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Endocrine System > Disorders > Flashcards

Disorders Flashcards

1
Q

What are the disorders associated with the anterior lobe of the pituitary gland?

A

Hyperpituitarism
1. Gigantism
2. Acromegaly
Hypopituitarism
1. Dwarfism

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2
Q

What do acromegaly and gigantism have in common?

A
  1. Overgrowth of connective tissue, coarsened facial features, protruding jaw, ear thickness
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3
Q

What is hyperthyroidism?

A

Graves disease
The thyroid increases secretion which increases in thyroxine (T4)
Appearance: protrusion of the eyes (swelling behind the eyes)
-Symptoms: nervous, increase DTR, tremors, fatigue
-Cardio: palpitations, tachycardia, increase RR
-Integ: HEAT INTOLERANCE
GI: diarrhea, hungry, WEIGHT LOSS, polyuria

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4
Q

What happens if hyperthyroidism is left untreated?

A

Thyroid storm which is fatal.
-Acute episode of thyroid overactivity, high fever, severe tachycardia, delirium, dehydration, extreme irritability and agitation
Stressors: surgery, infection, labor, diabetic ketoacidosis, MI, pulmonary embolism, med overdose

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5
Q

PT for hyperthyroidism?

A

-Thyroid hormone replacement
-If they get fevers or rashes use antithyroid drugs
-Monitor vital signs
-Avoid hot warm pools or aquatic therapy
-Reduce exercise capacity : CO enhanced during exercise -> Afib, CHF and fatigue

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6
Q

What is hypothyroidism?

A

Decreased thyroid secretion
-HASHIMOTO DISEASE
-Symptoms: mental/physical lethargy, slowed speech, fatigue, prolonged DTR, PROXIMAL MUSCLE WEAKNESS
Cardio: sustained bradycardia w/ cardiac enlargement and dyspnea
INTOLERANCE TO COLD, dry skin/hair
Constipation
WEIGHT GAIN

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7
Q

What happens if hypothyroidism is left untreated?

A

Myexedema
Severe bilateral swollen hands, and feet and also the face
Coma
Death
Call 911

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8
Q

What to do for PT with hypothyroidism?

A

Acute care: dry edema more prone to skin tears and breakdown, pressure injuries

Exercise
-activity intolerance, weak, apathy-decreased metabolic rate
-exercise induced myalgia- RHABDOMYLOSIS (unexplained muscle pain, weakness which progresses to renal failure) TEA COLORED URINE, reduced SV which leads to decreased CO

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9
Q

Know where the thyroid and parathyroid are

A
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10
Q

What is hyperparathyroidism?

A

Increased calcium and decreased phosphate
Symptoms: proximal weakness, fatigue, drowsiness, confusion, myalgia, depression, osteopenia, GOUT, GLOVE AND STOCKING SENSORY LOSS, OSTEOPENIA

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11
Q

What do we do for PT for hyperparathyroidism?

A

-They are predisposed to pathological fractures
-fall risk
-Caution with gait training
-Good balance needed

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12
Q

What is hypoparathyroidism?

A

Decreased calcium and increased phosphate
Symptoms: neck stiffness, muscle cramp, muscle twitch, irritable, depressed, seizures which can lead to cardiac arrhythmias, paresthesias in fingertips and mouth

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13
Q

What to do for PT for hypoparathyroidism?

A

Acute tetany
-Chronic tetany- less severe- usually affects one side which causes difficulty with gait and balance
-Hyperventilation which makes tetany worse

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14
Q

Know where the adrenal gland is

A

On top of kidneys

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15
Q

What is Addison disease?

A

Primary adrenal insufficiency
-Cortisol and aldosterone levels are DECREASED
-Symptoms: anorexia, weight loss, bronze pigmentation of skin **, weak, decreased endurance, GI disturbances, dehydration, decreased tolerance to stress and cold **

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16
Q

What is the medical management for Addison disease?

A

-Glucocorticoids, adrenal corticoids, increase fluid intake, control NA and K, increase carbs and proteins

If it is untreated it is fatal and can go into adrenal crisis so call 922

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17
Q

What is secondary adrenal insufficiency?

A

-cortisol and aldosterone levels are decreased
-Causes: prolonged steroids (ACTH)
-rapid withdrawal from drugs
-Hypothalamic

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18
Q

What is Cushing’s disease?

A

-Adrenocortical hyperfunction

-Cushings Disease: Pituitary adenoma- more ACTH which stimulates the adrenal gland and releases cortisol
-Cushings syndrome: increased cortisol - taking meds- corticosteroids
Symptoms: round moon face, butterfly rash, obesity, BUFFALO HUMP, decreased testosterone and menstrual periods, emotional changes, MUSCULAR ATROPHY, edema, HYPOKALEMIA

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19
Q

What is the medical management for Cushings disease?

A

Decrease ACTH- surgical excision of the pituitary, monitor weight, fluid and electrolytes

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20
Q

What are the symptoms of obesity?

A

-Type 2 DM, excessive food intake w/o physical activity
-Stimulates hyperinsulinemia, asthma
-Functionally- increase risk of falls, SOB, fatigue, ADL limitations, hip, knee, back pain
-Complications: pregnancy- health problems prenatal, postnatal, increase risk of gestational diabetes, pregnancy HTN, DVT

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21
Q

What is the BMI classification?

A
  1. <18.5= underweight
  2. 18.5-24.9= normal
  3. 25-29.9= overweight
  4. 30-40= obese
  5. > 40 = extreme obese
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22
Q

What is the role of the pancreas?

A

To stimulate secretion of glucagon and insulin

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23
Q

What does insulin do?

A

Reduces blood glucose

24
Q

What does glucagon do?

A

Increases blood glucose levels

25
Q

What is type I diabetes?

A

Don’t produce enough insulin
- So you inject insulin

26
Q

What is type 2 diabetes?

A

-The pancreas produces less insulin
-more insulin in the blood and insulin moves less glucose cells

27
Q

What are the signs and symptoms of diabetes?

A

Integumentary: slow healing sores
Cardio: high BP, infections of gums, skin, vagina and bladder
Symptoms: increased thirst, frequent urination, constant hunger, fatigue, sweat, blurry vision, tingling, burning, numbness in feet/hands, neuropathy, pain in joints, cramping, weakness

28
Q

What is hypoglycemia?

A

Onset is rapid <70
Early symptoms: excessive hunger, shaking, trembling, sweating, tachycardia, palpitations, dizzy, fainting, weak, poor coordination/gait
Late symptoms: nervous irritable, HA, blurry vision/diplopia, slurred speech, drowsy, irritability to concentrate, confused, delusions, LOC, coma

Response: awake: sugar, orange juice, candy
Unresponsiveness: call 911

29
Q

What is hyperglycemia?

A

Onset: gradual, glucose >300
Symptoms: increased thirst, dry mouth, frequent, scant urination, decreased appetite, N/V, abdominal tenderness, dull senses, weak, confused, decreased reflexes, flushed/paresthesias, deep rapid respiration, rapid pulse, FRUITY/ACETONE BREATH, coma
Response: call 911

30
Q

What are the posterior lobe disorders of the pituitary gland?

A

Diabetes insipidus

31
Q

What is gigantism?

A

Excessive growth hormone caused by a pituitary tumor
-Benign adenoma
-Overgrowth of long bones, Happens in children before the epiphysis of bone closes. They can grow 9 feet tall

32
Q

What is acromegaly?

A

Increase bone thickness and hypertrophy of soft tissues
-Disease in adults which develops after the closure of the epiphysis, develops slowly
-Weakness, change in joint mobility, poor exercise tolerance, affects the jaw, hand and feet
-Unusual and PT needs to refer

33
Q

What do acromegaly and gigantism have in common?

A

-Connective tissue overgrowth
-Coarsened facial features, protruding jaw, ear thickness, nose, tongues, spade fingers

34
Q

What is the post op care for gigantism and acromegaly?

A

-Ambulation and exercise, encouraged within 24 hours
-Alteration in LOC, visual acuity, falling, pulse, increase BP - increase intracranial pressure, intracranial bleeding or cerebellar edema - call 911!!
-Meningitis- nuchal (back of neck) rigid, severe HA, irritable- 911!!

35
Q

What is dwarfism?

A

-Anterior lobe disorder of pituitary
-Decreased secretion by anterior pituitary glands
-Results in hypothyroidism-Thyroid dependent on TSH
-Sexual and reproductive disorders
-Absent secondary sex characteristics, infertile, impotence

36
Q

What to do in PT for dwarfism?

A

Symptoms of hormonal deficiency- hormone replacement therapy. The pt is weak, has fatigue, lethargy, apathy, orthostatic hypotension
-Infection prevention is vital
-Impaired peripheral vision- associated bilateral hemionopia (blindness in 1/2 visual field)
-fall risk!!!!!

37
Q

What is diabetes insipidus?

A

-Also stems from pituitary
Physiological imbalance of water secondary to ADH deficiency/inaction
-ADH promotes water reabsorption by the kidneys and control osmotic pressure of extracellular fluid
-ADH fails - kidney fails to reabsorb water- urine dilute, contain NO GLUCOSE- in DM see glucose

38
Q

How would they present in the clinic?

A

-polydipsia: excessive thirst
-Nocturia: excessive urination at night
-Dehydration: poor tissue turbar, constipated, muscle weakness, dizziness, hypotension, fatigue, irritability

39
Q

What is the intervention for diabetes insipidus?

A

Conscious- give water- sip water
-Unconscious- shock, rapid dehydration, die -> call 911
-Remember!!!! Diabetes insipidus is related to H20 and DM 1&2 is related to insulin/sugar

40
Q

What is phenylketonuria?

A

Pediatric
Autosomal recessive disease
Genetic defect metabolism
Phe accumulates in blood and excretes in urine

41
Q

What is the treatment for phenylketonuria?

A

Untreated: mental retardation, tremors, poor muscle coordination, excessive perspiration, musky odor, seizures
Treat: restrict phe in diet (milk, eggs, meat)

42
Q

What is Wilsons disease?

A

Progressive inherited autosomal recessive defect in copper
-It accumulates in liver, brain, kidneys

43
Q

What are the clinical manifestations of Wilson disease?

A

-Keyserfisher rings around the iris
-Cirrhosis of liver
-Degenerative changes in brain
-Cerebellar, athetoid, ataxia
-Pill rolling tremor in hand **
-Muscle rigidity, muscle atrophy, wasting, contractures
-Osteomalacia
-Progress to fatal
-Hepatic failure

44
Q

What is the treatment of Wilson disease?

A

Manage hepatic disease
Lifetime administration of vitamin B16 and D

45
Q

What is appendicitis?

A

Inflammation of the vermiform of appendix
-As condition progresses, appendix becomes swollen, gangrenous, and perforated
-Perforation can be life threatening and lead to development of peritonitis
-P! Is abrupt at onset, and localized to epigastric of periumbilical area and increases over time
IMMEDIATE MEDICAL ATTENTION IS REQUIRED WITH POSITIVE SPECIAL TESTS> ELEVATIONS IN WBC COUNT (>20,000) ARE INDICATIVE OF PERFORATION AND SURGERY IS INDICATED

46
Q

What is peritonitis?

A

-Inflammation of the peritoneum (serous membrane) lining the abdominal cavity
-Results from bacterial invasion & infection of peritoneum (E.coli, and streptococci)
-Causes: penetrating wounds, surgery, perforated peptic ulcer or diverticulum, ruptured appendix
-Symptoms: ABD distension or pain, rigidity from guarding, decreased bowel sounds, N/V
-** elevated WBC count, fever, electrolyte imbalance, and hypotension involved
-***Can lead to toxemia and shock, circulatory failure and respiratory distress

47
Q

What is hepatitis?

A

Inflammation of the liver caused by bacterial infection; chemical agents (alcohol, drugs, toxins, herbals); autoimmune hepatitis, biliary cirrhosis and metabolic disorders such as Wilson’s disease **

48
Q

What are the clinical S&S’s of hepatitis?

A

-Initial: low grade fever, anorexia, N/V, diarrhea, fatigue, malaise, HA, ABD tenderness, myalgia/arthralgia
-Jaundice phase: fever, jaundice, enlarged liver with tenderness, abatement of earlier symptoms
-**amber color or dark urine
-Lab values: elevated bilirubin and hepatic transaminases
-Course: acute: may last weeks-months, chronic: HBV and HCV may lead to chronic liver infection including necrosis, cirrhosis, and liver failure

49
Q

What are the medical interventions for Hepatitis?

A

-No specific trx for acute viral hepatitis; treatment is symptomatic. Ex: IV fluids, analgesics
-Chronic hepatitis: direct acting antivirals are main therapy
-Viral hepatitis is leading cause of liver cancer and common reason for liver transplantation

50
Q

What is Cirrhosis?

A

Irreversible chronic injury of the hepatic parenchyma as a result of chronic hepatitis
-Clinical manifestations: jaundice, peripheral edema, Dupuytrens contracture**, palmar erythema, angiomas, hepatomegaly, splenomegaly, and ascites
-Presentation: later complications include: neuropsychiatric abnormalities with personality changes, intellectual impairment, depressed levels of consciousness, slurred speech and slowed movement

51
Q

What is the treatment of Cirrhosis?

A

-Furosemide (Lasix) or spironolactone (potassium-sparing diuretic)
-Paracentesis drainage can be used to remove peritoneal fluid

52
Q

What are the two conditions of the gallbladder?

A

Cholelithiasis/cholecystitis

53
Q

What is cholelithiasis?

A

-Gallstones present in the gallbladder
-Often asymptomatic and no intervention needed
-If gallstones block the common bile duct, biliary colic can result
-Pain in RUQ with radiation to R scapula **
-Can worsen after a fatty meal **

54
Q

What is Cholecystitis?

A

-Partial or complete obstruction of common bile duct resulting in inflammation of gallbladder
Symptoms: severe RUQ pain radiating to right scapula. N/V or low grade fever
-MURPHYS SIGN

55
Q

What is pancreatitis?

A

-Caused by gallstones, alcoholism, substance abuse
-Bandlike pain which radiates to back and worse in supine position
-May be accompanied by hypotension, tachycardia, N/V
-Intervention: IV fluids, NPO, and surgery
-Chronic pancreatitis: epigastric or LUQ pain, anorexia, N/V, greasy stools
Interventions: diet modification, pain control, and supplemental pancreatic enzymes

56
Q

What is a rectal fissure?

A

-Tear or ulceration of lining of the anal canal
-Constipation and large hard stools

57
Q

What are hemorrhoids?

A

-Also called piles
-Varicosities in the lower rectum or anus caused by congestion of the veins in the hemorrhoidal plexus
-Can be external (protruding from the anus) or internal
-Symptoms: irritation, pain, rectal itching
-Prolonged bleeding can = anemia
-Straining with defamation, constipation and prolonged sitting contribute to discomfort
-Trx: topical medications to shrink the hemorrhoid, dietary changes, sitz bath, local hot or cold compresses or surgery

Endocrine System (4 decks)

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