OTH: Metabolic Obesity/Thyroid/Adrenal Flashcards
Overweight BMI
25-29.9
Obese BMI
> 30
Morbidly obese BMI
> 40
Health risks associated with obesity? (7)
- HTN
- Hyperlipidemia
- DMT2
- CVD
- gallbladder disease
- Infertility
- CA (endometrium breast, prostate, colon)
Genetics may account for ___% of BMI
30-40
Medical causes that may lead to obesity? (4)
- Metabolic disorders
- Endocrine problems
- hypothyroidism
- Cushing’s syndrome
Obesity: reduce caloric intake- fat intake < __% total energy intake
30
Obesity: Exercise testing at what level? (__ METs), with small workload increments of ___ METs
Submax, low initial workload (2-3 METs), increments of .5-1 METs
Obesity ExRx: FITT
F: 5-7 days
I: initially 40-60% VO2R or HRR, progress to 50-70%
T: 30-60 min
T: aerobic, circuit training, aquatic
Obesity: RED FLAGS Exercise Pxns
- Typically have __ compromise (__, increased __, __)
- Exhibit altered biomechanics leading to ___
- Increased risk of ___ breakdown
- Increased __ intolerance
- Increase risk of therapist ___
- CV (SOB, increased BP, angina
- Joint pain and injury
- Skin
- Heat
- Injuring self due to body mechanics
Hypothyroidism: decreased activity of thyroid gland with deficient thyroid secretion of _____ (__ T4 levels, __ TSH)
Thyroxine
Decrease, increase
Hypothyroidism: ___ metabolic processes, affects body temp, HR, __ body processes
Slow
Slow
Hypothyroidism: etiology
- Decreased ____ hormone secreted by __ or ___
- Atrophy of ___ gland
- Chronic autoimmune (_____ disease)
- OD with ___ meds
- Thyroid-releasing hormone, hypothalamus/pituitary
- Thyroid
- Hashimoto’s
- Antithyroid
If untreated, hypothyroidism can lead to ___ with swelling of ___, ___, ____. What is tx?
Myxedema
Hands, feet, face
Tx: lifelong thyroid replacement therapy
RED FLAG: hypothyroidism- exercise ____, weakness, apathy, exercise induced ____ and ___ CO.
Intolerance
myalgia
Decreased
Hyperthyroidism: hyperactivity of thyroid gland (___ TH4 levels, __ TSH)
Increase
Decrease
Etiology of hyperthyroidism?
Unknown (iodine deficiency)
Hyperthyroidism: thyroid typically ___, secretes greater than normal thyroid hormone ___
Enlarged
Thyroxine
Hyperthyroid related to 3 conditions:
- Grave’s disease
- Thyroid storm
- Thyrotoxicosis
Tx for hyperthyroidism?
Antithyroid drugs, radioactive iodine may also be prescribed or surgical ablation may be indicated
RED FLAG: hyperthyroidism can result in exercise ___, ___ associated with hypermetabolic state
Intolerance, fatigue
HYPO or HYPERthyroidism?
Constipation
Hypo
HYPO or HYPERthyroidism?
Depression, fatigue
Hypo
HYPO or HYPERthyroidism?
Dry thin hair, hair loss
Hypo
HYPO or HYPERthyroidism?
peripheral edema, peripheral neuropathy
Hypo
HYPO or HYPERthyroidism?
CTS
Hypo
HYPO or HYPERthyroidism?
Slow HR, swelling of thyroid gland (goiter)
Hypo
HYPO or HYPERthyroidism?
Depression, dry skin
Hypo
HYPO or HYPERthyroidism?
Unexpected weight gain
Hypo
HYPO or HYPERthyroidism?
Cold intolerance
Hypo
HYPO or HYPERthyroidism?
nervous, tremor
Hyper
HYPO or HYPERthyroidism?
Hyperreflexia, palpitations/tachycardia
Hyper
HYPO or HYPERthyroidism?
Hunger, diarrhea
Hyper
HYPO or HYPERthyroidism?
Wt loss
Hyper
HYPO or HYPERthyroidism?
Heat intolerance
Hyper
HYPO or HYPERthyroidism?
Goiter
Both (?)
HYPO or HYPERthyroidism?
Increased sweating, anxiety
Hyper
HYPO or HYPERthyroidism?
Exuphthalmia (bulging eyes)
Hyper
HYPO or HYPERthyroidism?
Dyspnea
Hyper
Parathyroid: secretes ___, which regulates __ and __ metabolism
PTH, calcium, phosphorous
Hyperparathyroidism: increased PTH leads to ___ Ca levels and __ serum phosphate
Increased Ca, decreased phos
Hyperparathyroidism:
___ of bone, subsequent __ of bone strength/density
Demineralization, loss
Hyperparathyroidism: often discovered how?
Asymptomatic hypercalcemia on dx
Hypoparathyroidism: decreased or absent ___, commonly result of ___ of gland
PTH, removal
Hypoparathyroidism: ___ serum Ca, ___ serum phosphate, __ serum PTH
Decrease, increase, decrease
HYPER or HYPOparathyroidism?
proximal weakness
Hyper
HYPER or HYPOparathyroidism?
Fatigue, drowsy, depression
Hyper
HYPER or HYPOparathyroidism?
Arthralgia/myalgia
Hyper
HYPER or HYPOparathyroidism?
Pancreatitis
Hyper
HYPER or HYPOparathyroidism?
Gout, osteopenia/fx
Hyper
HYPER or HYPOparathyroidism?
Confusion/memory loss
Hyper
HYPER or HYPOparathyroidism?
Glove/stocking sensation loss
Hyper
HYPER or HYPOparathyroidism?
Osteitis fibrosis cystica (bone lesions: Brown tumors)
Hyper
HYPER or HYPOparathyroidism?
Neck stiffness, muscle cramps
Hypo
HYPER or HYPOparathyroidism?
Seizures, irritability, tetany
Hypo
HYPER or HYPOparathyroidism?
Shaking arms/legs, depression
Hypo
HYPER or HYPOparathyroidism?
Chovstek’s sign (twitching facial muscles with tapping of facial N in front of ear)
Hypo
Primary adrenal insufficiency
Addson’s disease
Addson’s disease: partial/complete failure of adrenocortical fxn, results in __ production of __ and __
Decreased, cortisol, aldosterone
Etiology of Addson’s disease
AI process, infection, neoplasm, hemorrhage
Medical interventions for addson’s disease?
Replacement therapy (glucocorticoid, adrenal corticoids), adequate fluid intake, diet high in complex carbs/protein
Addson’s Disease sx:
- ___ pigmentation of skin
- __ and __ endurance
- __ (eating), dehydration
- Wt __, __ disturbances
- psych conditions?
- Decreased tolerance to __ temp
- Intolerance to stress
- __ calcification
- Bronze
- Weakness, decreased
- Anorexia
- Loss, GI
- Anxiety, depression
- Cold
- Tendon
Secondary adrenal insufficiency can result from prolonged __ therapy (____), rapid withdrawal of __, __ or __ tumors
Steroid (ACTH), drugs, hypothalamic/pituitary
Metabolic disorder from chronic and excessive production of cortisol by adrenal cortex
Cushing’s Syndrome
___ is result of drug toxicity (over-administration of glucocorticoids)
Cushing’s
Etiology of Cushing’s?
Most common is PITUITARY TUMOR with increased secretion of ACTH
Medical interventions for Cushing’s?
Decrease excess ACTH, irradiation or surgery excision of pituitary tumor or control of meds
- monitor weight, electrolyte/fluid balance
S/sx Cushing’s:
- __ glucose tolerance
- Facial characteristics?
- Weight gain/loss? Where?
- Bone condition?
- __ testosterone or __ menstruated period
- Muscle __
- Edema
- Hypo__
- Emotional changes
- Decreased
- Moon face, increased facial hair
- Gain, increased fat pads abdomen, chest, BUFFALO HUMP
- Osteoporosis
- Decreased, decreased
- Atrophy/wasting
- —
- Hypokalemia