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CEN Medical Emergencies > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Thyroid Storm temperature tx

A

Acetaminophen

not ASA - releases thyroid from tissue binding sites elevating serum thyroid levels

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2
Q

Myxedema Coma temperature tx

A

Passive rewarming

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3
Q

Thyroid storm to tx increased HR

A

BB (Propranolol) IV

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4
Q

Myxedema Coma to tx decreased breathing

A

Mechanical ventilation

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5
Q

Thyroid Storm Rx

A

PROP or Methimazole
(Tapazole, Thiamazole)

Block thyroid hormone synthesis - Does not help right NOW

ONE HOUR LATER

Iodine - pushes the serum thyroid hormone back into the tissue (Lugol sodium)

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6
Q

Problem w/ Lugols?

A

It’s known to stimulate new thyroid hormone production

THAT’S WHY YOU GIVE PROP OR METHIMAZOLE FIRST

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7
Q

Myxedema Coma Rx

A

IV thyroid hormone replacement

Thyroxine
Levothyroxine

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8
Q

Thyroid storm nutrition

A

Increase calorie/fluid intake

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9
Q

Myxedema Coma nutrition

A

Fluids - Gental rehydration

Ileus for a few days

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10
Q

What is released during mild blood sugar to try and increase sugar (60-80)

A

Epi

Tells the store glycogen in the liver to be released

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11
Q

Why do those on BB not show the hypoglycemic s/s?

A

Blockage of EPI

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12
Q

Why do ETOH not have show hypoglycemic s/s?

A

Don’t have a glycogen storage to work off of

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13
Q

Hypoglycemic Unawareness

A

Fail to go through EPI phase

Long standing DM
BB
ETOHs

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14
Q

Neuroglycemic Symptoms of hypoglycemia

A

Brain can’t extract O2 anymore due to lack of glucose
AMS
40-60

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15
Q

<40 BS

A

Seizures
Coma
Permeant Damage

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16
Q

Conscious hypoglycemia?

A

15-20 G of rapid acting carbohydrate (sugar)
1/2 cup OJ
1 cup of milk
1/2 cup apple juice

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17
Q

Semi-Conscious hypoglycemia?

A

Adult: 50% IV dextrose
Child: 25% IV dextrose
Infant: 10-12.5% IV dextrose
IV infusion D5W or D10W

No IV?
IM glucagon

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18
Q

What is common with IM glucagon

A

vomiting - position to avoid aspiration

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19
Q

What does glucagon do

A

Stimulates breakdown glycogen into glucose

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20
Q

Insulin does what?

A

Takes glucose across the cell wall and drops it off so the cell has a source of energy

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21
Q

Type 1 diabetes

A

Do not make insulin

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22
Q

How does the serum glucose work in DKA

A

Serum hyperglycemia –> pulls sugar into the vascular bed –> bed becomes swollen with fluid –> piss it out

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23
Q

Cell isn’t getting sugar in DKA what is the alternate energy source?

A

Fatty acids -> release of hydrogen ion and ketone body

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24
Q

Metabolic acidosis in DKA results in what

A

Kussmaul’s respirations

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25
Ketone DKA results in what
Ketonuria/Acetone on the breath
26
HHS more common in what type of diabetic
Type 2
27
Type 2 DM
Make some insulin - some sugar still gets into the cell (don't need to break down the fats)
28
Why does HHS have more profound dehydration and BUN?
Longer onset -- can go days or weeks without realizing something is wrong
29
DKA and HHS tx fluid
NS 1-2 L/hour (adult) | NS 20 ml/kg (pediatric)
30
DKA and HHS tx hyperglycemia
IV insulin (bolus 0.1 units/kg/hour) Why not SC? Fluid may not be absorbed SC due to dehydration
31
DKA and HHS tx Electrolytes
K+ could be high due to acidotic you could also be pissing it out, once acidosis is gone during the shift it may become depressed due to pissing it out Correct other electrolytes as needed
32
What does Cortisol do?
Regulates blood sugar
33
What does Aldosterone do?
Facilitates sodium and water reabsorption
34
Cushing's Syndrome BS is
High
35
Addison's Crisis BS is
Low
36
Cushing's Syndrome K+ is
Decreased
37
Addison's crisis K+ is
Increased
38
Cushing's Syndrome NA+ is
Increased
39
Addison's crisis NA+ is
Decreased Urinate it off
40
Prednisone is
an adrenal hormone | CUSHING SYDNROME
41
Pt's who take prednisone but have addison crisis s/s?
PT cold turkeyed on their prednisone Their adrenal glands done up and shrunk! cause they don't need them!! Adrenal glands too small to keep up w/ whatcha need!
42
Cushing Syndrome Tx
Reduce corticosteroid dose
43
Addison Syndrome Tx
``` Symptoms!!! Hypovolemia Hyperkalemia Hyopatremia/Hypocholermia Replace Aldosterone Reduce Cortisol ```
44
How do you replace aldosterone?
IV Hyodrocortisone (solu-cortef)
45
How do you replace cortisol?
IV Dexamethasone (Decadron)
46
What does the thyroid do?
Maintains body temperature Metabolism - helps body absorb nutrients Inc O2 consumption (inc HR, RR)
47
2 Thyroid Hormones
T3 and T4
48
What does the thyroid do with T3 and T4
Releases them into your bloodstream
49
What does the pituitary gland do for your thyroid
Has TRH and TSH that regulates the bodys T3 and T4 hormones
50
Graves Disease
Autoimmune disorder | Characterized by presence of an antibody
51
Graves Disease Hormone
TSI
52
What is bad with TSI?
Stimulates the thyroid gland - NOT regulated - uncontrolled thyroid hormones : can cause a goiter
53
Pancreas Exocrine functions
Enzymes for digestion (Bile + Pancreatic juices = released into duodenum) Break down fats/carbs/proteins
54
Pancreas enzymes
Amylase Lipase Trypsin Chymotrypsin
55
Amylase breaks down ...
Carbohydrates
56
Lipase breaks down ...
Fats
57
Trypsin and Chymotrypsin breaks down ...
Digest proteins
58
Adrenal Gland : Adrenal Cortex hormones
1. Aldosterone 2. Cortisol 3. Sex Hormones
59
What is cortisol used for
controls immune system inflammation stress response
60
Adrenal Gland : Adrenal Medula hormones
Catecholamines : Adrenaline Nore, Epi, Dopamine
61
Hypothydroisim
Myxedema Coma
62
Hyperthyroidism
Grave's Disease
63
Grave's Disease turned bad
Thyroid Storm
64
Elevated pancreas
Hypoglycemia
65
Decreased pancreas (2 forms)
DKA and HHS
66
Decreased adrenal glands (2 forms)
Addison's Disease --> Addison's Crisis
67
Elevated adrenal glands
Cushing Disease

CEN Medical Emergencies (6 decks)

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