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NUR 718 exam 2 > endocrine > Flashcards

endocrine Flashcards

1
Q

POS diagnosis

A

2 of the following:

irregular ovulation
elevated levels of androgens
appearance of polycystic ovaries on ultrasound

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2
Q

PCOS is a risk factor for

A

cardiovascular disease
insulin resistance
hyperlipidemia

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3
Q

PCOS symptomatology

A

menstrual abnormalities
hyperandrogenism - hirsutism
infertility
obesity
diabetes

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4
Q

PCOS meds

A

PO contraceptives
Clomiphene if trying to conceive

metformin

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5
Q

synthroid dosing

A

initial 25-75 mcg PO daily

increase by 25 mcg q 1-2 weeks

goal TSH 0.4-2.0mU/L

pt>60 - start low, go slow!

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6
Q

myxedema coma s/s

A

AMS - stupor, delirium, seizures, coma
extreme hypothermia
hyponatremia
respiratory depression
hypotension
bradyarrhythmias

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7
Q

myxedema coma treatment

A

check TSH, but start therapy before lab results

synthroid 400 mcg IV x1, then 50-100 mcg IV daily

hydrocortisone

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8
Q

hyperthyroidism management

A

propranolol 10-80 mg PO for symptom relief

thiourea drugs (methimazole, propylthiouracil)

radioactive iodine

thyroidectomy

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9
Q

hyperthyroid red flags

A

fever
tachycardia
hypertension
neurologic/GI abnormalities

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10
Q

hyperthyroid red flags

A

fever
tachycardia
hypertension
neurologic/GI abnormalities

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11
Q

thyroid storm management

A

D5 IVF resuscitation
ABCs
beta blockers
high-dose PTU, methimazole

avoid aspirin!!!

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12
Q

Cushing’s triad

A

hypokalemia
hyperglycemia
leukocytosis

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13
Q

Cushing’s diagnosis

A

elevated plasma cortisol in AM
high urine cortisol

ACTH normal

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14
Q

Cushing’s treatment

A

high-protein diet
tumor resection
gradual withdrawal of glucocorticoids if that’s the cause

long term f/u - osteoporosis, immunosuppression, DM, HTN, risk for adrenal crisis (stress dose steroids in acute illness)

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15
Q

primary cause of Addison’s disease

A

autoimmune destruction of adrenal gland

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16
Q

Addison’s triad

A

hypoglycemia
hyponatremia
hyperkalemia

17
Q

Addison’s s/s

A

weakness, fatigue, weight loss, anorexia, N/V/D

hyperpigmentation
orthostatic hypotension
scant body hair

18
Q

Addison’s diagnosis

A

plasma cortisol <3mg/dL at 8pm
low ACTH

19
Q

Addison’s treatment

A

supplemental glucocorticoids

will need to increase doses in times of stress

20
Q

diabetes insipidus

A

insufficient vasopressin (ADH)

passage of large volume (>3L/24h) of dilute urine (<300mOsm/kg)

21
Q

diabetes insipidus s/s

A

thirst
polyuria
weight loss, fatigue
LOC change
dizziness

febrile
tachycardia, hypotension
poor skin turgor

22
Q

DI lab findings

A

hypernatremia
elevated BUN/Crt
serum osmolal >300
urine osmolal <100
USG <1.005

central - plasma vasospressin <1

23
Q

TBW deficit calc

A

0.6 * weight in kg * (Na/140 - 1)

24
Q

DI fluid replacement

A

give fluids hypoosmolar to serum

Na > 150 - D5W
Na < 150 - 0.45% or 0.9% NS

try to decrease Na by 0.5 mmol/L/h

25
Q

DI treatment

A

central - DDAVP
nephrogenic - thiazide diuretic or indomethacin

fluids

26
Q

SIADH

A

excess ADH
excess water

hyponatremia`

27
Q

SIADH s/s

A

headache, seizures, coma, cold intolerance, decreased DTRs

weight gain, edema

28
Q

SIADH labs

A

hyponatremiaa
serum osmolality <280
urine osmolality >100
urine Na >20

29
Q

SIADH treatment

A

if Na >120: 1L fluid restriction

if Na 110-120 w/o symptoms: 500 ml fluid restriction

if Na <110 or neuro symptoms: isotonic or hypertonic saline 3% at 0.5ml/kg/hr & lasix 0.1-1mg/kg

30
Q

pheochromocytoma syndromes

A
  • von hippel-lindau (VHL) syndrome
  • multiple endocrine neoplasia type 2 (MEN2)
  • neurofibromatosis type 1 (NF1)
31
Q

s/s of pheochromocytoma

A

HA
polydipsia, polyphagia
anxiety
palpitations
diaphoresis
weight loss
dyspnea

labile HTN
hyperglycemia
postural hypotension

32
Q

pheochromocytoma diagnostics

A

plasma free metanephrines

24 hour urine for metanephrines

33
Q

pheochromocytoma treatment

A

tumor resection
BP control - <140/90
alpha adrenergic blockers - phentolamine

NUR 718 exam 2 (5 decks)

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