Endocrine Diseases

Question 1

What hormones are released in the anterior pituitary gland?

(6)

FLAT PG

Answer 1

• Follicle- stimulating hormone (FSH)
• Lutenizing hormone (LH)
• Adrenocorticotrophic hormone (ACTH)
• Thyroid-stimulating hormone (TSH)
• Prolactin
• Growth hormone (GH)

Question 2

What hormones are released in the posterior pituitary? (2)

Answer 2

Anitdiuretic hormone (ADH)
 Oxytocin

Question 3

What does thyroid-stimulating hormone promote?

Answer 3

growth and metabolism

Question 4

What are the hormones of the thyroid? (2)

Answer 4

thyroxine T4

triiodothyronine T3

Question 5

What is a result of excessive secretion of T3 and/or T4?

Answer 5

hyperthyroidism

Question 6

What can cause hyperthyroidism? (4)

Answer 6

Graves disease

TSH-secreting pituitary tumors

iatrogenic

thyroiditis

Question 7

What are they symptoms of hyperthyroidism? (4)

WAFA

Answer 7

weight loss

fatigue

arrhythmias

anxiety

Question 8

What is the treatment for hyperthyroidism? (3)

ABS

Answer 8

antithyroids

beta antagonists

surgical

Question 9

What do we need to be careful of for hyperthyroid patients? (3)

Answer 9

TAPE EYES WELL

Versed for anxiety

Do NOT give drugs that result in sympathetic discharge(phenylephrine, ketamine)

Question 10

Does hyperthyroidism increase the MAC of drugs?

Answer 10

No

Question 11

What are risks intraoperatively for thyroidectomies? (2)

Answer 11

Accidentally cutting 1 is OK, but if both recurrent laryngeal nerves are cut, it results in re-intubation.

Also, accidentally cutting into parathyroid can result in hypocalcemia–> longer QT interval

Question 12

What is a life-threatening exacerbation of hyperthyroidism that may be caused by trauma, infection, surgery, or medical illness?

Answer 12

Thyroid Storm, or thyrotoxic crisis

Question 13

When does the thyrotoxic crisis usually occur?

Answer 13

Most often appears in post-op period, esp. if surgery was emergent.

Question 14

What are the symptoms of a thyroid storm? (4)

FACT

Answer 14

anxiety

fever

tachycardia

cardiovascular instability

Question 15

What is the treatment for a thyroid storm?

Answer 15

give high blood pressure and thyroid meds

Question 16

If you have high TSH levels and low T3, T4 levels, what condition do you have?

Answer 16

hypothyroidism

Question 17

What is the most common type of hypothyroidism?

Answer 17

autoimmune–Hashimoto’s thyroiditis

then, iatrogenic

Question 18

What are the symptoms or hypothyroidism? (4)

Answer 18

lethargy

weight gain

cold intolerance

hypoactive reflexes

Question 19

What are perioperative considerations for hypothyroidism? (3)

Answer 19

DECREASED CLEARANCE OF ANESTHESIA

decreased gastric emptying

hypotension

Question 20

What medication is typically prescribed to hypothyroidism?

Answer 20

Synthroid, PO T4

Question 21

What is the major complication caused by hypothyroidism? What are the symptoms and causes?

Answer 21

myxedema coma

SEVERE HYPOTHERMIA, loss of DTRs

Mostly elderly patients forgetting to take meds

Question 22

What condition causes a stimulated calcium circulation in the blood?

It also causes a compensatory increase in PTH due to _______.

Answer 22

hyperparathyroidism, usually benign

hypocalcemia

Question 23

Parathyroid hormone does 2 things:

Answer 23

increases calcium

decreases phosphate

Question 24

What are the symptoms of hyperparathyroidism? (4)

Answer 24

renal stones from hypercalcemia

HTN

constipation

fatigue

Question 25

What is the treatment for hyperparathyroidism? (3)

Answer 25

diuretics

fluid loading

parathyroidectomy

Question 26

What are perioperative considerations for hyperparathyroidism?

Answer 26

Need more NMB because of decreased response due to hypercalcemia!

Question 27

Adrenocorticotrophic hormone responsible for creating what?

Answer 27

adrenalin in the adrenal cortex