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01 CCRN Exam > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What hormones does the Hypothalamus help produce and release? (3) Think FLAT

A
  1. Growth hormone releasing hormone: FSH, LH
  2. Corticotrophin Releasing Hormone: aka ACTH
  3. Thyrotrophic Releasing Hormone aka TSH
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2
Q

Growth Hormone, TSH (thyroid stimulating hormone, acting on thyroid gland?) and ACTH are released from what gland?

A

The anterior pituitary gland. The hypothalamus releases hormones to signal the AP to release the hormones.

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3
Q

Antidiuretic Hormone is released from what gland and acts directly on which organ?

A

It’s released from the posterior pitruitary gland, and acts on the kidney

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4
Q

What are S&S of hypoglycemia? HR? LOC? Skin?

A

Seizures, blurred vision, tachycarida, AMS - LOC , Pale cool and clammy skin

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5
Q

DKA is more common in which kind of DM?

A

DM I.
HHS is more common in DM II

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6
Q

If pt is in DKA, when would you start D5 1/2 NS?

A

When BG <250, started to prevent cerebral edema

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7
Q

What does dx of DKA include? BG, pH, anion gap, ketones

A
  1. BG>250,
  2. pH<7.3,
  3. anion gap >12,
  4. +ketones in urine
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8
Q

DKA fluid therapy would include..

A

restoring circulating volume, switch to D5 1/2 NS after BG<250,

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9
Q

Drug therapy for DKA would involve:

A
  1. Continuous/Bolus regular insulin
  2. Monitor K levels d/t shifts
  3. Bicarbonate for severe acidosis
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10
Q

How does HHS differ from DKA?

A

HHS does not have ketosis since there’s enough insulin produced to stave it off. So HHS typically occurs in DM II.

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11
Q

What is the following like in HHS? BG, Osmolality, pH, HCO3,

A

BG >600
Osmolality >320 mOsm/Kg
pH>7.30
HCO3 >15 mEq/L normal

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12
Q

What is DI?

A

Diabetes insipidus, an issue of the kidney conserving water. It leads to fluid deficit

Despite name, disease is about water regulation

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13
Q

What is does DI present?

A
  1. Polyuria
  2. Low urine specific gravity
  3. Hypernatremia
  4. Fluid deficit
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14
Q

What’s the difference between neurogenic and nephrogenic DI?

A

Neurogenic is lack of ADH. Nephrogenic is where there is enough ADH but kidney does not respond to ADH.

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15
Q

What is the data like for DI? Plama Osm, Serum Na, Urine Osm, Urine SG?

A

Plasma osm higher> 295
Serum Na normal or higher >145
Urine osm is low< 250 (3000-1400 normal)
Urine SG low <1.005

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16
Q

DI Tx?

A
  1. Correct underlying cause
  2. free water replacement
  3. ADH replacement if neurogenic
  4. Thiazide diuretics if nephrogenic
17
Q

What are some causes of SIADH?

A
  1. Lung ca, pancreas, duodenum, lymph, prostate,
  2. Meningitis
  3. Brain abscess/tumors
  4. Head injury
  5. Drugs like chemo, nicotine, general anesthesia, thiazide
18
Q

S&S of SIADH?

A

Weight gain, edema, signs of over hydration

19
Q

What is the following data like in SIADH? Plasma Osm, Serum Na, Urine Osm, Urine SG

A

Plasma Osm is low <280 mOsm/kg
Serum Na low <135
Urine Osm normal or high >100 mOsm
Urine SG high >1.030

20
Q

Would be SIADH treatment?

A
  1. Correct underlying cause
  2. Fluid restriction
  3. Give Na, hypertonic saline etc
  4. Diuretic tx
21
Q

Acute hyperthyroidism, Graves, Thyroid Storm. S&S?

A

Hypermetabolism
Tremors, restlessness, agitation
Hyperthermia/ sweating
tachycardia & afib
HTN,
HF
elevated T3, T4, BG, Ca++ , LFTs

22
Q

What is the tx for hyperthyroidism?

A
  1. Dexamethasone to inhibit the release of thyroid hormone
  2. Thyroidectomy
  3. Tx hypermetabolic state: beta blockers, cool, antiHTN agents
23
Q

S&S of Myxedema coma/hypothyroidism

A
  1. Hypometabolism
  2. Bradycardia, Low RR
  3. EKG aV block,
  4. High TSH, BUN/Cr
  5. decrease T3, T4, H&H
24
Q

Addison’s Disease, aka adrenal insufficiency

A

Too little production of adrenal steroids: mineralocorticoids, Glucocorticoids and cortisol that stimulates gluconeogenesis.

25
Q

What may be the caused of adrenal insufficiency/Addison’s Disease?

A
  1. Extended stress response
  2. Lung / Breast Mets
  3. Stopping long term steroids
  4. Sarcoidosis
  5. Stroke
26
Q

S&S of adrenal insufficiency? What are lab values of BG, NA, cortisol, K, Ca, BUN, creat

A
  1. Fever
  2. Confusion
  3. Weakness and fatigue
  4. Hypotension, tachycardia, tachypnea,
  5. Ventricular dysrhythmias
  6. Anorexia * weigh tlost
    Labs: decreased BG, NA Cortisol
    Labs: increased K, Ca, BUN, Creatine
27
Q

What would be treatments for adrenal insufficiency/addison’s crisis?

A
  1. Steroids
  2. D50
  3. Fluid replacement
  4. Possibly vasopressor
  5. Possibly fludrocortisone acetate
28
Q

Hormonally, what happens during SIADH?

A

Too much ADH is released, stimulating kidney to retain water.

29
Q

What would be a treatment for hypothyroidism?

A
  • Vasopressors
  • synthroid, hormone replacement
  • balance diet
  • exercise

01 CCRN Exam (17 decks)

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