Endocrine Final PDF

Endocrine Final Study online at https://quizlet.com/_bzjgqc 1. urine or bile metabolites are excreted via: 2. paracrine hormone signals diffuse to and...

Endocrine Final Study online at https://quizlet.com/_bzjgqc 1. urine or bile metabolites are excreted via: 2. paracrine hormone signals diffuse to and affect nearby cells 3. autocrine hormones that acts on same cell that secreted them 4. endocrine signaling what is the most common hor- mone signaling in the human body? 5. negative feedback (positive/negative) feedback reg- ulates the hormone produc- ing physiological responses and eventually inhibits further secre- tion 6. steroid hormones, peptidic hormones, what are the three major classes amino acid hormones (tyrosine deriva- of hormones? tives or biogenic amines) 7. peptidic hormones and amino acid hor- which two hormones are mones non-steroid? 8. cholesterol all steroid hormones are lipids that are derived from: 9. lipophilic and hydrophobic steroid hormones chemically are: 10. transport proteins (shuttle buses) how are a majority of steroid hor- mones carried in the blood? 1 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 11. lipophobic and hydrophilic protein hormones chemically are: 12. steroid hormones thyroid hormones are examples of tyrosine derivatives that are chemically similar to: 13. protein hormones epinephrine and norepinephrine are examples of tyrosine deriva- tives that are chemically similar to: 14. down-regulation less number of receptors on tar- get tissue causing a decreased response 15. up-regulation increased number of receptors on target tissue causing an in- creased response 16. primary endocrine deficiency disorders endocrine organ's trophic hor- mone levels is actually elevated due to normal feedback respons- es and these is a problem with the endocrine gland at the end of the endocrine axis 17. thyroid gland; TRH and TSH hashimoto's thyroiditis, which gland is the problem? which hor- mone is elevated? 18. secondary endocrine deficiency disor- occurs when the trophic hormone ders for the target tissue organ is defi- cient 19. pituitary gland; TRH secondary hypothyroidism, which gland is the problem? which hormone is elevated? 20. tertiary endocrine deficiency disorders problem occurs at the top of the endocrine axis 2 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 21. hypothalamus; none tertiary hypothyroidism, which gland is the problem? which hor- mone is elevated? 22. autoimmune destruction what is the most common reason for hormone deficiency? 23. genetic predisposition and an environ- autoimmune processes appear mental trigger to require two factors: 24. hypersecretion if endocrine cells themselves become cancerous, the en- docrine tissue produces (hyper- secretion/hyposecretion) of hor- mones? 25. hyposecretion if the neoplasm destroys hor- mone-producing cells, there will be a (hypersecretion/hyposecre- tion) of hormones? 26. neoplasms craniopharyngiomas and null-cell tumors are examples of: 27. craniopharyngioma slow-growing tumors that orig- inate from the remnants of Rathke's pouch above the sella 28. ischemia an inadequate blood supply to an organ or part of the body 29. infarction death of tissue 30. infiltrative disease diffuse disease process that spreads throughout an entire or- gan 31. sheehan's syndrome 3 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc disorder is a form of postpartum pituitary necrosis or infarction; ex- ample of ischemia and infarction 32. type 1 diabetes mellitus patients with chronic pancreatitis may develop transient ________________________ from insufficient insulin secretion 33. hemochromotosis hypopituitarism, particularly a form resulting in hypogo- nadotropic hypogonadism is a prominent manifestation of _________________ 34. thyroid gland or gonads although extremely rare, lack of endocrine gland development during embryogenesis usually occurs in: 35. endocrine hypofunction can be due to congenital defects in hormone biosynthesis result- ing in a mutation genes that en- code hormones or hormone-pro- ducing enzymes 36. removing the underlying cause or hor- what is the general principles for mone supplementation treating endocrine hypofunction? 37. TRUE (true/false) tumors can cause an excess production of hormones in an endocrine glands 38. Graves' disease autoimmune stimulation resulting in hyperfunction is seen most commonly with: 39. true (true/false) autoimmune stimula- tion leading to hyperfunction of endocrine glands is rare 4 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 40. ectopic production of hormones tumors cause hormone produc- tion in tissues that ordinary do not produce the hormone; it's rare but include ACTH, ADH and cal- citonin 41. insulin which hormone is rarely ex- pressed ectopically? 42. iatrogenic intentional exogenous adminis- tration of hormone; doctor pre- scribed 43. factitious exogenous administration of hor- mone by the patient without the clinician's knowledge 44. tumor removal, radiation, pharmacolog- what are the three treatments for ic intervention endocrine hyperfunction? 45. diencephalon hypothalamus is part of the: 46. anterior lobe (adenohypophysis) and what are the two main parts of the posterior lobe (neurohypophysis) pituitary gland? 47. sella turcica hypothalamus and pituitary gland are encapsulated by a cavity in the sphenoid bone called: 48. hypothalamic nuclei clusters of neuron cell bodies within the hypothalamus 49. antidiuretic hormone and oxytocin hor- which two hormones are made in mone the hypothalamus and released from the posterior pituitary? 50. paraventricular nucleus which hypothalamic nucleus pro- duces oxytocin? 5 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 51. supraoptic nucleus which hypothalamic nucleus pro- duces antidiuretic hormone? 52. increased plasma osmolality what is the most important phys- iologic stimulus for increasing ADH secretion? 53. hypovolemia decrease in extracellular fluid vol- ume of 10% or more cause a sig- nificant decrease in arterial blood pressure that leads to ADH se- cretion 54. ethanol what is an important inhibitory factor for ADH that causes an in- crease in urination? 55. water reabsorption by the kidneys what is the primary action of ADH? 56. increase; decrease ADH causes an __________ in urine osmolality and a ____________ in urine volume 57. principal cells ADH has cellular effects in ___________ cells of the late dis- tal convoluted tubule and collect- ing duct 58. V2 receptors ADH binds to _______ receptors causing the insertion of aquapor- in-2 channels, thereby increasing water permeability 59. contraction of arteriolar vascular what is the secondary action of smooth muscle ADH? 60. V1 receptors ADH binds to _______ receptors thereby causing vasoconstriction and increased blood pressure 6 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 61. neurogenic diabetes insipidus lack of ADH secretion in posterior pituitary 62. hypothalamus neurogenic diabetes insipidus is an issue in the __________________ 63. neurogenic diabetes insipidus, nephro- which three hypothalamic and pi- genic diabetes insipidus, dipsogenic di- tuitary disorders have a clinical abetes insipidus (primary polydipsia) manifestations in dilute urine and intense thirst? 64. desmopressin (DDAVP; ADH analogs) what is the treatment for neuro- genic diabetes insipidus? 65. neurogenic diabetes insipidus if there was a response to desmopressin, does the patient have (neurogenic/nephrogenic) diabetes insipidus? 66. nephrogenic diabetes insipidus kidneys are unresponsive to ADH due to a defect in the V2 recep- tors or cell signaling process 67. polycystic kidney disease or malfunc- nephrogenic diabetes insipidus tion in V2 receptors causes: 68. thiazide diuretics (HydroDIURIL) what is the treatment for nephro- genic diabetes insipidus? 69. thiazide diuretics what is the medication that caus- es an increased reabsorption of sodium and water in proximal tubules? 70. dipsogenic diabetes insipidus decrease in blood osmolality 71. drinking LOTS of water due to mental what causes dipsogenic diabetes issues (Schizophrenic patients) insipidus? 7 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 72. therapy what is the treatment for dipso- genic diabetes insipidus? 73. oxytocin stimulation of the nipple through suckling produces a neurohu- moral reflex that causes secre- tion of: 74. oxytocin causes contraction of the my- oepithelial cells of the mammary alveoli and ducts and the ejection of milk 75. oxytocin affects the myometrium, as it in- creases both the frequency and the duration of action potentials during uterine contractions 76. pitocin (oxytocin) what is used to induce or atten- uate labor in pregnant females needing assistance and prevent postpartum uterine hemorrhage? 77. thyrotropes, corticotropes, soma- what are the cell types of the an- totropes, lactotropes, gonadotropes terior pituitary? 78. somatotropes what is the primary cell type in the anterior pituitary? 79. TSH (thyroid stimulating hormone) thyrotropes secrete: 80. ACTH (adrenocorticotropic hormone) corticotropes secrete: 81. GH (growth hormone) somatotropes secrete: 82. prolactin lactotropes secrete: 83. FSH (follicle stimulating hormone) and gonadotropes secrete: LH (luteinizing hormone) 8 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 84. gonadotropin-releasing hormone, thy- which of the six anterior pituitary rotropin-releasing hormone, corti- hormones do NOT have an in- cotropin-releasing hormone hibiting hormone? 85. somatostatin (GHRH and GHIH) what are the main regulators of growth hormone (GH) secretion? 86. skeletal muscle, liver, adipose tissue what are the target tissues for growth hormone (GH)? 87. somatomedins (insulin-like growth fac- group of proteins, released main- tors) ly from the liver (also skele- tal muscle, bone and kidneys) in response to growth hormone, that aid body growth and mainte- nance 88. puberty when does growth hormone peak? 89. acromegaly and pituitary gigantism excess growth hormone due to overstimulation of hypothalamus on GHRH causing an overpro- duction of GH from anterior pitu- itary 90. pituitary adenoma and congenital syn- what are the two causes for drome acromegaly and pituitary gigan- tism? 91. multiple endocrine neoplasia Type 1 what is the specific congenital (Werner) Syndrome syndrome found in individuals with acromegaly and pituitary gi- gantism? 92. adults having LARGE hands, feet and what is the clinical manifestations face for acromegaly? 93. what are symptoms of acromegaly? 9 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc carpal tunnel syndrome, diabetes mel- litus, congestive heart failure, gastroin- testinal cancers 94. macroglossia, prognathic mandible, what are the six oral manifesta- malocclusion, spacing in teeth, thick tions for acromegaly and pituitary lips, enlarged salivary glands gigantism? 95. prognathic mandible enlarged mandible 96. class III which class of maloclusion would you predict to see in a patient with acromegaly? 97. tall and large body what is the clinical manifestations of pituitary gigantism? 98. octreotide (sandostatin) and lanreotide what medications (2) are GHIH (somatostatin) preparations used to treat acromegaly? 99. pegvisomant (somavert) what medication is a growth hormone receptor antagonists used to treat acromegaly that blocks growth hormone receptors throughout the body and reduces blood levels of IGF-1? 100. pituitary dwarfism growth hormone deficiency 101. tumors what is the cause of pituitary dwarfism? 102. delayed tooth eruptions, small maxil- what are the four oral manifesta- la and mandible, malocclusion due to tions of pituitary dwarfism? overcrowding, decreased salivary flow with increased caries and periodontal disease 103. 10 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc genotropin, humatrope, norditropin, nu- what medications (6) are used to tropin, protropin, saizen treat pituitary dwarfism and given subcutaneous? 104. pituitary adenoma tumor on the pituitary gland caus- ing increase/decrease in hor- mone secretion 105. pituitary adenoma (hyperprolactine- what causes an increase of pro- mia) lactin hormone? 106. tumors due to genetics what causes pituitary adenoma? 107. infertility die to inhibitory effect on what are the clinical manifesta- spermatogenesis (depends on hor- tions of pituitary adenoma? mone) 108. dopamine for a female that is not preg- nant or lactating, prolactin se- cretion is tonically inhibited by _____________ from the hypo- thalamus 109. prolactin stimulated milk production in the postpartum period 110. promotes additional breast tissue de- what does prolactin, estrogen, velopment in preparation for milk pro- progesterone, insulin and cortisol duction do to breast tissue? 111. GnRH (gonadotropin-releasing hor- prolactin inhibits ovulation by in- mone) hibiting the synthesis and release of: 112. hyperprolactinemia high prolactin levels in males due to a prolactinoma causing inhibitory effect on GnRH se- cretion and spermatogenesis re- sulting in infertility; gynecomastia and galactorrhea 11 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 113. cabergoline (cabaser) and bromoscrip- what medications (2) are used to tine (parlodel); dopamine agonists treat prolactinoma caused by pi- tuitary adenoma? what are they categorized as? 114. bitemporal hemianopsia what does a pituitary adenoma do to the eyes when it pushes on the optic chiasm? 115. thyroid gland located anterior and lateral to tra- chea just below the thyroid carti- lage (Adam's apple) 116. isthmus what connects the two (some- times three) lobes of the thyroid gland? 117. cricoid cartilage isthmus is located below: 118. thyroglobulin (TGB) protein synthesized inside the thyroid's follicular cells 119. C cells (parafollicular cells) secrete calcitonin in thyroid gland 120. T3 (triiodothyronine) and T4 (thyroxine) what are the two types of thyroid hormones? 121. tyrosine thyroid hormones are derivatives of the amino acid: 122. T4 (thyroxine) majority of the thyroid hormone secreted by the thyroid gland is: 123. T3 (triiodothyronine) (T3 or T4) is 4-5 times more po- tent 124. iodine what trace element is contained in thyroid hormone? 12 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 125. T3 MIT + DIT = 126. T4 DIT + DIT = 127. thyroid peroxidase what's required in thyroid hor- mone synthesis? 128. thyroxine-binding globulin (TBG), thy- what are the three major thyroid roxine-binding pre-albumin (TBPA), al- hormone transport proteins? bumin 129. thyroid gland what is the first endocrine gland to develop during gestation? 130. maturation of CNS thyroid hormone is important in the development of: 131. thyroid hormone which hormone maintains alert- ness, concentration and focus in adults? 132. true (true/false) thyroid hormone is re- quired for growth to adult stature 133. increased intestinal motility what effect does thyroid hormone have on the GI tract? 134. Hashimoto's thyroiditis what is the most common patho- physiology for hypothyroidism? 135. Hashimoto's thyroiditis autoimmune system attacks thy- roid gland 136. hypothyroidism Post-hyperthyroid treatment is the removal of the thyroid gland (thyroidectomy) due to a overpro- duction of thyroid hormone. A thy- roidectomy causes: 137. hypothyroidism 13 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc what can an iodine deficiency cause? 138. true (true/false) if the thyroid gland is completely absent at birth this can cause hypothyroidism 139. hypothyroidism lack of TSH is due to a problem with the anterior pituitary or hypo- thalamus and can cause: 140. thyroid hormone (T3 and T4) deficiency what is the overall cause of hy- pothyroidism? 141. hypothyroidism following clinical manifestations are associated with? -moodiness/irritability -depression -loss of body hair -dry, patchy skin -weight gain -cold sensitivity -constipation -accumulation of glycosamino- glycans 142. myxedema swelling due to an accumula- tion of glycosaminoglycans in hy- pothyroidism 143. myxedema coma severe hypothyroidism leading to a decreased mental status and hypothermia; medical emergency with a high mortality rate 144. hypothyroidism following dental aspects are as- sociated with? -macroglossa 14 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc -thick lips -micrognathia (small jaw) - dysgeusia (taste alteration) -enamel hypoplasia -delayed tooth eruption in kids - poor periodontal health - delayed wound healing -burning mouth syndrome 145. levothyroxine (T4) and liothyronine (T3) what are the two categories of synthetic thyroid preps to treat hypothyroidism? 146. levoxyl, synthroid, levothroid, unithroid what 4 medications are catego- rized as levothyroxine? 147. cytomel what medication is categorized as liothyronine? 148. cardiovascular system when taking levothyroxine, mov- ing from hypothyroid to a euthy- roid state can cause excessive stress on: 149. morning on an empty stomach when should you take levothyrox- ine? 150. factitious hyperthyroidism what is the boxed warning for levothyroxine? 151. Graves' disease what is the most common cause of hyperthyroidism? 152. Graves' disease hyperthyroidism; TSI antibodies do NOT destroy thyroid gland, but BIND to TSH receptors causing the thyroid gland to constantly be stimulated 153. primary hyperthyroidism 15 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc acute thyroiditis, toxic nodular goiter, hyperfunctioning thyroid adenoma 154. TSH-secreting adenoma secondary hyperthyroidism 155. increased T3 and T4 production hyperthyroidism causes: 156. glycosaminoglycan accumulation what causes the bulging eyes in individuals with hyperthyroidism, specifically Graves' disease? 157. is NOT acute (destructive) thyroiditis (is/is NOT) the same as Hashimoto's thyroiditis 158. acute thyroiditis initial presentation of hyperthy- roidism which is followed by a hy- pothyroid phase and then recov- ery of thyroid function 159. is NOT Hashimoto's thyroiditis, there (is/is NOT) recovery of thyroid function 160. hyperthyroidism following clinical manifestations are associated with? -bulging eyes -weight loss despite increased appetite -heat intolerance (body produces more heat) -rapid heart rate -sweating -hyperactivity -anxiety/nervousness/irritability -insomnia -goiter -mentural irregularities -frequent bowel movements 16 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 161. hyperthyroidism following dental aspects are as- sociated with? -accelerated dental eruption in children -increased susceptibility to caries and periodontal disease -burning mouth syndrome -increased dental pain response 162. methimazole, proplythiouracil (PTU), what are the six HYPERthryoid radioactive iodine therapy, beta-block- medications/treatments? ers, iodine salts, corticosteroids 163. methimazole (tapazole) and propylth- which two hyperthyroid medica- iouracil (PTU) tions inhibit thyroid peroxidase and are considered thionamide drugs? 164. thionamide drugs inhibit the synthesis of T4 and T3 by inhibiting thyroid peroxi- dase-catalyzed steps in the syn- thetic process 165. PTU (propylthiouracil) which hyperthyroid medication inhibits the conversion of T4 to T3 in peripheral tissues? 166. thyroid hormone is stored in colloid of why does it take several weeks thyroid follicles for thyroid hormone levels to re- turn to normal after taking thion- amide drugs? 167. agranulocytosis and liver failure what are the serious ad- verse/side effects for methima- zole and propylthiouracil medica- tion? 168. stop taking medication and do a CBC 17 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc While taking a thioanamide drug (methimazole or propylth- iouracil), the patient starts to ex- perience a sore throat and is run- ning a fever. What should the pa- tient do? 169. CBC and liver profile prior to initiating thionamides, many clinicians obtain: 170. takes awhile to see effects since the what are the special considera- thyroid stores T3 and T4 tions for thionamide drugs? 171. radioactive iodine (RAI) therapy administered in solution or cap- sule of sodium iodine and can re- sult in extensive local tissue dam- age to thyroid 172. radioactive iodine (RAI) therapy what is the best treatment for Graves' Disease? 173. self-isolate to avoid radioactive spread what are adverse/side effects to radioactive iodine therapy? 174. DO NOT give to pregnant women what is a special consideration for radioactive iodine therapy? 175. hypothyroidism most experts advocate radioio- dine (RAI) therapy doses that re- sult in: 176. transient vocal cord paralysis what is the most concerning com- plication for thyroidectomy? 177. beta-blockers (tenormin) controls symptoms of hyperthy- roidism by decreases adrenergic manifestations (tachycardia, pal- pitations, anxiety, etc.) and start- ed after diagnosis until thion- amide starts to be effective 18 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 178. iodine salts/solutions potassium iodide that block ra- dioactive iodine uptake during ac- cidental exposure 179. corticosteroids (prednisone) medication given specifically for ophthalmopathy caused by Graves' Disease 180. thyroid storm rare, life-threatening condition caused by severe clinical mani- festations of hyperthyroidism 181. elevated T3 and T4 and low TSH what does the lab work look like when an individual has a thyroid storm? 182. TRUE (true/false) thyroid nodules are not always cancerous and are of- ten benign 183. papillary thyroid cancer which thyroid cancer is the most common? 184. papillary thyroid cancer arise from follicular cells, slow-growing, females are 3x more likely and can spread to lymph nodes 185. follicular thyroid cancer arise from follicular cells, slow-growing but MORE aggres- sive than papillary, associated with low iodine and can spread beyond the lymph nodes 186. lungs, liver, bone, brain where can follicular thyroid can- cer spread? 187. hurthle cell thyroid cancer 19 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc arise from follicular cells, spreads through blood aggressively and has a lower cure rate 188. medullary thyroid cancer arise from C-Cells, tumor secrets a lot of calcitonin, spreads to lymph nodes, males and females have this equally 189. anaplastic thyroid cancer rare, extremely aggressive, looks different under a microscope and poor prognosis 190. dry mouth (xerostomia) when treating thyroid cancer, ra- diation therapy and chemothera- py can lead to oral health con- cerns such as: 191. parathyroid gland humans typically have 4 (could have as few as 2 or as many as 8); adhere to the posterior sur- face of thyroid gland 192. inferior thyroid arteries parathyroid glands are well vas- cularized and derive their blood supply mainly from: 193. principal (chief) cells and oxyphil cells what are the two most predom- inant cells in the parathyroid glands? 194. principal (chief) cells synthesis and secretion of PTH and sensors of minute fluctua- tions of extracellular fluid calcium 195. unknown what is the function of oxyphil cells in the parathyroid glands? 196. hypercalcemia 20 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc what is the major stimulus for se- cretion of parathyroid hormone (PTH)? 197. hypercalcemia what is the stimulus for calcitonin secretion? 198. osteoclasts PTH effects bone by stimulating: 199. reabsorption of calcium in distal con- PTH effects kidneys by stimulat- voluted tubules and 1-hydroxylation of ing: 25-hydroxycholecalciferol 200. uptake of calcium by active Vitamin D PTH effects the intestines by stimulating: 201. decrease phosphate reabsorption how does PTH effect phosphate? 202. vitamin D 1,25 dihydroxycholecalciferol is the active form of: 203. primary hyperparathyroidism adenoma causing an INCREASE in PTH 204. stones, thrones, bones, groans, psychi- what are the clinical mani- atric overtones festations (5) of hyperparathy- roidism/hypercalcemia? 205. primary hyperparathyroidism following dental aspects are as- sociated with? -gradual loosening, drifting and loss of teeth -spacing of teeth -brown tumor lesions of the bones surrounding oral cavity raising the risk of fracture -malocclusion -dental pain -soft tissue calcification 21 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc -sialolithiasis (stones in salivary gland) 206. hypocalcemia and hyperphosphatemia what is the pathophysiology for primary hypoparathyroidism? 207. primary hypoparathyroidism adenoma causing a DECREASE in PTH 208. cardiac arrhythmias, paresthesia what are the clinical manifes- (numbness), Trousseau's sign and tations of primary hypoparathy- Chvostek's sign roidism? 209. Trousseau's sign arm/carpal spasm associated with hypocalcemia 210. Chvostek's sign cheek/facial spasm associated with hypocalcemia 211. primary hypoparathyroidism following dental aspects are as- sociated with? -enamel hypoplasia -delayed eruption -poorly calcified dentin -microdontia (small crowns) -malformed roots -dental caries 22 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc -paresthesia (tingling of tongue or lips) 212. synthetic PTH, oral calcium carbonate what treatment is recommended tablets, vitamin D for individuals with primary hy- poparathyroidism? 213. spongy bone and compact bone what are the two types of bone tissue? 214. spongy bone bone tissue that is strong, light-weight and flexible 215. compact bone bone tissue that is strong and heavy 216. flexible without mineral, bone is: 217. brittle without collagen, bone is: 218. osteogenic cells bone stem cells found mainly in the periosteum and endosteum 219. osteoblasts bone forming cells derived from osteogenic cells; synthesis and secrete unmineralized osteoid and collagen AND pump calcium and phosphate salts into and out of the bone tissue 220. osteocytes derived from osteoblasts that have secreted osteoid around themselves; referred to as mature bone cells 221. osteoclasts derived from monocytes and known as bone-resorbing (dis- solving) cells 222. osteons 23 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc structural unit of compact bone; tiny, weight-bearing pillars 223. lamellae concentric rings of compact bone tissue that help form the osteons 224. lacunae bony depression in the lamellae in which bone cells are housed 225. Haversian (central) canal canals found in the core of os- teons in which blood vessels and nerves pass through 226. volkmann's (perforating) canals canals that connect osteons to- gether; also a passageway for blood vessels and nerves to enter and leave bone 227. osteoporosis bone resorption is faster than bone formation and leads to de- terioration of bone quality 228. DEXA scan scan used to measure bone den- sity 229. lifestyle, genetic factors, medical condi- what are the four causes for os- tions, medications teoporosis? 230. low calcium intake, vitamin D deficien- what are the lifestyle factors that cy, excess vitamin A intake, smoking, can cause an individual to have alcohol abuse osteoporosis? 231. hyperparathyroidism and cushing syn- what are the two medical condi- drome tions that can cause an individual to have osteoporosis? 232. fragility fracture and decreased bone what are the clinical manifesta- mass tions of osteoporosis? 233. 24 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc loss of bone mass in the mandible can what is the dental aspect of os- cause tooth loss teoporosis? 234. calcium and vitamin D supplements, what treatment is recommended bisphosphonates, SERMs, nasal calci- for individuals with osteoporosis? tonin 235. calcium carbonate and calcium citrate what are the two most widely available calcium supplements? 236. calcium carbonate what is the cheapest and best first choice for calcium supple- mentation? 237. raloxifene (evista) tissue selective estrogen recep- tor modulator (SERM) that had been approved by the FDA for the prevention and treatment of osteoporosis; causes blood clots 238. miacalcin and fortical nasal calcitonin used for treat- ment of osteoporosis; isolated from salmon 239. denosumab (prolia) injection of humanized mono- clonal antibody against RANKL; inhibiting osteoclast formation, decreasing bone resorption, in- creasing BMD and reducing risk of fracture 240. calcitonin protein hormone (32 amino acids) that are synthesized and secreted by the parafollicular cells of the thyroid gland 241. alendronate, risedronate, ibandronate, what are the four bisphosphonate zoledronic acid drugs? 242. oral bisphosphonates 25 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc what is the first line of therapy for osteoporosis? 243. bisphosphonates which medication must be taken in the morning with a full glass of water at least 30 minutes be- fore other food/drink and remain in an upright position for at least 30 minutes afterwards to avoid reflux and esophageal issues? 244. ONJ (osteonecrosis of the what is the most alarming ad- jaw/mandible) verse effect of bisphosphonate? 245. hormone replacement therapy (HRT) in the past, what WAS consid- ered the primary therapy for the prevention of postmenopausal osteoporosis and menopausal symptoms? 246. increases the risk of breast cancer, why is hormone replace- stroke and venous thromboembolic ment therapy (HRT) no longer events the primary therapy for post- menopausal osteoporosis? 247. PTH (parathyroid hormone) stimulates osteoblasts to in- crease osteoblast production of RANKL (receptor activator of nu- clear factor kappa-b ligand) 248. RANK receptor M-CSF give rise to osteoclasts that express the: 249. osteoprotegerin (OPG) osteoblasts also produce a "decoy receptor" called ___________________ that binds to RANKL and prevents the RANKL/RANK interaction caus- ing osteoclastogenesis inhibitory activity 26 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 250. estradiol what increases the production of osteoprotegerin (OPG) to dimin- ish bone resportion? 251. rickets/osteomalacia calcium and vitamin D deficiency causing weight-bearing bones to bend and deform in children and increase in fractures for adults 252. adrenal glands located in the retroperitoneal cav- ity above each kidney; surround- ed by fat and enclosed in the re- nal fascia 253. right adrenal gland which adrenal gland that is shaped like a pyramid? 254. left adrenal gland which adrenal gland is semilunar in shape and the larger of the two? 255. adrenal cortex what is the outside of the adrenal gland and makes up 80% of its composition? 256. adrenal medulla what is the inside of the adrenal gland and makes up 20% of its composition? 257. TRUE (true/false) adrenal cortex and adrenal medulla are two separate glands that make up the adrenal gland 258. zona glomerulosa (outer), zona fascicu- what are the three distinct layers lata, zona reticularis (inner) of the adrenal cortex? 259. zona glomerulosa mineralocorticoids (aldosterone) 27 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 260. zona fasciculata glucocorticoids (cortisol) 261. zona reticularis adrenal androgens (DHEA and androstenedione) 262. chromaffin cells what is the cell type in the adrenal medulla? 263. epinephrine and norepinephrine which two hormones are made by the adrenal medulla? 264. glucocorticoids (cortisol) which hormone allows you to cope with adversity and is essen- tial for life? 265. glucocorticoids (cortisol) which hormone protects against hypoglycemia by increasing glu- cose production by the liver (glu- coneogenesis), increasing pro- tein breakdown and fat break- down? 266. an hour before you wake up when do you have the biggest surge of glucocorticoids (corti- sol)? 267. cushing syndrome excess cortisol causing an ele- vated blood glucose level with high insulin levels; primary form of hypersecretion 268. adrenal cortex cushing syndrome is caused by a problem in: 269. cushing disease excess ACTH and cortisol due to a tumor in the anterior pituitary; secondary form of endocrine hy- persecretion 270. 28 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc obesity, moon face, buffalo hump, hy- what are the clinical manifesta- perglycemia, osteoporosis, hyperten- tions (7) for cushing syndrome? sion, thin extremities 271. acne, ruddy color of facial skin, what are the dental aspects for mouth-related immunosuppression, cushing syndrome? impaired wound healing, gingival and periodontal disease 272. surgery what is the recommended treat- ment for cushing syndrome? 273. alpha-MSH addison's disease, hyperpigmen- tation is a result of elevat- ed ACTH and subsequent me- tabolism to ________ which then stimulates melanocytes in the skin to produce increased amounts of melanin 274. addison's disease (primary adrenal in- decreased cortisol production sufficiency) and adrenal crisis (addis- and sometimes aldosterone due onian crisis) to a problem in the adrenal cortex 275. autoimmune destruction in developed countries, prima- ry adrenal insufficiencies are caused by: 276. tuberculosis in developing countries, prima- ry adrenal insufficiencies are caused by: 277. secondary adrenal insufficiency diminished ACTH secretion 278. decrease plasma ACTH levels (in- crease/decrease) in Cushing Syndrome 279. increase 29 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc plasma ACTH levels (in- crease/decrease) in Addison Dis- ease 280. autoimmune disease, fungal infection, what causes addison's disease metastatic carinoma (primary adrenal insufficiency)? 281. adrenal crisis (addisonian crisis) serious infection or stress in pa- tient with Addison's Disease 282. addison's disease (primary adrenal in- following clinical manifestations sufficiency) are associated with? -hyperpigmentation (elevated ACTH) -metabolic acidosis -hyperkalemia -hypotension -weakness -hypoglycemia -weight loss/anorexia -nausea/vomiting 283. hypotensive shock what is the predominant manifes- tation of adrenal crisis? 284. adrenal crisis following clinical manifestations are associated with? -hypotensive shock -anorexia -nausea -weakness -fever -lethargy 285. addison's disease and adrenal crisis following dental aspects are as- sociated with? -patchy brown pigmentation on 30 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc oral mucosa -increased pigmentation of lips, gingival margins, buccal mucosa, palate 286. stress what should you try to reduce prior to dental treatment for a patient diagnosed with addison's disease? 287. morning when should schedule surgery for a patient with primary adrenal insufficiency? 288. immediate infusion of cortisol and sup- what treatment is used for adren- portive care al crisis? 289. hydrocortisone (oral cortisol) and flu- what treatment is used for addi- drocortisone (mineralocorticoid) son's disease? 290. aldosterone what is the primary mineralocor- ticoid? 291. aldosterone major function is to control body fluid volume by increasing the re- absorption of sodium by the kid- neys (decrease Na+ excretion) AND increases potassium and hydrogen excretion 292. ACE inhibitors class of anti-hypertensive drugs that block the conversion of an- giotensin I to angiotensin II; lisinopril and elanopril 293. hypertension and hypokalemia what is the pathophysiology in conn syndrome (primary hyperal- dosteronism)? 294. 31 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc conn syndrome (primary hyperaldos- What syndrome that is due to teronism) an adrenal gland adenoma pro- duces excess aldosterone? 295. muscle weakness, fatigue, cramps what are the clinical manifesta- tions for conn syndrome? 296. aldosterone antagonist followed by sur- what is the treatment for conn gical removal of the tumor syndrome? 297. spironolactone which medication is an example of aldosterone antagonist? 298. epinerphrine pheochromocytoma causes high levels of: 299. phenochromocytoma tumor in adrenal medulla 300. hypertension, headache, sweating, what is the clinical manifestation weight loss or hyper-metabolism, palpi- of phenochromocytoma? tation, hyperglycemia 301. TRUE (true/false) phenochromocytoma usually only happens in one adrenal gland 302. head, uncinate process, neck, body, tail five parts of the pancreas? 303. exocrine pancreatic juice (digestive en- zymes + electrolytes + HCO3-) 304. endocrine hormones in pancreas; insulin and glucagon 305. major duodenal papilla point that joins the main pancre- atic duct and the common bile duct 306. acini (acinar cells) what are the exocrine cells of the pancreas? 32 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 307. pancreatic islets (islets of Langerhans) what are endocrine cells of the pancreas? 308. alpha, beta, gamma what are the three types of cells in the pancreatic islets? 309. beta cells which cells makes up the majority of cells in the pancreatic islets? 310. alpha cells secrete glucagon 311. beta cells secrete insulin 312. gamma cells secrete somatostatin 313. brain, retina, gonads what three tissues only use glu- cose as an energy substrate un- der normal condition making it important to maintain constant blood glucose concentration? 314. liver, skeletal muscle, adipose tissue what three tissues does insulin act on to store nutrients? 315. 51 (21 A chain and 30 B chain) insulin is made up of ____ amino acid chains 316. two disulfide bridges what hooks A and B chains to- gether in insulin? 317. GLUT2 increases in blood glucose con- centration rapidly stimulate the secretion of insulin via: 318. insulin secretion of this hormone in- cludes increased amino acid con- centration, increased fatty acid concentration and parasympa- thetic NS via vagus nerves re- leasing Ach 33 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 319. decreased blood glucose, fasting, exer- what inhibits insulin secretion? cise 320. 29 glucagon is made up of a straight-chain peptide with ____ amino acids 321. decreases in blood glucose concentra- what stimulate the secretion of tion and fasting rapidly glucagon? 322. glucagon which hormone acts to mobilize nutrients by breaking down glyco- gen and fat? 323. diabetes mellitus disorder of glucose metabolism in which the action of insulin on body cells is inadequate, either because of impaired insulin pro- duction by the beta cells of the pancreas or because of a com- bination of impaired insulin pro- duction and resistance of target tissues to insulin's actions 324. Hemoglobin A1C test a test that shows the amount of glucose that sticks to the red blood cell; reflects glucose expo- sure over the previous 3 months 325. 4-6% what is a normal A1C result? 326. diabetes mellitus if an A1C result comes back high- er than 6%, what is that indicative of? 327. type 1 diabetes mellitus diabetes in which no beta-cell production of insulin occurs and the patient is dependent on in- sulin for survival 34 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc 328. immune mediated type 1 diabetes mel- cellular-mediated autoimmune litus destruction of the beta-cells of the pancreas; markers include islet cell autoantibodies, au- toantibodies to insulin, glutamic acid decarboxylase autoantibod- ies and many others 329. type 2 diabetes mellitus accounts for 90-95% of all diag- nosed cases of DM; insulin resis- tance and usually have relative (rather than absolute) insulin de- ficiency 330. idiopathic type 1 diabetes mellitus no evidence of autoimmunity ex- ists; this form of type 1 diabetes mellitus is strongly inherited 331. true (true/false) individuals with type 2 diabetes mellitus usually do NOT need insulin treatment to survive, but may need to take insulin at some point to control blood glu- cose 332. diabetic retinopathy damage to the retina cause of new cases of blindness as a com- plication of uncontrolled diabetes 333. non-proliferative diabetic retinopathy makes up 90-95% of cases of retinopathy and does not cause visual loss; consists of venous dilation, exudates, small hemor- rhages, microinfarcts and/or mi- croaneurysms 334. proliferative diabetic retinopathy makes up 5-10% of cases and is more ominous causing retinal detachment and blindness; same 35 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc characteristics and non-prolif- erative plus neovascularization brought on by vascular occlusion and/or ischemia 335. diabetic nephropathy accumulation of damage to the glomerulus capillaries due to the chronic high blood sugars of di- abetes mellitus; single leading cause of end-stage renal disease 336. microalbuminuria what is the earliest clinical evi- dence of diabetic nephropathy? 337. diabetic neuropathy nerve cells are vulnerable to damage from chronic hyper- glycemia and clinical manifesta- tions tend to appear as a lat- er complication of diabetes; re- sulting in sharp pain in toes, feet, legs and hand then eventual numbness 338. charcot's joints diabetic peripheral neuropathy; resulting from nerve damage that impairs the patient's ability to per- ceive pain coming from a joint 339. cardiovascular heart disease (CHD) what accounts for majority of dia- betic deaths? 340. diabetes mellitus following dental aspects are as- sociated with? -periodontal disease -xerostomia -thrush (oropharyngeal candidia- sis) -burning mouth syndrome -impaired/delayed wound healing 36 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc DENTIST SHOULD ALWAYS EVALUATE FOR ORAL SIGNS AND SYMPTOMS 341. early morning when should dental appoint- ments be scheduled for patients with diabetes mellitus? 342. hypoglycemia abnormally low level of sugar in the blood; < 70 mg/dl 343. injectable glucagon what can be used in a diabetes mellitus medical emergency if a patient become unconscious? 344. type 1 diabetes mellitus diabetes ketoacidosis (DKA) is more commonly seen in: 345. type 2 diabetes mellitus hyperosmolar hyperglycemic state (HHS; also known as non- ketotic hyperglycemia) is more commonly seen in: 346. medical stress and discontinuation of what two events commonly insulin therapy cause DKA and HHS? 347. DKA (DKA/HHS) evolves rapidly over a 24 hour period 348. HHS (DKA/HHS) develop more insid- iously with polyuria, polydipsia and weight loss often persisting for several days before hospital admission 349. diabetic ketoacidosis not enough insulin causing ener- gy stores in fat to be quickly me- tabolized into fatty acids, which are then transported to liver he- 37 / 40  Endocrine Final Study online at https://quizlet.com/_bzjgqc patocytes for conversion to glu- cose and ketones 350. hypoglycemic most common complication of in- sulin therapy; result from skipping a meal or snack, unusual physical exertion and insulin-induced re- actions by taking too much insulin 351. sulfonylureas first oral antidiabetic medications, but none of these drugs are around anymore 352. sulfonylureas MOA inhibit ATP-sensitive K+ chan- nels, thereby increasing the se- cretion of pancreatic insulin 353. glimepiride, glipizide, glyburide what are the second-generation oral antidiabetic drugs? 354. biguanides generally the first drug prescribed for type 2 diabetes mellitus 355. metformin what is the only available agent of biguanides? 356. biguanides MOA increa