Endocrine System Flashcards
Addison’s Disease
- Low cortisol, lack of aldosterone by the adrenal gland
- Assess blood pressure (low) and heart rhythm (high)
- Presentation:
hyperpigmentation
weak
craves salty food
hypoglycemic
-Addisonian Crisis:
similar to signs of shock
tachycardia
hypotension
pallor
tachypnea
hyponatremia
hyperkalemia
-Treatment:
avoid caffeine
avoid alcohol
high protein
high carbs
lifelong steroid treatment
normal cortisol levels: 5-25
Cushing’s Disease and Syndrome
- High cortisol due to hypersecretion of glucocorticosteroids
-Presentation
osteoporosis
upper body obesity and thin extremeties
amenorrhea
elevated triglycerides and hypertension
increased thirst and urination
hypernatremia
-Dexamesthasone test (9-10 hour test) if cortisol is suppressed it indicates pituitary axis is working normally
-Medications:
metyrapone
aminoglutethimide
mitotane
ketoconazole
Diabetes Insipidus
-low ADH = high urine output
-increase fluids
-Presentations:
decreased urine specific gravity (diluted urine, <1.005)
decreased urine osmolarity
increased sodium
polyuria, polydipsia
tachycardic and dehydrated
weak pulses
hypotension
-treatment:
vasopressin (ADH)
SIADH
- High ADH = low urine output
-restrict fluids to 500 - 1,000 mL per day
-Presentations:
increased urine specific gravity (>1.030)
decreased sodium
confused
seizures
weakness
anorexia, nasuea, vomiting (from low sodium)
weight gain
Hypoglycemia vs Hyperglycemia
-Hypoglycemia:
sweating
tachycardia
tremors
palpitations
hunger
anxiety
-Hyperglycemia:
warm skin
rapid respirations
changes in mental status
DKA
- elevated BUN (>20), creatinine(>1.5), specific gravity (>1.030)
- blood sugar 300-800 (less than 300 is an improvement)
- common for type I diabetes
- caused by missed dose of insulin, infection, untreated diabetes
- polyuria, polydipsia, polyphagia
- metabolic acidosis with ketonuria
- kussmaul’s respirations
- treat with IV fluids 0.9% IV fluids followed by 0.45%, followed by D5W once blood glucose is <250. Secondly, treat with insulin at 0.1mg/kr/hr (regular insulin is the only one that can be given IV). check glucose hourly
- monitor K+
HHS
- high urine specific gravity, high BUN,
- hypotension, tachycardic
- administer fluids as you would with DKA
- blood sugar >600
Thyroid Storm
- Individual’s heart rate, blood pressure, and body temperature can soar to dangerously high levels.
- can happen after thyroidectomy, monitor temp.