Screening for Endocrine and Metabolic Disease

Question 1

What is the endocrine system?

Answer 1

9 organs- role of hormone production

transported through the bloodstream

Question 2

What reacts faster endocrine or nervous system?

Answer 2

nervous, ex fight or flight response

Question 3

What are common endocrine sx reported to PT?

Answer 3

weakness, myalgia, fatigue, B CTS (like liver), joint stiffness confusion, Tachycardia, N/V

Question 4

Who should be screened?

Answer 4

previous thyroid dz or metabolic dz , B CTS, B proximal weakness, long term corticosteroid use

Question 5

What are systemic symptoms of endocrine dz?

Answer 5

delayed/excessive growth, polyuria/polydipsia, confusion, hair or skin changes, increased vitals, hyperhydorsis, dehydration/fluid retention

Question 6

What is the biggest sign of endocrine changes?

Answer 6

hair and skin changes

Question 7

What are neuromuscular sx of endocrine disease?

Answer 7

weakness, atrophy, myalgia, B CTS, adhesive capsulitis, jt pain

Question 8

What are three types of pituitary dz?

Answer 8

1. diabetes insipidus
2. SIADH
3. Acromegaly

Question 9

What is DI?

Answer 9

not enough ADH which causes extreme thirst and extreme urine output

Question 10

What is SIADH?

Answer 10

too much ADH, excess fluid in body and lack of urine output but also decrease in sodium leading to confusion and headaches

Question 11

What is acromegaly?

Answer 11

too much GH, bony enlargement, DM, diaphoresis, HTN, back pain, cardiac sx

Question 12

What happens when you have too much adrenal gland function?

Answer 12

Cushing’s- hyper and humps, moon face, muscle wasting, osteopenia, big hips small extremities

Question 13

What happens if you have too little adrenal function?

Answer 13

Addison’s- progressive fatigue, weakness and decreased tone(hyperkalemia), GI sx, jt pain, hypotension, hypoglycemic

Question 14

What is goiter?>

Answer 14

enlarged but not effective thyroid gland due to lack of iodine

sx: neck changes, dyspnea, dysphagia, hoarseness

Question 15

What is thyroiditis?

Answer 15

infection of thyroid gland

ex: Hashimoto’s women 30-50 y/o leads to hypothyroidism

Question 16

What is hyperthyroidism?

Answer 16

graves dz, exopthalamus, tachycardia, sweaty, hyper reflexia, proximal mm weakness, weight loss

Question 17

What is hypothyroidism?

Answer 17

women more likely and increases with age

puffy face, cold, constipation, CTS, weight gain, opposite of hyper

Question 18

What is thyroid storm?

Answer 18

medical emergency, Hyper x 10, due to trauma, infection or surgery

Question 19

What are sx of thyroid storm?

Answer 19

severe tachy, hyperthermia, restlessness, agitation, abdominal pain can’t result in a coma

Question 20

What is hyperparathyroid?

Answer 20

problem with Ca, phosphate absorption into bone, too little in bone not enough in bloodstream

Question 21

What are sx of hyperparathyroid?

Answer 21

proximal muscle weakness, loss of appetite, depression, thirsty, polyuria, osteopenia

Question 22

What is hypoparathyroid?

Answer 22

worse than hyper and usually related to surgical removal, too little calcium in bloodstream leads to: muscle spasms, parenthesis, tetany and cardiac arrhythmia

Question 23

Sx of DM?

Answer 23

polyuria, polydispia, polyphagia,glucose or ketones in urine, fatigue, blurred vision, irritable, recurring infections, numbness/ tingling

Question 24

What is most common complication from DM?

Answer 24

neuropathy

Question 25

What are norms for A1C?

Answer 25

should be biannually checked, normal 4-6

7 if BS are under 170

Question 26

What is the goal for FBS?

Answer 26

80-120

Question 27

What is DKA?

Answer 27

BS over 300

sx: hyperventilation, extreme thrist, fruity breath, drunk like confusion

Question 28

Sx of hypo?

Answer 28

less than 70 BS, sx can be masked if pt on a beta blocker

pale, sweating, irritable, weak, HA, blurred vision, slurred speech

Question 29

What to do if someone if hypo?

Answer 29

2 sugar packets or 1/2 cup soda

Question 30

What are three types of fluid imbalances?

Answer 30

1. dehydration
2. water intoxication
3. potassium depletion

Question 31

What are causes of dehydration?

Answer 31

decreased intake, DI, high glucose levels, hemorrhage, V/D

Question 32

What are sx of dehydration?

Answer 32

weight loss, turgor, dry mouth, stop eating, low urine output, OTN, increased Hct could lead to clots

Question 33

What are sx of water intoxication?

Answer 33

lowers NA, and too much ADH from too much H2O

sleepiness, poor coordination, confusion, bradycardia

Question 34

What are causes of edema?

Answer 34

CHF, liver dz, burns

sx: weight gain daily, pitting and dept edema, neck vein enlargement

Question 35

What are causes and sx of potassium depletion?

Answer 35

diuretics, or usually ppl with blood pressure issues

sX: weakness, fatigue, NV/ abdominal distention

Question 36

What is worrisome potassium level?

Answer 36

less than 3.5

Question 37

What are triple threat numbers?

Answer 37

FBS over 100, Triglycerides over 150 and HDl over 40 (men) or 50 (women)

Question 38

What is metabolic alkalosis?

Answer 38

pH over 7.45

vomiting, diuretic use

Question 39

What is metabolic acidosis?

Answer 39

pH drops below 7.35

lactic acidosis, renal failure

Question 40

What are sx of gout?

Answer 40

tophi, joint pain first MTP, fever, redness,

men over 40 or women post menopause

Question 41

What are risk factors for osteoporosis?

Answer 41

over 65, screen if over 60 or over 50 with fx history, weight less than 125

Question 42

What is a normal T score?

Answer 42

1.0

osteo -2.5 or less, severe 2.5 or less with fx history

Question 43

Who should be sent out immediately?

Answer 43

hypoglycemia or DKA
K depletion with weakness, cramping, N/V
thyroid storm

Question 44

Who is a should see doctor soon?

Answer 44

fever with corticosteroid use, hoarseness with hemoptysis, dehydration with diuretic use