Endocrine Flashcards by Beth Hansen

Define gland:

Any structure that makes and secretes a hormone

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What is the master gland?

Pituitary gland

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Structure of hormones:

Amino acids (proteins): water soluble, receptors on outside of target cells
Lipids (cholesterol): lipid soluble, receptors inside target cells

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Growth hormone (GH) function:

Promotes growth and repair of cells

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Thyroid stimulating hormone function:

Synthesis and release of thyroid hormone, growth and function of thyroid

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Adrenocorticotrophic hormone (ACTH)

Growth of adrenal cortex; secretion of corticosteroids

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Follicle stimulating hormone (FSH) function

Reproductive function

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Prolactin function

Milk production

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Oxytocin function:

Milk secretion; uterine contraction

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Antidiuretic hormone (ADH):

Reabsorption of H2O

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Hormones secreted by the thyroid:

Thyroxine (T4): Precursor to T3
Triiodothyronine (T3): Regulates metabolic rate and cell growth
Calcitonin: Regulates calcium and phosphorous levels
Parathyroid hormone: regulates calcium and phosphorous levels (bones)

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Hormones secreted by the adrenals:

Adrenaline/noradrenaline: response to stress; enhances and prolongs effects on SNS
Corticosteroids: promotes metabolism; response to stress
Androgens: masculinisation in men; sexual activity in women
Mineralcorticosteroids: Na+, H2O, K+ balance

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Hormones secreted by the pancreas:

Insulin: movement of glucose into cells
Glucagon: glycogenolysis
Somatostatin: inhibits insulin and glucagon secretion
pancreatic polypeptide: regulation of pancreas functioning

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Hormones secreted by ovaries and testes:

Oestrogen: secondary sex characteristics; preparation of uterus for pregnancy; foetal growth; stimulates bone growth
progesterone: maintains lining of uterus for pregnancy, precursor to testosterone
testosterone: secondary sex characteristics

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Endocrine subjective assessment

use of medications
family history
weight changes
difficulty swallowing or change in neck size (goitre)
changes to skin or hair
elimination pattern
sleep-rest pattern
menstruation changes
stressors

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Associated symptoms with endocrine dysfunction:

Polyuria
Polydipsia (thirst)
Polyphagia (hunger)
Tachycardia
palpitations
fatigue
altered mood
depression
weight gain

Endocrine objective assessment:

Inspect:
skin, nails, hair
neck
thyroid (swelling)
chest wall
Palpate:
neck & chest wall
vital signs
GCS
mental - anxiety
height & weight

Complications of feet/lower extremities:

Foot ulcers
Peripheral vascular disease
Sensory neuropathy
higher risk of infection

Homeostatic glucose levels:

90mg glucose/100mL blood

3-8mmol/L

Type I diabetes:

Results from progressive destruction of beta cells due to autoimmunity
Genetic predisposition
Requires exogenous source of insulin

Type II diabetes:

Results from cells becoming resistant to insulin or pancreas producing little insulin
insufficient insulin or poorly utilised by cells
pancreas usually continues to produce some insulin

Gestational diabetes:

develops during pregnancy due to high blood glucose levels in mother
brings extra glucose to baby
causes baby to put on extra weight

Diagnosing diabetes:

Fasting plasma glucose>7mmol/L
2hr oral glucose tolerance test (OGTT) >11.1mmol/L using 75g glucose load
HbA1c (glycosylated haemoglobin) - amount of glucose attached to Hb over a 3 month period; normal range: 4-5% non diabetic

Chronic complications of diabetes:

Vascular: atherosclerosis (stroke, MI, PVD), thickening of vessel wall

Retinopathy: damage to retina, development of microaneurysms (haemorrage, retinal oedema)

Nephropathy: damage to vessels that support glomeruli, impotence/difficulty passing urine

Neuropathy: nerve damage, sensory neuropathy (loss of sensation, numbness, pain, paraesthesia - pins and needles)

Symptoms of T1DM:

- Polydipsia - Polyuria - Wasting - Hyperglycaemia - Keto-acidosis (most common first presentation)

What is keto-acidosis?

* When levels of ketones in your body are dangerously high * Insulin is responsible for decreasing lipolysis, in its absence, more fats are broken down, causing high amounts of ketones

Symptoms of T2DM:

- Gradual onset of symptoms | - IHD, nephropathy, neuropathy, retinopathy

T2DM treatment options:

- Diet control and weight loss - Oral hypoglycaemic agents (decrease glyconeogenesis, reduce intestinal/renal absorption of glucose, improves peripheral uptake of glucose, stimulates insulin release) - Insulin

Diabetic keto-acidosis indicators:

Triad: hyperglycaemia (14-40mmol/L), metabolic acidosis (pH <7.3), ketonaemia, ketonuria * Dehydration * Electrolyte loss (K+) * Nausea & vomiting * Ketone breath * lethargy * Kussmaul's respirations (deep sighing)

Diabetic keto-acidosis treatment:

- Electrolytes (potassium replacement) - Fluid - Insulin - IV drip - airway management - education

Hypoglycaemia symptoms:

- Neurogenic reaction: pallor, sweating, tachycardia, palpitations, hunger, restlessness, anxiety, tremor - Cellular malnutrition: fatigue, irritability, headache, loss of concentration, visual disturbances, dizziness, hunger, confusion, coma, death

Hyperthyroidism treatments:

- Antithyroid medications/iodides (prevents formation of T3/T4) - Beta-blockers (suppresses symptoms such as anxiety, tremor, tachycardia) - Surgical removal of thyroid gland/part of OR tumour - Sodium iodide I 131 (radioactive isotope of iodine that destroys thyroid cells)

Hypothyroidism treatments:

- Thyroxine sodium (T4, long-term therapy) | - Liothyronine sodium (T3, short-term therapy)

Hypoparathyroidism treatments:

- IV calcium salts - calcium supplements - Vitamin D administration

Hyperparathyroidism treatments:

- Surgery - Diuretics (promote excretion of excess calcium) - Calcitonin - Pamidronate disodium (reduces bone resorption of calcium) - Phosphate supplementation

Hypopituitarism treatments:

- Replacement of corticosteroids, thyroid and sex hormones

Hyperpituitarism treatments:

- Chemo, radiation, surgery - Bromocriptine (treats conditions associated with excess GH) - Cabergoline (dopamine agonist to inhibit excess prolactin production) - Octreotide (mimics somatostatin to inhibit insulin and glucagon)