Endocrine Flashcards
what are the 3 types of hormones? (P,A,S)
peptides/proteins, amines/AA, steroids
most hormones are what type?
peptides/proteins
Tryptophan and tyrosine are what type of hormones?
amines/AA
tryptophan converts into what hormone?
serotonin
tyrosine converts into what 2 hormone types? (T,C)
thyroid hormones, catecholamine hormones
reporductive hormones are what type of hormones?
steroids
steroid hormones come form where?
adrenal cortex
what 2 hormone types bind to intracellular hormone receptors? (T,S)
thyroid and steroid hormones
are hormone receptor number inversely or directly related to the amount of circulating hormone?
inversely
what is downregulation?
decreased number of receptors d/t an increased number of hormones
what is upregulation?
increased number of receptors d/t an decreased number of hormones
what hormones does the anterior pituitary secrete? (P,T,F,L,A,G)
prolactin, TSH, FSH, LH, ACTH, GH
what are 5 symptoms of anterior pituitary hyposecretion? (D,VL,FN/P,S)
diplopia, visual loss, facial numbness/pain, seizures
Transsphenoidal adenohypophysectomy is a combined approach from what 2 services?
ENT, NSG
why is the LLE prepped for Transsphenoidal adenohypophysectomy?
for fat harvesting and packing of the sinuses
Avoid what breathing pattern and what drug during maintenance of Transsphenoidal adenohypophysectomy? (H,N)
hyperventilation, N2O
Goal of anesthesia for a Transsphenoidal adenohypophysectomy is a smooth, rapid emergence to permit a what assessment? (N)
neuro assessment
what are the 2 most common postop complications with Transsphenoidal adenohypophysectomy? (CR,DI)
csf rhinorrhea, diabetes insipidus
what 3 hormones are the most common produced in anterior pituitary hypersecretion? (P,A,G)
prolactin, ACTH, GH
what are the 3 airway difficulties with acromegaly? (SN, EV, NTE)
subglottic narrowing, enlarged VCs, nasal turbinate enlargement
what are the 2 hormones secreted by the posterior pituitary? (A,O)
ADH, oxytocin
ADH:
- acts on renal collecting ducts to reabsorb what?
- does it increase or decrease urine osmolarity and blood volume?
- vasodilator or vasoconstrictor?
- promotes hemostasis by increasing what 2 factors?
- H2O
- increase
- vasoconstrictor
- vWF & factor VIII
is DI too much or not enough ADH?
not enough
is SIADH too much or not enough ADH?
too much
DI:
- Polyuria or oliguria?
- serum osmolarity > what? (mOsm/L)
- urine osmolarity < what? (mOsm/L)
- specific gravity < what?
- urine output is > how mL/kg/day?
- diagnosed when urine osmolarity increases after what is administered? (V)
- polyuria
- 290 mOsm/L
- 300 mOsm/L
- 1.010
- 30 mL/kg/day
- vasopressin
DI treatment:
1. what is intraop vasopressin dose range? (units/hr)
0.1-0.2 units/hr
for DI, avoid what VA d/t renal dysfunction?
sevoflurane
when giving vasopressin, prepare for what and what should be monitored? (LB, EFI)
labile blood pressure, ECG for ischemia
SIADH:
- serum sodium < what? (mEq/L)
- edema where causes HA, lethargy and nausea?
- is urine hypotonic or hypertonic?
- what drug is an antagonist of vasopressin? (D)
- correct serum Na what range per hour? (mEq/hr)
- correct serum Na what range per day? (mEq/L/day)
- 130 mEq/L
- cerebrum
- hypertonic
- demeclocycline
- 0.5 mEq/hr
- 6 mEq/L/day
why is anti-nausea prophylaxis important in SIADH pts?
nausea stimulate ADH release
thyroid cartilage is located at what 2 number tracheal rings?
2nd, 4th
Thyroid gland secretes what 3 hormones? (C,T,T)
calcitonin, T3, T4
Hypothyroidism:
- T3 & T4 levels increased or decreased?
- TSH levels increased or decreased?
- decreased
2. increased
Causes of hypothyroidism
- what 2 meds? (A,L)
- what autoimmune disease? (HT)
- severe deficiency in what mineral? (I)
- what congenital condition? (C)
- amiodarone, lithium
- hashimoto’s thyroiditis
- iodine
- cretinism
hypothyroidism is associated with what 2 effusions? (P,P)
percaridal, pleural
hypothyroidism can have tracheal deviation from what? (EG)
enlarged glands
hypothyroid pts with what disease may not tolerate the full replacement dose of thyroid hormone?
CAD
caution giving what 3 drug types with hypothyroidism pts? (B,O,ID)
benzos opioids, induction drugs
what drug may be a better induction drug choice for hypothyroidism?
ketamine
should you use direct or indirect BP meds to treat hypotension in hypothyroidism pts?
direct
Myxedema coma is a loss of brain function in pts with a long history of what? (H)
hypothyroidism
Hyperthyroidism:
- what is the one eye sign? (E)
- what 3 BP measurements are increased?
- what 2 C/V symptoms are seen? (P,D)
- is blood volume increased or decreased?
- is CO increased or decreased?
- myocardial depression d/t what? (PC)
- exophthalmos
- SBP, DBP, pulse pressure
- palpitations, dysrhythmias
- increased
- increased
- protein catabolism
for hypothyroidism and hyperthyroidism what 2 things should always be assessed? (A, VQ)
airway, vocal quality
Hyperthyroidism:
- what 3 drugs should be avoided? (P,K,A)
- what type of obstruction can a tumor causes? (BVO)
- direct or indirect agents for hypotension?
- hypotension can occur from stimulating what artery? (C)
- what is the most common dysrhythmia?
- pancuronium, ketamine, atropine
- ball-valve obstruction
- direct
- carotid
- A fib
MH vs thyroid storm:
- what 2 electrolytes increase in MH?
- what one sign is seen in MH?
- increased K
- increased Ca
- muscle rigidity
what 3 complications of a thyroidectomy can cause airway compromise? (RD, T, H)
RLN damage, tracheomalacia, hematoma
acute hypoparathyroidism is seen as what sign 24-48 hours postop? (S)
stridor
thyroid storm can mimic what 3 conditions? (MH, LA, P)
MH, light anesthesia, pheochromocytoma
Normal Ca levels:
- serum (range)
- ionized (range)
- 8-10
2. 0.8-1.0