ADVANCED PATHOPHYSIOLOGY Exam 3 Study Guide – COVERING 14 CHAPTERS LATEST UPDATE

ADVANCED PATHOPHYSIOLOGY Exam 3 Study Guide – COVERING 14 CHAPTERS LATEST UPDATE Chapter 22: Mechanisms of Hormonal Alterations 1. Alterations of the Hypothalamic-Pituitary System a. SIADH i. High levels of ADH ii. The results of enhanced renal water retention iii. Leads to dilutional hyponatremia, hypoosmolality, urine that is inappropriately concentrated iv. Decreased serum sodium b. Diabetes Insipidus i. Insufficiency of ADH 1. Polyuria and polydipsia 2. 2 forms a. Neurogenic or Central (hypothalamic) i. Insufficient secretion b. Nephrogenic (renal) i. Inadequate response of renal tubules to ADH, usually acquired or may be genetic 3. Serum hypernatremia and hyperosmolality 4. Serum electrolytes not affected c. Hypopituitarianism i. Absence or deficiency of one or more anterior pituitary hormones 2. Alterations of thyroid function a. Primary dysfunction i. Alterations of thyroid hormone (TH) with secondary feedback effects on pituitary TSH levels 1. Primary elevations in TH level, TSH secondarily decreases – negative feedback ii. Subclinical thyroid disease lOMoARcPSD| 1. No or minimal symptoms, but with abnormal lab values 2. TSH low or elevated, T4 and T3 may be WNL b. Secondary as a result of pituitary or hypothalamic alterations i. Disorders of pituitary gland TSH production c. Thyrotoxicosis – results from increased TH levels – AKA hyperthyroidism i. Diseases that cause primary hyperthyroidism: 1. Graves disease a. Autoimmune disease b. Results from type II hypersensitivity reaction c. Autoantibodies override negative feedback mechanisms, resulting in hyperplasia of gland (goiter) and increased synthesis of TH 2. Toxic multinodular goiter 3. Solitary toxic adenoma