Endocrine

Question 1

Thyroid Hormone does what?

Answer 1

is stimulated by the secretion of TSH, it increases Carbohydrate absorption and decreases cholesterol, needed for neuronal functioning, increases affinity of B1 and B2 receptors to catecholamines

Question 2

What is Thyroid Storm

Answer 2

severe form of hyperthyroidism; thought to be the release of large quantities of thyroid hormone; can result in MI, CHF, cardiovascular collapse, and death

Question 3

Causes of Thyroid Storm

Answer 3

if prior history of hyperthyroidism: infection, trauma, stress, drugs, alcohol, steroids;
If no preexisting conditions: tumors, autoimmune disease, radiation, shock, surgery

Question 4

Signs and Symptoms of Thyroid Storm

Answer 4

Sweating, heat intolerance, hyperthermia, tachycardia, cardiovascular shock, arrhythmias, hypovolemia, hyperreflexia, decreased LOC, tremors, psychosis

Question 5

TSH will be high or low in hyperthyroidism?

Answer 5

It will be low- because it’s a negative feed back loop so it thyroid hormone is high then the TSH will be low.

Question 6

Management of Thyroid Storm

Answer 6

Treat precipitating factors, antithyroid drugs, beta blockers, decrease myocardial O2 demand, respiratory support and airway protection, careful monitoring of neuro status, fluid and electrolyte monitoring, body temperature control- might need to use antipyretics or cooling therapy

Question 7

What is Myxedema Coma

Answer 7

Hypothyroidism, usually seen in older patients, especially women, more common in winter because of exposure to cold

Question 8

Causes of Myxedema Coma

Answer 8

Stress, trauma, infection especially pulmonary

Question 9

Complications of Myxedema Coma

Answer 9

Pericardial and pleural effusions, paralytic ileus, seizures

Question 10

Sign and Symptoms of Myxedema Coma

Answer 10

low BMR, decreased energy metabolism and heat production, EDEMA IS REMARKABLE and unexplainable, severe depression of sensorium, hypothermia (without shivering), hypotension, hypercapnia, hyperreflexia, bradycardia, decreased glucose, decreased Na, increased K+, decreased thyroid hormone, and increased TSH

Question 11

Management of Myxedema Coma

Answer 11

administer thyroid hormones and steroids, administer hypertonic solution to correct dilutional hyponatremia, may have to use vasopressors to increase BP, warming therapy to correct hypothermia

Question 12

What is Adrenal Crisis (Insufficiency)

Answer 12

the inability of the adrenals to meet metabolic function with the advent of increased stress in situations like illness- any critically ill patient can develop adrenal crisis because of depletion of cortisol levels

Question 13

Primary Causes of Adrenal Crisis

Answer 13

Addison’s disease- autoimmune causing destruction of adrenal gland, TB,

Question 14

Secondary causes of Adrenal Crisis

Answer 14

Abrupt withdrawal of ACTH, complication of cortisol therapy, metastatic tumors

Question 15

Aldosterone is a mineralocorticoid or glucocorticoid?

Answer 15

Mineralocorticoid

Question 16

Cortisol is a mineralocorticoid or a glucocorticoid?

Answer 16

Glucocorticoid

Question 17

Signs and Symptoms of Aldosterone Deficiency

Answer 17

hyperkalemia, hyponatremia, hypovolemia, elevate BUN

Question 18

Signs and Symptoms of Cortisol Deficiency

Answer 18

hypoglycemia, decreased gastric motility, decreased vascular tone, hypercalcemia

Question 19

Signs and Symptoms of Adrenal Crisis

Answer 19

orthostatic hypotension, weakness, fatigue, Anorexia, N/V/D, abdominal pain, hyperpigmentation, HA, lethargy, tachycardia, fatigue, weakness

Question 20

Lab values of Adrenal Crisis

Answer 20

hyperkalemia, hyponatremia, decreased bicarb, elevated BUN, hypoglycemia, anemia, elevated ACTH

Question 21

Management of Adrenal Crisis

Answer 21

CT looking for adrenal gland pathology, administer hormones, restore fluid and electrolyte balance, use of steroids, frequent assessment of cardiac, respiratory, neuro, I&O

Question 22

What is Diabetes Insipidus

Answer 22

disease characterized by water imbalance, inadequate or resistance to ADH

Question 23

Signs and Symptoms of Diabetes Insipidus

Answer 23

increased urine output, increased HR, Serum osmolality > 300, serum Na>145, specific gravity <1.005

Question 24

Management of Diabetes Insipidus

Answer 24

aggressive fluid replacement, replacement of ADH (DDAVP), vasopressin, monitor fluid and electrolytes

Question 25

What is SIADH

Answer 25

increased ADH production or secretion, which results in an increase in total body water

Question 26

Signs and Symptoms of SIADH

Answer 26

personality changes, headache, lethargy, disorientation, confusion, N&V, abd cramping, diarrhea, dilutional hyponatremia

Question 27

Treatment of SIADH

Answer 27

Treat underlying disease, treat water retention, monitor neurological status closely, monitor electrolytes, monitor I&O