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Med Surg III Final > Med Surg Endocrine > Flashcards

Med Surg Endocrine Flashcards

1
Q

Endocrine system are all negative or positive feedback mechanisms?

A

Negative

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2
Q

Secretes directly into blood?

A

Hormones

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3
Q

Hormones and neuronal system regulate?

A

Organ function

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4
Q

Neuro=

Hormonal=

A

Fast

Slow regulation.

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5
Q

General S/S of malfunction

A 
Changes in energy level
Temperature tolerance
Weight
Sexual function
Secondary sexual characteristics
Mood, memory, ability to concentrate, and sleep.
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6
Q

Pituitary gland

A

Under control of hypothalmus

Although its knows as master gland, most hypo/hyper conditions are due to the target gland itself.

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7
Q

Anterior pituitary

A

GH, TSH, ACTH, FSH, LH, prolactin, and melanocyte stim hormone.

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8
Q

Posterior pituitary

A

Oxytocin and ADH (vasopressin)

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9
Q

Hypopituitarism

GH deficiency

A

Inhibit somatic growth (dwarf)

Can increase fat, decreased muscle, thin bones, reduced energy.

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10
Q

give GH when?

A

Before growth plate fuses.

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11
Q

Hyper-pituitary= excess what

A

GH
Vertical growth, weight is proportional.
Andre the giant.

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12
Q

Excess GH after epiphyseal closure is called?

A

Acromegaly.

Increased head lips tongue, jaw, mastoid sinuses

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13
Q

Precocious puberty

A

Early maturation and development of gonads and secondary sex characteristics.
More frequently in girls.

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14
Q

Diabetes insipidus DI

A

Principle disorder of the posterior pituitary.
Hyposecretion of ADH.
Uncontrolled diuretics.
Familial.
Secondary causes trauma, tumors, CNS infection, aneurysm.

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15
Q

Diabetes insipidus-
Decreased ADH— decreased h20 reabsorption— decreased intravascular fluid volume—increased osmolality(hyperNA)—excessive UO.

A 
Can be neurological or kidney. 
Give thiazides and low NA diet.
Do hourly weights. 
Make NPO to see in UO goes down.
Give vasopressin.
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16
Q

DI

Cardinal signs

A

Polyuria, polydypsia, enuresis.
Infants- irritability relieved with feeding of water. Dehydration often occurs.
Daily vasopressin. For life.
Must wear ID band and keep med on them at all times.

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17
Q

Syndrome of inappropriate antidiuretic hormone SIADH

Give steroids

A

Oversecretion of posterior pituitary, increased ADH.
Fluid retention
Kidneys reabsorption water.
Anorexia, NV, irritability and personality changes.

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18
Q

SIADH s/s

A 
Increased BP, HA,
Decreased UO, increased specific gravity
Hypoglycemia, decreased K and CA, NA
Edema
Fluid restriction
Monitor LOC.
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19
Q

SIADH—

A

Increased ADH—increased water reabsorption in renal tubules—increased intravascular fluid volume—dilution always hypoNA and decreased osmolarity.

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20
Q

Adrenal glands secretes what from
Medulla?
Cortex?

A

M-catecholamines(epi, NE) increased BMR and glucose.

C-steroids. Hydrocortisone, cortisol, aldosterone.

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21
Q

Adrenal function

Cortex secretes three groups of steroids.

A 
Glucocorticoids(cortisol, corticosterone)
Mineralcorticoids(aldosterone)
Sex steroids(androgens, estrogens, progestins)
22
Q

Addisons
Acute adrenocortical insufficiency
Give NA and steroids. 911

A 
Insufficient in all adrenal hormones.
Weight loss, hypoglycemia, decreased NA.
Increased K, CA
Fatigue, muscle weakness.
Check Ck, corticotropin.
bronzing
23
Q

Cushings

Too much steroids

A

Excessive circulating cortisol and ACTH

Don’t stop steroids abruptly.

24
Q

Cushings s/s

A

Buffalo hump, heave trunk, thin extremities.
Glucose intolerance, osteoporosis, fragile skin. Moon face, mostly female 20-40. Amenorrhea. Sleep/mood changes, increased libido,facial hari, balding, fluid retention, HTN.

25
Q

Pheochromocytoma

A

Tumor on adrenal.
Can lead to hypertensive crisis. HA, diaphoresis, increased CBG, SOB.
Elevate HOB, give muscle relaxants, klonadine.

26
Q

Primary aldosteronism

Aldosterone controls blood volume, from adrenal cortex.

A

Excretes less NA, more K(causes hypoK) and hydrogen.
Decreased renin.
May cause HTN.

27
Q

Thyroid

A

Synthesizes stores and releases hormones.
Increase BMR
Causes increased o2 demand and body temp.
Stimulate GI system.

28
Q

Secretory function

A

Hypothalamus—>TRH(thyrotropin releasing hormone)—>pituitary gland—>TSH—>thyroid gland—> T3, T4–> body

29
Q

Thyroid function

T3 T4

A

Amino acids with iodine attached.

Iodine essential for synthesis fo the thyroid hormones.

30
Q

Parathyroid

A

Calcitonin. Secreated in response to high CA.

Reduces by depositing into bones.

31
Q

TSH levels

A

0.4-6.15 is normal.

If elevated than hypothyroidism.

32
Q

Hypothyroidism

A

Myxedema, hashimotos.

33
Q

Hyperthyroidism

A

Graves (increased catecholamines)

34
Q

Hypothyroidism

A

Cretinism(thyroid did not develop) stunted physical and mental development

35
Q

Goiter-

A

Increased TSH

Mostly female.

36
Q

Myxedema hypothyroidism.

A

Depressed metabolic activity.
Women.
Fatigue, feel cold,muscle weakness. CV issues. Can have polydypsia,
Activity intolerance, bad temp regulation, tough thought process.
No soy.

37
Q

Hyperthyroidism

A 
Graves
Excessive hormone output.
Women.
Nervousness, emotional, irritable, palpitation, tachy, heat intolerant. Flushed, puritis, exophthalamos, increased appitite, amenorrhea, bad BM’s, HF, increased BMR, HTN, thyroid storm.
Give PTU and beta blockers.
38
Q

Thyroid storm

A

Severe hyperthyroidism,
Abrupt onset, fatal if untreated.
High fever over 101.3, tachy,altered Neuro, hyper GI and CV.
Cool them down, no ASA, give steroids, give NA.

39
Q

Other thyroid conditions

A

Tumor- usually benign.
Endemic goiter-lack of iodine in diet.
Modular goiter- hyperplasia. Can be malignant.

40
Q

Thyroidectomy

A

CA gluconate at bedside.

Post of bleeding, nerve injury, lymphatic drainage.

41
Q

Parathyroid

A

Regulates CA and phos metabolism.

Increases CA and decreases phos.

42
Q

Hyperparathyroidism

A

Bone decalcification and development of renal calculi.

43
Q

primary Hyperparathyroidism

A

Decreased phos, tumor.

Women. May be asymptomatic.

44
Q

Secondary hyper parathyroid

A

Renal insufficiency . Happens in renal failure. Phos retention.

45
Q

Tertiary hyper parathyroid

A

Dialysis

Renal transplant.

46
Q

Hyper parathyroid S/S

A

May have none.
Fatigue, HA, insomnia, stone formation, renal damage. HTN, NV, constipation, dysrhythmias, pathological fractures.
Get them mobile, hydrate, meds.
Watch for tetany.

47
Q

Hypo parathyroid

A

Decreased hormone. Hyperphos, and hypoCA

48
Q

Hypo parathyroid S/S

A

Irritability, tetany, tremor, anxiety, delirium,

Test CA, trousseau, and chvostek.

49
Q

Hypo parathyroid tx

A

Give sedatives, CA gluconate. Increase vitamin D.

50
Q

Metabolic syndrome

A

Not a disease but a cluster of disorders.
HTN, high CBG, excess of fat around waist. Abnormal cholesterol/triglycerides.
In combination these disorders increase the risk of diabetes and heart disease and stroke. Tendency to clot.

51
Q

S/S metabolic syndrome.

A

Central obeisity, HTN, high triglycerides, low HDL, high LDL, insulin resistant.
Thirst, urination fatigue blurred vision.

52
Q

Hyper parathyroid

A

Moans and groans- stones and bones

NV, constipations, HTN- renal calculi pathologically FX’s

Med Surg III Final (13 decks)

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