CHP 24: ENDOCRINE EMERGENCIES Flashcards
chemical messengers that are secreted into bloodstream by endocrine glands
hormones
what is the link between the endocrine system and the nervous system
hypothalamus
what structure controls release of hormones by pituitary gland
hypothalamus
a decrease in the body’s water content triggers release of what
ADH (antidiuretic hormone)
what are tropic hormones
hormones secreted to stimulate release of other hormones
the ___ secretes TSH so the thyroid releases what?
anterior pituitary gland, T4
which gland secretes calcitonin and what is it for
thyroid - limits calcium levels
what does the parathyroid hormone do
antagonist to calcitonin - stimulates osteoclasts to break down done and decreases calcium released in urine from kidneys
main function of the thymus gland
helps immune system identify and destroy foreign substances
which organ is both endocrine and exocrine gland
pancreas
where is the islets of Langerhans
pancreas
3 types of cells and what they release in islets of Langerhans
alpha: glucagon
beta: insulin
delta: somatostatin
what organ does glucagon stimulate and to do what
the liver to convert glycogen into sugar
what organ does insulin stimulate and to do what
the liver to store glucose as glycogen
where are the adrenal glands located
superior aspect of each kidney
2 sections of adrenal glands
cortex and medulla
what does aldosterone do
stimulates kidneys to reabsorb sodium from urine to increase blood volume and BP
what organ releases aldosterone
adrenal cortex
what organ releases norepi and epi
adrenal medulla
norepi vs epi
norepi: raises BP through arterioconstriction and bronchiole dilation
epi: stimulates sympathetic nervous system and stimulates liver to convert glycogen to glucose for energy
what do the testes produce
androgens
anterior pituitary gland directions actions of ovaries through what two hormones
FSH and LH
two hormones released by ovaries
estrogen and progesterone (small amount of testosterone)
what causes myxedema coma
severe, untreated hypothyroidism
what causes thyrotoxicosis
excessive levels of thryoid hormone
3 tell-tale signs of Cushing syndrome
buffalo hump, moon face, acne
mottled skin can be associated with what
pancreatitis
what causes SIADH and its symptoms
excess ADH causes decreased urinary output and systemic fluid overload
symptoms: enlarged or abnormal body parts with edema
what is anasarca
extreme generalized edema
what is exophthalmos
protruding eyeballs
what is Graves disease and its symptoms
autoimmune disorder that causes thyroid gland hypertrophy and severe hyperthyroidism
symptoms: exophthalmos
what is panhypopituitarism
inadequate production or absence of pituitary hormones
symptoms in patients with undiagnosed or poorly managed diabetes
polyphagia, polyuria, polydipsia
symptoms in patients with hyperthyroidism and thyrotoxicosis
tachycardia, PVCs and atrial dysrhythmias (PACs)
what skin condition is a classic sign of shock or hypoglycemia
cold and clammy
what skin condition is a sign of sedative OD or alcohol intoxication
cold and dry
what skin condition is a sign of hyperglycemia or heatstroke
hot and dry
what do Kussmaul respirations often signify
diabetic ketoacidosis
what two breathing motions require intact brainstem and what two indicate brainstem damage
intact: yawn and sneezing
damaged: hiccupping and coughing
3 signs in Cushing reflex
slowing pulse, rising BP, erratic respiratory pattern
what is diabetes mellitus
disease of body’s inability to sufficiently metabolize glucose
what is polyphagia
increased appetite
what is polydipsia
increased thirst
what is polyuria
excessive urine
how does diabetes affect kidneys
principal cause of kidney failure because it causes kidneys to work harder
what is microangiopathy
deterioration of vessel walls
why does diabetes increase chance of heart disease
lipolysis increases level of fat in blood and adheres to vessel walls
what contributes to increased risk of silent MI in diabetes patients
microangiopathy and neuropathy
what is neuropathy
nerve damage that results in loss of sensation
which type of diabetes is insulin-dependent
type 1
what is latent autoimmune diabetes
variant of type 1 diabetes that occurs in adults older than 30y/o
what happens in type 2 diabetes
“insulin resistance” body can’t produce enough insulin to compensate for inability to use insulin effectively
type 1 diabetes is insulin ____
type 2 diabetes is insulin ____
dependent
resistant
what is metformin prescribed for
type 2 diabetes
how to test for prediabetes
A1c blood test
when is gestational diabetes usually diagnosed and when does it peak
28 weeks, third trimester
hypoglycemia is less than ___mg/dL
45
3 lines of defense for hypoglycemia
1st: reduce insulin production and increase glucagon production
2nd: catecholamine release (will show as tachycardia) and cortisol
3rd: ANS stimulation for counter-regulatory hormones
what is the dawn phenomenon
body releasing cortisol and catecholamines in the morning before waking triggers release of glucose from the liver
what os Somogyi effect
low BGL causes release of hormones that trigger release of glucose from liver
what BGL range does HHNS occur
above 600
treatment for DKA with peaked T waves
1L of saline, albuterol, calcium chloride, sodium bicarb
what is hyperosmolarity
highly concentrated blood as a result of releative dehydration
2 most common causes of pancreatitis
gallstones and alcohol abuse
what causes flank pain with pain worsening when patient is placed supine
pancreatitis
what disease is linked to primary adrenal insufficiency
Addison disease
what is Addison disease caused by
atrophy/destruction of adrenal glands
S/S of Addison disease
weight loss, fatigue, salt craving, joint pain, postural dizziness, increased pigmentation, palmar creases
treatment for Addison disease
Hydrocortisone, 5% dextrose saline
what is secondary adrenal insufficiency
lack of ACTH secretion from pituitary gland
most common cause of addisonian crisis
corticosteroid withdrawal
what causes Cushing syndrome
overproduction of cortisol by adrenal glands or excessive corticosteroid use
symptoms of Cushing syndrome
weight gain “moon face” or “buffalo hump”, darkening of neck skin, high BGL, increased thirst/urination
what is pheochromocytoma
tumor in the medulla of adrenal gland causes excessive release of epi and norepi
what is acromegaly
over secretion of GH from anterior pituitary gland (usually from tumor) that causes gigantism
what is dwarfism
under secretion of GH from anterior pituitary gland causing delayed development and growth
what causes a goiter
hypertrophied thyroid from Graves disease
what is exophthalmos and what disease is it linked to
edema of tissue behind eyes - Graves
what is pretibial myxedema and what disease is it linked to
“orange peel” appearance and non-pitting edema in leg below knee - Graves
what is myxedema
adult hypothyroidism
what causes thyrotoxicosis
excessive levels of circulating thyroid hormone
most common cause of hyperparathyroidism
benign tumor on the gland called adenoma
2 hormone levels that characterize hyperparathyroidism
hypercalcemia and decreased phosphate levels
what is panhypopituitarism
inadequate production or absence of pituitary hormones
what is diabetes insipidus
body can’t regulate fluid due to lack of ADH or kidneys are unable to respond appropriately
difference between diabetes insipidus and SIADH
diabetes insipidus: decreased levels of ADH, polyuria, dehydration
SIADH: increased ADH levels, oliguria, systemic fluid overload
what is SIADH
excess of ADH causing decreased urinary output
