Endocrine System Screen Flashcards
What other systems can the endocrine system effect?
General health Psychologic/cognitive Gastrointestinal Urogenital MSK Sensory Dermatologic Misc - Temp intolerance, visual changes, bruising, orthostatic hypo, increased thirst
Pituitary Gland: Diabetes Insipidus (definition/ signs and symptoms)
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
Pituitary Gland: Acromegaly (Def + signs and symptoms)
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)
Adrenal Gland: Addison’s Disease
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
Adrenal Gland: Cushing’s Disease
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
Thyroid Gland: Hyperthyroidism/graves disease
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
Thyroid Glad: Hypothyriodism
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
Pancreas: DM
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
DM exercises related complications
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
Severe Hyperglycemic states - uncontrolled or untreated DM
Can progress to severe hyperglycemia > 400 mg
Diabetic ketoacidosis (DKA)
Hyperglycemic, hyperosmolar, nonketotic coma (HHNC)
When should you test blood glucose and refer immediately?
If confused, lethargic, changes in mental function
What are upper GI system checklist?
Swallowing difficulties
Indigestion, heart burn
Food intolerance
What are lower GI system checklist?
Bowel dysfunction
- color of stool
- Shape, caliber of stool
- constipation
- Diarrhea
- Difficulty initiating
- Incontinence
What are the potential causes of dysphagia (muscle coordination)
myasthenia gravis
MS
Amyotriohic lateral sclerosis
Parkinsons
What are the potential causes of dysphagia (mechanical obstruction)
Neoplasms
Goiter of thyroid gland
Cx spinal osteophytes
Aortic Aneurysm
Clinical manifestations of dysphagia (MOTOR)
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
Clinical manifestations of dysphagia (mechanical)
Faster onset Faster progression More difficulty swallowing solids Swallowing not affected by temp Can be accompanied by regurgitation
Possible causes of Upper GI (heartburn, indigestion, dyspepsia
GERD
Peptic Ulcer
NSAID use
Insidious onset
What questions do you ask Upper GI patients?
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)
What are common irritants/triggers for upper GI foods intolerance?
Cheeses, chocolate, citrus fruits, nuts, red wine
Timing intake is important with PT
Upper GI: Bowel dysfunction/Melena
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
Indicators of Bowel Dysfunction?
Color of stool Shape color Constipation Diarrhea Difficulty initiating Incontinence
Have you noticed and difficulties with bowel?
Notice any changes
Constipation: Impaired motility
Inadequate fiber Inactivity Diverticulitis Hypothyriodism Hypercalemia Scleroderma
Constipation: neurologic dysfunction
MS
Spinal cord injury
Constipation: psychosocial
depression
Situational stress
Anxiety
Potential causes of diarrhea
Infections agents laxative abuse Colon cancer IBS Crohn's disease Ulcerative collitus Diabetic enteropathy
Constipation and diarrhea screening questions
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 ?
Possible manifestations of dehydraiton
Rapid breathing Confusion Postural hypotension Rapid pulse >100bpm Irritability Dizziness Headache Increased thirst Skin turgor Capillary refil Darker urine color Dry mouth
Lower GI: Hematochezia
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
Lower GI: Colon Carcinoma
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?
Possible symptoms for Colon Carcinoma
Change in bowel habits Blood in toilet Weakness Constipation Diarrhea Fatigue Rectal Bleeding Abdominal Pain, cramps, gas, Unexplained weight loss
