Endocrine Pathology Flashcards
Pituitary Syndromes
- gigantism
- dwarfism
- acromegaly
- diabedes insipidus
Thyroid Syndromes
- hyperthyroidism
- hypothyroidism
- thyroid cancer
Parathyroid Syndromes
- hyperparathyroidism
- hypoparathyroidism
Adrenal Syndromes
- addison’s disease
- cushing’s syndrome
- conn’s syndrome
Pancreatic Syndromes
-Diabetes Mellitus (Type I & II)
Endocrine Disorder Hierarchy
- Primary (Gland)
- Secondary (Pituitary)
- Tertiary (Hypothalamus)
Gigantism
- overgrowth of long bones
- caused by increased GH produced during childhood
Dwarfism
-too little growth hormone produced
Acromegaly Defn
-too much GH produced during adulthood
Acromegaly Treatment
- radiation/surgical removal of pit gland
- thyroid, cortisone, and hormone replacement post surgery
PT Implications of Acromegaly Post-surgery
- sneeze, cough, blowing nose is contraindicated
- monitor blood glucose
- osteophyte formation & widening of joint spaces
Diabetes Insipidus (DI)
-rare disorder of neurohypophysis: deficient production/response of ADH
ADH deficiency—>imbalance of H2O
S/Sx Diabetes Insipidus
- polydipsia
- polyurea/nocturia
- dehyddration
Neurogenic DI
- defect in synthesis or release of ADH
- usually damage to pit gland
Management of neurogenic DI
- drugs to stimulate ADH
- vasopressin
Nephrogenic DI
- kidneys don’t respond to ADH
- excessive urination & thirst
Management of Nephrogenic DI
- drugs to increase sodium excretion by kidneys (diuretics)
- anti-inflammatory meds
Diabetes Mellitus (versus DI)
- disorder of pancreas
- insufficient insulin–>abn glucose metab
- S/Sx: polydipsia, polyuria, increased appetite, fatigue
DI (versus DM)
- disorder of pit gland or kidney
- ADH deficient
- S/Sx poly dipsia, polyuria, dehydration
PT Implications of DI
- side effects of ADH administration include contraction of smooth muscle of vasculature
- side effects of water intoxication
Side Effects of Water Intoxication
3
- pulmonary crackles
- cerebral edema
- seizures
Side effects of ADH Administration
3
- incr BP
- GI Irritability
- coronary arteries
Hyperthyroidism
-imbalance of metabolism caused by over production of thyroid hormone
Common type of Hyperthyroidism
-Grave’s Disease
Grave’s Disease
- common type of hyperthyroidism
- caused by immunoregulation defect in genetically predisposed individuals, leading to production of thyroid stimulating antibodis
Causes of Hyperthyroidism
4
- non-cancerous growths of thyroid/pit glands
- tumors of testes/ovaries
- ingestion of excessive thyroid hormone
- ingestion excessive iodine
S/Sx Hyperthyroidism
12
- weight loss
- incr appetite
- nervousness
- restlessness
- heat intolerance
- sweating
- diarrhea
- tremor
- palpitations
- periarthritis
- weakness
- goiter
Vitals with Hyperthyroidsim
- incr cardiopulmonary function
- SBP elevated
Hyperthyroidism Lab Tests
- TSH decreased
- T3 elevated
- T4 normal
Storm
- thyroid crisis
- acute worsening of hyperthryroidism Sx (from stress/infection)
Sx of Hyperthyroidism Storm
3
- fever
- decreased mental alertness
- abdominal pain
Hyperthyroidism Treatment
4
- antithyroid medications
- radioactive iodine
- surgery (remove thyroid)
- beta-blockers (for heart Sx)
PT implications of Hyperthyroidism
6
- monitor vitals
- heat intol
- calcific tentonitis
- precaution with raio iodine therapy
- exercise intolerance
- decreased ex’s capacity
most common disorder of thyroid function
-hypothyroidism
Hypothyroidism
-deccrease in thyroid hormone–>decreased metabolism
Hypothyroidism S/Sx
14
- fatigue
- weakness
- weight gain
- coarse, dry hair
- dry, rough pale skin
- hair loss
- myxedema
- constipation
- depression
- irritability
- memory loss
- abnormal menstrual cycles
- decreased libido
- muscle cramps/muscle aches
Diagnosis of Hypothyroidism
-blood tests of TSH, T4
Treatment of Hypothyroidism
1
-thyroid hormone pill
Goiter
- enlarged thyroid gland
- enlarges to compensate for insufficient hormone production
Goiter associated with/causes:
4
- hyperthyroidism
- lack of iodine in diet
- inflammation
- tumors
PT Implications of Hypothyroidism
5
- edematous tissues prone to skin tears/breakdown
- watch for signs of hyperthyroidism
- gradual increase ex’s tolerance
- watch for rhabdomyolysis
- decreased SV & HR–>decr CO
Thyroid Cancer Profile
- rare
- women>men (2:1)
- 40-60 years old
Risk factors of Thyroid Cancer
-Hx radiaion to neck
Diagnosis of Thyroid Cancer
-fine-needle aspiration/biopsy
treatment of Thyroid Cancer
2
- surgical resection of thyroid
- radiation
PT considerations of Thyroid Cancer
- any palpable mass discovered in exam of neck demands referral
- dysphagia, dyspnea, hoarseness
Hyperparathyroidism
- primary/secondary/tertiary
- increase PTH disruptes calcium/phosphate ion balance in blood
S/Sx Hyperparathyroidism
4
- bone damage
- hypercalcemia
- kidney damage
- GI complaints
Diagnosis of Hyperparathyroidism
1
-PTH levels in hypercalcemic clients
Treatment of Hyperparathyroidism
4
- surgical excision of parathyroid glands
- pharmocologic: decrease serum calcium levels
- inhibit resorption of bone
- promote excretion of calcium in urine
PT Considerations of Hyperparathyroidism
9
- bone pain
- pathologic fractures
- chronic renal failure
- proximal muscle weakness
- muscle atrophy
- myalgias
- gout/pseudogout
- joint hypermobility
- osteogenic synovitis
Hypoparathyroidism
- insufficient secretion of PTH
- disrupts calcium/phosphate balance in blood
Low PTH cause:
3
- decr bone reabsorption
- GI tract absorption slows
- serum calcium levels fall
S/Sx Hypoparathyroidism
4
- neuromuscular tetany
- hypocalcemia
- +Trousseau’s Sign (arm)
- Chvostek’s Sign (face)
Diagnosis of Hypoparathyroidism
3
- Hx
- exam
- lab values
Treatment of Hypoparathyroidism
1
-increase serum calcium levels (IV)
PT Considerations of Hypoparathyroidism
1
-muscle twitching first sign of acute tetany
Adrenal Insufficiency
-Primary Adrenal Insufficiency (Addison’s Disease)
Result of Adrenal Insufficiency
-decr in glucocorticoids, mineralocorticoids and adrenal androgens
Adrenal Insufficiency profile
- women>men
- 40-60 years old
S/Sx Adrenal Insufficiency
11
- hypoglycemia
- fatigue
- hypotension
- weight loss
- NV
- dehydration
- decr CO
- decr stress tolerance
- decr coordination
- crave salty food
- incr skin pigmentation
diagnosis of Adrenal Insufficiency
2
- blood/urine hormonal assays
- clinical resposne to ACTH
Treatment of Adrenal Insufficiency
2
- pharmacologic
- synthetic corticosteroids/mineralocorticoids
PT Considerations of Adrenal Insufficiency
-be aware of side-effects of long-term steroid treatment (osteoporosis, myopathy, AVN)
Adrenocortical Hyperfunction Syndromes
- Cushing’s Syndrome
- Conn’s Syndrome
- Adrenal Hyperplasia
Cushing’s Syndrome
-too much cortisol (glucocorticoid)
Conn’s Syndrome
-too much mineralocorticoid (aldosterone)
Adrenocortical Hyperfunction cause
2
- overstimulation of adrenal gland
- medication-induced hypercortisolism
S/Sx Adrenocortical Hyperfunction
5
- protuberant abdomen
- poor wound healing
- thin skin
- general weakness
- marked osteoporosis
Diagnosis of Cushing’s Disease
- presentation
- levels of urine & serum cortisol
Treatment of Cushing’s Disease
4
- decrease cortisol levels gradually
- radiation
- surgery
- drug therapy
PT considerations for Cushing’s disease
-aware of side effects of long term steroid treatment (osteoporosis, AVN, myopathy)
S/Sx Cushing Syndrome
4
- lipoma on back of neck/upper TS
- bruise easily
- round face
- abnormal facial hair growth
S/Sx Conn’s Syndrome
9
- hypernatremia
- hypervolemia
- hypokalemia
- metablic alkalosis
- HTN
- polyuria
- polydipsia
- DM
Fasting Blood Glucose Levels
80-120
60-100 for children
Diagnosis of Conn’s Syndrome
- elevation in serum and urine hormone levels
- CT scan of abdomen for tumors
Treatment of Conn’s Syndrome
- surgical excision of tumor
- pharmacologic: incr sodium excretion, decr HTN, increase K+
PT Considerations Conn’s syndrome
4
- evidence of tetany
- cardiac arrhythmias
- parestheisas
- muscle weakness
Hypoglycemia
- Low Blood Sugar
- not enough to fuel body’s blood cells
Causes of Hypoglycemia
8
- too much insulin in diabetics
- other drugs
- psychological disturbances
- alcohol intake w/o eating
- missing a meal
- strenuous ex’s
- insulin producing tumor in pancreas
- hypokalemia
Sx of Hypocalcemia
12
- shakiness
- dizziness
- sweating
- hunger
- HA
- irritability
- pale skin color
- sudden moodiness
- behavior changes
- clumsy/jerky movements
- diff paying attn/confusion
- tingling around mouth
Diagnosis of Hypoglycemia
4
- med Hx
- med exam
- blood tests
- blood sugar/insulin levels
Treatment of Hypoglycemia
4
- consume sugar
- glucagon
- small frequent meals
