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endocrine Flashcards

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1
Q

What is Addisons disease

A

adrenocortical insufficiency-not enough steroids

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2
Q

what is cushings disease

A

too many steroids

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3
Q

What do glucocorticoids do

A

affect mood
cause immunosuppression
breakdown fats and proteins
inhibit insulin

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4
Q

what do mineralcorticoids responsible for

A

retention of sodium and water
excretion of potassium

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5
Q

what is aldosterone

A

a mineralcorticoid

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6
Q

symptoms of decreased glucocorticoids

A

fatigue
weight loss
hypoglycemia
confusion

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7
Q

symptoms of decreased mental corticoids

A

loss of sodium and water> hyponatremicm FVD
retention of potassium> hyperkalemic
hypotension

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8
Q

what will you find in someone with addisons

A

hair loss
hyperpigmentation
weightlos
gi distrubances
fatigue
hypoglycemia
postural hypotension
weakness

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9
Q

symptoms of an adrenal crisis

A

extreme fatigue
dehydration
fever
hypotension
renal shutdown
^serum K
decreased NA

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10
Q

How do you treat an adrenal crisis

A

think shock
IV fluids
increase sodium intake
I&O
daily weight
replace steroids

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11
Q

how do you replace steroids

A

prednisone
fludrocortisone

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12
Q

What happens with too many mineralocorticoids

A

fluid retention
sodium retention
potassium excretion

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13
Q

what happens with too many glucocorticoids

A

immunosuppression
hyperglycemia
mood alteration
fat redistribution

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14
Q

findings in Cushings disease

A

thinning hair
moon face
increased facial hair
increased weight
pendulous abdomen
stretch marks
thin skin
buffalo hump
increased fat around neck
easy bruising
cns irritability
fluid retention
osteoprosis
thin extremities
slow healing

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15
Q

treatment of Cushing

A

adrenalectomy
avoid infection

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16
Q

What does not enough ADH lead to

A

DI

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17
Q

what does too much ADH lead to

A

SIADH

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18
Q

What can lead to increased ADH

A

craniotomy
head injury
sinus surgery

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19
Q

what is a synthetic ADH medication

A

Vasopressin

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20
Q

where is ADH made

A

pituitary gland

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21
Q

What is diabetes insipidus

A

not enough ADH in the body
kidneys produce large amounts of urine
leads to FVD
hypotension and shock

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22
Q

Assessment finding is diabetes insipidus

A

lack of concentration
dry mouth and thirst
rapid heart rate
low blood pressure
muscle cramps
light headedness
dry eyes
weight loss
large amounts of urine

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23
Q

What happens to labs with DI

A

urine is dilute
-decrased use
-decreased urine osmolarity
blood is concentrated
-increased serum NA
increased serum osmolarity
-serum HCT>40%

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24
Q

Treatment of diabetes insipidus

A

monitor neuro status
replace fluids
-monitor UOP
-replace volume
vasopressin

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25
Q

What is SIADH

A

body is making too much ADH
body retains water
decreased UOP
retention of water in vascular space
only water is retained not sodium

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26
Q

assessment finding in SIADH

A

weight gain
no peripheral edema
anorexia
nausea
vomitint
low serum sodium

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27
Q

lab values with SIADH

A

urine is concentrated
-decreased UOP
-increased urine osmolality
-increased specific gravity
-increased urine sodium
blood is dilute
-increased blood volume
decreased blood osmolality
hyponatremia
anemia

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28
Q

Treatment of SIADH

A

monitor serum sodium- sodium replacement
seizure precautions
fluid restriction
hypertonic saline

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29
Q

What is graves disease

A

too much thyroid hormone

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30
Q

symptoms of graves disease

A

sweating
tremor
exophthalmos
arrhythmia and tachycardia
nausea and diarrhea
oligomenorrhea
muscle weakness
headache
weight loss
nervousness
emotional instability

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31
Q

Symptoms of a thyroid storm

A

very high fever
very high heart rate
palpitations
chest pain
shortness of breath

32
Q

risk factors of a thyroid storm

A

graves disease
recent surgery on thyroid or trauma to thyroid

33
Q

graves disease treatment

A

antithyroid (methimazole
iodine compounds
radioactive iodine therapy
thyroidectomy

34
Q

What is hypothyroidism

A

not enough T3 and T4 with high TSH

35
Q

Symptoms of hypothyroidism

A

thinning hair or hair loss
puffy face
dry and coarse skin
constipation
cool extremities and swelling of limbs
loss of eyebrow hair
enlarged thyroid
slow HR
poor appetite
infertility and heavy menstruation
carpal sunnel
intolerance to cold
fatigue

36
Q

treatment of hypothyroidism

A

levothyroxine

37
Q

how should you take levothyroxine

A

on an empty stomach
same time every day

38
Q

What does parathyroid hormone do

A

causes calcium to be pulled out of the bones and into the blood
increases serum calcium

39
Q

What happens with hypoparathyroidism

A

parathyroid glands to not produce enough PTH
low serum calcium levels
high phosphorus levels

40
Q

how does hypoparathyroidism effect CNS

A

seizures
calcifications
Parkinsonism or dystonia

41
Q

how does hypoparathyroidism affect cardiovascular system

A

cardiac arrhythmias
hypocalcemia associated dilated cardiomyopathy

42
Q

how does hypoparathyroidism affect respiratory system

A

laryngospasm

43
Q

how does hypoparathyroidism affect the renal system

A

nephocalcinosis
kidney stones
chronic kidney disease

44
Q

how does hypoparathyroidism affect the PNS

A

paraesthesia
muscle cramp
tetany

45
Q

how does hypoparathyroidism affect the neuropsychiatric system

A

symptoms of anxiety and depression

46
Q

how does hypoparathyroidism affect ophthalmological system

A

cataracts
papilloedema

47
Q

how does hypoparathyroidism affect the dental system

A

altered tooth morphology

48
Q

how does hypoparathyroidism affect skin

A

dry skin
onycholysis
coarse thin hair
pustular psoriasis

49
Q

how does hypoparathyroidism affect musculoskeletal system

A

myopathy
spondyloarthropathy

50
Q

Treatment of hypoparathyroidism

A

fix electrolyte imbalances
calcium replacement
phosphorus binders

51
Q

What is hyperparathyroidism

A

parathyroid glands secrete too much PTH
high levels of serum calcium levels
low phosphorus levels

52
Q

how does hyperparathyroid affect digestive system

A

loss of appetite
nausea
vomiting
constipation

53
Q

how does hyperparathyroid affect musculoskeletal system

A

muscle weakness
aches and pains in bones and joints

54
Q

how does hyperparathyroid affect nervous system

A

fatigue
confusion
depression

55
Q

how does hyperparathyroidism effect urinary system

A

kidney stones
increased thirst
increased urination

56
Q

treatment for hyperparathyroidism

A

partial parathyroidectomy

57
Q

what can not enough insulin lead to

A

DM, DKAm HHNS

58
Q

what can too much insulin lead to

A

hypoglycemia

59
Q

What is type 1 diabetes

A

autoimmune disease or idiopathic
pancreas cannot produce insulin
glucose cannot get to cells for fuel

60
Q

findings in diabetes type

A

frequent urination
irritability
weight loss
increased thirst
gatigue
extreme hunger
blurred vision

61
Q

onset, peak and duration of rapid acting insulin

A

15 min
30-90 min
3-5 hours

62
Q

onset peak and duration regular insulin (short acting)

A

30-60
2-4 hours
6-8 hours

63
Q

onset peak an duration of intermediate acting insulin (NPH)

A

1-2 hours
6-14 hours
16-24 hours

64
Q

onset peak and duration of long acting insulin

A

1-2 hours
none
24 hours

65
Q

What is the only cloud insulin

A

NPH

66
Q

what order do you draw insulin

A

regular then NPH never long acting

67
Q

What type of diabetics get DKA

A

Type 1

68
Q

what are early signs of DKA

A

polyuria
polydipsia
polyphagia
high blood glucose levels
high keystone levels in urine

69
Q

late signs of DKA

A

feeling weak or constantly sleepy
dry/flushed skin
nausea, vomiting, abdominal pain
difficulty breathing, fruity smelling breath

70
Q

treatment for DKA

A

hourly BG and serum potassium
ABG
fluids- decrease blood sugar, drive potassium back into the cell

71
Q

what are long term effects of diabetes type 2

A

poor wound healing
frequent infections
vision problems
kidney problems

72
Q

Treatment of Diabetes 2

A

low carb-complex carbs
proteins and veggies
exercise-before eating and when BS is at its highest
oral agents-metformin
insulin

73
Q

Causes of hypoglycemia

A

not enough food
too much insulin
too much exercise

74
Q

signs of hypoglycemia

A

cold
clammy
confused
shakey
nervous
nausea
headache
hungry
blurry vision

75
Q

Treatment of hypoglycemia

A

consume 15 grams of carbs
wait 15 minutes check again
eat another 15 if still low
after rising eat a snack with complex carb/protein to keep it up

76
Q

what to do if unconscious hypoglycemia

A

push D50W if IV acces
glucagon if no IV

Hesi PN (24 decks)

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