Disorders of Endocrine System

Question 1

s/s addison’s dz; addisonian crisis

Answer 1

Muscle weakness, GI symptoms (nausea & vomiting, anorexia) ,

fatigue,

dark pigmentation of skin and mucosa,

hypotension,

hypoglycemia,

hyponatremia,

hyperkalemia,

apathy, emotional lability, confusion

Addisonian crisis- life-threatening complication
Severe hypotension, cyanosis, fever, nausea, vomiting , LOC, and signs of shock

Question 2

Solu-Cortef

Answer 2

hydrocortisone

used in acute and chronic adrenal insufficiency

administer daily at same time w/ meal or snack

Question 3

diet- addison’s

Answer 3

Restore fluid balance
Encourage increase fluid and sodium intake
Encourage diet higher in sodium and fluids, lower in postassium

Question 4

IV fluids- addison’s

Answer 4

Administer fluids and corticosteroids
IV hydrocortisone
Aggressive fluid replacement – 3- 4L of NS or 5% dextrose

Question 5

Ketoconazole

Answer 5

adrenal enzyme inhibitor

tx Cushing’s syndrome

interactions- antacids, anticholinergics –> decrease effects of drug

Take with fruit juice, water, coffee, tea (acidic drinks –> increase absorption)

Question 6

diet- cushing’s

Answer 6

Restrict fluid and sodium intake
Increase potassium, calcium, and protein intake

Question 7

acromegaly vs pituitary gigantism

Answer 7

acromegaly -excess GH- in adults

pituitary gigantism -excess GH- in children before fusion of epiphyseal growth plates- grow 7 or 8 ft tall

Question 8

fluid deprivation test

Serum osmolality
Urine specific gravity
Serum na

Answer 8

used to dx DI

is carried out by withholding fluids for 8-12 hrs or until 3% -5 % of body weight is lost

Pt is weighed during test

Plasma and urine osmolality are performed at beginning and end of test

Test is terminated if tachycardia, excessive wgt loss, or hypotension develops

Serum osmolality is increased
urine specific gravity is decreased
Serum sodium is increased

opposite of nml dehydration

Urine concentration (osmolarity) is UNCHANGED

Question 9

desmopressin

Effects
Don’t give if

Answer 9

artificial ADH

given to pt to tx DI

has vasoconstrictive effects

don’t give if have CAD or moderate-sev kidney dz (creatinine cl <50) b/c have decreased perfusion

Question 10

Acromegaly meds

Answer 10

Bromocriptine- causes gastric disruption  take with meal or snack
causes orthostatic HTN (dizziness, lightheadedness)
-Negative effect on contraceptives –> notify DR

Octreotide- Administer in intragluteal site- IM, Rotate injection sites

Question 11

SIADH- serum osmolality, serum Na, urine Na, ADH levels

Answer 11

Serum osmolality is decreased bc of
Serum sodium level is decreased

Urine sodium is increased
ADH level is elevated

Question 12

pt in hypoglycemic crisis

Answer 12

Give glucagon
Check vitals
Give simple carb
document

Question 13

What to do if patient with Addison’s sz experiences stressful activity or situtation?

Answer 13

administer hydrocortisone

Question 14

potassium managment- addisonian crisis

Answer 14

insulin
K binding resin
loop thiazide diuretics

Question 15

s/s- buffalo hump, thin extremities, thin-fragile skin, ecchymosis, straie

Answer 15

cushing’s

Question 16

green leafy vegetables high in what? which patients should eat more of this?

Answer 16

ca2+

cushings

Question 17

hyposecretion of GH before fusion of epiphyseal growth plate in children

Answer 17

dwarfism

Question 18

dilutional hyponatremia

Answer 18

SIADH