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M/S 3 > Exam 5 - Endo > Flashcards

Exam 5 - Endo Flashcards

1
Q

what is pheochromcytoma

A

tumor of medulla (center) of adrenal glands

can be a single tumor or multiple

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2
Q

what occurs with pheochromcytoma

A

excessive production of catecholomines (epi, norepi)

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3
Q

are men or women more likely to have pheochromcytoma

A

equally common in men and women

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4
Q

pheochromcytoma age

A

can occur at any age, rarely after 60

textbook says peak is 40-60 years

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5
Q

are pheochromcytoma tumors malignant or benign

A

90% are benign

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6
Q

risk factors for pheochromyctoma

A

family hx
tumors in other glands
hormonal disorders
genetic disease

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7
Q

s/sx of pheochromyctoma is directly related to which type of bodily response

A

fight or flight

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8
Q

s/sx of pheochromyctoma

A

hyperglyemic
HTN (rapid onset, abrupt cessation)
HA ** (#1 s/sx)
N/V
abdominal, CP
tachycardia
agitation
emotional instability
diaphoresis
increased metabolic rate

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9
Q

acute attacks r/t pheochromyctoma

A

profuse diaphoresis
dilated pupils
cold extremities
severe HTN (can lead to stroke, sudden blindness)
c/o black floaters

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10
Q

normal range for urinary catecholamines

A

14g/100 mL of urine

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11
Q

normal vanillylmandelic acid (VMA)

A

< 7 mg over 24 hours

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12
Q

how will does alpha blockers help with pheochromcytoma

A

relax muscles
keep small blood vessels open

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13
Q

alpha blocker SE

A

orthostasis
nasal stuffiness
increased fatigue
retrograde ejaculation

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14
Q

how do beta blockers help with pheochromcytoma

A

heart beast more slowly, less forceful
stops norepi

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15
Q

pheochromcytoma complications

A

HTN
MI
HF
stroke
kidney failure
cognitive decline
dementia
visual impairment

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16
Q

pheochromcytoma treatment if medication therapy is not effective

A

adrenalectomy

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17
Q

should you palpate the abdomen is a person has or suspected to have pheochromcytoma

A

no bc it can cause a release in additional catecholamines

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18
Q

5 H’s of pheochromcytoma

A

HTN
HA
hypermetabolism
hyperglycemia
hyperhidrosis

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19
Q

what type of drinks should be avoided prior to adrenalectomy

A

caffeine

coffee, tea, cola, energy drinks

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20
Q

adrenalectomy requires what for life

A

cortical replacement therapy

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21
Q

diabetes insipidus (DI) is a disorder of what gland

A

posterior pituitary gland

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22
Q

what is there a deficiency of with DI

A

ADH (vasopressin)

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23
Q

DI results in the inability to conserve what

A

water

will have a large amount of UOP

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24
Q

what are the 4 types of DI

A

neurogenic
nephrogenic
dipsogenic
gestagenic

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25
Q

neurogenic vs. nephrogenic DI

A

neuro: deficiency of ADH

nephro: insensitivity of the kidneys to the effect of ADH

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26
Q

what occurs with dipsogenic DI

A

form of primary polydipsia

abnormal thirst, excessive intake of liquids

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27
Q

causes of DI

A

head injury **
family hx
idopathic
neurosurgery
damage to hypothalamic areas

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28
Q

DI causes extreme ___ and ___

A

polydipsia
polyuria

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29
Q

DI causes a risk for ___ if there is an impaired thirst mechanism

A

dehydration

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30
Q

how does ethanol and phenytoin cause DI

A

inhibits ADH secretion

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31
Q

how does lithium and demecyocycline cause DI

A

inhibits ADH action in the kidneys

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32
Q

DI plasma osmolality will be > ___

A

> 295

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33
Q

DI urine osmolality will be < ___

A

< 500

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34
Q

will DI cause hypo or hypernatremia

A

HYPERnatremia

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35
Q

what is a normal specific gravity

A

1.01-1.025

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36
Q

DI urine specific gravity

A

1.001-1.005

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37
Q

what needs to be monitored HOURLY with a fluid deprivation test

A

VS
UOP
urine specific gravity

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38
Q

what leads to a positive DI dx with a fluid deprivation test

A

specific gravity remains low
continued large UOP
continued rise in serum osmolality
continued decline in urine osmolality
continued rise in serum sodium

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39
Q

DDAVP is a synthetic form of ___

A

desmopressin

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40
Q

how is DDAVP administered

A

SQ
intranasally

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41
Q

SE of DDAVP

A

chest tightness
nasal ulcerations
allergy

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42
Q

medications for mild/moderate ADH deficit

A

Tegretol PO
Atromid PO

43
Q

how does tegretol and atromid work

A

augment action of existing ADH

44
Q

how to know DI meds are effective

A

UOP will decrease
osmolarity will increase

45
Q

what occurs with syndrome of inappropriate ADH (SIADH)

A

sustained secretion of ADH (water intoxication)

too much ADH is released = water retention

46
Q

SIADH urine osmolarity will be > __

A

> 11

47
Q

SIADH urine sodium concentration will be > __

A

> 20

48
Q

causes of SIADH

A

PNA
TB asthma
small cell lung cancer
CHF
Positive-pressure ventilation
excessive exogenous vasopressin

49
Q

meds that can cause SIADH

A

morphine
barbituates
vincristine
general anesthetics
thiazides
NSAIDs
MAOIs
oxytocin
haldol
ASA
tylenol
beta adrenergic agonists

50
Q

malignancies r/t SIADH

A

bronchiogenic
pancreatic
duodenal
lymphoid tissue
prostate
thymus
colon
brain

51
Q

nonmalignant causes of SIADH

A

hypothyroid
TB
lung abscesses
PNA
COPD
status astmaticus
SLE

52
Q

SIADH s/sx will be r/t ____

A

HYPOnatremia s/sx

irritable
lethargic
impaired memory

53
Q

SIADH daily UOP will be <

A

< 500 cc/24 hours

54
Q

with SIADH there will be weight gain with or without edema

A

without edema

55
Q

precautions needed if Na is < 119

A

seizure precautions

56
Q

what to do if low Na is a new finding

A

report to HCP

57
Q

SIADH fluid restriction

A

800-1000 mL

58
Q

how does declomycin work for SIADH

A

blocks action of ADH but can cause nephrotoxic DI

59
Q

SIADH intervention if pt is on a fluid restriction and c/o of thirst

A

suck on hard candies

60
Q

what type of IVF can be administered with SIADH

A

3% NS
hypErtonic: Enters vessels from the cells

61
Q

how can phenytoin help with SIADH

A

inhibits ADH release

62
Q

with SIADH, HOB should not be > __ degrees

A

10 degrees

63
Q

acute inflammation of demyelinating disorder of peripheral nervous system; acute onset of ascending motor paralysis

A

GBS

64
Q

GBS occurs how long after infectious onset

A

1-3 weeks

65
Q

viruses r/t GBS

A

epstein barre
cytomegalovirus (CMV)
shingles
chickenpox

textbook: epstein barre, campylobacter jejuni, mycoplasma pneumoniae, HiB, Zika virus

66
Q

GBS recovery is usually ___

A

spontaneous

67
Q

will the body be inflamed with GBS

A

no, only nerves

68
Q

GBS onset is ___ but recovery is ___

A

ascending; descending

69
Q

does GBS affect cognitive function or LOC

A

No

70
Q

stage 1: acute stage GBS

A

severe, rapid weakness
loss of muscle strength
quadriplegia
respiratory failure
decrease deep tendon reflex
paresthesia
numbness
pain

71
Q

stage 2: stablizing/plateau stage GBS

A

2-3 weeks after onset
marks end of condition
autonomic function returns

72
Q

stage 3: recovery stage GBS

A

several months to years
marked by improvement of s/sx
muscle strength, function return in descending order

73
Q

is GBS muscle weakness symmetrical or asymmetrical

A

symmetrical

74
Q

what can be the first s/sx of a compromised airway

A

drooling

75
Q

what test can be done to confirm GBS dx

A

electromyogram (EMG)

76
Q

these 2 forms of treatment are most effective for GBS if performed within the first 2 weeks of symptom onset

A

plasmapheresis (plasma exchange)
IVIG

77
Q

GBS primary focus is on ___

A

ventilation

be ready for intubation PRN

78
Q

lyme disease is caused by spirochete borrelia burgdorferi which is transmitted primary by ___

A

ticks

may be carried by mice, deer, dogs, and cats

79
Q

lyme disease outbreaks are commonly seen when

A

summer months

80
Q

lyme disease incubation period

A

30 days

81
Q

what is erythema mirgrans

A

flat or slightly raised (bullseye shaped) red lesion that expands over several days

82
Q

systemic s/sx of lyme disease

A

fatigue
malaise
fever
chills
myalgia

83
Q

lyme disease can cross the BBB and lead to ___

A

meningitis

dx: LP
precautions: droplet

84
Q

what test is used to dx lyme disease within the first 2-4 weeks of initial skin lesion

A

ELISA or Western blot

85
Q

abx for lyme disease

A

doxycycline
tetracycline
amoxicillin
erythromycin

86
Q

how to remove a tick

A

tweezers

use a straight, upward pull

87
Q

what to use to disinfect skin after removing a tick

A

soap + water
rubbing alcohol
H2O2

88
Q

lyme disease prevention education

A

use insect repellents that contains DEET on clothing and exposed skin

89
Q

what is scleroderma

A

overproduction of collagen

autoimmune disoder

90
Q

systemic scleroderma is aka ___ ___ ___ ___

A

hardening of the skin

91
Q

is scleroderma more common in men or women

A

women

onset 25-50 y/o

92
Q

CREST r/t scleroderma

A

Calcinosis
Raynauds phenomenon
Esophageal dysfunction
Sclerodactyly
Telangiectasias

**must have 4/5 for dx

93
Q

prognosis for localized scleroderma is ___

A

good because it is just on the skin, organs are not affected

94
Q

which med group is used for raynauds

A

CCB

95
Q

scleroderma room temp should be ___

A

constant; keep warm

96
Q

how long should a pt with scleroderma sit up after meals

A

1-2 hours

97
Q

scleroderma education re: foods + drinks

A

small frequent meals
avoid spicy foods
avoid caffeine, alcohol

98
Q

what is sjogrens syndrome

A

autoimmune disorder that causes inflammation and dysfunction of the exocrine glands throughout the body

99
Q

sjogrens syndrome is often associated with other ___ diseases

A

rheumatic

RA
SLE
scleroderma
hashimotos
thyroiditis

100
Q

does sjogrens syndrome commonly occur in women or men

A

women

101
Q

most common s/sx of sjogrens syndrome

A

xerophthalmia (dry eyes)
xerostomia (dry mouth)

can also cause dryness in the nose, bronchi, vagina, and skin

102
Q

sjogrens will cause the paratoid gland to become ___

A

enlarged

103
Q

how is sjogren’s dx

A

H&P
lacrimal or salivary gland tissue bx

104
Q

sjorgen’s treatment is ___

A

supportive

M/S 3 (17 decks)

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