Adult Endocrine Flashcards
1
Q
Hypothyroidism (myxedema)
A
- low T4; high TSH
- flattened affect
- constipation
- weight gain
- pedal edema
- low HR and BP
2
Q
Myxedema coma
A
- severely low thyroid levels
3
Q
Hyperthyroidism
A
- excessive T3 and T4
- agitation
- weight loss
- insomnia
- HR and BP up
- heat interlorance
- injected (red) cojunctiva
4
Q
Cushing’s disease
A
- Hypersecretion of ACTH from the pituitary gland
- excessive corticosterioids
- causes suppresion of white blood cells
- immune suppresion
- thyroid labs not affected
- osteoporosis
5
Q
Cushing disease symptoms
A
- sodium and water retention
- low hematocrit
- hypernatremia
- weight gain
- fatigue
- hyperglycemia
- thirst
- delayed wound healing
- sexual dysfunction
- acne
6
Q
Cushing disease care
A
- modify diet to low glycemic and sodium foods
- increasing potassium rich foods
- Low impact, weight bearing exercises to increase bone density
7
Q
Main symptom?
Addison’s disease
A
- decrease in androgens (sex hormones) and glucocorticoids
- shock and hypoglycemic**
- hyper-pigmented (very tan)
- do not adapt to stress
- hyponatremia
8
Q
Adrenal crisis
A
- abrupt end to steriods (prednisone)
- severe dehydration (fluid volume deficit)
- tachycardia
- hypotension
- hyponatremia
- weakness/fatigue
- henoconcentration (high hematocrit)
- hyperkalemia
- peaked T wave
- give sodium polystyrene
- adjust dose of steroids if planning serious exercise
9
Q
Give what?
Addisons Crisis
A
- Add a SONE (give steroids)
10
Q
pathophysiology of diabetes mellitus
A
Destruction of pancreatic beta-cells
11
Q
Pheochromocytoma
A
- Tumor in adrenal glands
- too much of epinephrine and norepinephrine
- diagnose through 24-hour urine test
- measure catecholamines (stress hormone)
- elevated = positive
- classic triad
- hypertension
- hyperglycemia
- headache
- weight loss
12
Q
pheochromocytoma high risk for
A
- hypertensive emergency
- avoid diet that can raise BP like cheese
- avoid caffeine, smoking
- avoid stress
- cardiac dysrhythmias
- panic (sweating, headache)
13
Q
Regular Insulin peak
A
- IV
- 15-30 min
- Sub Q
- 2-3 hours
14
Q
Most common cause of hyperthyroidism
A
Grave’s disease
15
Q
Grave’s disease
A
- HIGH LEVEL of thyrotropin receptor antibodies (TRAbs)
- give radioactive iodine
- UNLESS PREGNANT/BREASTFEEDING
- exophthalmos/redness
- no blinking
- cool compress
- elevate HOB
- sunglasses
- artifical tears
- stop smoking
- risk for thyorid storm
- tachcardia
- excessive sweating
- weight loss
- agitation
- heat intolerance
- fatigue
- shortness of breath
- muscle tremors
- thin hair
16
Q
Myxedema
A
- severe, non-pitting edema
- puffy face and periorbital area (around eyes)
- coarse facial features
- dry skin and hair (coarse)
hypothyroidism w/ skin involvement
17
Q
Hypophysectomy
A
- neurosurgical technique for removing pituitary tumors
- urine output greater than 300 mL/hr is alarming
- Semi-Fowlers/Fowlers position is appropriate
- prophylactic nausea vomiting needed
- Ondansetron!
- CSF leakage is serious
- risk for meningitis!
- increased ICP
- decreased smell is expected for a few months
- do not brush teeth = foul-smelling breath
18
Q
severe complication from neurosurgery around the pituitary
A
- Diabetes insipidus
- daily weights
- too much urine output can lead to shock
19
Q
Diabetic nephropathy
A
- proteinuria > 300 mg
- kidney fails
- monitor high BP
20
Q
Hyperglycemia
A
- glucose over 250
- if over than check for serum ketones
- excessive thirst
- flushed, dry skin
- abdominal cramping
- orthotic hypotension
- hot and dry, your sugars high
21
Q
Jaundice in dark-skin
A
- examine
- mucous mebranes
- hard palate
- sclera
22
Q
BMI + waist size
A
- BMI
- 25-30 = overweight
- 30+ = obese
- obese waist size
- men
- 40 inches (102 cm) or greater
- women
- 35 inches (88 cm) or greater
- men
23
Q
Acanthosis nigricans
A
- darkening patches in skin folds
- happens with insulin resistance
- can indicate diabetes mellitus
24
Q
Thyroid panel test
A
- given for
- constipation
- decreased sex drive
- reduced activity tolerance
25
Q
PSA test
A
- test for potential prostate cancer
- start at age 55
26
Q
Metabolic syndrome
A
- hypertension
- hyperglycemia
- hyperlipidemia
- obesity
- precursor to acute coronary syndrome and diabetes type 2
- pregnant —> significant risk for gestational diabetes
27
Q
Serum cardiac enzymes
A
- diagnose acute coronary syndrome
- given with angina
28
Q
C-reactive protein
A
- diagnose atherosclerosis
29
Q
Water deprivation test
A
- diagnose diabetes insipidus (DI)
30
Q
Hypoglycemia
A
- mild
- less than 70
- 15g of carbohydrates
- moderate
- less than 40
- 30g of rapidly absorbed carbohydrates
- UNLESS LETHARGIC AND SLURRED SPEECH = ASPIRATION RISK
- severe
- less than 20
- give glucagon
- lethargy
- garbled speech
- KEEP THEM NPO
- ASPIRATION RISK
- hypertension
- blurred vision
- can look like stroke
31
Q
Essential hypertension
A
Hypertension without a known cause
32
Q
Metabolic panel
A
- information about fluid balance
- electrolytes
- sodium, potassium
- how kidneys are working
33
Q
Diabetes insipidus
A
- lifelong treatment of Desmopressin
- intranasally or by mouth
- MAY NEED ADDITIONAL DOSE IF POLYURIA PERSISTS
- can cause water intoxication
- risk for water toxicity = EMERGENCY
- headache, confusion, n/v
- risk for water toxicity = EMERGENCY
- daily weights at same time
- monitor intake and output
- drink equal to amount losing
