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Primary Care > Endocrine System Screen > Flashcards

Endocrine System Screen Flashcards

1
Q

What other systems can the endocrine system effect?

A 
General health 
Psychologic/cognitive
Gastrointestinal
Urogenital
MSK
Sensory
Dermatologic
Misc - Temp intolerance, visual changes, bruising, orthostatic hypo, increased thirst
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2
Q

Pituitary Gland: Diabetes Insipidus (definition/ signs and symptoms)

A

Lack of secretion of vasopressin (antidiuretic hormon, ADH) - NOT sugar based/not sugar imbalanced, always thirsty

Signs/symptoms: Polyuria, Polydipsia
Dehydration
Fatigue
Irritability
Increased serum sodium
Decreased Urine gravity
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3
Q

Pituitary Gland: Acromegaly (Def + signs and symptoms)

A

Hypersecretion of growth hormone (GH_ most often due to a tumor in the pituitary gland

Signs/Symptoms
Bony enlargement
Amenorrhea - menstrual cycle
Profused sweating/diaphoresis
Hypertension
Carpal tunne/hand stiffness/pain 
Back pain (thoracolumbar)
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4
Q

Adrenal Gland: Addison’s Disease

A

Hyprosecretion of adrenal glands, due to autoimmune response or tumor, treated with cortisol/hormone replacement

Signs/symptoms
Dark pigmentaion of skin
Progressive fatigue 
Hyperkalemia - affects muscles and neuro control 
Hypotension
GI disturbances
Arthalgias, myalgias, 
tendon calcification
hypoglycemia
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5
Q

Adrenal Gland: Cushing’s Disease

A

Hypersecretion of cortisol by adrenal glands, due to tumor, excessive corticosteroids or pituitary disfunction

Signs/Symptoms
Weight gain
Fatty deposit, midsection + face (moon) and buffalo hump 
Thinning skin that bruises easily
Skin injuries that are slow to heal
Fatigue 
Muscle weakness
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6
Q

Thyroid Gland: Hyperthyroidism/graves disease

A

Hyperfunction = too much thyroid hormone

Sign/Symptoms
Elevation in body metabolism
3 major signs in adults > 70 (tachycardia, fatigue, weight loss)
Signs in adults < 50 (tachycardia, hyperactive reflexes, increased sweating, heat intolerance, fatigue, tremor, nervousness, polydipsia, weakness, increased appetite, dyspnea, and weight loss

Other signs/sxs
Periarthritis (shoulder)
proximal muscle weakness and atrophy
Higher incidence of myasthenia gravis

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7
Q

Thyroid Glad: Hypothyriodism

A

Hypofunction = insufficient thyriod hormone

Signs/Sxs
Generalized depression in body metabolism
Constipation
Depression
Dry Hair and hair loss
Dry skin
Fatigue
Greater sensitivity to cold
Slow heart rate
Swelling of the thyroid glad (goiter)
Unexplained weight gain or difficulty losing weight
Carpal tunnel syndrome
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8
Q

Pancreas: DM

A

Deficient or defective insulin

Long term sequela
- State of hyperglycemia, distruption in metabolism of carbohydrates, fats, and protiens, small vessel disease, large vessel vascular complications, neuropathies

Signs/sxs 
polyuria, polydipsia, polyphasgia
Neuropathy numbness/tingling, feet hands
Blurred vision, irritability
hand stiffness
Glycosuria, ketouria
Fatigue and weakness
Slow healing
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9
Q

DM exercises related complications

A

must be planned, executed with caution
Monitor glucose before, during, after exercise
Blood glucose > 250 post
Blood glucose <100mg give 10-15g carb snack

Retinopathy & Neuropathy (AVOID HIIT)
AVOID insulin injection to active extremities within 1 hour of exercise

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10
Q

Severe Hyperglycemic states - uncontrolled or untreated DM

A

Can progress to severe hyperglycemia > 400 mg

Diabetic ketoacidosis (DKA)

Hyperglycemic, hyperosmolar, nonketotic coma (HHNC)

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11
Q

When should you test blood glucose and refer immediately?

A

If confused, lethargic, changes in mental function

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12
Q

What are upper GI system checklist?

A

Swallowing difficulties
Indigestion, heart burn
Food intolerance

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13
Q

What are lower GI system checklist?

A

Bowel dysfunction

  • color of stool
  • Shape, caliber of stool
  • constipation
  • Diarrhea
  • Difficulty initiating
  • Incontinence
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14
Q

What are the potential causes of dysphagia (muscle coordination)

A

myasthenia gravis
MS
Amyotriohic lateral sclerosis
Parkinsons

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15
Q

What are the potential causes of dysphagia (mechanical obstruction)

A

Neoplasms
Goiter of thyroid gland
Cx spinal osteophytes
Aortic Aneurysm

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16
Q

Clinical manifestations of dysphagia (MOTOR)

A

Gradual onset
Slow progression
Equal difficulty swallowing sold foods vs liquids
Swallowing cold substances = worsening difficulties
Bolus passage - facilitated by repeating swallowing, valsalva maneuver throwing back head and shoulder s

17
Q

Clinical manifestations of dysphagia (mechanical)

A 
Faster onset
Faster progression
More difficulty swallowing solids
Swallowing not affected by temp 
Can be accompanied by regurgitation
18
Q

Possible causes of Upper GI (heartburn, indigestion, dyspepsia

A

GERD
Peptic Ulcer
NSAID use
Insidious onset

19
Q

What questions do you ask Upper GI patients?

A 
How long have you had these symptoms?
Do you know whats causing them?
Constant or intermittent?
How are you treating these symptoms?
Any associated symptoms?  (fatigue, weakness, SOB)
20
Q

What are common irritants/triggers for upper GI foods intolerance?

A

Cheeses, chocolate, citrus fruits, nuts, red wine

Timing intake is important with PT

21
Q

Upper GI: Bowel dysfunction/Melena

A

Melena: passage of black tarry stools

GI bleeding, probably upper GI origin (esophagus, stomach, duodenum)

Follow up questions: how long have you had black tarry stools, fave you felt light headed, any nausea, sweating with these stools?

Check HR and BP

22
Q

Indicators of Bowel Dysfunction?

A 
Color of stool
Shape color
Constipation 
Diarrhea
Difficulty initiating
Incontinence

Have you noticed and difficulties with bowel?

Notice any changes

23
Q

Constipation: Impaired motility

A 
Inadequate fiber
Inactivity 
Diverticulitis 
Hypothyriodism
Hypercalemia
Scleroderma
24
Q

Constipation: neurologic dysfunction

A

MS

Spinal cord injury

25
Q

Constipation: psychosocial

A

depression
Situational stress
Anxiety

26
Q

Potential causes of diarrhea

A 
Infections agents
laxative abuse 
Colon cancer 
IBS
Crohn's disease 
Ulcerative collitus 
Diabetic enteropathy
27
Q

Constipation and diarrhea screening questions

A 
How long have you been constipated?
Last time for bowel movement?
Do you have periods of constipation alternating with periods of diarrhea? 
Associated symptoms?
Recent changes in diet or fluid intake?
Medication changes ?
28
Q

Possible manifestations of dehydraiton

A 
Rapid breathing
Confusion
Postural hypotension
Rapid pulse >100bpm
Irritability
Dizziness
Headache
Increased thirst
Skin turgor
Capillary refil
Darker urine color
Dry mouth
29
Q

Lower GI: Hematochezia

A

Passage of bright blood red stools

Origin: L side of the colon or anorectal area

Screening question

How long have you noticed?
Red blood mixed in the stools or not?
Any associated symptoms? Irritating bowel movements or feeling of lightheadedness or fatigue

30
Q

Lower GI: Colon Carcinoma

A

Malignancy in large intestine

Orgin: polyps in color (upper) or rectum (lower)

Screening: unusual shape in stool, pencil like in diameter? ribbon like?
Any blood in stool?

31
Q

Possible symptoms for Colon Carcinoma

A 
Change in bowel habits
Blood in toilet
Weakness
Constipation
Diarrhea
Fatigue
Rectal Bleeding
Abdominal Pain, cramps, gas, Unexplained weight loss

Primary Care (11 decks)

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