Endocrine system

Question 1

addison’s disease causes an increase in the melanocyte-stimulating hormone….how does this manifest in PTs?

Answer 1

some PTs will have abnormally dark and pigmented skin

Question 2

indications of Addison’s disease (adrenal insufficiency) include:

Answer 2

fatigue, weakness, dehydration, decreased resistance to stress, alopecia (hair loss), and abnormally dark and pigmented skin

Question 3

what is levothyroxine sodium (synthroid)

Answer 3

synthroid is a thyroid hormone that increases metabolic processes in the body, including glomerular filtration, therby increasing UO; edema will decrease as water is excreted through the kidneys

Question 4

normal glucose level

Answer 4

60-110mg/DL

Question 5

what is a transsphenoidal hypophysectomy

Answer 5

the surgical removal of the hypophysis (pituitary gland). It is most commonly performed to treat tumors, especially craniopharyngioma tumors. Sometimes it is used to treat Cushing’s syndrome due to pituitary adenoma.

Question 6

What are complications of a thyroidectomy (removal of thyroid gland)

Answer 6

hemorrhage, respiratory distress, tetany caused by parathyroid injury, damage to laryngeal nerves

Question 7

why do we administer strong iodine solution to PTs BEFORE they undergo total thyroidectomy surgery?

Answer 7

decreases release of thyroid hormones, decreases basal metabolic rate, reduces vascularity and size of thyroid which reduces chance of postop hemorrhage
-iodine solution is given 10-14 days before surgery

Question 8

causes of addison’s disease

Answer 8

1. damage to adrenal cortex: Adr gland tumors, Adr gland TB, Adr gland infection, Adr gland hemorrhage
2. Pituitary gland dysfunction (decr ACTH)
3. Abrupt Corticosteroid withdrawal

Question 9

Addison’s disease

Answer 9

hypofunction of the adrenal cortex

Question 10

functions of adrenal cortex

Answer 10

secretes gluco- and mineralocorticoids, and androgens

Question 11

nutrition recommendations for PT with Cushing’s disease

Answer 11

high protein, high potassium, low sodium, low calorie, and low carb

Question 12

primary glucocorticoid

Answer 12

cortisol (steroid)

Question 13

primary role of glucocorticoids

Answer 13

provide rapid energy from conversion of protein and fat into glucose; they are also anti-inflammatory agents

Question 14

what is Cephulac

Answer 14

a laxative that promotes excretion of ammonia (used with PTs who have hepatic encephalopathy)

Question 15

hepatic encephalopathy

Answer 15

a brain dysfunction and damage caused by increased ammonia in the blood, resulting from severe liver disease

Question 16

How to reduce serum ammonia?

Answer 16

Eliminate dietary protein and administer antibiotics.

Cephulac (laxative) can also promote excretion of ammonia in stools.

Question 17

gastrectomy

Answer 17

surgical excision of all or (more commonly) part of the stomach for treatment of an ulcer or removal of a malignancy

Question 18

cholecystitis

Answer 18

inflammation of gallbladder

Question 19

Laennec’s cirrhosis

Answer 19

liver disease caused by alcohol

Question 20

postnecrotic cirrhosis

Answer 20

liver diseased caused by viral infections or toxins

Question 21

biliary cirrhosis

Answer 21

liver disease caused by bile stasis or obstruction

Question 22

what’s the most common symptom for a PT with a duodenal ulcer

Answer 22

epigastric pain

Question 23

senstaken-blakemore tube

Answer 23

3-lumen nasoenteric tube used to treat bleeding esophageal varices by applying pressure to sites of bleeding

Question 24

what is Isosorbide

Answer 24

a nitrate vasodilator (used to treat and prevent angina)

Sublingual is for treatment; PO is for prevention