AG2-Endocrine Flashcards
What are the 6 hormones secreted by the anterior pituitary gland?
growth hormone (GH), prolactin, ACTH, TSH, FSH, LH
What are the 2 hormones secreted by the posterior pituitary gland?
ADH and oxytocin
What is acromegaly?
uncommon condition characterized by an overproduction of GH
What is hypopituitarism?
rare disorder that involves a decrease in production of one or more of the pituitary hormones (GH, LH, FSH are most common)
What is selective hypopituitarism?
The deficiency of only one pituitary hormone
What is pan hypopituitarism?
total failure of the pituitary gland and deficiency of all pituitary hormones.
What are early manifestations associated with a space-occupying lesion?
HA, visual changes, loss of sense of smell, N/V, sz
What is SIADH?
the release of ADH despite normal or low plasma osmolarity
What is the most common cause of SIADH?
small cell lung cancer
Drugs associated with SIADH?
Carbamazepine, Chlorpropamide, General anesthesia agents, Opioids, Oxytocin, Thiazide diuretics, SSRIs, TCAs, chemotherapy drugs
CNS disorders associated with SIADH?
head injury, stroke, brain tumors, infection (encephalitis, meningitis), cerebral atrophy, Guillain Barre syndrome, SLE
Misc conditions associated with SIADH?
hypothyroidism, lung infection, COPD, positive pressure mechanical ventilation, HIV, adrenal insufficiency
What causes hyponatremia in SIADH?
excess of water rather than deficiency of Na
Global symptoms of SIADH?
Fluid retention, serum hypoosmolality, dilutional hyponatremia, concentrated urine in the presence of normal or increased intravascular volume, low urine output, increased body weight.
Early sx of SIADH with mild hyponatremia?
thirst, dyspnea on exertion, fatigue, muscle cramping, irritability, HA
Severe sx of SIADH w/ serum sodium <120mEq/L.
Vomiting, abdominal cramps, msl twitching
Life threatening symptoms of SIADH from cerebral edema?
lethargy, confusion, sz, coma
What is diabetes insipidus (DI)?
deficiency in production or secretion of ADH or a decreased renal response to ADH.
Central or neurogenic DI causes?
brain tumor, head injury, brain surgery, CNS infections
Nephrogenic DI caues?
LITHIUM, renal damage, hereditary renal disease
Primary DI causes?
structural lesion in thirst center, psychologic disorder
Patho of DI?
Decreased ADH→ Decreased water reabsorption in the renal tubules → Decreased intravascular fluid volume → Excessive urine output and hypernatremia
Primary characteristics of DI?
polyuria, low specific gravity (<1.005), urine osmolality of < 100mOsm/kg
General manifestations of DI?
hypernatremia, excessive thirst, fatigue, gen weakness, dilute urine
What is hypophysectomy?
Surgical removal of the pituitary gland
Areas to monitor with SIADH?
I&Os, VS, ht and lung sounds, daily weights, signs of hyponatremia (sz, HA, vomiting, decreased neuro function)
Tx of severe hyponatremia? (Na< 120)
- IV hypertonic solution given slowly
- Fluid restrictions
- Conivaptan IV
- Tolvaptan PO
Tx of chronic SIADH?
- fluid restriction
- ice chips or sugarless chewing gum to decrease thirst
- daily weights
- Na and K supplements (diuretic use)
