Endocrine Flashcards
Hormones released by the anterior pituitary
6 hormones
FLATPiG
Posterior pituitary hormones
Most common cause for diabetes insipitus
Pituitary surgery
SIADH
conditions
SIADH Plasma
volume
osm
sodium
SIADH Urine
volume
osm
sodium
SIADH treatment
Diabetes insipidus
Conditions
too little ADH
Diabetes insipidus Plasma
volume
osm
sodium
Diabetes insipidus Urine
volume
osm
sodium
Diabetes Insipidus Treatment
Gigantism considerations
Hormones released by the thyroid glands
T3 vs T4 hormones
How do thyroid hormones affect the metabolic rate
elevated thyroid hormones effects on volatile gas MACs
elevated thyroid hormones effects on cardiovascular system
elevated thyroid hormones effects on GI
increased gastric motility = diarrhea
elevated thyroid hormones effects on cellular metabolism
elevated thyroid hormones effects on musculoskeletal system
Hypethyroidism etiology
Hyperthyroidism general findings
Hypothyroidism etiologies
Hypothyroidism general findings
Hypothyroidism cardiac and pulmonary findings
most common time frame for thyroid storm
6-18 hrs post-op
myxedema come - what is it
coma as a consequence of end-stage hypothyroidism
amiodarone in the thyroid patient
- amiodarone contains high concentration of iodine per wieght
- It can cause hyper or hypothyroidism
Which drugs are thionamides and what do they do?
Which drugs are thionamides and key details about them
- propylthiouracil PTU
- methimazole
- carbimazole
beta-blockers used for hyper-thyroidism and their action
Esmolol - easier to titrate
Propanalol
potassium iodide in hyperthyroidism - role and key details
radioactive iodine - role and key details
thyroidectomy complications
- hypothyroidism
- hypocalcemia
- hemorrage with tracheal compression
- recurent laryngeal nerve damage
thiopental and hyperthyroidism
hyperthyroidism and neuromuscular blockers
cautions as hyperthyroidism is associated with myastenia gravis and myopathy
hyperthyroidism and positioning in the OR
caution d/t higher incidence of osteoporosis
thyroid storm
incidence, causes and timing of occurance
thyroid storm - sxs
thyroid storm - differential diagnosis
thyroid storm main treatment
thyroid storm supportive treatment
hypocalcemia sxs
Chevostek’s sign vs Trousseau’s Sign
upper = chevostek’s
lower = troussease’s
where are androgens, mineralocorticoids and glucocorticoids produced
where are cathecholamines produced?
adrenal medulla
the layers of the adrenal medulla and what it produces
what stimulates aldoseterone release?
- RAAS activation
- hyponatremia
- hyperkalemia
what stimulates cortisol release?
aldosterone role
cortisol roles
- energy mobilization (gluconeogenesis in the liver to make glucose in the blood, protein catabolism and mobilization of fat to increase sugar in the blood)
- anti-inflammatory - stabilizes lysosomal layer of cells and decreases number of eosinophils and lymphocytes in the blood (does not help with histamine release)
- increases response to cathecholamines making the myocardium more sensitive to beta 2 stimulation and increasing the number of beta 2 receptors and the vasculature to catecholamines
- androgenic effects
which endogenous steroids have equal parts gluco / mineralo corticoid properties ?
Cortisol and Cortisone
which synthetic steroids have equal parts gluco / mineralo corticoid properties ?
none
which synthetic steroids do not have mineralocorticoid properties ?
dexamethasone
betamethasone
triamcinolone
what’s Conn’s disease ?
hyper-aldoseteronism
- hypertension (sodium and water retention)
- hypokalemia (potassium wasting)
- metabolic alkalosis (H+ wasting)
Conn’s anesthetic considerations
Cushing’s syndrome
excess cortisol
(Cushing’s disease is excess production of ACTH from anterior pituitary)
Cushing’s syndrome clinical features
Cushing’s syndrome anesthetic considerations
Addison’s disease - what is it?
adrenal insuficiency sxs
acute adrenal crisis sxs
d/t adrenal insuficiancy with stressor like sepsis, surgery, infection, illness
Bioequivalence prednisone with hydrocortisone
5mg prednisone = 20mg hydrocortisone
who is at risk of adrenal supression and who should recieve stress dose
what are the stress doses of hydrocostisone based on surgery type?
what drugs cause adrenal supression?
- etomidate - 8 hrs of supression after a single dose (inhibits 11-beta-hydroxylase)
- ketoconazole (nizoral) - inhibits cortisol synthesis
what hoemones are produes by th epancreas and what cells produce them
insulin elimination
by th eliver and the kidneys
t1/2 5 min
drugs that increase the serum glucose (aka can’t mask hypoglycemia intra-op)
hydrochlorothiazide
metolazone
indapamide
graves disease labs and sxs
most common hyperthyroidism - autoimmune dx - caused by TSH receptor antibodies stimuklating the thyroid to produce hormones
what stimultaes growth hormone secretion ?
Addison’s disease causes
(low cortisol levels)
somatotropin effects
aka growth hormone
max glucose reabsorption in the kideneys
180 mg/dl
