Endocrine Flashcards
What hormones does the Hypothalamus help produce and release? (3) Think FLAT
- Growth hormone releasing hormone: FSH, LH
- Corticotrophin Releasing Hormone: aka ACTH
- Thyrotrophic Releasing Hormone aka TSH
Growth Hormone, TSH (thyroid stimulating hormone, acting on thyroid gland?) and ACTH are released from what gland?
The anterior pituitary gland. The hypothalamus releases hormones to signal the AP to release the hormones.
Antidiuretic Hormone is released from what gland and acts directly on which organ?
It’s released from the posterior pitruitary gland, and acts on the kidney
What are S&S of hypoglycemia? HR? LOC? Skin?
Seizures, blurred vision, tachycarida, AMS - LOC , Pale cool and clammy skin
DKA is more common in which kind of DM?
DM I.
HHS is more common in DM II
If pt is in DKA, when would you start D5 1/2 NS?
When BG <250, started to prevent cerebral edema
What does dx of DKA include? BG, pH, anion gap, ketones
- BG>250,
- pH<7.3,
- anion gap >12,
- +ketones in urine
DKA fluid therapy would include..
restoring circulating volume, switch to D5 1/2 NS after BG<250,
Drug therapy for DKA would involve:
- Continuous/Bolus regular insulin
- Monitor K levels d/t shifts
- Bicarbonate for severe acidosis
How does HHS differ from DKA?
HHS does not have ketosis since there’s enough insulin produced to stave it off. So HHS typically occurs in DM II.
What is the following like in HHS? BG, Osmolality, pH, HCO3,
BG >600
Osmolality >320 mOsm/Kg
pH>7.30
HCO3 >15 mEq/L normal
What is DI?
Diabetes insipidus, an issue of the kidney conserving water. It leads to fluid deficit
Despite name, disease is about water regulation
What is does DI present?
- Polyuria
- Low urine specific gravity
- Hypernatremia
- Fluid deficit
What’s the difference between neurogenic and nephrogenic DI?
Neurogenic is lack of ADH. Nephrogenic is where there is enough ADH but kidney does not respond to ADH.
What is the data like for DI? Plama Osm, Serum Na, Urine Osm, Urine SG?
Plasma osm higher> 295
Serum Na normal or higher >145
Urine osm is low< 250 (3000-1400 normal)
Urine SG low <1.005
DI Tx?
- Correct underlying cause
- free water replacement
- ADH replacement if neurogenic
- Thiazide diuretics if nephrogenic
What are some causes of SIADH?
- Lung ca, pancreas, duodenum, lymph, prostate,
- Meningitis
- Brain abscess/tumors
- Head injury
- Drugs like chemo, nicotine, general anesthesia, thiazide
S&S of SIADH?
Weight gain, edema, signs of over hydration
What is the following data like in SIADH? Plasma Osm, Serum Na, Urine Osm, Urine SG
Plasma Osm is low <280 mOsm/kg
Serum Na low <135
Urine Osm normal or high >100 mOsm
Urine SG high >1.030
Would be SIADH treatment?
- Correct underlying cause
- Fluid restriction
- Give Na, hypertonic saline etc
- Diuretic tx
Acute hyperthyroidism, Graves, Thyroid Storm. S&S?
Hypermetabolism
Tremors, restlessness, agitation
Hyperthermia/ sweating
tachycardia & afib
HTN,
HF
elevated T3, T4, BG, Ca++ , LFTs
What is the tx for hyperthyroidism?
- Dexamethasone to inhibit the release of thyroid hormone
- Thyroidectomy
- Tx hypermetabolic state: beta blockers, cool, antiHTN agents
S&S of Myxedema coma/hypothyroidism
- Hypometabolism
- Bradycardia, Low RR
- EKG aV block,
- High TSH, BUN/Cr
- decrease T3, T4, H&H
Addison’s Disease, aka adrenal insufficiency
Too little production of adrenal steroids: mineralocorticoids, Glucocorticoids and cortisol that stimulates gluconeogenesis.
