ENDOCRINE FINAL Flashcards
Normal ADH secretion
Plasma osmolality maintained at mean set point ~ 285 mOsm/kg
SUSPECT siadh WHEN URINE NA IS LESS THAN ___
40
Antidiuretic Hormone Antagonist iv AND po
Conivaptan IV
Tolvaptan: selective oral
Insufficiency of ADH leads to
Diabetes Insipidus
Neurogenic
Inadequate synthesis and release of ADH
Lesion of hypothalamus
Nephrogenic
Inadequate response to ADH
Acquired from renal infection
Pathophysiology
Partial or total inability to concentrate urine
Excretion of large volumes of dilute urine
SUSPECT Diabetes Insipidus
WHEN URINE Na is
up, peeing a lot
Two ADH preparations
- Desmopressin acetate (DDAVP)
↑ antidiuretic activity; ↓vasopressor activity - Vasopressin
Non-selective - ↑Vasopressor & ↑ADH activity
Somatropin is used for…
Pediatric growth hormone deficiency (growth failure)
6 inches of growth early therapy
Contraindicated after epiphyses have closed
Regular assessments of glucose tolerance and thyroid function
Adult growth hormone deficiency
Can ↑ lean body mass, lumbar spine density
Adverse effects
Hyperglycemia
Caution with diabetics; insulin will need to be adjusted
GH-secreting pituitary adenoma causes what
In children: ↑ GH →Gigantism
Bone growth d/t non-closure epiphyseal plates
Excessive skeletal growth (8-9 feet)
In Adults: ↑ GH → Acromegaly
↑connective tissue and extracellular matrix
Gradual onset
Enlarged tongue, coarse skin & body hair
Enlargement of small bones of hands, feet, face and skull, broad nose, protruding lower jaw, slanting forehead
difference between primary and secondary hyper/hypothyroidism
Primary: Thyroid is dysfunctional, affecting the production of TH
Secondary: Pituitary or hypothalamic alterations affecting TSH production
Sole therapy for Graves
Methimazole/Propylthiouracil
inhibit (suppress) thyroid hormone synthesis by inhibiting the incorporation of iodine atoms into (tyrosine) → T3 and T4
Myxedema Coma is caused by
extreme hypothyroidism
hypothermia
hypoventilation
hypotension
hypoglycemia
inadequate tissue perfusion
