Endocrine Flashcards
hypothyroidism assessment
**don’t worry about the stars once you flip, just things to help me remember from another website I use! :)
weight gain and edema *weight gain edamame
lethargy *leather jacket
cold intolerance *shivering ice cube
bradycardia *snail heart
hypertension *hiker BP
brittle nails and dry skin
constipation *corked con toilet
goiter *goiter goat
prolonged menses’
slowed thinking *gummed up gears
**hypertension is a compensatory response to the body’s decreased CO. BUT in myxedema coma, the body cannot compensate and so you can see hypotension
hypothroidism diagnositics
blood work will reveal decreased free T4 but increased TSH with primary hypothroidism
TISSUE BOX IS MAD IN THE PICMONIC
T4 IS BEING POURED OUT
hypothyroidism interventions, treatment and considerations
meds: levothyroxine (synthroid)
or liothyronine (cytomel)
**complication: myxedema coma (emergency!! profound hypotension, subnormal temperature, and decreased respiratory drive)
need for lifelong replacement hormones
monitor vitals, especially with stress, infection, and prescribed drugs as these can all cause changes to thyroid and hormone therapy
intake: fluids and fiber
important: medication education (DO NOT SWITCH BRANDS)
diet: low calorie and low fat
Hashimoto’s thyroiditis
sx: hypothyroidism with bouts of hyperthyroidism
enlarged/non-tender thyroid
have antibodies: anti-thyroid peroxidase and antithyroglobulin
Labs reveal hurthle cells and lymphoid follicles
genetics: HLA-DR5, DR3 gene
increased risk of developing non-Hodgkin’s lymphoma
Hyperthyroidism Assessment
heat intolerance (d/t increased metabolic rate)
exophthalmos (can see in grave’s disease)
warm moist skin and silky hair
fine tremor
goiter
diarrhea and weight loss (d/t increased metabolic rate)
tachycardia, hypertension (d/t increased SNS stimulation)
amenhorrhea
Hyperthyroidism diagnostics
lab work will reveal decreased TSH but elevated free T4.
Hyperthyroidism interventions
Meds:
antithyroid: propothyouracil (PTU), or methimazole (tapazole) : both work by inhibiting the synthesis of thyroid hormones
PTU has lesser teratogenic effects so it is preferred in the first trimester of pregnancy
Methimazole has fewer hepatic effects
Iodine used as prep for thyoridectomy (inihibits T3 and T4 synthesis and reduces vascularity of the thyroid.
beta blockers can be given to reduce SNS stimulation
also radioiodine ablation or thyroidectomy (RISK for thyrotoxicosis and post surgery hypocalcemia because of inadvertent damage/removal of parathyroid glands that regulate Ca2+)
Grave’s Disease asessment
typically presents in women 20-40 years old
disease forms anti-TSH receptor antibodies in the thyroid gland
sx/sx: ophthalmopathy or exophthalmos
hyperthyroidism, goiter
pretibial myxedema
Grave’s Disease: labs and treatment
labs will reveal decreased TSH (d/t negative feedback), increased T3, increased T4, increased radioactive iodine uptake
Tx: beta blockers
methimazole
radioiodine ablation
Hypoparathyroidism
hypocalcemia leading to lethargy
tetany
arrythmias
dx: labs show low Ca2+ and high phosphate (PO4-)
considerations: IV Calcium Chloride , rebreather mask to lower bodily pH.
LIFELONG commitment to medications and oral Ca2+ supplements with vitamin D.
Hyperparathyroidism
hyercalcemia
kidney stones
osteoporosis
arrthymias
labs: increased Ca2+, decreased phosphate (PO4-)
considerations: decreased bone density **prevent injury
medication education
surgery
Acute Thyrotoxicosis: “Thyroid Storm”
LIFE-THREATENING EMERGENCY
severe tachycardia, cardiogenic shock, hyperthermia, agitation, seizures abdominal pain, vomiting, diarrhea, delirium coma
Hyperthyroidism Tx
anti-thyroid meds, radioactive iodine therapy, surgery
meds are useful in treat thyrotoxic states but not curative
tx for 6-15 months
Iodine: inhibits synthesis of T3 and T4, blocks release into circulation
REDUCES vascularity of thyroid making surgery safer and easier.
Beta blockers:
symptomatic relief of thyrotoxicosis
blocks effects of SNs stimulation, decreases tachycardia, nervousness, irritability, tremors,
Thyroidits
acute infection or inflammation
manifestations: silent and painless
management: NSAIDs, corticosteroids, antibioctics, surgical drainage
myxedema coma
dull, puffy skin
coarse, sparse hair
periorbital edema
prominent tongue
