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CH 23 Endocrine Emergencies > Missy Lecture > Flashcards

Missy Lecture Flashcards

1
Q

What is the function of the endocrine system

A

Maintain homeostasis

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2
Q

Difference between exocrine and endocrine glands

A

Exocrine- secrete outside the body, have ducts, ex. Sweat, salivary, liver
Endocrine- secrete inside the body, ductless, ex. Thyroid, Gonads, adrenal, pituitary

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3
Q

Characteristics of the hypothalamus

A

Region in the brain
Primary link between endocrine and nervous system
Stimulates anterior pituitary to release hormones
Produces ADH and Oxytocin

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4
Q

Characteristics of the pineal gland

A

Synthesizes melatonin, regulates sleep/wake cycle

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5
Q

Characteristics of the anterior pituitary gland

A

Secretes GH, TSH, ATCH, MSH, FSH, LH, PRL

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6
Q

Characteristics of the posterior pituitary gland

A

Secretes and stores but does not produce ADH and Oxytocin

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7
Q

Characteristics of the thyroid gland

A

Increases metabolic rate
Secretes thyroxine, T3, T4
Iodine is important component of thyroxine
Secretes calcitonin in response to high calcium serum levels

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8
Q

Characteristics of the parathyroid glands

A

Secretes parathyroid hormone PTH when calcium serum levels are low

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9
Q

Characteristics of the thymus gland

A

Secretes thymosin to stimulate the immune system
Located behind the sternum
T-lymphocytes evolve from stem cells in the thymus

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10
Q

Characteristics of the adrenal glands

A

Adrenal cortex secretes cortisol in response to stress and aldosterone in response to low BP
Adrenal Medulla secretes catecholamines and stimulates liver to convert glycogen to glucose

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11
Q

Characteristics of the pancreas

A

Alpha cells produced glucagon with low BG
Beta cells produce insulin with high BG
Delta sells produce somatostatin to signal insulin and glucagon inhibition to slow nutrient absorption
Considered both an exocrine and endocrine gland

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12
Q

Name the exocrine and endocrine cells of the pancreas

A

Exocrine - Acinus - digestive juices

Endocrine - Islets of Langerhans

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13
Q

Characteristics of the gonads

A

Male- Testosterone (androgens)

Female- estrogen (signals LH) and progesterone

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14
Q

Describe type I diabetes

A

IDDM, no insulin is produced, Child onset

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15
Q

Describe type II diabetes

A

NIDDM, insulin resistance or ineffective, “adult onset”

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16
Q

Describe gestational diabetes

A

Placenta produces hormones that inhibit the function of insulin
Usually diagnosed after 28 weeks (3rd trimester)
Glucose intolerance during pregnancy

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17
Q

Signs and symptoms of hypoglycemia

A

ALOC, pale, cool, diaphoretic, seizure, agitated

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18
Q

Treatment of hypoglycemia

A

Oral glucose if gag intact
IV D50 25g
1 mg glucagon IM if no IV access
Turn off insulin pump

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19
Q

Signs and symptoms of hyperglycemia or DKA

A

DLOC, fruity breath, Kussmaul’s respirations, tachycardia, N/V/D, dehydration, seizure
3 P’s = polyurea, polydipsia, polyphagia

20
Q

Treatment of DKA

A

Hydration, insulin, electrolyte replacement, EKG monitor for peaked T waves, wide QRS, sine waves

21
Q

What is HONK

A

Hyperosmolar non-Ketotic Coma
Similar to DKA except for lack of key tones
Commonly caused by infections or severe dehydration

22
Q

Treatment for hyperglycemia

A

Fluids, treat acidosis, treat shock, treat underlying cause

23
Q

The Adrenal gland disorders

A

Addison’s disease - aldosterone deficiency, glucocorticoid deficiency
Cushing’s syndrome- excessive cortisol production

24
Q

Hyperthyroid disorders

A

Graves’ disease- goiter, exophthalmos, most severe

Hashimoto’s- effects TSH receptors

25
Q

Hypothyroid disorders

A

Myxedema coma -physiologic manifestations of longterm hypothyroid
Thyrotoxicosis - triggered by a stressful event increasing volume of thyroid hormones in circulation

26
Q

What is panhypopituitarism?

A

An inadequate production of any pituitary hormones

ACTH, TSH, LH, FSH, ADH

27
Q

What is ACTH, what is it produced by and what is the target tissue?

A

Adrenocorticotrophic hormone
Anterior Pituitary gland
Adrenal gland

28
Q

What is TSH, what is it produced by, and what is it target tissue?

A

Thyroid stimulating hormone
Anterior pituitary
Thyroid

29
Q

What is LH, FSH and PRL, what is it produced by, and what is its target tissue?

A

Leutinizing hormone, follicle-stimulating hormone, prolactin
Produced by the anterior pituitary
Testes and ovaries

30
Q

What is GH, what is it produced by, and what is the target tissue

A

Growth hormone
Anterior pituitary
Bones and muscle and other various cells

31
Q

What is a ADH, what is it produced by and what is the target tissue

A

Antidiuretic hormone
Hypothalamus, secreted by the posterior pituitary
The kidney

32
Q

What is oxytocin produced by and what is the target tissue?

A

Produced by the hypothalamus, secreted by the posterior pituitary
Breasts lactation and uterine contractions

33
Q

How does calcitonin work?

A

Secreted when calcium levels are high
Stimulates osteoblasts tubes or calcium
Stimulate kidneys to absorb and secrete excess calcium
Decrease calcium uptake in G.I. tract

34
Q

How does parathyroid hormone work

A 
Secreted when calcium levels are low
Antagonist to calcitonin
Decreases calcium released in urine
Stimulates osteoclasts to release calcium into the blood
Increases calcium uptake in G.I. tract
35
Q

Typical pathologies caused by diabetes

A 
Kidney failure
Neuropathy
Retinopathy
CVA's
ACS
36
Q

Common oral diabetes medications

A

Chlorpropamide, Glipizide, Glyburide, Metformin (Glucophage),

37
Q

Why is it necessary to differentiate between CVA S&Sy and hypoglycemia S&Sy?

A

A rapid infusion of glucose to a patient experiencing a CVA could exacerbate cerebral damage, especially if it is a hemorrhagic stroke

38
Q

Why do patients with hyperglycemia have polyuria?

A

the high solute concentration of the blood causes osmotic diuresis and can lead to dehydration and shock

39
Q

What EKG rhythms may you see in a patient with hyperglycemia

A

tachycardia (dehydration)
Peaked T waves, wide QRS, sine wave (electrolyte imbalances)
Treat with Ca++Cl- and albuterol

40
Q

Characteristic effects of HONK

A

Severe dehydration, AMI, Neurological changes, signs of infection

41
Q

Common causes of pancreatitis

A

alcohol abuse and gall stones

42
Q

S&Sy of pancreatitis

A

Flank or epigastric Px increases when supine, tachycardia, fever and jaundice

43
Q

Primary adrenal insufficiency a.k.a

A

Addison disease

Atrophy or destruction of the adrenals leading to a deficiency in all of the steroid hormones

44
Q

Secondary adrenal insufficiency

A

Lack of ACTH secreted by the pituitary

Can because by a patients who abruptly stop taking corticosteroids

45
Q

Typical characteristics of Cushings syndrome

A

hyperglycemia, moon face, buffalo hump, thin skin, excessive facial hair, scalp hair loss

46
Q

Common characteristics of diabetes insipidus

A

Kidneys are unable to function properly and there may be a lack of ADH
Dehydration or water toxicity, hyponatremia

CH 23 Endocrine Emergencies (1 decks)

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