Get lethargy, Nausea, anorexia, and Coma from HYPOosmolarity
Diabetes INSIPIDUS (DI) is when there is a LOW level of ADH. What are two types of DI?
Neurogenic (decreased synthesis of ADH)
Nephrogenic (failure of nephron to respond to ADH)
What are some s/s of low ADH (DI)?
↑ thirst
↑ urine volume
↓ specific gravity (1.001-1.005)-very dilute urine!
How do you treat low ADH (DI)
Replace deficiency (vasopressin or DDAVP)
Give an example of neural regulation of hormones.
adrenal medulla releases epinephrine in response to SNS stimulation
TRUE or FALSE
Hyperprolactinemia is the most common anterior pituitary disorder.
TRUE!
Cause is tumor or meds (specially antipsychotics and tricyclic antidepressants)
Treat with drugs that stimulate dopamine receptors in the brain
If there is an excess of Growth Hormone (from anterior pituitary) it will cause ____ in adults and ____ ____ in kids.
Acromegaly in adults. Proportional giantism in kids.
S/S Big hands/feet, metabolic imbalances, increased glucose
A deficiency of Growth hormone (from anterior pituitary) will cause ____ ___ in adults and ____ in kids.
metabolic syndrome in adults and dwarfism (or short stature) in kids (interferes with bone growth)
Adrenal glands secrete mineralcorticoids like ______ and glucocorticoids like _____.
Aldosterone (mineral): secreted in response to Angiotensin II. (Causes water retention by conservation of Na in nephron)
Cortisol (gluco): immunologic and anti-inflammatory effects
Low cortisol could be from a primary cause like _____ disease. Describe it!
Addison's. (could be from autoimmune or TB) Destruction of all layers of adrenal cortex, so they can't secrete adrenal cortical hormones (see an increase in ACTH because pituitary really wants adrenal gland to secrete these hormones)
A secondary cause of low cortisol could be from _______.
Hypopituitarism. Could be surgical removal of pituitary or iatrongic (rapid removal of glucocorticoids)
What are some s/s of low cortisol?
weakness
GI disturbances
Hyperpigmentation (bronzed skin)
hypoglycemia
hypotension
In an acute adrenal crisis (or Addison's crisis) there is an drop in BP. Why?
Aldosterone is unable to conserve water so you get low blood volume which leads to low BP
Why do you get bronzed skin from adrenal insufficiency?
Melanin Releasing hormone and ACTH share same progenitor (parent) hormone
So if there is an increase in the parent hormone because thinks it needs more ACTH to stimulate the cortisol secretion
What is Cushing's disease?
Chronic increase in the function of the adrenal cortex (or iatrogenic) so there is an INCREASE in cortisol
In Cushing's syndrome you get excessive ACTH from the pituitary. TRUE or FALSE?
TRUE
What is the difference between primary and secondary causes of Cushing's syndrome?
Primary: problem with the adrenal gland
Secondary: pituitary adenoma (70%)
There are a lot of s/s of Cushing's, list them! (think high cortisol)
Weight gain (truncal obesity, moon face, buffalo hump)
Abdominal striae
glucose intolerance leading to DM
protein wasting
osteoporosis
hypercalcuria
poor wound healing
HTN
Mood disturbances
Impaired inflammation/immune response
GI bleeding
Whey is hyperfunction of the adrenal medulla a bigger problem than hypofunction?
Adrenal medulla secreted Epi and Norepi. If too much, can cause too much fight or flight response.
Other areas in body also secrete these hormones so hypofunction is less of problem.
What is the usual cause of hyperfunction of the adrenal medulla?
Usually a tumor (pheochromocytoma)
What happens when there is hyperfunction of the adrenal medulla?
Chronic secretion of catecholamines. Leads to severe HTN (fight or flight).
Tumors are usual cause and are very vascular and may rupture
TRH is secreted by the ____ gland and T3/T4 are secreted by the ____
