4] Metabolic Disease Flashcards
2 main types of dysfunction in endocrine and metabolic disease
Hormonal imbalance
Tumor
Some signs and Sx of endocrine and metabolic disease
Muscular weakness Carpal tunnel syndrome bilateral Periarthritis Calcitic tendinitis Adhesive capsulitis Mental and vital sign changes
Hypo or insufficiency of hormone or hyperactivity
Adrenal gland
Screening for endocrine and metabolic disease
Check for nodules in the thyroids
Pain would be in the
Joint or muscle
Many conditions in endocrine and metabolic disease may cause
Bilateral proximal Sx
Red flag
PT is not helping improve
Digestive enzymes
Exocrine
Insulin and glucagon
Endocrine
Type I diabetes
Children – young adults
Insufficient insulin production
Type II DM
After 40 years old
Defective insulin
Risk factors for type I DM
Family history
Genetics
Geography
Age
Risk factors for type II DM
No exercise Fat Family Hx Race More than 45 years old HTN Low HDL Smoker Gestational diabetes or more than 9 lb baby
Signs and Sx of DM
Polyuria Polydipsia Polyphagia Weight loss Tired and weak Blurry vision Irritable Recurring skin, gum, bladder other infections Paraesthesia Delayed healing
Hyperglycemia #s
Fasting more than 126
Long term complications of DM
Atherosclerosis
Infection
Neuropathies
Periarthritis and hand stiffness
Neural pathway connections to the posterior pituitary gland
Hypothalamus
What hormones are in the posterior pituitary gland
ADH
Oxytocin
What hormones are in the anterior pituitary gland
HGH ACTH TSH FSH LH Prolactin
Increased secretion of HGH
Hyperpituitarism
Long bones
Gigantism
2 parts of adrenal gland
Adrenal cortex and medulla
What’s in the adrenal cortex
Mineralocorticoids
Glucocorticoids- cortisol
Sex hormones
What’s in the adrenal medulla
Epinephrine and norepinephrine
Primary adrenal insufficiency
Addison’s disease
Secondary adrenal insufficiency
Decreased ACTH acting on adrenals
Primary and secondary insufficiency can cause
Hyperpigmentation Hypotension Fatigue Hypercalcemia Hypoglycemia Secondary- myalgia, arthralgia
Too much cortisol is
Cushing’s syndrome
Characteristics of Cushing’s syndrome
Muscle wasting and weakness
Bone loss (kyphosis)
HTN
Appearance of Cushing’s syndrome
Moon face
Buffalo hump
Enlarged abdomen
Thyroid dysfunction
Hyperthyroidism
Graves’ disease
Increased metabolism
Tachycardia & palpitations (A-fib)
• Hyperactive reflexes
• Increased sweating & heat intolerance
Hyperthyroidism
Weight loss and increased appetite
Exopthalmos
• Fatigue, weakness
Polydipsia
Hyperthyroidism
Most common disorder of thyroid
Hypothyroidism
May be due to thyroid ablation
Hypothyroidism
Signs and Sx of hypothyroidism
Cold intolerance Weight gain Fatigue Headache Dry skin NM Sx
Parathyroid hormone regulates
Calcium and phosphorous metabolism
- Increased release of calcium from bone• Female > male
- Age: > 60 years
- Osteopenia – bone pain
- Kidney damage
• Hyperparathyroidism
Ppl with hypoparathyroidism have (4)
Hypocalcemia
Nm irritability
Dry skin
Brittle fingernails
Porous bone
Osteoporosis
Risk factors of osteoporosis
Aging Women Menopause Family history Low weight White or Asian
Risk factors for osteoporosis
Not enough calcium and Vit D, fruits or veggies Too much protein, salt, coffee Not active Smoking Too much alcohol Losing weight Anorexic
Two main risk factors for secondary osteoporosis
Meds
Endocrine and metabolic disorders
Medication risk factors for osteoporosis
Corticosteroid
Anticoagulants
Thyroid supplements
Immunosuppressant
Endocrine and metabolic disorders
Adrenal insufficiency
Cushings disease
Acromegaly
Hyperparathyroidism
Signs and Sx of osteoporosis
“Silent” early Back pain: mild-severe Loss of height Increased thoracic kyphosis Dowagers hump
CPR for osteoporotic vertebral compression Fx
More than 52 years old
No leg pain or exercise
BMI less than 22
Female
Rule in or out for osteoporotic vertebral compression Fx
Rule out less than 2
Rule in more than 4
