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NSG219 > Better Endocrine > Flashcards

Better Endocrine Flashcards

1
Q

What does the adrenal cortex release

A

glucocrtiocids and mineralcorticoids

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2
Q

what is the primary glucocorticoid

A

Cortisol

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3
Q

what does glucocorticoids do

A

regulate fluid balance, anti inflammatory and regulating BP

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4
Q

what does the thyroid gland affect

A

metabolism, HR, RBC production, RR

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5
Q

what are the main thyroid gland hormones

A

T3 and T4

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6
Q

what does the adrenal medulla release

A

catecholamine (norepinephrine and epinephrine)

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7
Q

what does the parathyroid gland secrete

A

calcitonin

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8
Q

How does calcitonin work

A

stops the bones from releasing calcium and phosphorous to regulate calcium levels

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9
Q

what happens when steriods arent tapred off

A

adrenal insufficency

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10
Q

what are the ss of adrenal insufficency

A

decrease BP and decrease BG

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11
Q

what is included in the gonads

A

ovaries and testes

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12
Q

what does the pancreas secrete and regulate

A

glucagon and insulin to maintain BG

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13
Q

what does the posterior pituitary glands effect

A

hematocrit, serum sodium, and urine specific gravity

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14
Q

what does the parathyroid affect

A

calcium, ionized calcium, Vit D, magnesium, and phosphorus

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15
Q

what are the aging changes for endocrine

A

gonads, thyroid gland, gradually decrease, decrease in ADH, glucose tolerance and metabolism

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16
Q

what does the luiteinizing hormone effect

A

ovulation and testosterone

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17
Q

what does the prolactin hormone effect

A

mammary glands for milk (breast feeding)

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18
Q

what labs help diagnosis hypopituitarism

A

TSH, FSH, LH, prolactin, growth hormone, ACTH

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19
Q

what is the diet for someone with Hypopituitarism

A

adequate amounts of Vit D and calcium

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20
Q

what does the follicle stimulating hormone do

A

maturation of ovaries and sperm production

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21
Q

what could be the cause of hypopituitarism

A

dysfunction (from tumor or damage), increased intracranial pressure, CNS infection, it is gradual

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22
Q

what are the ss of hypopituitarism

A

depends on what hormone is effected, increased weight, slow metabolism, increased sensitivity to cold, infertility, increased estorgen, hair loss, increased urine out put (even if input is decreased), decreased BP, decreased specific gravity

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23
Q

what is the management goal of hypopituitarism

A

restore target hormone, increase vit d and calcium

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24
Q

what is the cause for hyperpituitarism

A

Hyper-secreting tumor not genetic

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25
Q

what does bromocriptide mesylate med do

A

dopamine antagonist, stops releasr of anterior pituitary hormones

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26
Q

what is sterotactic radoisurgrey

A

minimally invasive, high dose of radiation to specific part of the brain

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27
Q

what are some complications of hyperpituitarism

A

increase BG, increase BP, acromegaly, excess TSH increase thyroid hormone which could cause thyroid storm

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28
Q

what are the ss of DI after transsphenodal hypophysectomy

A

decreased BP and increased HR

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29
Q

if someone had a fever after transsphenodal hypophysectomy what would you expect

A

infection or CNS leakage,

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30
Q

what are the ss of meningitis after a transsphenodal hypophysectomy

A

increased temp, stiff neck, photophobia

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31
Q

what does the pituitary gland secrete and effect

A

secretes ADH and oxytocin
maintains fluid and electrolyte balance, circadian homeostasis (oxytocin), release of breast milk and cervical changes during labor

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32
Q

what are the ss of DI

A

depends of water loss, increase sodium and hematocrit, decrease BP, increase HR, clinical manifestations are polyuria, polydipsia, and nocturia

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33
Q

what does desmopressin med do

A

increase amount of fluid absorbed in kidneys then returned to the blood

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34
Q

what is the drug of choice for DI

A

desmopressin

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35
Q

why would someone take vasopressin over desmopressin

A

cheaper

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36
Q

what are the ss of hyperpituitarism

A

increase BP, BG sodium, bone density, menstural irregularties, expothalamos, acromegally

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37
Q

what is a transsphenoidal hypophysectomy

A

removal of hyper-secreting tumors of hyperpituitarism graft is placed after to aide in healing

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38
Q

what does somatosatin analog do

A

stops growth hormone

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39
Q

what is central DI

A

decreased ADH, autoimmune destruction of hypothalamus

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40
Q

what do you expect urine specific gravity to be if diagnosing DI

A

less then 1.005

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41
Q

what is the key indicator of DI

A

osmolarity lower then 200

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42
Q

how do you manage DI

A

Maintaining adequate fluids, in emergencies IV fluids can be given (but if so monitor for fluid overload and increased BP)

43
Q

when correcting high sodium in DI how much should you lose

A

0.5/hr

44
Q

what are the complications of DI

A

dehydration and hypovolemia

45
Q

someone with permanent DI they will need what for life

A

hormone replacement daily

46
Q

what is SADH

A

increased ADH, water overload and hemodialation

47
Q

how do you manage SADH

A

correction of increased sodium, so give 3% NS but it may cause hyperosmolarity

48
Q

what do you need to assess for SADH

A

neurological, I/O, sodium osmolarity

49
Q

what do you need to assess for DI

A

BP, HR, I/O, weight, sodium, hematocritwhat a

50
Q

what are the side effects for SADH

A

decrease urine output, increased sodium,

51
Q

when sodium decreases too fast what can happen

A

seizures or coma

52
Q

what is demeclocycline for and what does it do

A

SADH

increases water secretion

53
Q

what does coritsol do

A

fat, carb, and protein metabolism, supress immune response, and controls the bodies stress response

54
Q

what does aldosterone do

A

promotes sodium and water reabsorption and potassium excretion

55
Q

what is the cause of adrenal gland insufficency

A

autoimmune,

56
Q

what is a insulin tolerance test

A

uses hypoglycemia stress to induce cortisol production

57
Q

what does an enlargement of the adrenal cause by

A

infection

58
Q

what does shrinkage of adrenal mean

A

destruction

59
Q

what is adrenal crisis

A

severe decrease in fluids, decreased BP and increased potassium

60
Q

what are the ss of hypercortisolism/ cushings

A

increased BP, fluid retention, decreased postassium, buffalo hump, moon face, skinny arms

61
Q

how do you diagnosis cushings/ hypercoritolism

A

cortisol levels, electrolyte levels, 24 hour urine recall (bc cortisol fluctuate)

62
Q

what does epinephrine and norepinephrine do

A

mimics SNS - fight or flight

63
Q

what are the ss of adrenal insufficiency/ addisons

A

darkened skin, decreased BP (bc of fluid loss), decreased weight

64
Q

how do you diagnosis addisons, or adrenal insufficency

A

cortisol below 3, decreased sodium/glucose

increased potassium/cortisol

65
Q

what is the treatment of choice for adrenal insufficency/ addisons

A

Hydrocortisone

66
Q

what could adrenal hyper function be caused by

A

tumor, medication

67
Q

what is the main focus of managing cushings

A

prevent complications associated with with fluid overload

68
Q

what does aminoglutethimide

A

interferes with cortisol production

69
Q

what does pasireotide (signifor) do

A

inhibits corticotropin with cushings

70
Q

what is crohns

A

hyperaldosterone

71
Q

what are the ss of hyperaldosterone/crohns

A

increased sodium, decreased potassium, increased BP, edema, cardiac irregularities , headache, thirst, memory loss

72
Q

what can severe BP cause

A

stroke or MI

73
Q

how do you diagnosis phenochromocytoma

A

sudden increase in BP, severe headache, increase in HR, usually only seen on autopsy

74
Q

when measuring blood catechlolamine for phenochromocytoma what are the interventions

A

client must lay 30 min prior

75
Q

when measuring urine for phenochromocytoma what should the patient avoid

A

bananas, tea, chocolate, vanilla (foods high in amines)

76
Q

what is a goiter

A

enlargement of thyroid gland happens when compensating for low T3 and T4

77
Q

what is synthroid for and when should you take it

A

Hypothyroidism, started low, take in AM on empty stomach bc it effects metabolism

78
Q

what does cyproheptadine do

A

impacts ACTH

79
Q

what is hyperalodsterone/crohns diet

A

low sodium high potassium

80
Q

what are the complications for hypercortisolism/ cushings

A

osetoprosis, abrupt withdrawal, increased BG, GI bleeding

81
Q

what must the patient do before a bilateral adrenalectomy

A

take alpha blockers a week before have a BP of 120/80

82
Q

what will a patient have to take after a bilateral adrenalectomy

A

adrenal cortex hormone for life

83
Q

what are the ss of hypothyroidsm/ hasimotos

A

decreased metabolism, decreased energy, increased sleep, decreased appetitie, weight loss, hair loss, lack of sweating, myxedema

84
Q

what will you test for hasimotos

A

antithyroid antibodies

85
Q

what is hyperthyroidsm/ graves

A

over secretion of TRH, TSH, or T3 and T4

86
Q

what is the cause of graves disease

A

hereditary

87
Q

what is iodine preparations

A

Radioactive iodine to damage or destroy thyroid cells

88
Q

after iodine preparations for hyperthyroidsms what must the patient do

A

avoid close contact with others, social distance, sleep alone, dont share personal items, clean your stuff separately

89
Q

what is a thyroid storm

A

poorly managed hyperthyroidism,

90
Q

what is the priority for a thyroid storm

A

airway management and fluid resusictation

91
Q

what do you want to assess for hypothyroidism

A

HR,RR, temp, weight, cholesterol, O2, calcium, skin, bowel elimination

92
Q

what are the ss of hyperthyroidsm

A

accelerated metabolism, increased HR, heat intolerance, decreased weight, fatigue, insomnia, increased appetite, expothalamous (vision changes)

93
Q

how do you diagnosis hyperthyroidsm

A

elevated T3 adn T4 decreased TSH

94
Q

what does lithium carbonate do

A

interferes with thyroid hormone synthesis, drink lots of fluid

95
Q

what are the ss of a thyroid storm

A

increased HR/temp/BP, abdominal pain, changes in LOC, tremors

96
Q

after a thyroidectomy what should you assess

A

damage to laryngeal nerve, voice assess every hour, semi fowlers, monitor airway

97
Q

Trousseau and choveks increases the risk for what

A

laryngealspasms and airway compromise

98
Q

what are the ss of hypoparathyroidsm

A

trousseau, choveks, numbness/tingling around mouth/hands/feet, cramps

99
Q

what could be the cause of hyperparathyroidsm

A

renal failure or decreased calcium

100
Q

what happens to the bones for hyperpatathyroidsm

A

osteoclasts which breaks down bones

101
Q

what is the definitive diagnosis of hyperthyroidsm

A

PTH

102
Q

what can happen to the PR and QT for hyperparathyroidsm

A

prlonged PR shortened QT

103
Q

what are the ss of hyperparathyroidsm

A

polyuria, anorexia, constipation, cardiac changes, muscle weakness

NSG219 (11 decks)

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