Endocrine lecture

Question 1

Endocrine system parts

Answer 1

Pineal gland
Hypothalymus
Thyroid/ parathyroid
Thymus
Pancreas
Ovary/ Testes
Placenta

Question 2

Endo vs exo definitions

Answer 2

Endo- distance (vascular)
Exo- Ducts (sweat, salivary)

Question 3

Types of hormones

Answer 3

Steroids- cortisol, aldosterone
Tyrosine derivatives- t3, t4, norepi, epi
Peptide/ protein- many insulin, gh, adh, vasopressin
Others- endocannibinoids, vit d3

Question 4

HPA Axis

Answer 4

Stimulatory hormone
Target gland
Target tissue

Question 5

3 stages of thermoregulation

Answer 5

Afferent- skin, deep tissue, spinal cord
Central regulation- hypothalymus preoptic region, brainstem
Efferent response- if its cold->vasoconstrict, piloerection, shivering, non shivering thermogenesis if its hot- vasodilation and diaphoresis

Question 6

Core body temp can be taken from

Answer 6

Bladder
Rectum
Esophagus
Nasopharynx risk epistaxis
External auditory meatus risk TM rupture
PA catheter

Question 7

Hypothermia consequences

Answer 7

Vasoconstriction/ hypoperfusion
Shivering increases O2 consumption
Risk of MI
PVR increases, makes resp difficult
Hepatic blood flow decreases and decreases clearance
CMRO2 decreases 7% for every 1 degree drop in temp
MAC decreases 7% for every degree drop

Question 8

What is a sever burn injury?

Answer 8

> .40

Question 9

What happens after severe burn injury

Answer 9

Hypermetabolic/ hyperthermodynamic phase starting 24 hours and lasting 2 years
MODS
Blunted growth
Insulin resistance
Risk of infection
10-50x catecholamine surges

Question 10

Surgery time limit for severe burns

Answer 10

2 hours if below 35c or >1.5 below baseline or if 10 prbcs

Question 11

What does the anterior pituitary gland secrete

Answer 11

GH
Corticotropin
TSH
FSH
LH
Prolactin

Question 12

What does the posterior pituitary gland secrete

Answer 12

ADH/ vasopressin
Oxytocin

Question 13

What is the opposite of PTH hormone

Answer 13

Calcitonin

Question 14

Criteria for adequate fluid resuscitation

Answer 14

Normal bp
UO 1-2ml/kg/hr
Lactate <2

Question 15

patho of shivering

Answer 15

induced by cooling of preoptic region of hypothalymus which causes heat production

Question 16

prevention of post of shivering

Answer 16

meperdine is most common 50mg
synthetic opioid agonist- mu, kappa
decrease shivering twice as musch threshold
contraindicated in renal, maoi use

Question 17

MH triggers

Answer 17

volatile agents
succ
NO N2O
NO tiva

Question 18

dantrolene dose

Answer 18

2.5mg/kg q5min

Question 19

prolactin and dopamine

Answer 19

inverse relationship

Question 20

too much oxytocin

Answer 20

infertility