Endocrine Flashcards

1
Q

Thyroid hormone (T3 and T4)

A

Thyroid hormone

  • regulate basal metabolic rate
    • by increasing, body temperature also increases
    • thyroid affects numerous other processes, affecting nearly every cell in th body
  • life-long medication management of thyroid issues
  • DO NOT suddenly stop medication - can send them into crisis
  • hypothalamus secretes TRH –> TRH stimulates pituitary gland to secrete TSH –> TSH stimulates thyroid gland to secrete T3 and T4
    • negative feedback system - as thyroid hormone levels increase, negative feedback supresses the secretion of TSH and TRH.
    • High levels of iodine can also cause a temporary decrease in thyroid activity that can last for several weeks

Hypothyroidism

  • Cause: results from either a poorly functioning thyroid gland or low secretion of TSH by the pituitary gland
    • Most common cause: Hashimoto’s thyroiditis or chronic autoimmune thyroiditis - results in destruction of the thyroid gland
  • Clinical Manifestation:
    • early symptoms: general weakness, muscle cramps, dry skin
    • more severe symptoms: slurred speech, bradycardia, weight gain, decreased sense of taste and smell, intolerance to cold enviroinments
    • Goiter may be absent or preesent depending on the cause of disease
    • Lab results generally revealed elevated TSH with diminished T3 and T4 levels
  • Tx: levothyroxine (Synthroid, Levothroid)
    • take on EMPTY stomach in MORNING
    • do not take SOY PRODUCTS w/in 1 - 4 hrs
    • do not take CALCIUM w/in 4 hrs
    • Watch iodine
  • Contraindications: use for weight loss
  • Misc. Management:
    • serum TSH levels used to eval progress of therapy
    • avoid switching bands of medicatin once condition has stabilized

Hyperthyroid

  • Causes:
    • Most common type of hyperthyroidism: Graves’ Disease - autoimmune disease;
    • Other causes are adenomas of the thyroid, pituitary tumors, and pregnancy
  • Hypersecretion of thyroid hormones:
    • increased body metabolism, weight loss
    • tachycardia, elevated body temp
    • anxiety
  • If left untreated, can cause thyroid storm
    • s/s:
      • high fever
      • CV effects (tachycardia, heart failure, angina, MI)
      • CNS effects (agitation, restlessness, delirium, progressing to coma)
  • Treatment:
    • surgical removal of part or all of thyroid gland
    • antithyroid drugs - hepatotoxic
      • methimazole (tapazole)
        • NOT BABY SAFE; pregnancy D
          • if pregnant notify physician asap
      • propylthiouracil (PTU)
        • BABY SAFE
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2
Q

antidiuretic hormone (ADH)

A
  • posterior pituitary gland directly secretes ADH that acts on collecting ducts of kidneys to increase water reabsoprtion
    • ADH
      • regulates body fluid
      • acts as vasoconstrictor
  • Deficiency of ADH
    • diabetes insipidus - production of large volumes of very dilute urine
    • S/S:
      • polyuria -
      • polydipsia -
    • Tx:
      • acts on kidneys to help reabsorb water, reduce urination → increase reabsoprtion of water
      • desmopressin
        • make sure sodium levels are normal before administering, otherwise may use other drug
      • vasopressin
    • Monitor:
      • blood pressure (increase circulatory volume → increased BP, increased HR)
        • monitor esp. if underlying CV issues
    • Precaution: acute or chronic renal disease
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