WorksheetsDisorders of the endocrine system for Paramedics
Total questions: 41
Worksheet time: 26mins
Endocrine function often declines with age. β-cell function in the pancreatic islets, especially when combined with weight gain predisposes to :
Type I diabetes mellitus
Type 2 diabetes mellitus
osteoporosis
postural hypotension
HYPERsecretion of growth hormone (GH) from the anterior pituitary gland, often due to a tumour in the pituitary, can cause (cheek all that apply):
excessive growth of bones and connective tissue
enlargement of internal organs
enlargement to the heart and raise BP
reduced glucose tolerance
increased amount of sweating
Hypersecretion of GH in the anterior pituitary can lead to the following conditions:
Gigantism
Acromegaly
Grave's disease
Goitre
HYPOsecretion of anterior pituitary hormones can cause:
tumours in the pituitary or hypothalamus
Sheehan's syndrom (postpartum necrosis following hypotensive shock after childbirth)
Pituitary dwarfism (severe deficiency of GH in childhood)
Frohlich's syndrome (diminished growth & development, obesity and sterility)
all of these are possible
Excessive urine excretion (>10L daily) is associated with which posterior pituitary condition?
Diabetes insipidus
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Pituitary necrosis
HYPERthyroidism (also called thyrotoxicosis) arises when there is too much T3 and T4 in the blood. It can cause the following symptoms:
increased basal metabolic rate
Weight loss with good appetite
anxiety, excitability
palpitations, atrial fibrillations, tachycardia
dry cold skin, prone to hypothermia
HYPOthyroidism can cause all of the following symptoms EXCEPT one:
decreased basal metabolic rate
Weight gain with poor appetite
lethargy, bradycardia
constipation
hot, sweaty skin, intolerance to heat
The main causes of HYPERthyroidsm are
Grave's disease (accounting for 75% of cases, mostly females)
Toxic nodular goitre
Adenoma (a benign tumour)
Exophthalmos
Deficiency of T3 and T4 in the blood leads to HYPOthyroidism. A condition prevalent in older adults, more common in women. The most common causes are:
Auto-immune thyroiditis (often called Hashimoto's disease)
Grave's disease (an auto-immune disorder where an antibody mimics the effects of TSH)
Congenital (you are born with it)
Severe iodine deficiency
Healthcare interventions (eg removal of thyroid gland, ionizing radiation etc)
Enlargement of the thyroid gland caused by a relative lack of T3 & T4 stimulating extra production of TSH (thyroid stimulating hormone).
Goitre
Exophthalamos
Acromegaly
Cushing's syndrome
What is the most common cause of hyperparathyroidism?
A benign parathyroid tumour, secreting high levels of parathormone (PTH)
Chronic kidney disease
Vitamin D deficiency
pancreatitis
HYPERparathyroidism is characterized by HIGH calcium levels in the blood. Effects might include all of these EXCEPT:
polyuria (excessive urine formation) & polydipsia (excessive thirst)
Formation of renal calculi
obesity & diarrhoea
muscle weakness and fatigue
anorexia & constipation
HYPOparathyroidism is caused by PTH deficiency and it causes hypocalcaemia (very low blood calcium levels). Symptoms might include:
tetany (powerful muscle spasms)
anxiety
paraesthesia (feelings of pins and needles, tingling or feeling as if ants are crawling over/under the skin)
grand mal seizures
cataracts and brittle nails
The main glucocorticoid hormone secreted by the adrenal cortex.
(a)
Cushing's syndrome is a disease caused by over secretion of glucocorticoids from the adrenal cortex.
True
False
Cushing's syndrome can have many symptoms. These might include (check all that apply):
stretch marks, bruising, tendency to infections
"moon" face
osteoporosis or pathological fracture (bones breaking due to underlying disease)
peptic ulcers, kidney stones
hypotension
Chronic adrenocorticol insufficiency is known as ADDISON's disease. The most important effects of this condition are:
muscle weakness & wasting, tiredness. Increased skin pigmentation,
GI disturbances (vomiting, diarrhoea, anorexia)
Hypoglycaemia & confusion
Menstrual disturbances, loss of body hair (in women)
chronic dehydration and hypotension
Explain why tumours of the adrenal medulla causes symptoms such as hypertension, weight loss, anxiety and excessive sweating.
because too much adrenaline (epinephrine) hormone is being released
because too much noradrenaline (norepinephrine) hormone is being released
because too little adrenaline (epinephrine) hormone is being released
because too little noradrenaline (norepinephrine) hormone is being released
Diabetes mellitus is caused by the complete absence of, deficiency of, or resistance to the action of the hormone:
(a)
A kind of diabetes which develops during pregnancy and may disappear after delivery, but often recurs later in life. It is associated with high birth weight, stillbirth or neonatal death.
(a)
Previously called insulin dependent diabetes, occurs mainly in children or young adults, onset is sudden and can be life threatening. Treatment with insulin is essential in all cases.
(a)
Previously known as non-insulin dependent diabetes, this is the most common form of diabetes (90% of cases). Onset is gradual and requires insulin treatment in approx 20% of cases) Predisposing factors include:
obesity
a healthy lifestyle (plenty of exercise)
young age
Family history of the condition
Raised plasma glucose level (a)
What happen to the glucose that isn't absorbed by diabetics' bodies?
It's excreted from their bodies
It collects in body fat
It's stored in the pancreas
It's converted to other chemicals
Insulin inhibits the release of what
Glucagon
ADH
Beta cells
Somatostatin
The pancreas releases insulin when:
Stress hormones rise
Blood glucose levels get low
A person exercise
Blood glucose levels rise after eating
If you haven't eaten all day, what hormone is your pancreas most likely secreting?
Insulin
Hemoglobin
Glucagon
Betadine
The type of feedback used in response to diabetes is...
Positive
Negative
During digestion, ________ are broken down into _________ which provides ________ for the cells.
Fats, amino acids, oxygen
Fibers, fatty acids, free radicals
Carbohydrates, glucose, energy
Proteins, sugar, fuel
Which is a common symptom of high blood glucose?
Thirst
Shortness of breath
Diarrhea
Vomiting
Hyperglycaemia is when ________
blood sugar is high
blood cholesterol is high
blood sugar is low
blood oxygen is low
Hypoglycaemia is when ______
blood sugar is high
blood sugar is low
blood oxygen is low
blood cholesterol is high
True or False: Hypoglycaemia can happen in diabetics if they exercise too hard
True
False
Ketoacidosis is a medical emergency. It may be due to stressors such as pregnancy, infection or acute illness, missed or inadequate insulin doses, especially when requirements are increased. Consequences if left untreated may result in coma or death. Other indicators might be:
Increasing acidosis and hyperglycaemia in the blood (both getting worse)
Hyperventilation, confusion
Acidification of urine, polyuria (Up to 15L a day)
Dehydration and hypovolaemia (leads to hypotension & tachycardia)
All of these
HYPOglycaemia causes drowsiness, confusion, difficulty with speech, sweating, trembling and a rapid pulse. It can occurs the result of:
Accidental overdose of insulin
eating immediately after insulin administration
drinking alcohol with a big meal
gentle exercise
Long term complications of diabetes mellitus increase with severity and duration of hyperglycaemia. What can you see here?
peripheral vascular disease - diabetic foot
diabetic nephropathy
boils and carbuncles
candidiasis (thrush)
Diabetes mellitus is a significant factor for cardiovascular disorders even when well controlled. The most common consequences are ischaemic heart disease (angina, MI), stroke and peripheral vascular disease.
True
False
Only in the elderly
Spots or dark strings floating in your vision (floaters)
Blurred vision.
Fluctuating vision.
Dark or empty areas in your vision.
Vision loss.
diabetic retinopathy
diabetic neuropathy
diabetic nephropathy
diabetic foot
What symptom of Graves' disease (one of the main kinds of hyperthyroidism) can you see here?
exophthalmos
nodular goitre
cretinism
tumour
