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Undeleted > 3 Endocrine > Flashcards

3 Endocrine Flashcards

1
Q

function: pituitary gland

A

many

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2
Q

function: thyroid & parathyroid

A

metabolism, bones

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3
Q

function: adrenals

A

stress response, sugar, electrolytes

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4
Q

function: testes

A

male characteristics

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5
Q

function: ovaries

A

female characteristics

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6
Q

function: pancreas

A

glucose

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7
Q

function: thymus

A

immune response

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8
Q

function: pineal

A

body rhythms

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9
Q

hypothalamus

A

master gland!

  • integration of neuroregulatory
  • critical link between CNS and endocrine
  • major controller of anterior, posterior pituitary
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10
Q

HP & POA

A

hormones, pituitary & posterior: oxytocin ADH

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11
Q

hypopituitarism: GH

A

children: small stature
adults: osteoporosis

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12
Q

somatomedin c

A

stimulated by GH

bone and cartilage maintenance

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13
Q

hypopituitarism: LH, FSH

A

men

  • decreased facial & body hair, libido, muscle mass
  • impotence
  • facial wrinkles

women

  • amenorrhea, anovulation
  • breast atrophy
  • decreased libido, axillary and pubic hair
  • loss of bone density
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14
Q

*hypopituitarism assessment

A

LOOK AT CLIENT
some hormones measured directly
indirectly: T3 & T4 for TSH
- stimulation tests: insulin > increased GH, ACTH
- changes in sella turcica: MRI, CT
- hormone replacement necessary for the rest of their lives

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15
Q

hyperpituitarism most common cause

A 
pituitary adenoma (benign tumor)
- tumor grows, neurological & endocrine issues emerge (HA, visual changes, intracranial pressure)
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16
Q

hyperpituitarism: GH

A

gigantism before puberty
acromegaly: adult (high blood sugar = red flag)

antagonist to insulin

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17
Q

hyperpituitarism: GH manifestations

A
  • organomegaly (larger larynx = deeper voice, larger tongue = dysphagia)
  • hypertension
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18
Q

hyperpituitarism interventions

A
  • drug therapy
  • radiation therapy
  • surgery
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19
Q

*bromocriptine mesylate

A

Parlodel

  • *dopamine agonist given for hyperpituitarism
  • side effects: GI, orthostatic hypotension
20
Q

disorders of posterior pituitary

A

remember; HP & POA (oxytocin, ADH)

  • ADH deficiency: diabetes insipidus, polyuria -> dehydration, skin dry/turgor change
    • neuro: irritability, lethargy > coma
    • manage with vasopressin
  • ADH excess: SIADH, GI disturbances, hyponatremia due to free water retention
    • neuro: lethargy > coma
    • manage with diuretics, NaCl
21
Q

*Addison’s Disease

A

adrenal cortical hypofunction

  • *requires 90% destruction of gland
  • bronze skin, hirsutism
22
Q

Addison’s Disease causes

A
  • idiopathic atrophy (autoimmune) - 60 to 70% of US cases
  • granulomatous disease (TB most common in 3rd world)
  • metastases (especially lung and melanoma)
23
Q

reduced cortisol results

A

HYPOGLYCEMIA (decreased gluconeogenesis)

  • seizures, confusion, combative
  • GFR, gastric acid production decreases -> increased BUN, anorexia, weight gain
  • muscle weakness, fatigue
24
Q

reduced aldosterone

A

HYPOKALEMIA (K excretion decreased)

  • K retention promotes reabsorption of H+ > acidosis
  • Na+, H20 excretion increased > hyponatremia, hypovolemia
25
Q

Addisonian Crisis

A

life-threatening event in which physiologic need for gluco and mineralocorticoid hormone is greater than supply
- usually result of stressful event

26
Q

Addisonian Crisis s/s

A
  • profound fatigue
  • dehydration
  • vascular collapse
  • renal shutdown
  • hyponatremia
  • hyperkalemia
27
Q

Florinef

A

fluocortisone
- treatment for hypoaldosteronism, Addison’s Disease
- counterproductive effect with diuretics
DO NOT GIVE WITH DIURETICS
- always assess cardiovascular status, ESPECIALLY elderly

28
Q

adrenal insufficiency: diagnostic assessments

A

ACTH stimulation test = most definitive

29
Q

*Cushing’s disease

A

adrenal gland hyperfunction

30
Q

*Cushing’s syndrome

A

hypercortisol

31
Q

*hyperaldosteronism

A

excessive mineralocorticoid OR excessive androgen production

32
Q

*pheochromocytoma

A

tumor = hyperstimulation of adrenal medulla

  • excessive secretion of catecholamines (80% epi, 20% norepi): HR, BP
  • *HYPERTENSION hallmark of disease (doesn’t resolve with dose of anti-hypertensive)
  • do NOT palpate abdomen
33
Q

Cushing’s Syndrome causes

A
  • pituitary adenoma (Cushing’s disease)
  • adrenal cortical adenoma, carcinoma
  • ACTH-producing non-adrenal, non-pituitary tumor (lung, others)
  • iatrogenic (anti-inflammatory therapy)
  • self-administered (body builders, etc)
34
Q

Cushing’s Syndrome s/s

A
  • increased fat due to low turnover of plasma fatty acids: moonface, central adiposity + striae
  • increased breakdown of protein
  • decreased production of lymphocytes
  • htn, hyperpigmentation, hypokalemia, hyperglycemia
35
Q

pheochromocytoma treatment

A

adrenalectomy

corticosteroids for rest of life

36
Q

assessing thyroid function

A

TSH - best screening test in outpatient setting

37
Q

Grave’s Disease

A

hyperthyroidism

  • toxic, diffuse goiter
  • exopthalmia
  • heat intolerant
  • tachycardia, dysrhythmias
  • SOB w/ w/o exertion
  • weight loss, increased appetite, diarrhea

increase protein to prevent neg nitrogen!
increase calories and carbs!

38
Q

thyroidectomy complications

A
  • damage to laryngeal nerve

- hypoparathyroidism - hypocalcemia

39
Q

hypoparathyroidism

A

hypocalcemia
- increased neuromuscular activity > tetany

IV CALCIUM GLUCONATE!

40
Q

hypothyroidism

A
  • main cause (US): thyroid surgery, radioactive iodine treatment for HYPER
  • most common in women 30-60
  • decreased metabolic rate!
41
Q

myxedema coma

A

usually in hypothyroid patients subject to stress
- clinical features: CHF!, hypothermia, stupor/coma, hypoventilation/respiratory failure, hyponatremia, hypotension, seizures, hypoglycemia

42
Q

levothyroxine

A

(synthroid) treatment for hypothyroidism
- synthetic T4
- converts to T3
- speeds up metabolism
- be careful not to induce THYROTOXICOSIS

43
Q

PTH normal function

A

increased:

  • bone resorption
  • Ca resorption (urine)
  • calcitrol (Ca absorption from gut)

stimultates:
- new osteoid formation ready for calcification during increase of dietary calcium

44
Q

hyperparathyroid

A

HYPERCALCEMIA!

  • increased bone resorption
  • depressed serum P
  • hypercaluria
  • decreased neuromuscular irritability
45
Q

hypoparathyroid

A
  • decreased bone resorption
  • depressed Ca serum
  • elevated serum P
  • increased neuromuscular activity = TETANY
46
Q

hyperparathyroid management

A
  • diuretic + fluid therapy
  • drugs
  • surgical management
47
Q

hypoparathyroid management

A
  • focus on correcting hypocalcemia, vitamin D deficiency

- avoid P (milk, yogurt, processed cheese)

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