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CEN Medical Emergencies > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

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USMLE® Step 1 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
Q

Ketone DKA results in what

A

Ketonuria/Acetone on the breath

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26
Q

HHS more common in what type of diabetic

A

Type 2

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27
Q

Type 2 DM

A

Make some insulin - some sugar still gets into the cell (don’t need to break down the fats)

28
Q

Why does HHS have more profound dehydration and BUN?

A

Longer onset – can go days or weeks without realizing something is wrong

29
Q

DKA and HHS tx fluid

A

NS 1-2 L/hour (adult)

NS 20 ml/kg (pediatric)

30
Q

DKA and HHS tx hyperglycemia

A

IV insulin (bolus 0.1 units/kg/hour)

Why not SC? Fluid may not be absorbed SC due to dehydration

31
Q

DKA and HHS tx Electrolytes

A

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
Q

What does Cortisol do?

A

Regulates blood sugar

33
Q

What does Aldosterone do?

A

Facilitates sodium and water reabsorption

34
Q

Cushing’s Syndrome BS is

A

High

35
Q

Addison’s Crisis BS is

A

Low

36
Q

Cushing’s Syndrome K+ is

A

Decreased

37
Q

Addison’s crisis K+ is

A

Increased

38
Q

Cushing’s Syndrome NA+ is

A

Increased

39
Q

Addison’s crisis NA+ is

A

Decreased

Urinate it off

40
Q

Prednisone is

A

an adrenal hormone

CUSHING SYDNROME

41
Q

Pt’s who take prednisone but have addison crisis s/s?

A

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
Q

Cushing Syndrome Tx

A

Reduce corticosteroid dose

43
Q

Addison Syndrome Tx

A 
Symptoms!!!
Hypovolemia
Hyperkalemia
Hyopatremia/Hypocholermia
Replace Aldosterone
Reduce Cortisol
44
Q

How do you replace aldosterone?

A

IV Hyodrocortisone (solu-cortef)

45
Q

How do you replace cortisol?

A

IV Dexamethasone (Decadron)

46
Q

What does the thyroid do?

A

Maintains body temperature
Metabolism - helps body absorb nutrients
Inc O2 consumption (inc HR, RR)

47
Q

2 Thyroid Hormones

A

T3 and T4

48
Q

What does the thyroid do with T3 and T4

A

Releases them into your bloodstream

49
Q

What does the pituitary gland do for your thyroid

A

Has TRH and TSH that regulates the bodys T3 and T4 hormones

50
Q

Graves Disease

A

Autoimmune disorder

Characterized by presence of an antibody

51
Q

Graves Disease Hormone

A

TSI

52
Q

What is bad with TSI?

A

Stimulates the thyroid gland - NOT regulated - uncontrolled thyroid hormones : can cause a goiter

53
Q

Pancreas Exocrine functions

A

Enzymes for digestion
(Bile + Pancreatic juices = released into duodenum)
Break down fats/carbs/proteins

54
Q

Pancreas enzymes

A

Amylase
Lipase
Trypsin
Chymotrypsin

55
Q

Amylase breaks down …

A

Carbohydrates

56
Q

Lipase breaks down …

A

Fats

57
Q

Trypsin and Chymotrypsin breaks down …

A

Digest proteins

58
Q

Adrenal Gland : Adrenal Cortex hormones

A
  1. Aldosterone
  2. Cortisol
  3. Sex Hormones
59
Q

What is cortisol used for

A

controls immune system
inflammation
stress response

60
Q

Adrenal Gland : Adrenal Medula hormones

A

Catecholamines : Adrenaline

Nore, Epi, Dopamine

61
Q

Hypothydroisim

A

Myxedema Coma

62
Q

Hyperthyroidism

A

Grave’s Disease

63
Q

Grave’s Disease turned bad

A

Thyroid Storm

64
Q

Elevated pancreas

A

Hypoglycemia

65
Q

Decreased pancreas (2 forms)

A

DKA and HHS

66
Q

Decreased adrenal glands (2 forms)

A

Addison’s Disease –> Addison’s Crisis

67
Q

Elevated adrenal glands

A

Cushing Disease

CEN Medical Emergencies (6 decks)

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