1-27-12 Friday

PHYS/PATH

Acromegaly: too much GH, get too big.
can happen in kids is called gigantism, adults it is acromegaly
affects flat bones more, big forehead and jaw
shorter life- Andre the Giant
GH also release insulin like growth factor (IGF-I[one]) (somatomedin C)
problems with heart-careful with massage

Addison Disease: not enough adrenal H.; not enough aldosteral- balance o f electrolytes/ help absorb sodium
not absorbing water because not enough aldosteral
low cortisol too, adrojenic H.
tumors can be a cause
70% of the time it's autoimmune
tuberculosis
Primary Addison's is with the adrenals
Secondary Addison's is decreased anterior pituitary secretion of ACTH (too much makes people look too tan/orange)
Tertiary Addison's is problem with hypothalamus
-cortisol depletion-- weak mm, fatigue, decreased bp, hypoglycemia, irritability, depression, hyperpigmentation,
tend to be thin due to electrolyte imbalance; nausea, vomiting, diarrhea
Addisonia crisis: sudden onset of extreme symptoms if these come on real quick they can die
Die without adrenal H.
M-bp concern

Cushing Syndrome (opposite Addison's): too much adrenal H.; hyypercortisolism
exogennous-external source (Cushing's syndrome)- from meds, cortisol-based steriodes
endogenous (Cushing's disease)-- body is doing it-autoimmune; too much ACTH
--pituitary adenoma- benign tumor W>M
--eptopic ACTH- secreted outside of pituitary M>W
S&S: cortisol breads down body producing: weak lig, fatty deposits neck, face, abs, upperback, bone thinning, purple stretch marks, hirutism: hair growth
M risks: increase bp, delicate skin, bone, compromised immunity

Diabetes Mellitus
Type 1: autoimmune reaction; islets of Langerhans (can't grow back) killed off?
can't produce insulin (dependent)
Type 2: dietary; $132 bill/yr = 11% of health care
some genetic and social aspects involved
insulin (key to get in cells) in short supply
insulin resistant
either way glucose accumulates in blood cells
Type 1: autoimmune or complication of infection, exposure to drugs or chemical
Type 2: 90% obese, diet, exercise; can wear and tear pancreas causing decrease insulin production
gestational diabetes - with pregnancy and can become type 2

**S&S: 3Ps:
-Polyuria: pee a lot more; sweet pee; water follows sugar and salt
-polydipsia: increase thirst do to lots of peeing
-Polyphagia: increase hunger
fatigue, wight loss, etc.
ketoacidosis: fruity breath, type 1 only,
metabolism of fat and protein = ketomes, acidosis which leads to convulsions
triggered by stress, infection, trauma
leads to shock, coma, death
Hyperosmolality: insulin shock
Complications: cardiovascular, edema, kidney (**number 1 cause of renal failure), impaired vision, endothelium, ulcers, gangrene, amputation, neuropathy at cranial nerves
HgbA1C (hemoglobin) 80-90 is great blood sugar reading
Tx: type 1: insulin supplementation
type 2: diet, exercise, the meds and insulin


Hyperthyroidism: thyroid produces excessive hormones that stimulate metabolism of ___into energy
Graves- autoimmune and most common (70-80%); goiter(thyroid grows), excess thyroxine
w>m, can see other autoimmune
Graves, lupus, type1
inflammation of thyroid
nodules on thyroid
S&S: can't sleep, hot, diarrhea, increase heartbeat, brittle nails, bones are osteoporosis, eyes are exophthalmus? bulging out looking

Hypothyroidism: decrease thyroid production
Hashimoto thyroiditis
autoimmune, high TSH, T4 low, T3 normal
factors: complication with hyperthroid, birth defect, postpardum, meds, radiation, Iodine deficiency
S&S: metabolism decrease, weight gain, fatigue, depression, sluggish, digestion, intolerant to cold
edema-swell carpal tunnel
goiter
hair loss at lateral eyebrow
heavy menses
increase risk heart disease


Metabolic syndrome: aka syndrome X, on way to type 2 or heart disease; Pre-diabetes
S&S: central obesity, increase bp, increase fasting glucose, increase triglyceride
limit alcohol

Thyroid Cancer:
papillary thyroid cancer- 70-80% of cases, stays near thyroid
follicular thyroid cancer- 10%, goes other places too
respect the cancer
Tx; remove thyroid

CHAPTER 12 - BLOOD

circulating blood
important in maintaining homeostasis
classified as connective tissue
8% of body weight

Function
Transportation: (gases, nutrients, waste) carries O2 to tissues, carries CO2, hormones, ...
Regulations: pH levels 7.35-7.45, substance maintain osmotic/oncotic pressure (pull waste in veins, and regulation of heat
Protection: disease, blood loss- cells and antibodies of immune system, carries factors to protect blood loss

Blood constituents
Plasma: liquid portion (salty)
**Formed elements:
-erythrocytes: rbc, no organelles, lots of hemoglobins
-leukocytes: wbc
-platelets (thrombocytes): tiny things help with clotting; pieces of a meagcarrior cell

Plasma: 91% water, 8% protein: albumin, clotting fact, antibodies, complement; and 1% other: glucose, amino acids, lipids, electrolytes, ...
Plasms = serum + clotting factors

Formed elements- produced in red bone marrow
-hematopietic (making blood) stem cells
can develop into any bc
short lived 3months
rbc are about 7micrometers

Erythrocytes:
RBC, most numerous
biconcave shape, mature cells anuclear
contain hemoglobin
-binds to o2 for transport
-carries hydrogen ions for buffering
-carries co2 for elimination

Leukocytes: WBC, colorless, round, 2 goups:
-Granulocytes (shotgun guys)
neutrophils (polymorphs) should have more of these
eosinophis: seen with parasites or allergies
basophils: high number can mean cancer
-Agranulocytes (gobble things up)
lymphocytes: B-cells and T-cells
monocytes: gobble things up


Platelets: blood coagulation
meagkaryocytes fragments

Hemostasis

Bloodclotting: needs calcium
fibrinogen converts into fibrin
procoags
anticoags
serum is fluid left over after blotting takes place

Blood types, must be compatible; protein