endocrine Flashcards
What is Addisons disease
adrenocortical insufficiency-not enough steroids
what is cushings disease
too many steroids
What do glucocorticoids do
affect mood
cause immunosuppression
breakdown fats and proteins
inhibit insulin
what do mineralcorticoids responsible for
retention of sodium and water
excretion of potassium
what is aldosterone
a mineralcorticoid
symptoms of decreased glucocorticoids
fatigue
weight loss
hypoglycemia
confusion
symptoms of decreased mental corticoids
loss of sodium and water> hyponatremicm FVD
retention of potassium> hyperkalemic
hypotension
what will you find in someone with addisons
hair loss
hyperpigmentation
weightlos
gi distrubances
fatigue
hypoglycemia
postural hypotension
weakness
symptoms of an adrenal crisis
extreme fatigue
dehydration
fever
hypotension
renal shutdown
^serum K
decreased NA
How do you treat an adrenal crisis
think shock
IV fluids
increase sodium intake
I&O
daily weight
replace steroids
how do you replace steroids
prednisone
fludrocortisone
What happens with too many mineralocorticoids
fluid retention
sodium retention
potassium excretion
what happens with too many glucocorticoids
immunosuppression
hyperglycemia
mood alteration
fat redistribution
findings in Cushings disease
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
treatment of Cushing
adrenalectomy
avoid infection
What does not enough ADH lead to
DI
what does too much ADH lead to
SIADH
What can lead to increased ADH
craniotomy
head injury
sinus surgery
what is a synthetic ADH medication
Vasopressin
where is ADH made
pituitary gland
What is diabetes insipidus
not enough ADH in the body
kidneys produce large amounts of urine
leads to FVD
hypotension and shock
Assessment finding is diabetes insipidus
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
What happens to labs with DI
urine is dilute
-decrased use
-decreased urine osmolarity
blood is concentrated
-increased serum NA
increased serum osmolarity
-serum HCT>40%
Treatment of diabetes insipidus
monitor neuro status
replace fluids
-monitor UOP
-replace volume
vasopressin
What is SIADH
body is making too much ADH
body retains water
decreased UOP
retention of water in vascular space
only water is retained not sodium
assessment finding in SIADH
weight gain
no peripheral edema
anorexia
nausea
vomitint
low serum sodium
lab values with SIADH
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
Treatment of SIADH
monitor serum sodium- sodium replacement
seizure precautions
fluid restriction
hypertonic saline
What is graves disease
too much thyroid hormone
symptoms of graves disease
sweating
tremor
exophthalmos
arrhythmia and tachycardia
nausea and diarrhea
oligomenorrhea
muscle weakness
headache
weight loss
nervousness
emotional instability
Symptoms of a thyroid storm
very high fever
very high heart rate
palpitations
chest pain
shortness of breath
risk factors of a thyroid storm
graves disease
recent surgery on thyroid or trauma to thyroid
graves disease treatment
antithyroid (methimazole
iodine compounds
radioactive iodine therapy
thyroidectomy
What is hypothyroidism
not enough T3 and T4 with high TSH
Symptoms of hypothyroidism
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
treatment of hypothyroidism
levothyroxine
how should you take levothyroxine
on an empty stomach
same time every day
What does parathyroid hormone do
causes calcium to be pulled out of the bones and into the blood
increases serum calcium
What happens with hypoparathyroidism
parathyroid glands to not produce enough PTH
low serum calcium levels
high phosphorus levels
how does hypoparathyroidism effect CNS
seizures
calcifications
Parkinsonism or dystonia
how does hypoparathyroidism affect cardiovascular system
cardiac arrhythmias
hypocalcemia associated dilated cardiomyopathy
how does hypoparathyroidism affect respiratory system
laryngospasm
how does hypoparathyroidism affect the renal system
nephocalcinosis
kidney stones
chronic kidney disease
how does hypoparathyroidism affect the PNS
paraesthesia
muscle cramp
tetany
how does hypoparathyroidism affect the neuropsychiatric system
symptoms of anxiety and depression
how does hypoparathyroidism affect ophthalmological system
cataracts
papilloedema
how does hypoparathyroidism affect the dental system
altered tooth morphology
how does hypoparathyroidism affect skin
dry skin
onycholysis
coarse thin hair
pustular psoriasis
how does hypoparathyroidism affect musculoskeletal system
myopathy
spondyloarthropathy
Treatment of hypoparathyroidism
fix electrolyte imbalances
calcium replacement
phosphorus binders
What is hyperparathyroidism
parathyroid glands secrete too much PTH
high levels of serum calcium levels
low phosphorus levels
how does hyperparathyroid affect digestive system
loss of appetite
nausea
vomiting
constipation
how does hyperparathyroid affect musculoskeletal system
muscle weakness
aches and pains in bones and joints
how does hyperparathyroid affect nervous system
fatigue
confusion
depression
how does hyperparathyroidism effect urinary system
kidney stones
increased thirst
increased urination
treatment for hyperparathyroidism
partial parathyroidectomy
what can not enough insulin lead to
DM, DKAm HHNS
what can too much insulin lead to
hypoglycemia
What is type 1 diabetes
autoimmune disease or idiopathic
pancreas cannot produce insulin
glucose cannot get to cells for fuel
findings in diabetes type
frequent urination
irritability
weight loss
increased thirst
gatigue
extreme hunger
blurred vision
onset, peak and duration of rapid acting insulin
15 min
30-90 min
3-5 hours
onset peak and duration regular insulin (short acting)
30-60
2-4 hours
6-8 hours
onset peak an duration of intermediate acting insulin (NPH)
1-2 hours
6-14 hours
16-24 hours
onset peak and duration of long acting insulin
1-2 hours
none
24 hours
What is the only cloud insulin
NPH
what order do you draw insulin
regular then NPH never long acting
What type of diabetics get DKA
Type 1
what are early signs of DKA
polyuria
polydipsia
polyphagia
high blood glucose levels
high keystone levels in urine
late signs of DKA
feeling weak or constantly sleepy
dry/flushed skin
nausea, vomiting, abdominal pain
difficulty breathing, fruity smelling breath
treatment for DKA
hourly BG and serum potassium
ABG
fluids- decrease blood sugar, drive potassium back into the cell
what are long term effects of diabetes type 2
poor wound healing
frequent infections
vision problems
kidney problems
Treatment of Diabetes 2
low carb-complex carbs
proteins and veggies
exercise-before eating and when BS is at its highest
oral agents-metformin
insulin
Causes of hypoglycemia
not enough food
too much insulin
too much exercise
signs of hypoglycemia
cold
clammy
confused
shakey
nervous
nausea
headache
hungry
blurry vision
Treatment of hypoglycemia
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
what to do if unconscious hypoglycemia
push D50W if IV acces
glucagon if no IV
