tumor reports headaches and visual disturbances. Why might this be?

    <p>Elevated intracranial pressure and compression of the optic chiasm (B)</p> Signup and view all the answers

    What is a characteristic feature of acromegaly in adults due to hyperpituitarism?

    <p>Overgrowth of long bones (B)</p> Signup and view all the answers

    Which of the following conditions is associated with an over-secretion of ACTH, a hormone of the anterior pituitary gland?

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

    What is a common cause of Cushing's Disease?

    <p>An adenoma of the anterior pituitary gland or exposure to glucocorticoids (B)</p> Signup and view all the answers

    What is a potential effect of increased prolactin levels due to hyperpituitarism?

    <p>Amenorrhea, gynecomastia, and lactation (C)</p> Signup and view all the answers

    What is the most common treatment for benign pituitary tumors causing hyperpituitarism?

    <p>Surgery and/or radiation (A)</p> Signup and view all the answers

    What are some signs of increased intracranial pressure that a physical therapist should be aware of?

    <p>Changes in consciousness/vision and pulse (B)</p> Signup and view all the answers

    What is a common cause of hypopituitarism?

    <p>Tumors and destruction of the pituitary gland (A)</p> Signup and view all the answers

    What is one of the roles of Human Growth Hormone (HGH) in the body?

    <p>To enhance fatty acid production for energy (A)</p> Signup and view all the answers

    Which symptom is a common manifestation of hypopituitarism?

    <p>Erectile dysfunction and irregular menstruation (B)</p> Signup and view all the answers

    What is a primary cause of Type I hypothyroidism?

    <p>Destruction of thyroid tissue (A)</p> Signup and view all the answers

    Which of the following is NOT a common symptom of hypothyroidism?

    <p>Increased metabolic rate (B)</p> Signup and view all the answers

    What diagnostic result is expected in a patient with hypothyroidism?

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

    Which of the following is a potential complication of thyrotoxicosis?

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

    Which musculoskeletal effect is associated with hypothyroidism?

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

    In women with rheumatoid arthritis, what condition is often observed?

    <p>Increased thyroid dysfunction (A)</p> Signup and view all the answers

    What treatment is commonly administered for hypothyroidism?

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

    What effect does hypothyroidism have on cholesterol levels?

    <p>Increased cholesterol and triglycerides (D)</p> Signup and view all the answers

    What is a common symptom of hyperthyroidism?

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

    What is the main characteristic of diabetes insipidus?

    <p>Copious diluted urine (B)</p> Signup and view all the answers

    Which test is commonly used to evaluate hormonal levels in hypopituitary disorders?

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

    What condition can result from untreated hyperthyroidism?

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

    What hormonal treatment is primarily used for patients with hypopituitary disease?

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

    Which symptom is associated with Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)?

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

    What is a likely effect of gonadotropin deficiency in males?

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

    Which of the following is a treatment for diabetes insipidus?

    <p>Replacement of ADH with medication (D)</p> Signup and view all the answers

    What is a common characteristic of thyroid disorders?

    <p>Affects multiple body systems (D)</p> Signup and view all the answers

    What age group is primarily affected by Graves disease?

    <p>20-40 years old (A)</p> Signup and view all the answers

    What is a common cause of iatrogenic hypoparathyroidism?

    <p>Accidental removal during thyroid surgery (C)</p> Signup and view all the answers

    Which electrolyte imbalance is associated with hypoparathyroidism?

    <p>Hyperphosphatemia (B), Hypocalcemia (D)</p> Signup and view all the answers

    What systemic effect is associated with hypoparathyroidism?

    <p>Increased osteoclast activity (B)</p> Signup and view all the answers

    What is a primary function of cortisol released from the adrenal cortex?

    <p>Stress response and food metabolism (C)</p> Signup and view all the answers

    What potential consequence may occur if Addison's disease is untreated?

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

    Which hormone's secretion decreases in Addison's disease leading to hypotension?

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

    What is a common diagnostic method for Addison's disease?

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

    What effect does hypoparathyroidism have on respiratory muscles?

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

    Which symptom is least likely associated with hypoparathyroidism?

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

    What treatment may be necessary in the event of tetany due to hypoparathyroidism?

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

    Study Notes

    Endocrine System Overview

    • Composed of numerous glands producing hormones
    • Hormones travel through the bloodstream to target organs, affecting their function
    • The endocrine system is responsible for:
      • Fetal development of reproductive system and CNS
      • Growth and development in childhood/adolescence
      • Coordinating reproductive systems
      • Maintaining internal environment
      • Responding to emergency situations

    Primary Function

    • Secretion of hormones

    Glands

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

    Endocrine Dysfunction

    • Dysfunction causes alterations in the body's systems because the endocrine system regulates growth and development

    Results from

    • Hyperfunction or hypofunction

    Neuroendocrine Response to Stress

    • Immune and endocrine systems are intimately related
    • Stress increases sympathetic nervous system activity
    • Adrenal glands release catecholamines
      • Pituitary gland releases:
        • ADH (antidiuretic hormone)
        • Prolactin
        • GH (growth hormone)
        • ACTH (adrenocorticotropic hormone)

    Neuroendocrine Response to Stress (Catecholamines)

    • Epinephrine
      • Increases heart rate and strength
      • Causes peripheral vasoconstriction
      • Elevates blood pressure
      • Elevates blood glucose
      • Stimulates fat breakdown
    • Norepinephrine
    • Dopamine

    Neuroendocrine Response to Stress (Cortisol)

    • Released from adrenal cortex
    • Regulates proteins, carbohydrates, and lipids to increase blood glucose
    • Inhibits fibroblast proliferation (poor wound healing, increased infection risk)
    • Helps with 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 (antidiuretic hormone), Oxytocin

    Pituitary Tumors (Adenomas)

    • Signs/symptoms:
      • Headaches
      • Increased intracranial pressure (ICP)
      • Decreased drainage from 3rd ventricle
      • Visual disturbances (optic chiasm, bilateral temporal hemianopsia)
      • Endocrine abnormalities

    Anterior Pituitary Gland Disorders

    • Over secretion of at least one hormone (hyperpituitarism):
      • HGH (Human Growth Hormone) → acromegaly in adults (usually benign tumor)
        • Excessive growth (overgrowth of long bones, hypertrophy of soft tissues, widened joint spaces)
        • Children can grow to >7ft (often up to 9 ft).
        • Adults (30-50yrs)-Increased size of jaw bones, hands/feet
      • ACTH → Cushing's disease (often due to an adenoma or exposure to glucocorticoids)
        • Muscle wasting, osteopenia, moon face, easy bruising, abdominal striae, acne, obesity, glucose intolerance, 5:1 women to men ratio, typically seen in childbearing years.
    • Prolactin diseases (over-secretion) - Amenorrhea, Gynecomastia, Lactation, Decreased libido, impotence.

    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 hours post-op
    • Watch for changes in consciousness, vision, pulse, and blood pressure (may signal increased ICP); report these changes
    • Monitor for meningitis symptoms (headache, irritability, neck rigidity)

    HYPOPituitarism

    • Diminished secretion by anterior lobe (>70%)
    • Congenital and acquired etiologies:
      • Tumours
      • Postpartum hemorrhage
      • Anorexia
      • Anemia
      • GI dysfunction
    • Gradual onset of symptoms and signs
    • HGH → decreased growth, delayed puberty (affects cartilage, skeletal muscle, connective tissue, skin; enhances fatty acid production)
    • LH/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/poor growth in children

    Congenital HGH Deficiency

    • Normal birth length
    • Drop off height curve by 1-2 years of age
    • Normal intelligence
    • Obesity
    • Delayed skeletal maturation
    • Delayed puberty
    • Short
    • HGH replacement therapy (daily shot 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 and axillary hair
    • Hypothermia
    • Hypotension
    • 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 to determine growth

    HYPOPituitary Disease Medical Treatment

    • Removal of causative factor (e.g., surgical tumor removal)
    • Hormone replacement therapy (lifelong):
      • Steroids to replace adrenal hormones
      • Synthroid to correct loss of TSH
      • Sex hormones
      • Growth hormones

    HYPOPituitarism - Implications for Physical Therapy

    • May observe weakness, fatigue, lethargy, apathy, orthostatic hypotension
    • Prevent infections
    • Impaired vision may occur (bilateral hemianopia)

    Posterior Pituitary Lobe Disorders

    • Diabetes Insipidus:
      • Rare; caused by damage to hypothalamus or posterior pituitary
      • ADH (antidiuretic hormone) deficiency
        • Kidneys don't reabsorb enough water
        • Copious, diluted urine
        • Dehydration, dizziness,fatigue, polydipsia
      • Treatment: ADH replacement with medication
    • Syndrome of Inappropriate ADH Secretion (SIADH)
      • Increased ADH secretion
      • Caused by infections, trauma, tumors, medications
      • Increased water retention, hyponatremia (low sodium in blood)
        • Lethargy, weakness, coma
      • Treatment: Correct sodium balance (surgery, chemotherapy, radiation if tumor, fluid restriction, diuretics)

    Thyroid Gland

    • Located inferior to larynx
    • Secretes:
      • Thyroxine (T4)
      • Triiodothyronine (T3)
      • Calcitonin
    • Actions:
      • Regulates basal metabolism
      • Promotes growth and development
      • Mobilizes fat
      • Exchanges electrolytes and proteins

    Thyroid Disorders

    • More common in women (4:1) and those with family history
    • Affects many body systems:
      • Hair
      • Nails
      • Eyes
      • GI tract
      • Lungs
      • Heart
      • Nervous tissue
      • Bones
      • Muscles

    Hyperthyroidism

    • Graves Disease: An autoimmune disease causing thyroid enlargement and increased hormone secretion (sympathetic nervous system activity increase)
      • Accounts for 85% of hyperthyroidism cases
      • Typically occurs between 20-40 years of age; predominantly seen in women (4:1)
      • Can occur during pregnancy
    • Symptoms:
      • Increased size of thyroid (goiter)
      • Heat intolerance
      • Weight loss
      • Sweating
      • Tremor
      • Tachycardia
      • Irritability
      • Poor concentration
      • Diarrhea
      • Mood swings
      • Exophthalmos (eye protrusion)
    • Diagnosis: Decreased or normal TSH, elevated T3 & T4, increased radioactive iodine uptake
    • Treatment: Medication to inhibit synthesis (30% remission without treatment), radioactive iodine (RAI), followed by thyroid medication (RAI causes hypothyroidism), surgery
    • Physical Therapy Implications: Exercise intolerance and reduced exercise capacity, proximal muscle weakness and myopathy, thyrotoxicosis can aggravate pre-existing heart disease, lead to atrial fibrillation, congestive heart failure, and worsen angina pectoris, increased risk for myocardial infarction.

    Hypothyroidism

    • Decreased thyroid hormones, slowing metabolism
    • Causes:
      • Autoimmune (Hashimoto's Thyroiditis)
      • Surgery affecting thyroid
      • Overmedication for hyperthyroidism
      • Diet
      • Congenital
    • More prevalent in women (30-60 years old)
    • Type I: Hormone deficient (loss of thyroid tissue).
    • Type II: Hormone resistant (pituitary failure to synthesize adequate TSH)
    • Pathology: Thyroid tissue destruction → decreased thyroid hormone secretion → increased TSH secretion from the anterior pituitary
    • Symptoms:
      • Slowed metabolism (decreased GI tract mobility, weight gain)
      • Bradycardia
      • Slowed neurologic function (slow speech, decreased short-term memory, increased sleep, headache, cerebellar ataxia, mood changes)
      • Increased cholesterol and triglycerides
      • Anemia
      • Musculoskeletal effects (proximal hip weakness, myalgia, stiffness in small joints, paresthesia, joint edema, increased bone density, carpal tunnel)
    • Diagnosis: Elevated TSH, normal or decreased T3 & T4, elevated CPK-MB
    • Treatment: Synthetic thyroid hormones (Synthroid)
    • Prognosis: Untreated can cause severe CAD (increased triglycerides and cholesterol)
    • Physical Therapy Implications: Correlation between hypothyroidism and fibromyalgia syndrome (FMS) continues to be investigated. Increased activity and exercise help clients with constipation from slowed metabolism and decreased peristalsis.

    Thyroid Cancer

    • Rare, usually slow-growing
    • More prevalent in women (20-60 years old)
    • Risk factors: 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 Gland

    • Two glands on each lobe of the thyroid.
    • Secretes parathyroid hormone (PTH).
    • Manages calcium levels: If calcium levels are low, PTH releases calcium from bones and absorbs it from the GI tract.
    • Hyperparathyroidism: too much PTH production.
      • Primary: Tumor in one or both glands. Symptoms may include thirst, frequent urination, high blood pressure, heartburn, confusion, kidney stones, and joint pain.
      • Secondary: Low calcium levels in the blood. Common causes are low vitamin D and kidney diseases which affect phosphate
    • HYPOparathyroidism: decreased PTH secretion, leads to hypocalcemia (low calcium levels), increased phosphate, and tetany (muscle spasms)
      • Causes: Iatrogenic (accidental removal during thyroidectomy), hypovolemia and infarction of parathyroid, scar tissue, tumors, Low vitamin D Deficiency.
      • Symptoms: Irritable, anxiety, agitation, increased osteoclast activity, spasms of respiratory muscles.
      • Diagnosis: PTH levels, electrolytes, X-rays,
      • Treatment: IV calcium if tetanic, vitamin D supplements, medications.

    Adrenal Gland

    • Located in each kidney, outer cortex and inner medulla
    • Adrenal Cortex: Secretes mineralocorticoids (aldosterone- regulates blood pressure, sodium and potassium balance), glucocorticoids (cortisol-affects metabolism, response to stress, inflammation), androgens (testosterone, estrogen, progesterone)
    • Adrenal Medulla: Secretes epinephrine, increasing heart rate, contractility, blood pressure, blood glucose

    Adrenal Insufficiency (Addison's Disease)

    • Cause is a drop in the secretion of cortisol (glucocorticoid) and aldosterone (mineralocorticoid)
    • Possible etiologies: TB complications, autoimmune diseases, radiation, neoplasm, infections.
    • Risk factors: Surgery, pregnancy, trauma, infection
    • Pathogenesis: Hypoglycemia, weakness, hypotension, nausea, emotional lability, paranoia, increased skin pigmentation
    • Diagnosis: Cortisol levels
    • Treatment: Corticosteroids
    • Prognosis: Untreated cases are usually fatal
    • Physical Therapy Implications: Aquatic therapy may be contraindicated, because heat/humidity of the pool environment requires more cortisol, adrenal gland cannot regulate body temperature sufficiently

    Secondary Adrenal Insufficiency

    • Causes: Tumors in hypothalamus or pituitary, rapid taper of corticosteroids
    • Symptoms: Arthralgia, myalgia, tendon calcification
    • Treatment: ACTH replacement, managing fluid/electrolyte balances

    Cushing Syndrome

    • Increased cortisol levels, resulting from adrenal gland tumors or high-dose steroid treatments
    • Symptoms: Muscle loss (amino acids), stretch marks, decreased wound healing, thin skin, muscle weakness, osteoporosis, fractures, Cushingoid face, increased weight, hair growth, buffalo hump
    • Physical Therapy Implications: Adverse effects of corticosteroid treatment such as changes in sleep/mood, GI irritation, hyperglycemia, and fluid retention.

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