Brainscape's Knowledge GenomeTM

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


See full index

NURS 503 > Endocrine disorders > Flashcards

Endocrine disorders Flashcards

1
Q

What are adrenal disorders marked by?

A

Due to changes in the adrenal gland itself, from the hypothalamic, or pituitary gland dysfunction or through exogenous cause

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

What three main hormone types are secreted from the adrenal gland?

A
  • Glucocorticoid - cortisol
  • Mineralocorticoid - aldosterone
  • Androgen hormones - male hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the three most prevalent types of adrenal gland disorders?

A
  • Addison’s disease
  • Cushing’s syndrome
  • Pheochromocytoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What causes Addison’s disease?

A

Low cortisol secretion

  • Due to autoimmune disturbances (70%), physiologic stress, TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of Addison’s disease

A
  • Chronic malaise
  • Dizziness, nausea, chronic abdominal pain
  • Muscle cramps
  • Hyperpigmentation
  • Decreased libido
  • Weight loss, salt craving
  • Decreased axillary and pubic hair with altered menses (low androgens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes Cushing’s syndrome?

A

Overproduction of cortisol or excess ACTH from the pituitary gland

  • Can be caused by exogenous medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Symptoms of Cushing’s syndrome

A
  • Rapid weight gain
  • Loss of menses
  • Decreased libido
  • Weakness, bruising
  • HTN
  • Glucose intolerance
  • Insomnia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes pheochromocytoma?

A

Catecholamine-secreting tumor of chromaffin (pheochromocyte) cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of pheochromocytoma

A
  • Headache
  • Diaphoresis
  • Palpitations
  • Secondary HTN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Findings on physical exam for Addison’s disease

A
  • Appears chronically ill
  • Exhibits weight loss
  • Dehydration
  • Increased skin pigmentation on light exposed skin folds
  • Darkened creases on the palms, elbows, knees, lips
  • People of color have darkened mucous membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If a patient has Addison’s disease and has hypothyroidism, what changes need to be made to their levothyroxine dosage?

A

Levothyroxine metabolizes corticosteroids → need to be followed by endocrinologist

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

Findings on physical exam for patient’s with Cushing’s disease

A
  • Central obesity
  • Moon face
  • Thickening of facial fat
  • Buffalo hump
  • Increased supraclavicular fat pads, HTN, muscle weakness, wasting
  • Hirsutism, red-purple abdominal skin striae
  • Acne
  • Emotional lability or depression, “senile”, purpura on the hands, bruising
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Findings on physical exam for patient’s with pheochromocytoma

A
  • New onset moderate to severe HTN (systolic pressures >170 mmHg)
  • Arrhythmias
  • Sinus tachycardia/bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adrenal gland diagnostic studies

A
  • Adrenal antibody studies
  • Rule out TB
  • Medication review (screening for precipitant triggers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diagnostic studies specific for Addison’s disease

A
  • Will have elevated serum ACTH
  • Suppressed levels of cortisol
  • Hyponatremia
  • Hyperkalemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diagnostic studies specific for Cushing syndrome

A

Classically diagnosed by measurement of >100 mcg of cortisol in the urine during a 24 hour period

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

Diagnostic studies specific for pheochromocytoma

A

Elevated levels of fractionated metanephrines in urine or plasma

  • Collection during symptomatic episodes (e.g. diaphoresis, palpitations)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Addison’s disease management

  • Acute adrenal crisis
A

Hospitalization w/ IV corticosteroids and shock stabilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Addison’s disease management

  • Chronic adrenal insufficiency
A

Managed outpatient with oral hydrocortisone in divided daily doses (20-30 mg) to allow restoration of a diurnal pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cushing’s syndrome management

A
  • Daily ketoconazole which mitigates the impact of cortisol
  • Primary tumor resection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pheochromocytoma management

A

Surgical treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the underlying cause of diabetes?

A

Group of metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Difference between type 1 DM vs type 2 DM

A
  • Autoimmune destruction of the beta cells within the islets of Langerhans in the pancreas in a genetically predisposed individual
  • Contributing to insulinopenia and lifelong dependence on exogenous insulin
  • Abrupt onset in infants and children; more gradual in adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Difference between type 1 DM vs type 2 DM

A
  • Insidious onset
  • Decreased glucose uptake
  • Increased hepatic glucose production
  • Impaired insulin secretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Type 1 DM clinical presentation

  • Acute symptoms
A
  • Polyuria, polydipsia, polyphagia
  • Weight loss
  • Blurred vision
  • Fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Signs of ketoacidosis

A
  • Glycosuria
  • N/V
  • Abdominal pain
  • Rapid shallow breathing
  • Hypotension
  • Dehydration
27
Q

Type 2 DM clinical presentation

A
  • May have no symptoms at first
  • Polyuria, polydipsia
  • Blurred vision
  • Fatigue
  • Slow healing wounds
  • Frequent infections or polyphagia
  • Weight loss
  • Tingling of hands and feet
28
Q

DM physical exam components

A
  • Neuro
  • Eyes
  • Derm
  • Thyroid
  • Cardiac
  • Abdominal
29
Q

True/false: Diagnostic criteria for DM are based on the glucose threshold above which the risk of retinopathy is increased

A

True

30
Q

Diagnostic studies: lab findings suggestive of DM

A
  • A1c >6.5%
  • Fasting plasma glucose >126 mg/dL
  • 2 hour plasma glucose level >200 mg/dL during oral glucose tolerance test
31
Q

If a patient is asymptomatic, had normal blood work, and a normal PE for DM, what is the providers next steps?

A

Will need second positive test for a definitive diagnosis (can use the same blood sample twice)

  • Ex: if plasma glucose was 128 and patient was asymptomatic, provider can add A1c test from the same vial of blood
32
Q

What test can be ordered to screen between type 1 DM vs type 2 DM?

A

C-peptide level

33
Q

DM management

A
  • Comprehensive annual exam → blood glucose, cardiac/BP, renal, endocrine/neuro, vision, derm monitoring
  • Encourage healthy diet and regular exercise
  • Review medications
  • Follow up every 3 months to check blood work
34
Q

Should the provider be concerned about collecting labs with new diagnosis of type 1 DM?

A

Not as concerned about kidney and eye damage because of sudden onset → can do eye exam and check for micro kidney damage five years after diagnosis

35
Q

Should the provider be concerned about collecting labs with new diagnosis of type 2 DM?

A

Will need to perform eye exam and assess for kidney damage at time of diagnosis (there is a gradual onset with type 2 DM so damage may have already been done)

36
Q

What should be done for the patient with recurrent hypoglycemia episodes (blood sugars <50)?

A

Need hospitalization

37
Q

What is the definition of primary hyperparathyroidism?

A

Inappropriate secretion of PTH in the setting of hypercalcemia

38
Q

What is the definition of secondary and tertiary hyperparathyroidism?

A

Secondary: increased secretion of PTH in the setting of low or normal serum calcium (can be caused by vitamin D deficiency or renal failure)

Tertiary: prolonged secondary hyperparathyroidism in which hypercalcemia develops

39
Q

What is the definition of hypoparathyroidism?

A

Inappropriately low or normal secretion of PTH in the setting of hypocalcemia

40
Q

Primary hyperparathyroidism clinical presentation

A

Asymptomatic, but will have nonspecific symptom

  • Weakness
  • Easy fatiguability
  • Depression
  • Intellectual weariness
  • Cognitive impairment
  • Loss of initiative
  • Anxiety
  • Irritability
  • Insomnia
  • HTN, CAD
  • Kidney stones
  • Osteoarthritic findings
41
Q

Secondary hyperparathyroidism clinical presentation

A

Calcium not properly absorbed

  • CKD
  • Vitamin D deficiency
  • Meds: PPI, glucocorticoids
42
Q

Hypoparathyroidism clinical presentation

A

Perioral and digital paresthesia to life threatening cardiac arrhythmias, seizures, laryngospasm

43
Q

Primary hyperparathyroidism physical exam components

A
  • Band keratopathy on temporal borders of the cornea
  • Bone tenderness - tibia, sternum
  • Palpable neck mass
44
Q

Hypoparathyroidism physical exam findings

A
  • Chvostek’s sign
  • Trousseau’s sign
45
Q

Parathyroid gland disorder diagnostic studies

A
  • Bone mineral density assessment of a cortical bone site and lumbar spine/hip
  • Renal ultrasound
  • ECG
46
Q

Parathyroid gland labs

A
  • PTH - 2nd or 3rd generation assay
  • Serum calcium, creatinine, albumin, vitamin D, fasting phosphorus
47
Q

Hyperparathyroidism management

A

ONLY cure for primary hyperparathyroidism → surgery

  • Refer to parathyroid surgeon
48
Q

Hypoparathyroidism management

A
  • Parenteral PTH
  • Calcitriol
  • Thiazides
  • Vitamin D supplementation
  • Encourage weight bearing exercises
49
Q

What is the definition of a thyroid nodule?

A

A distinct lesion within the thyroid that is radiologically different from the rest of the thyroid

50
Q

What is the definition of hyperthyroidism?

A

Thyroid hormone hyper secretion and increased metabolism

  • Graves disease is the most common cause
51
Q

What is the definition of hypothyroidism?

A

Thyroid hormone reduced secretion and decreased metabolism

52
Q

What is the definition of thyromegaly?

A

Localized nodules or generalized goiter (benign or malignant, solitary or multiple)

53
Q

What lab findings can be seen with subclinical hyperthyroidism?

A

Decreased TSH and normal T3/T4 (vice versa for hypothyroidism)

54
Q

Thyroid nodule clinical presentation

A
  • Usually asymptomatic
  • Identified as a lump by patients or by providers during routine thyroid examinations
  • If toxic, will have symptoms of hyperthyroidism
55
Q

Hyperthyroidism clinical presentation

A
  • Weight loss
  • Difficulty sleeping
  • Tremor
  • Irritability
  • Menstrual irregularity
  • Tachycardia/palpitations/Afib
  • Proptosis, periorbital edema
  • Thyroid gland diffusely enlarged with soft texture/well-delineated border
56
Q

What levothyroxine changes will have to be made for pregnant patients with hypothyroidism?

A

Increase levothyroxine dosage by 30%

57
Q

Hypothyroidism clinical presentation

A
  • Cold intolerance
  • Weight gain
  • Hoarseness
  • Puffiness of the face and hands
  • Heavy and irregular menstrual periods
  • Dry skin
  • Dry and brittle hair
  • Depression
  • Paresthesia
  • Muscle aches
  • Thyroid enlarged, firm, pebbly texture
58
Q

Thyroid gland disorder physical exam components

A
  • Energy level
  • Mental status and facial affect
  • Inspect texture, color, general appearance of skin
  • Inspect and palpate thyroid gland for nodules (size, consistency, mobility)
  • Check for lymphadenopathy → supraclavicular, anterior cervical, submandibular
  • Cardiac and neuro assessment
59
Q

Thyroid gland disorder diagnostic studies

A
  • TSH testing - most sensitive marker of thyroid function
  • Serum T3 and T4
  • Ultrasound
  • Thyroid cytology via FNA biopsy
  • Anti-TPO antibody levels for Graves
60
Q

Thyroid gland management

A
  • Biopsy for nodules
  • Thyroidectomy
  • Surveillance
  • Specialist consultation for central and severe cases
  • ED for myxedema coma
61
Q

What is myxedema coma?

A

Untreated hypothyroidism

  • IV levothyroxine/glucocorticoid therapy, warming, ventilatory support
  • Medical emergency
62
Q

Pharmacological therapy for hyperthyroidism

A
  • Beta blockers (for Graves disease)
  • Thioamides - methimazole and PTU
63
Q

Pharmacological therapy for hypothyroidism

A

Levothyroxine

NURS 503 (10 decks)

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