Test 3 Ch 51 Flashcards
CUSHINGS SYNDROME: Too much Cortisol (stress steriod).
CAUSE:
can be due to a tumor in pituitary or adrenal gland.
DIAGNOSTICS:
Hyperkalemia (high potassium), Hyperglycemia (high sugar), elevated cortisol levels
S/S: Bone loss (easy breaks), round face, weight gain in the middle portion of body with thinning limbs, stretch marks, increased thirst,increased urination,
TESTS:
Diagnose based on appearance, CT, MRI Adrenal Angiography.
DIET:
Low Sodium, low calories, High potassium, High Calcium & vitamin D( because can have weak bones)
TREATMENT :
Can include removal of tumor in pituitary/adrenal gland. radiation, chemotherapy, medicines.
Addison’s Disease: Low Cortisol & Aldosterone hormones.
Cause:
Autoimmune diseases, infections like tuberculosis, HIV, Fungal infections, tumors, hemorrhage into adrenal glands.
S/S:
Irritability, moodiness, Fatigue, Weight loss, hypoglycemia, abdominal pain & inability to deal with stress.
Diagnostic:
Low Serum Sodium, high potassium, Electrolyte & fluid imbalance, low cortisol & low aldosterone hypovolemia & dehydration.
Diagnostic tests:
CT, MRI, ACTH simulation test.
Diet:
Increase Sodium, low potassium diet, restore fluid & electrolytes, Increase calcium & vitamin D, hydration, lean proteins, vegetables, fruits
LIMIT/AVOID:
foods high in sugar/fat, avoid too much potassium( bananas & oranges) , avoid fried foods and processed meats
Type 1 Diabetes (Hypoglycemia): Require Insulin injections for life, cant be prevented or cured, disease when the bodys immune system destroys pancreatic cells that produce insulin, insulin regulates blood sugar levels and allows cells to use blood sugar for energy. Pts with T1 cant produce or make very little insulin & must take insulin daily to survive. without insulin T1 pts will go into DKA.
CAUSE:
unknown, but may be due to genetics or environmental factors.
S/S:
3 P’s (constantly Urinating, Hunger, thirst) fatigue, weight loss, blurred vision, poor wound healing, fruity breath. Normal or underweight. Imbalance of sodium, potassium & bicarbonate.
Diagnostics:
Urine strongly positive for ketones,
DIET:
Eat foods high in fiber, lean meats, low fat dairy products, whole grains.
DKA can occur if not controlled & pt can die
Type 2 Diabetes: Occurs when the body doesnt produce enough insulin, causing blood sugar levels to become high. (hyperglycemia),
CAUSE: Being overweight or obese, genetic factors, age, prediabetes, inactivity.
S/S: Polyuria, Polydipsia, Polyphagia (Frequent Urination, Thirsty, Hunger), fatigue, dark skin areas ( neck, armpit, groin, hands, elbows)
COMPLICATion’s:
HHNS, Stroke, heart disease, eye problems
DIET: Leafy greens, low fat milk, whole grains, legumes, nuts, fish
Diabetes Insipidus: AKA water diabetes, caused by a lack of ADH/vasopressin hormone which prevents the kidneys from retaining water causing the body to excrete large amounts of urine and feel extreme thirst.
CAUSE: Damage to the pituitary gland during surgery, head injury, tumors, infection, family heredity.
S/S: Polyuria & Polydipsia (urine & thirst), irritability, confusion and nocturia.
DIET: Reduce salt and protein, no process foods, meat, eggs and nuts. no caffeine, no sodas, drink lots of water.
SIADH: condition where the body produces too much ADH by the pituitary gland. ADH helps the kidneys control how much water the body loses through urine. when the body produces too much ADH the body retains a lot of water which causes electrolyte levels like sodium to fall, can lead to hyponatremia or low blood sodium levels.
CAUSE: Stroke, hemorrhage, infection, trauma, mental illness, cancer, tumor,certain medicines: antidepressins, antiseizure.
S/S: cracles in lungs, concentrated urine ( dark yellow), Diluted blood, weight gain, fatigue, loss of apetite, muscle cramps, abnormal heart rhythm, seizures, coma, irritability.
DIAGNOSTICS: Lab results high urine specific gravity (concentrated, very yellow), low sodium in blood.
DIET: limiting fluids, eat salty foods and fluids with sodium, eat protein
MEDICATIONS: Diuretics, Vasopressin
(Graves Disease) HYPERTHYROIDISM: The overproduction of T3 & T4. Low levels of TSH. (The thyroid gland, butterfly shaped)
LAB VALUES:
High T3 & T4, Low TSH
S/S:
exophthalmos (bulging eyes), HIGH bp, high Pulse, tremors, hair loss, goiter, weight loss, rapid/irregular heartbeat, sweating, irritable (elderly do not usually experience symptoms)
TREATMENTS: Anti thyroid medication: Methimazole, Iodine solution, Beta blockers (to lower HR & BP) or Radioactive Iodine therapy or sometimes surgery (Thyroidectomy: remove part/all thyroid.
DIAGNOSTICS: blood test, thyroid scan or ultrasound
Diet: Eat foods low in Iodine, rich in iron & selenium & contain antioxidants.
COMPLICATIONS:
Thyroid Crisis, Heart problems, Osteoporosis, Eye diseases
(Low, Low, Low) HYPOTHYROIDISM: when the thyroid gland doesn’t produce enough Thyroid hormone. Low T3 & T4 hormone and high TSH.
LAB VALUES:
LOW T3 & T4 and high TSH
RISK FACTORS: hashimotos disease, not enough iodine in diet, thyroidectomy, pituitary hormone,
S/S: cold sensitivity,no energy, fatigue, constipation, dry skin & weight gain, sexual dysfunction. Low RR, Low BP, Low HR, constipation, Low blood sugar
TREATMENTS: consist of hormone replacement (Levothyroxine)
DIET: recommended balanced diet, fruits veggies, protein, healthy fats.
COMPLICATIONS: Myxedema Coma, heart disease,
DKA Diabetic KetoAcidosis: (Hyperglycemia)
INSULINS P1765
Long Acting:
Lantus, Levemir
Rapid Acting/Fast:
Humalog, Novolog, Apidra
Short acting:
Humilin R, Novolin R
Intermediate acting:
Humulin N, Novolin N
Regular insulin is the only that can be given IV
Long-acting insulin is yhe only one we DO NOT MIX
STRESS HORMONES
Secreted by Adrenal Medulla:
Epinephrine & Norepinephrine
AKA Adrenaline & NORADRENALINe
are catecholamines that are released when blood pressure drops. (Think fight or flight)
- lowers acute stress in body
-activates nerves in the adrenal medulla
-Activation of Sympathetic Nervous System (SNS)
HELPS in times of acute stress
STRESS HORMONE
Secreted by the Adrenal Cortex:
Cortisol is a glucocorticoid.
-Regulates Metabolism
- Anti-inflammatory properties
- raises blood glucose levels
- inhibits glucose uptake (anti-insulin action)
HELPS in times of chronic stress
Parathyroid hormone (PTH) & Calcitonin controls the serum CALCIUM levels
CALCITONIN : Secreted by the thyroid gland.
1. Increased calcium levels in the blood (hypercalcemia)
2.Thyroid gland secretes calcitonin
3. Calcitonin inhibits calcium resorption from bones
4.lowers Serum calcium
CalciTONin helps TONe down serum calcium
Everytime calcium goes up, PTH goes down & vice versa.
Parathyroid hormone (PTH) & Calcitonin controls the serum CALCIUM levels
PARATHYROID HORMONE (PTH): Secreted by the parathyroid gland
1.Decreased calcium levels in the blood
2. Parathyroid glands secrete PTH in response to hypocalcemia
3. Raises calcium absorption by the GI tract, raises calcium reabsorption by the renal tubule, and releases calcium from the bones.
4. Raises serum calcium.
The increase in Calcium suppresses PTH
Everytime calcium goes up, PTH goes down & vice versa.
A1C test: (Blood Glucose)
Normal: 4-6
Pre-Diabetic: anything above 5.9
*If your already Diabetic: 7 is considered normal/good
Diabetes test:
Greater than 200mg
Greater than 126 (if fasting for 8 hrs)
NORMAL CALCIUM: 9 - 11 MG/DL
Hypercalcemia : 11mg and above
Hypocalcemia: 9mg and below
Diabetes Diet:
1600-2400 calories daily women
2000-3000 calories daily men
DWARFISM: Deficiency in GH, largr head, small stature
GIGANTISM & ACROMEGALY
Both occur when the pituitary gland produces too much growth hormone (GH).
Gigantism:
- too much GH during childhood
- occurs before the closure of epiphyseal growth plate
- Increase in height
Acromegaly: * Acro think Adlt After plates*
- too much GH during adulthood
- occurs after the closure of the epiphyseal growth plate
- no increase in height, increase in bone size (large hands, large feet, large face)
RISK FACTORS: Pituitary tumors & non-pituitary tumors
DIAGNOSTIC TESTS:
- Growth hormone suppression test
- MRI
- IGF-1 measurement
SURGERY/TREATMENT:
- Transphenoidal - remove tumor through sphenoid sinus
- Hypophysectomy - remove pituitary gland
- Radiation Therapy
