Endocrine

Question 1

Anterior Pituitary Gland

Answer 1

thyroid stimulating hormone (TSH), growth hormone (GH), adrenocorticotropic hormone (ACTH), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin

Question 2

Posterior Pituitary Gland

Answer 2

antidiuretic hormone (ADH), oxytocin

Question 3

Thyroid gland

Answer 3

works via COMPLEX FEEDBACK; a vascular gland that produces T4, T3, and calcitonin.

Question 4

T3 and T4

Answer 4

regulate cellular metabolism as well as growth and development, stress response (if body is cold or trauma) these will produce opposite effects

Question 5

Calcitonin

Answer 5

controls calcium levels in the blood

Question 6

The hypothalamus stimulates the pituitary gland to produce

Answer 6

TSH which stimulates T3 and T4

Question 7

What is required to synthesize thyroid hormones

Answer 7

iodine

Question 8

Overactive thyroid gland

Answer 8

weight loss, anorexia, fast metabolism

Question 9

Underactive thyroid gland

Answer 9

overweight, obesity

Question 10

Parathyroid gland

Answer 10

secretes PTH which works opposite of calcitonin to regulate serum calcium levels

Question 11

PTH is secreted when

Answer 11

serum calcium levels drop

increases osteoclast activity

Question 12

Adrenal glands

Answer 12

medulla

cortex

Question 13

Cortex is stimulated by

Answer 13

ACTH from anterior pituitary

Question 14

Mineralocorticoids

Answer 14

primary aldosterone (conserves na and water)

Question 15

Glucocorticoids

Answer 15

primary cortisol

Question 16

Transsphenoidal removal of the Pituitary gland (Hypophysectomy): after procedure

Answer 16

 Don’t blow nose for 2 months
 Avoid bending or stooping (keep intracranial pressure low to avoid loss of CSF through surgical site)
 Fever or drainage must be reported immediately
 Pt will wear a mustache dressing because they will be dripping CBS

Puts at risk for meningitis!!! s/s: nucal rigidity, fever

Question 17

Cushings disease

Answer 17

caused by adrenal cortext issues

Question 18

Cushings syndrome

Answer 18

resulting from something other than the gland itself (i.e. medications, steroids); is due to a ACTH-secreting tumor or is induced by corticosteroid drugs (prednisone)

Question 19

What happens to the glucose levels in cushings syndrome?

Answer 19

will go up because glucose mirrors cortisol

Question 20

Plasma cortisol levels morning

Answer 20

5-23

Question 21

Plasma cortisol levels evening

Answer 21

3-13

Question 22

Know what to assess for with SIADH remember this is inappropriate diuretic hormone so think about fluid status and s/s of fluid overload.

Answer 22

Hyponatremia

Severe hyponatremia

Question 23

Hyponatremia s/s

Answer 23

muscle cramps, weakness, thirst, fatigue, dulled sensorium, low UOP, WEIGHT GAIN

Question 24

Severe hyponatremia s/s

Answer 24

vomiting, abdominal cramps, muscle twitching, seizures, cerebral edema, anorexia, confusion, coma

Question 25

Understand why we would either restrict or not restrict fluids for patients experiencing SIADH.

Answer 25

restrict fluids

Question 26

Important point about SIADH is that you typically have normal renal function

Answer 26

but significant fluid retention

Question 27

Important to treat underlying cause in SIADH

Answer 27

tumors, head trauma, drugs

Question 28

SIADH monitor which electrolytes

Answer 28

sodium | potassium

Question 29

What happens with hyperthyroid? Speeds everything up remember fight or flight response what manifestations will be seen?

Answer 29

graves disease toxic nodular goiter CM

Question 30

Graves disease

Answer 30

autoimmune may be triggered by insufficient iodine levels, stress, infection

Question 31

Toxic nodular goiter

Answer 31

nodules that excrete excessive T3 and T4, independent of TSH stimulation

Question 32

CM

Answer 32

goiter, thyroid bruits from increased oxygen supply, exophthalmos, anorexia, weight loss, depression, a fib, nervousness, confusion

Question 33

What are complications of hyperthyroid?

Answer 33

Thyrotoxic crisis Severe tachycardia, heart failure, shock, hyperthermia, agitation, pain, nausea, vomiting

Question 34

Potential trigger of hyperthyroid

Answer 34

stress, infection

Question 35

T3

Answer 35

70-205

Question 36

T4

Answer 36

4-12

Question 37

TSH

Answer 37

2-10

Question 38

Hypothyroid

Answer 38

Decreased circulating thyroid

Question 39

Most common cause of hypothyroid

Answer 39

iodine deficiency

Question 40

Hypothyroid s/s

Answer 40

(cold intolerance, hair loss, muscle weakness, weight gain) | Myxedema (fat accumulation)

Question 41

REMOVAL OF THYROID GLAND

Answer 41

Lifetime replacement of hormone (Hormone Replacement Therapy HRT) Assess for s/s of hyper/hypo calcemia due to hormone level changes

Question 42

Hypercalcemia s/s

Answer 42

weakness, loss of appetite, constipation, need for sleep, emotional disorders, decreased attention span

Question 43

hypocalcemia s/s

Answer 43

looks like tetany, tingling lips, fingertips. Increased muscle tension leading to paresthesias and stiffness.

Question 44

calcium and phosphorus have an antagonistic relationship

Answer 44

When one is elevated the other is decreased