Endocrine Disorders Flashcards
Patient assessment
Thyroid disease
Hyperthyroidism
Hypothyroidism
Hyperthyroidism
Cons: nervous/insomnia/heat intol/sweating Bugging eyes/stare/lid lag Horse voice/goiter ST/diff swallowing Wgt loss Freq BMs Fine tremor Warm moist palms Infertility/menstral irregular/vomiting in pregnancy Osteoporosis
Hypothyroidism
Depression/forgetful/slow thinking/irritable/diff concentrate
Thinning hair
Thyroid crisis: thyroid storm (hyperthyroidism)
Thyroid storm is a life-threatening health condition that is associated with untreated or undertreated hyperthyroidism. During thyroid storm, an individual’s heart rate, blood pressure, and body temperature can soar to dangerously high levels.
Thyroid crisis: thyroid storm (hyperthyroidism)
Precipitating factors
Infection Trauma Stress Co existent medial illness Pregnancy Exposure to cold
Thyroid crisis: thyroid storm (hyperthyroidism)
Precipitating factors:
Medications
Chronic steroid therapy Beta blockers Narcotics, anesthesia Etch Tricyclics anti depres Glucocorticoid therapy Insulin therapy Thiazides diuretics Phenytoin Chemo Non steroidal anti I’m
Thyroid crisis: thyroid storm (hyperthyroidism)
Precipitating factors:
In the presence of an unknown preexisting condition
Pituitary tumors Radiation of head and neck Auto immune diseases Neurosurgical procedures Metastatic malignancies: lung breast Surgery Lon-term illness Shock postpartum status Trauma
Possible indications for thyroid emergencies
Thyroid storm
Myxedema coma
Thyroid storm
Tachy Hyperthermia Tracy Pena Diaphoresis Hyper cal Hyperglycemia Met acid Diarrhea Cadovas collapse: cardio,hyp,dysrhythmias:shock Irritability Loc Emotional Psychosis Tremors, restless Wgt loss
Myxedema coma
Brady Hypothermia Hypocenter Hyponatremia Hypoglycemia Resp and met acidosis Cardiovascular collapse Decreased vascular tone Depress loc Seizure Coma Hyporeflexia Wgt gain
Hyperthyroidism and elderly
Atypical Sox’s Apathetic hyper: single sx (depression, a fib, chef, muscle weak) Palpitations Sob Tremor Nervous Often Sxs masked Can deterioration into storm
Thyroid levels
TSH .34-4.25
T4 5.4-11.7
T3 77-135
HYPERTHYROIDISM
TSH-T4-T3
L——H—H
PRIMARY HYPOTHYROID
TSH-T4-T3
H——L—L
SECONDARY HYPOTHYROID
TSH-T4-T3
L——L—L
HASHIMOTOS
TSH-T4-T3
H—N/L-L
GRAVES
TSH-T4-T3
L—N/H—H
SICK EUGHYROID
TSH-T4-T3
H—-L—L OR HrT3
Thyrotoxicosis/storm
Cause
Signs and sxs
Thyrotoxicosis/storm
Treatment
Management Precipitating factors Control excessive thyroid hormone release Inhibit thyroid biosynthesis Treat the peripheral effects
Thyroid medications
PTU
Methimazole
Potassium iodide
SIADH AND DI: diabetes Insipidus
Know lab values Causes Medications *other causes Management Signs and sxs
Addison’s
Adrenal crisis
Aldosterone deficiency Cortisol deficiency Know generalized signs and sxs Crisis Management
Cushing syndrome
Sxs
Diagnosis
Treatment
