endocrine med surg Flashcards by Michael Charles

what causes diabetic ketoacidosis

no insulin so cells breakdown protein/fat and produce ketones

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respiratory signs of DKA

kussmaul respirations

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what type of diabetes causes DKA

type 1 (no insulin)

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rapid deep breathing at a consistent pace is called

kussmaul respirations

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hyperglycemia over 600+ is what disease

hyperglycemic hyperosmolar nonketotic syndrome (HHNS)

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what to give IV to unconcious pt w hyperglycemia

50% dextrose (d50)

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graves disease is caused by what thyroid issue

hyperthyroidism

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hashimotos disease is caused by what thyroid issue

hypothyroidism

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myxedema coma is caused by what thyroid issue

hypothyroidism

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what hormone controls calcium lvls in blood

parathyroid hormone

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causes of hyperparathryroidism

-tumor on parathyroid
-chronic kidney failure

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the increase of calcium in blood can cause what with hyperparathyroidism

kidney stones

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how hyperparathyroidism affects the joints

-bone pain
-pathological fractures

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how hyperparathyroidism affects the GI system

-abd pain
-N/V
-weight loss/loss of appetite
-constipation

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how hyperparathyroidism affects the neuro system

-irritability
-confusion

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how hyperparathyroidism is treated

parathyroidectomy

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medications for hyperparathyroidism

phosphates
calcitonin
IV/oral biphosphonates

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diet for hyperparathyroidism pt

increase fiber
moderate calcium

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mneumonic for hyperparathyroidism s/s

stones, bones, moans and groans

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relationship between calcium and phosphorus

inverse

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calcium lvls in hypoparathyroidism

low

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radiation can cause what parathyroidism

hypo

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magnesium depletion can cause what parathyroidism

hypo

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how does hypoparathyroidism affect the neuro system

-numbness/tingling
-anxiety
-irriability
-depression

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how does hypoparathyroidism affect the muskuloskeletal system

-muscle cramps -tetany

how does hypoparathyroidism affect the cardiovascular system

hypotension

how to test for hypoparathyroidism (same as hypocalcemia)

-trousseau -chvostek sign

results of chvostek and trousseau in hypoparathyroidism

positive

how to treat hypoparathyroidism

IV calcium phosphorus binding drugs

hypoparathyroidism diet

increase calcium decrease phosphorus

what do adrenal cortex hormones do to sodium and water

retain them

what do adrenal cortex hormones do to potassium

decrease

what kind of hormone are glucocorticoids

adrenal cortex hormones

what kind of hormones are mineralocorticoids

adrenal cortex hormones

what kind of hormones are sex. hormones

adrenal cortex hormones

what causes cushings disease

too many adrenal cortex hormones (females, too much cortisol meds, adrenal gland tumor)

cushings disease affect on glucose lvls

increased

cushings disease affect on sodium

increased

cushings disease effect on cardiovascular system

-htn (that cush will raise ur BP)

cushings disease effect on weight

weight gain

cushings disease affect on sex hormones

hirtuism (that cush will turn u into a man)

cushings s/s

moon face buffalo hump truncal obesity supraclavicular fat pads

how long will cushings disease pts need clucocorticoid replacement after adrenalectomy

forever

how is cushings disease treated

adrenalectomy

what is Glycosylated hemoglobin levels

hbA1c

what is Somogyi

hypoglycemia when sleeping that turns into hyperglycemia in the morning

causes of addison's disease

-adrenal gland removal -adrenal gland infection -TB -cytomegalovirus -bacterial infection

constitutional sxs of addisons disease

-fatigue

GI sx's of addisons disease

-N/V/D -anorexia

endocrine sxs of addisons disease

hypoglycemia

electrolyte signs of addisons disease

-decreased Na -decreased H2O -increased potassium

integumentary sxs of addisons

-hyperpigmentation -vitiligo

neuro sxs of addisons disease

-confusion

where are the adrenal glands

on top of the kidneys

constitutional sx's of addisonian crisis

-profound fatigue

electrolyte sxs of addisonian crisis

-dehydration -shock -hyponatremia -hyperkalemia

cardio sxs of addisonian crisis

-hypotension -hypovolemia -vascular collapse

renal sxs of addisonian crisis

-renal failure

treatment for addisonian crisis

-fluid resuscitation -high dose hydrocortisone

how to treat addisons disease

-glucocorticoid -mineralcorticoid

addisons pt diet education

increase protein and carbs

what does ADH control

amount of water in blood

where is ADH found

the pituitary gland

what are the 2 ADH pituitary gland disorders

Syndrome of inappropriate antidiuretic hormone (SIADH)

simple pathology of SIADH

too much ADH

causes of SIADH

-pulmonary diseases -CNS disorders -HIV -meds

what pulmonary diseases cause SIADH

-TB -severe pneumonia

what CNS disorders cause SIADH

-head injury -brain surgery -tumor

what meds cause SIADH

-vincristine -phenothiazines -antidepressants -thiazide diuretics -anticonvulsants -diabetes drugs -nicotine

s/s of SIADH

-oliguria -fluid volume overload -weight gain w/o edema -hyponatremia -N/V -tachycardia -HTN

meds for SIADH

-loop diuretics -vasopressin antagonists

what precautions should SIADH pts be put on

seizure

should SIADH pts be put on fluid restrictions

yes

simple pathology of diabetes insipidus

not enough ADH

neuro causes of diabetes insipidus

-head trauma -brain tumor -CNS infection -pituitary gland surge

renal causes of diabetes insipidus

renal tubles cant respond to ADH

urine sx's of diabetes insipidus

-polyuria -large amounts of dilated urine -low urine specific gravity

endocrine sx's of diabetes insipidus

-polydipsia -polyuria -large amounts of filated urine -low urine specific gravity

integumentary sxs of diabetes insipidus

-decreased skin turgor

ENT sx's of diabetes insipidus

-dry mucous membranes -dehydration

cardio sx's of diabetes insipidus

-postural hypotension -tachycardia

neuro sx's of diabetes insipidus

-headache

muskuloskeletal sx's of diabetes insipidus

-muscle pain -muscle weakness

sxs of diabetes insipidus

neuro: -headaches ENT: -dry mucous membranes -dehydration cardio: -tachycardia -postural hypotension endocrine: -polyuria -polydipsia -low urine specific gravity -lots of diluted urine integumentary: -decreased skin turgor (dry skin) muskuloskeletal: -muscle pain -muscle weakness

what kind of saline should u give diabetes insipidus pt

IV hypotonic saline

what do vasopressin and desmopressin do

replace ADH

what meds would you treat diabetes insipidus with

vasopressin desmopressin

what should u monitor in diabetes insipidus pt

-I&O -weight

what hormones are made in the adrenal glands

epinephrine and norepinephrine

what is an adrenal gland tumor called

pheochromocytoma

what does pheochromocytoma do

causes adrenal glands to secrete excessive amounts of epinephrine and norepinephrine

what causes pheochromocytoma

family history of adrenal gland tumors