Metabolism Flashcards
Define metabolism
Metabolism is a collection of biochemical reactions that occur in the body’s cells to produce energy, repair cells, and maintain life
What are the risk factors that put people at risk for metabolic disorders?
- dietary deficiency of vitamins and other nutrients
- Sedentary lifestyle
- Diet high in fats and refined sugars
- Medications that affect hormone levels
What are some prevention methods associated with metabolic disorder?
- routine monitoring of affected hormone levels
- Routine monitoring of fluid and electrolytes
- Testing for a secondary related disorder
- Patient education on Hormone Replacement Therapy
- Patient education to remind patients to report worsening or additional signs and symptoms
- Providing nutritional support for their conditions
- Encourage maintenance of a healthy weight and exercise routine
What are the causes of liver disease?
- Cirrhosis
- Drugs: excessive mounts of acetaminophen; statins
- alcohol abuse
- Hepatitis A, B, C, D, and E
- Infectious mononucleosis
- Nonalcoholic fatty liver disese
- Iron overload
What are the signs and symptoms of liver disease?
- Weakness
- Fatigue
- Weight loss
- Nausea
- Vomiting
- Jaundice
- Right upper quadrant abdominal pain
What is involved in the diagnosis of liver disease?
- history (may be difficult in patients who abuse alcohol)
- Physical exam of the entire body
- CT scan
- MRI
- Ultrasound
- Liver biopsy
- Other blood tests
What are covered during a liver biopsy?
- Specified liver function tests (LFT’s)
- AST
- ALT
- GGT
- Alkaline phosphatase
- Bilirubin
- Protein and albumin levels
What are the blood tests used to diagnose liver disease?
- CBC
- INR (blood clotting function)
- Lipase (pancreas inflammation)
- Electrolytes, BUN, Creatinine, ammonia blood level
What is hyperthyroidism?
It is over activity of the thyroid gland that leads to high levels of thyroid hormones and speeds up vital body function
What are the signs and symptoms of hyperthyroidism?
- hair loss, brittle/soft nails, finger clubbing
- bulging eyes
- sweating,rapid HR, high BP
- Weight loss
- Regular gas, diarrhea
- Heat intolerance
- sleeping difficulties, irritability, nervousness, tremors
- scant menstrual periods, breast enlargement
- facial flushing, enlarged thyroid, localized edema
What are some reasons why thyroids can flutuate?
- potency fluctuations or dosage errors
- medication timing and food interactions
- Herb/supplement interactions
- goitrogenic foods
- Change of seasons
- Hormone fluctuations
- Pregnancy
What are some diagnostic tests for the thyroid?
- Physical exam to see if the gland is enlarged
- A blood test to measure the levels of TSH, T4, T3, free T4
- Thyroid scanning
- Radioactive iodine uptake test
- Blood test
- If cancer is suspected, a small needle biopsy can be done
What is thyroid scanning?
It determines whether the growth is solid or filled with fluid. Helps determine whether the functioning of a specific area of the thyroid is normal, overactive, or underactive.
What is a radioactive iodine uptake test?
It is when a small amount of a radioactive substance is injected into the bloodstream. The thyroid gland becomes concentrated and a gamma camera does another type of scan that will detect the radiation and produce a picture of the gland
Why would they do a blood test for thyroid patients?
They could suspect an autoimmune disorder and they are checking for antibodies that can attack the thyroid gland
How often is screening recommended for women?
every 5 years for women over 35; pregnant women; newborns
How often is screening recommended for men?
every 5 years for men over 65; newborns
What are the most common causes of hyperthyroidism?
- Graves disease
- Toxic multinodular goiter
- Thyoiditis
- Single toxic nodule
- Thyroid Storm (crisis)
What are the signs and symptoms of a thyroid storm?
- hyperthermia, flushed smooth skin
- Tachycardia, diaphoresis, palpations, dyspnea, heart failure
- Systolic hypertension
- Abdominal symptoms
- Agitation
- Tremors
- Confusion, mood swings, coma
What is Graves Disease?
An autoimmune disorder that result in the overproduction of thyroid hormones and typically affects women 20 to 40 years of age
What are some symptoms of Graves disease?
- Bulging eyes due to inflammation of the orbits behind the eyes.
- Double vision (diplopia) do to the muscles having difficulty move the eyes normally or to coordinate eye movements
What are the common treatments for hyperthyroidism?
- Antithyroid medication
- Beta-blockers
- Iodine
- Radioactive iodine therapy
5, Surgery
What do antithyroid medications do?
They reduce TH production. Most common types are methiamozole and propylthiouracil
How do beta-blockers help with the thyroid?
May be given to decrease cardiovascular symptoms and help control the symptoms of hyperthyroidism
Why is iodine given to people with hyperthyroidism?
They may need rapid treatment such as those in a thyroid storm or until the patient can get a thyroidectomy. It is not for long term use and it is given orally
When given orally, when are results from radioactive iodine therapy typically seen?
After 6-8 weeks
What are patients taught to do if they have radioactive iodine therapy done?
Measure their pulse rate and notify their doctor if it exceed 100 bpm following therapy until released stores of TH diminish
After radioactive iodine treatment, how long should the patient stay away from infants and children, and what should they do if they have a partner?
- Stay away from children and infants for at least 2-4 days. Pregnancy should be avoided for 6 months
- Sleep in a separate bed at least 6 feet apart from their partner
What should patients be aware of if they go to an airport after having radioactive iodine treatments done?
The may set off radiation alarms at airports and other places several weeks after treatment. They should carry a doctor’s note describing their treatment when traveling.
What should the patient be given before a thyroidectomy?
Antithyroid drugs to reduce hormone levels and iodine preparations to decrease the vascularity and size of the gland
What rare complications can occur for someone who has a thyroidectomy?
paralysis of vocal cords and damage to the parathyroid glands
After the thyroidectomy what needs to be monitored?
Calcium levels need to monitored for hypocalcemia that can cause neuromuscular irritability
How does hyperthyroidism manifest itself in pediatric patients?
Clinical manifestations are similar to adults. However, it may affect their growth and development
What are the lifespan considerations for a pregnant woman with hyperthyroidism?
- Usually caused by Graves disease and may be caused by hyperemesis gravidarum.
- If it is left uncontrolled it can lead to congestive heart failure, preeclampsia, thyroid storm, miscarriage, premature birth, and low birth weight
What are the lifespan considerations for newborns with hyperthyroidism?
- Can result in rapid HR, leading heart failure, early closure of the fontanelles, poor weight gain, irritability, and breathing issues do to an enlarged thyroid gland that presses against the trachea.
- If the mother has been treated with antithyroid medication, fetal hyperthyroidism is less likely because the drug crosses the placenta
What are the lifespan considerations of older adults with hyperthyroidism?
- Toxic goiter is more frequent
- May only have 1 or 2 symptoms
- surgery is rarely recommended because of increased surgical risks
What are the causes of hypothyroidism?
- hashimoto thyroiditis (they gland is gradually being destroyed)
- Thyroid inflammation
- Lack of IODINE
- Radiation to the head and neck
- Inherited disorders that prevent the thyroid gland from making or secreting enough hormones
What is a secondary cause of hypothyroidism?
The pituitary gland fails to secrete enough TSH
Describe myxedema coma
- life-threatening
- slowed breathing
- decreased blood flow to the brain
- Triggered in a person with hypothyroidism by a physical stress like exposure to cold, infection, injury, surgery, and sedatives
- dry, course, and sparse hair
- Lateral eyebrows thin
- periorbital edema (swollen under eyes)
- puffy dull face with dry skin
What are the symptoms of Hashimoto’s disease?
- Constipation, fatigue, sluggishness, unexplained weight gain
- Excessive or prolonged menstrual bleeding, pale dry skin, enlargement of the tongue
- Muscle aches, weakness, tenderness, and stiffness
- Memory lapses, depression, joint pain and stiffness
- Goiter, a puffy face brittle nails, and hair loss
- Sensitivity to cold
What treatments are typically used for hypothyroidism?
Thyroid replacement hormone (levothyroxine gradually increased whn the level of TSH return to normal)
The use of iodized salt has reduced the risk of hypothyroidism in the US
What is the test for Bone density?
DEXA X-ray
Why is the DEXA X-ray used in hospital settings?
- detects osteoporosis before a fracture occurs
- Predicts chances of fracturing in the future
- Determines rate of bone loss
- Monitors the effects of treatment
What treatments are there for osteoporosis?
- Follow the doctor’s recommendations
- Take calcium and vitamin D supplements
- Eat dairy and Dark leafy green vegetables
- Take prescribed medications
How can someone prevent osteoporosis?
- limit alcohol intake
- Walk or job regularly
- Stop smoking
- Eat dairy products and dark leafy green vegetables daily
- Take calcium and Vitamin D Supplements
What are the signs and symptoms of osteoporosis?
- bone pain or tenderness
- Fractures with little or not trauma
- Loss of height over time
- Neck or lower back pain due to fractures
- Stooped posture
What is the acronym for the risk factors of osteoporosis?
A= Alcohol use C= Corticosteroid use C= Calcium low E= Estrogen low S= smoking S= Sedentary lifestyle
Why do athletes have an increased risk to get osteoporosis?
Those who are especially in sports that emphasize leanness like gymnastics or cross-country can develop this health problems because of decreased nutrition which causes low bone mass and amenorrhea
Why do pregnant women sometimes get osteoporosis?
If the mother does not eat foods high in calcium, the fetus will draw what it needs from the mother’s bones
Why do women who reach menopause often develop osteoporosis?
Menopause decreases estrogen levels and accelerates bone loss in women
