Endocrine

Question 1

Normal serum osmolality

Answer 1

275-295

Question 2

Normal urine spec grav

Answer 2

1.01-1.02

1. 005 diluted(⬇️ADH)
2. 03 concentrated(⬆️ADH)

Question 3

Factors affecting serum osmolality

Answer 3

Na, BUN, glucose directly correlate with ⬆️⬇️ osmolality

Question 4

Hypothalamus

Answer 4

Regulates endocrine center, temp, autonomic NS

Question 5

SIADH water rtn effects

Answer 5

⬇️serum Na, ⬇️UO, ⬆️urine SG, ⬇️serum osmolality

Question 6

SIADH is from

Answer 6

Viral PNA, oat cell carcinoma, head issues, thiazide diuretics

Question 7

SIADH tx

Answer 7

Address cause, FR, 3% saline if NA<120, phenytoin to inhibit ADH

Question 8

DI water loss effects

Answer 8

⬆️Serum Na, ⬆️UO, ⬇️urine SG, ⬆️serum osmollity

Question 9

DI is from

Answer 9

Head trauma

Phenytoin

Question 10

DI tx

Answer 10

Give fluids or LR if NA is high
Give ADH(pitressin, Vaso) but watch for ischemia sighs

Question 11

DKA is from

Answer 11

Infections, new T1DM, stress, noncompliance

Question 12

DKA s/s

Answer 12

Kussmaul R, dehydrated, rapid development, no insulin production

Question 13

DKA labs

Answer 13

BG>250, 4-6L deficit, acidotic, +ketones serum and urine, normal osmolality, ⬆️K with acidosis, but lowers once corrected.

Question 14

DKA tx

Answer 14

Fluids, insulin got, dextrose gtt once Bg is ~250, continue infusion until acidosis corrected

Question 15

HHS is from

Answer 15

T2DM
Pancreatitis
TPN
steroids, diuretics, phenytoin, certain meds

Question 16

HHS s/s

Answer 16

Slow development over days, very dehydrated, inadequate insulin production, rapid shallow RR

Question 17

HHS labs

Answer 17

Bg>600, 6-9L deficit, no acidosis, no ketones, hyper osmolality thick blood, elevated K

Question 18

HHS tx

Answer 18

Fluids, insulin, add dextrose gtt once bg ~300

Question 19

K and pH relationship

Answer 19

Every increase of 0.1 of pH, K will increase by 0.6; as acidosis is solved K will decrease

Question 20

⬇️BG s/s

Answer 20

Early ⬆️HR, palps, sweaty, irritable, restless

Late confusion, lethargic, slurring, sx, coma

*bblocker pt will have late signs first, masking

Question 21

Addison

Answer 21

⬇️Bg
⬇️NA
⬆️Ca
⬆️K
⬇️Cortisol

Question 22

Th crisis/storm

Answer 22

AMs, tremors, fever, ⬆️HR, ⬆️RR, goiter, ⬆️T3T4, ⬇️TSH

Cool pt, fluids, plasmapheresis, iodine, steroids

Question 23

Hypo th, myxedema coma

Answer 23

AMS, poor mem, delayed DTR, cold, ⬇️HR, ⬇️RR, macroglossia, ⬇️T3T4, ⬆️TSH, anemia

Tx rewarm, synthroid, correct labs