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Med Surg Test 4 > Med Surg Test 4 > Flashcards

Med Surg Test 4 Flashcards

1
Q

eosinophilic

A

pituitary tumor; early in life = gigantism; later in life = large hands, feet, nose and chin

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2
Q

basophilic

A

pituitary tumor; Cushing Syndrome - masculinization in females, amenorrhea, HTN and obesity

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3
Q

hyposphysectomy

A

removal of pituitary gland; menses ceases; infertility

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4
Q

anterior pituitary hormones (and amount)

A

ACTH (9-52); TSH (0.4-4); GH (male - 1-9 and female 1-16)

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5
Q

hyper anterior pituitary syndromes

A

Cushing’s syndrome, gigantism and acromegaly

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6
Q

hypo anterior pituitary syndromes

A

dwarfism

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7
Q

posterior pituitary hormones (and amount)

A

ADH (1-5) aka vasopressin

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8
Q

hypo posterior syndromes

A

diabetes insipidus

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9
Q

hyper posterior syndromes

A

SIADH

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10
Q

diabetes insipidus S/S

A

excessive thirst (polydipsia) and large volume of dilute urine (>250 mL/hour) with specific gravity 1.001-1.005

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11
Q

diabetes insipidus medications

A

desmopression, chloropropamine and thiazide diuretics

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12
Q

other diabetes insidious medical treatments

A

replace ADH and fluid replacement (2L/day of cold water)

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13
Q

desmopression dosage

A

IN 2x/day

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14
Q

SIADH

A

“dilutional hyponatremia”; retained water is excreted in kidneys

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15
Q

SIADH treatment

A

furosemide (Lasix)

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16
Q

thyroid hormones (and amount)

A

T3 (80-200); T4 (5.4-11.5) and calcitonin (<10)

iodine is contained in thyroid hormones

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17
Q

TSH

A

from the anterior pituitary; control the release of the thyroid hormones

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18
Q

thyroid controls what

A

cellular metabolic activity

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19
Q

calcitonin

A

secreted in response to high plasma calcium level and increase calcium deposits in bone

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20
Q

single best test for thyroid function

A

TSH; screen every adult >35 yo and test every 5 years

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21
Q

radioactive iodine uptake

A

see how many nodules picks up iodine

22
Q

medications that may alter thyroid test results

A

amiodarone, aspirin, cimetidine, diazepam, furosemide, heparin, lithium, phenytoin (anticonvulsants) and propranolol

23
Q

cretinism

A

condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid

24
Q

characteristics of cretinism

A

adult stature without treatment ranges from 3.3-5.2 feet; also have thickened skin, enlarged tongue or protruding abdomen

25
Q

main cause of hypothyroidism

A

autoimmune thyroiditis (Hashimoto’s disease)

26
Q

other causes of hypothyroidism

A

atrophy of thyroid gland with aging; therapy for hyperthyroidism (radioactive iodine and thyroidectomy); medications (lithium, antithyroid); radiation to head and neck in treatment for cancer; infiltrative disease of the thyroid; iodine deficiency and iodine excess

27
Q

early symptoms of hypothyroidism

A

hair (course), skin and nail changes; fatigue; numbness and tingling of fingers; menstrual disturbances; subnormal temp and pulse; weight gain; subdued mention response; slow speech; tongue, hands and feet may enlarge; personality and cognitive changes; cardiac and respiratory complications

28
Q

complications of hypothyroidism

A

myxedema; may progress to stupor, coma and death

29
Q

medications for hypothyroidism

A

synthetic levothyroxine replacement therapy

30
Q

guidelines for giving levothyroxine

A

give on an empty stomach; don’t give with iron or anti-acids

31
Q

most common cause of hyperthyroidism

A

Grave’s disease

32
Q

hyperthyroidism

A

a form of thyrotoxicosis; resulting from excessive output of thyroid hormones by the thyroid

33
Q

S/S of hyperthyroidism

A

nervousness, rapid pulse, heat intolerance, tremors, skin flushed, warm/soft/most ski, exophthalmos (bulging eyes), increased appetite, weight loss, elevated systolic BP and cardiac dysrhythmias, goiter

34
Q

treatment for hyperthroidism

A

radioactive 131I therapy; single dose to eliminate the hyperthyroid state; destroys thyroid cells and inevitably causes hypothyroidism

surgery- subtotal thyroidectomy (removal of 5/6 of the gland)

35
Q

medications for hyperthyroidism

A

propylthiouracil (PTU) and methimazole; sodium and potassium iodine solutions; dexamethasone; beta-blockers (propranolol)

36
Q

thyroid storm

A

also known as thyrotoxic crisis or thyrotoxicosis; severe form of hyperthyroidism (usually abrupt)

37
Q

characteristics of thyroid storm

A

high fever (>101.3); extreme tachycardia (>130); exaggerated symptoms of hyperthyroidism (weight loss, diarrhea and abdominal pain; edema, chest pain, dyspnea and palpitation)

38
Q

diagnostic test for thyroid tumors

A

“hot or cold”
hot - low risk
warm - low to moderate risk
cold - moderate risk

39
Q

thryroidectomy

A

treatment of choice for thyroid cancer; modified or radical neck dissection (with possible radioactive iodine)

40
Q

thryroidectomy pre-op

A

meet metabolic needs, avoidance of caffeinated beverages and other stimulants, explain test and procedure and the importance of supporting head and neck after surgery

41
Q

thryroidectomy post-op

A

monitor respirations (potential airway impairment); monitor for bleeding and hematoma formation; sit in semi-fowler’s position with support of head and neck with pillows; assess voice and discourage talking; potential hypocalcemia related to injury or removal of parathyroid glands

42
Q

parathyroid glands

A

4 glands on the posterior thyroid gland that releases parathormone

43
Q

parathormone

A

regulates calcium and phosphorus balance

44
Q

increased parathormone …

A

elevates blood calcium by increasing calcium absorption from the kidney, intestine and bone; and lowers phosphorus levels

45
Q

manifestations of hyperparathyroidism

A

elevated serum calcium, bone decalcifcation, renal calculi, apathy, fatigue, muscle weakness, nausea and vomiting, constipation, hypertension, cardiac dysrhythmias, psychological manifestations (all from too much calcium)

46
Q

treatment for hyperparathyroidism

A

parathyroidectomy, hydration therapy, encourage mobility and reduce calcium excretion

47
Q

medications for hyperparathyroidism

A

calcitonin, biphosphate; cytoxic agents (mithramycin)

48
Q

hypoparathyroidism cause

A

parathyormone deficiency caused by surgery (thyroidectomy, parathyroidectomy and radial neck dissection)

49
Q

hypoparathyroidism result

A

hypocalcemia and hyperphosphatemia

50
Q

S/S of hypoparathyroidism

A

tetany, numbness, tingling in extremities, stiffness of hands and feet, bronchospasm, laryngeal spasm, cardopedal spasm, anxiety, irritability, depression, delirium and ECG changes; positive Chvostek and Trousseau’s sign

51
Q

management of hypoparathyroidism

A

calcium gluconate IV; increase calcium levels to 9-10 mg/dL; pentobarbital to decrease neuromuscular irritability; diet high in calcium and low in phosphorus; vitamin D (helps absorption); quiet environment

Med Surg Test 4 (1 decks)

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