Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Adult assessment tools > Endocrine Assessment > Flashcards

Endocrine Assessment Flashcards

1
Q

State some of the major endocrine glands

A
  1. hypothalamus
  2. pineal
  3. pituatary
  4. thyroid
  5. thymis
  6. adrenal
  7. islets of langahans
  8. ovaries
  9. testes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What specific things could be picked up in a history taking for endocrine assessments?

A
  • Hormone replacement therapy
  • Surgeries, chemotherapy or radiation
  • Family history – diabetes, goitre, obesity, addison’s disease, infertility
  • Sexual history – changes, characteristic, meinstruation and menopause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some specific things to ask during a history taking for an endocrine assessment?

A
  • Energy level
  • Fatigue
  • Maintenance of ADLS
  • Sensitivity to heat or cold
  • Weight level
  • Bowel movements
  • Level of appetite
  • Urination, thirst and salt craving
  • Cardiovascular status changes
  • Vision changing, tearing or eye edema
  • Neurological – numbness, tingling lips or extremities (adrenal gland), mood, memory, sleep
  • Integumentary – hair changes, skin changes, nails, bruising, wound healing times
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

During a physical assessment what red flags should you look for endocrine assessment?

A
  • General appearance – vital signs, height or weight and changes
  • Integumentary – skin colour, temp, texture, moisture - bruising, lesions, wound healing, hair and nail texture, hair growth
  • Face – shape changes, symmetry, eyes and visual acuity and neck
  • Respiratory = thorax for lung and heart sounds
  • Extremiesies – sizes in hands feet truck, muscle strength and depp tendon reflexes, sensations to hot and cold and vibrations – extremity edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What symptoms in older pateints can make endorcine assessment results unclear and diagnosis difficult?

A
  • Relationship unclear
  • Aging causing fibrosis of thyroid gland
  • Reduces metabolic rate
  • Contributes to weight gain
  • Cortisol level unchanged in aging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Whats the action plan for a general endocrine assessment?

A

Diagnositic tests:
– Growth Hormone – fasting, well rested and not physical stressed
- Serum calcium or phosphatee – fasting may be required
- **Cortisol and aldosterone leave tests **
- **Epinephrine, norepinephrine and dopamine **– 24 hr urine collection to measure levels – can’t be stressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How and where should you palpate to find the thyroid gland?

A

Just over the trachea.

Standing behind patient
run down the neck
noticing enlargement of trachea (check for lumps and if it is visible)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the pathophysiology of how the thyroid gland should normally work

A
  1. Hypothalamic-pituitary-Thyroid axis
  2. Negative feedback loop was hormone T3/T4 increase the hypothalamus registers excess and stops the production of TRH
  3. TRH triggers TSH and T3/T4 used for liver function
  4. return to normal levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What symptoms should you look for during assessment for hypothyroidism?

A
  • Fatigue
  • Constipation
  • Apatchy more than 16 hours a day
  • Weight gain
  • Memory and mental impairment and decreased concentration
  • Masklike face
  • Menstrual irregularies and loss of liberia’s
  • Course so or loss of hair and eyebrows
  • Dry skin and cold intolerance
  • Menstrual disturbances
  • Numbness and tingling of fingers
  • Tongue thicker,hand and feet enlarge
  • Slurred speech and hoarseness
  • Hyperlipidemai
  • Reflex delay
  • Bradycardia
  • Hypothermia
  • Cardiac and respiratory complication
  • Diffused goitre (in primary hypothyroidism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is hypothyroidism Pathophysiology?

A

Low production of T3/T4 hormone effecting the liver.

Due to:
1. Reduced production of iodine in blood (iodine makes T3/T4)
2. Removal of thyroid gland (need hormonal therapy)
3. obstruction of gland
4. Inflammation of thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What different categories of hypothyroidism?

A
  1. primary (thyroid),
  2. secondary (pituitary)
  3. tertiary (hypothalamus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Whats the immediate action plan for treatment of hypothyrpidism?

A
  • Life of hormonal therapy
  • Labatrory assessment (low T3/T4, high cholestrol, high TRH)
  • Other tests neck eco graphs, resonance, electrocardiography, gammagraphy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What would you look for to investigate primary (thyroid effecting) hypothyroidism?

A
  1. Low T4 (normal 60-150nmol/l)
  2. Low T3 (noraml 1-3mol/l
  3. High TSH (normal 0.5-3.5 pU/ml)
  4. High Cholestrol
  5. High TRH in stimulation test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would you look for to investigate secondary (pituitary effecting) hypothyroidism?

A
  1. Low T3/T4 (noraml 60-150nmol/l and 1-3mol/l)
  2. Low TSH (noraml 0.5-3.5pU/ml)
  3. Prolonged or bad response to TRH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Whats the most common type of hyperthyroidism?

A

Graves disease

Autoimmune disease with genetic cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Graves disease?

A

Type of hyperthyroidism

Excessive output of thyroid hormone

Due to too much T3/T4 hormone

Autoimmune disease with genetic link

18
Q

What are some red flags that cause hyperthyroidism?

A
  1. May appear after emotional shock, stress or and infection
  2. Caused by thyroiditis and excessive ingestion of thyroid hormone
  3. Women 8x more likely than men (20-40 yo)
19
Q

What symptoms should you look for in the assessment of hyperthyroidism?

A
  • Increased T4 and T3
  • Bulging eyes
  • Dermatological problems (engrossed skin, distal part of legs and orange skin)
  • Diffused goitre (unsymmetrical )
  • Heat tolerance
  • Palpation, tachycardia, elecvated systolic BP
  • Increase appetite but weight loss
  • Menstruation irregularies and decreased libido
  • Perspiration, skin mood and flushed (elderly may be dry and pruritic)
  • Insomnia
  • Diarrhea
  • Fatigue and muscle weakness
  • Nervousness and irritability – can’t sit quietly
20
Q

Whats the plan for treatment and assessment of hyperthyroidism?

A
  1. Clinical history
  2. Physical examination (goitre and eyes)
  3. Low levels of TSH and high levels of T4 and T3
  4. Normally surgical to remove parts (NBM)
21
Q

What is the normal pathophysiology of adrenal glands?

A

Responsibel for retention of water due to sodium, potassium and hydrogen levels to effect pH.

  1. Adrenal medulla - autonomic nervous system to release catecholamines like epinephrine and nor epinephrine
    2.     Adrenal cortex     - glucocorticoids (cortisol) - mineralocorticoids and androgens
22
Q

What is adrenal hyperfunction?

A

Excess of cortisol

from adrenal cortex

Causes cushing syndrome (primary, secondary, ectopic and latrogenic)

23
Q

What is cushing syndrome?

A
  1. Adrenal hypertension causes
  2. Excessive adrenocortical activity or corticosteroid medication
  3. Excess cortisol
24
Q

Whats a risk factor for cushing syndrome?

A
  • Women between 20-40 (5x more likely than men)
25
Q

What are some symptoms of cushing syndrome?

A
  1. Hyperglycaemia. - Can develop into diabetes
  2. Weight gain
  3. Central type obesity with buffalo hump
  4. Heavy trunk and thin extremities
  5. Fragile thin skin
  6. Exxhymosis
  7. Striae
  8. Weakness
  9. Lassitude
  10. Sleep distrubances
  11. Osteoporosis
  12. Muscle wasting
  13. Hypertension
  14. Moon face
  15. Acne
  16. Increased susceptibility to infection
  17. Slow healing
  18. Virilization in women
  19. Loss of libido
  20. Mood changes
  21. Increased serum sodium
  22. Decreased serum potassium
26
Q

What should you focus on in the assessment for cushing syndrome?

A
  • Activity level and ability to carry out self care
  • Skin assessment
  • Changed in physical appearance and patient responses to change
  • Mental function
  • Emotional status
  • Medications

Test for raised level of cortisol

27
Q

What are the types of tests you can do for cortisol levels (cushing syndrome)?

A
  1. Dexamethasone suppression test - increased sodium and decreased potassium and metabolic alkalosis
  2. **Plasma cortisol **– expect elevated cortisol all day (normal varied)
  3. Sexamestasone test (administer 1 mg of dexametasone at 11-12 at night) – cortisol elevated and in urine
  4. Levels of ACVTH (elevated levels (unless primary cushing would expect very low)
  5. Stimulating with CRH (Secondary cushing great response to ACTH but no response in primary or ectopic)
  6. **Cerebral resonance **(locate pituitary adenoma
  7. CT scan, suprarenal resonance and ecopgraphy
28
Q

How can you plan and manage cushing syndrome?

A
  1. Prevent injury
  2. Increased protein, calcium and vitamin D in diet
  3. Mental asepsis
  4. Monitor blood glucose
  5. Moderate activity with rest periods
  6. Provide restful environment
  7. Improve skin integrity
29
Q

What is diabetes pathophysiology?

A
  • Raised blood glucose level (hyperglycaemia)
  • Insulin resistance receptor sites
  • Insulin can not bind to cells so glucose can not get into the cells
  • Diabetes 2 – excess weight
30
Q

What is the normal pathophysiology of people without diabetes?

A
  • Able to regulate plasma glucose level using hormones – insulin to reduce glucose
  • Glucagon, epinephrine, cortisol and growth hormone to increased glucose levels

Normally insulin joins the receptor sites of cell and and glucose is passaged through into cell using insulin.

31
Q

State the different classifications of diabetes mellitus?

A

**Type 1
**
- Insulin deficiency (juvenile onset)
**Type 2
**
- Combined insulin resistance and relative deficiency in insulin secretion (adult onset)
**Gestational diabetes mellitus
**
- During pregnancy but usually disappears after pregnancy
**Secondary DM
**

32
Q

What are the risk factors to look out for in history taking for diabetes?

A

Type 1 – genetic predisposition

Type 2 – habits, family history, obesity, physical inactivity, previously identified impaired glucose tolerance – impaired fasting glucose – hypertension – hyperlipidemia

33
Q

What is the clinical presentation of symptoms for type 1 diabetes?

A
  • Polyuria (increased urination)
  • Polydipsia (drink water)
  • Polyphagia
  • Weight loss
  • Weakness
  • Dry skin
  • Ketacidosis
34
Q

What is the clinical presentation of symptoms for type 2 diabetes?

A
  • Can be asymptomatic
  • Polyuria
  • Polydipsia
  • Polyphagia
  • Fatigue
  • Weight loss
35
Q

What is the general physical assessment for hyperglycaemia?

A
  • Extreme thirst
  • Frequent urination
  • Dry skin
  • Hunger
  • Blurred vision
  • Drowsiness
  • Decreased healing
36
Q

What is the general physical assessment for hypoglycaemia?

A
  • Shaking
  • Fast heartbeat
  • Sweating
  • Dizziness
  • Anxiety
  • Hunger
  • Impaired vision
  • Weakness/fatigue
  • Headaches
  • Irritability
37
Q

What are some diagnositic tests for diabetes?

A
  • Urine test - glucose rita – paper strip
  • Ketone test – ketonuria – paper strip
  • Fasting blood glucose – after last meal glucose blood concentration 0 at least 8 hours after last meal
  • Random blood glucose – concentration at any time after last meal
  • Glucose tolerance test – glucose administrated and blood samples taken
  • Glycosylated haemoglobin – for long term levels of glucose – glycemis state over weeks
38
Q

What is the normal non diabetic glucose levels?

A
  • before meals 4-5.9mmol/l
  • after meals under 7.8mmol
39
Q

What is the abnormal glucose levels for type 2 diabetes?

A
  • waking – none
  • before meals – 4-7pm;s
  • after meal – under 8.5mmol
40
Q

How can diabetes be managed?

A

1.Medication (insulin pumps)
2. dietary change
3. control risk factors – eg. Smoking, BP
4. exercise modification

Regular complication monitoring
Self monitoring blood glucose

41
Q
A

Adult assessment tools (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions