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z_MEDSURGE: FINAL REVIEW > Endocrine: Thyroid and Adrenal Disorders > Flashcards

Endocrine: Thyroid and Adrenal Disorders Flashcards

1
Q

What do T3/T4 hormones control?

A

Metabolism
Energy
Fluid balance
Tissue use of macronutrients

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2
Q

What hormones does the thyroid produce?

A

Thyroxine (T4)
Thriiodothyronine (T3)
Thryocalcitonin (Calcitonin)

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3
Q

What does calcitonin do?

A

Inhibits release of calcium from bone

Induces kidneys to excrete calcium

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4
Q

What is hyperthyroidism?

A

A hypermetabolic state that affects all body systems and exaggerates normal body function (everything is up!)

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5
Q

What is the most common cause of hyperthyroidism and explain it?

A

Grave’s disease
It is an autoimmune disease that produces antibodies that trigger the thyroid to release T3/T4 even when the pituitary has stopped releasing TSH.

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6
Q

What are some other causes of hyperthyroidism?

A

Family hx
Enlarged goiter or thyroid gland
Thyroid tumors
Excessive iodine consumption

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7
Q

What do we keep in mind re: s/s w/ hyperthyroidism?

A

They are all elevated with additional weight loss (due to hyperbolic state) and irregular menses

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8
Q

A thyrotoxic crisis is also called a…

A

thyroid storm

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9
Q

What is a thyrotoxic crisis?

A

emergent and most severe form of hyperthyroidism

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10
Q

What are some things that can trigger a thyrotoxic crisis?

A

Infection
Trauma
Emotional stress
Subtotal thyroidectomy / thyroid is manipulated

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11
Q

What are the s/s of thyrotoxic crisis?

A

acute exacerbation of all hyperthyroidism s/s w/ marked tachycardia, hyperpyrexia, cns irritability, heart failure and coma

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12
Q

What are the four diagnostic tests used for hyperthyroidism?

A

Serum TSH
Serum free T3
Radioiodine uptake
Radioiodine scintiscan

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13
Q

What do the results of a Serum TSH indicate?

A

HIGH TSH:
Thyroid is underactive and TSH is working to stimulate the thyroid to produce more hormones
LOW TSH:
Thyroid is overactive and pituitary is suppressing TSH to reduce thyroid hormone production

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14
Q

What do the results of Serum Free T3 indicate?

A

High = hyperthyroidism
Low = Hypothryroidism
Both will require further testing

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15
Q

What does the Radioiodine uptake show?

A

Hot and cold nodules
Hot = producing hormones
Cold = not
This scan cannot tell if nodules aren’t functioning due to non/malignancy

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16
Q

What does the Radioiodine scintiscan show?

A

That the gland is working properly and can determine malignancy of nodules/tumors

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17
Q

What is hypothyroidism?

A

Under production of thyroid hormone resulting in decrease in metabolic rate

18
Q

What are PRIMARY causes of hypothyroidism?

A 
Iodine deficiency
Thyroiditis/atrophy
Neck radiation
Manipulation of gland
PTU induced decrease in synthesis of TH
19
Q

What are SECONDARY causes of hypothyroidism?

A

Pituitary dysfunction or removal

20
Q

What are TERTIARY causes of hypothyroidism?

A

Hypothalmic reduction in release of TRH

21
Q

What is myxedema coma?

A

a severe form of HYPOthyroidism that most commonly occurs in individuals with undiagnosed or untreated hypothyroidism who are subjected to an external stress
exaggerated hypothyroidism

22
Q

What are the s/s of myxedema coma?

A 
Altered mental status
Hypothermia
Bradycardia
Hypercarbia
Hyponatremia
Cardiomegaly (overworked heart), pericardial effusion, cardiogenic shock, and ascites (the accumulation of fluid in the peritoneal cavity, causing abdominal swelling) may be present
23
Q

What are the key characteristics of myxedema coma to keep in mind?

A

Develops slowly
>50% mortality rate
It needs prompt and aggressive treatment

24
Q

Re: myxedema coma

How do we treat hypoventilation, hypoglycemia, hypothermia and hypotension?

A 
Hypoventilation = O2, intubate if unconscious
Hypoglycemia = IV glucose
Hypothermia = give blanky NOT electric
Hypotension = fluids, as always
25
Q

S/S in hypothyroidism are generally

A

supressed

26
Q

The adrenal medulla produces

A

ephedrine, norepinephrine and dopamine

27
Q

The adrenal cortex produces

A

Glucocorticoids (cortisol)
Mineralocorticoids (aldosterone)
both of the above are steroids
Androgen

28
Q

What does cortisol do?

A

regulates BP, metabolism, anti-inflammatory response, emotional behavior

29
Q

What does aldosterone do?

A

Regulates sodium levels and in tern, fluid levels, BP, etc

30
Q

Cortisol deficiency results in…

A

altered (slowed) metabolism, decreased stress tolerance, emotional lability

31
Q

Aldosterone deficiency results in…

A

urinary loss of sodium, chloride and water resulting in dehydration and electrolyte imbalances

32
Q

The release of cortisol, aldosterone and androgen are stimulated by the release of what from where?

A 
adrenocorticotropic hormone (ACTH)
anterior pituitary
33
Q

Is adrenal insufficiency primary or secondary?

A

can be either

34
Q

Secondary insufficiencies typically occur from disorders of…

A

the pituitary gland

35
Q

What is Addison’s disease?

A

deficiency of adrenocortical hormones following destruction of adrenal cortex

36
Q

What is the primary cause for Addison’s?

A

pathologic condition of adrenals

37
Q

What is the secondary cause of Addison’s?

A

caused by prior tx w/ glucocorticoids

pituitary issues that inhibit ACTH

38
Q

Glucocorticoid deficiency results in…

A

o Retards mobilization of tissue protein & Inhibits the liver’s ability to store glycogen

39
Q

Decreased aldosterone:

A

Na, Cl & water loss & increased K

40
Q

Characteristics of Acute Adrenal Insufficiency/Addisonian Crisis:

A 
Life-threatening
Cortisol & aldosterone (lose function)
Acute adrenal insufficiency (Addison’s) Crisis follows:
	Stress
	Most common
•	steroid withdrawal
	Adrenalectomy
	Removal of adrenal tumor   
	Destruction of pituitary
	Injury to adrenals

z_MEDSURGE: FINAL REVIEW (15 decks)

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