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Critical Care > Test 4 > Flashcards

Test 4 Flashcards

1
Q

Which hormone indicates to the pituitary to adjust thyroid hormones/stimulating hormones?

A

T4

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2
Q

What is the most common cause of hyperthyroidism?

A

Graves Disease

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3
Q

A dysfunction of the thyroid, you would expect to see what levels of TSH and T3/T4?

A

High TSH and low T3/T4

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4
Q

A dysfunction of the pituitary, you would expect to see what levels of TSH and T3/T4?

A

Low levels of both

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5
Q

How is hyperthyroidism managed?

A
  • Antithyroid drugs (methimazole, PTU)
  • Ablation (radioactive, surgery)
  • Iodides (SSKIs-decrease symptoms)
  • Beta blockers (decrease twitchy symptoms)
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6
Q

What is the worst case scenario of hyperthyroidism?

A

Thyrotoxicosis or Thyroid Storm

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7
Q

Which lab value should be monitored post op thyroidectomy?

A

Calcium- hypocalcemia can occur if the parathyroid glands are taken out unintentionally with the thyroid

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8
Q

What is the most common cause of hypothyroidism? What is the etiology?

A

Hashimotos thyroiditis- autoimmune destruction of gland

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9
Q

What is the worst case scenario of hypothyroidism?

A

Myxedema coma

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10
Q

What disease is associated with high levels of adrenal hormones (hypercortisolism)?

A

Cushing’s Disease

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11
Q

What disease is associated with low levels of adrenal hormones (hypocortisolism)?

A

Addison’s Disease

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12
Q

ACTH stimulates what to produce what?

A

Adrenal cortex to produce cortisol

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13
Q

What role does cortisol play in blood sugar regulation?

A

Cortisol allows the sugar to be available for the body to utilize it (gluconeogenesis)

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14
Q

What are the functions of cortisol/glucocorticoid?

A
  • Gluconeogenesis (blood sugar stuff)
  • Converts proteins into carbs
  • Enhances centralized fat deposition
  • Depresses immune response
  • Fluid and electrolyte balance
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15
Q

What is a complication of high aldosterone levels?

A

Increased Na and water retention

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16
Q

What level of ACTH would you expect to see in a patient who is taking prednisone (steroids in general)?

A

Low ACTH- body sees high levels of cortisol and thinks it doesn’t need to produce more

17
Q

What is a major complication of Cushing’s?

A

Infection

18
Q

Which life threatening lab value can be increased from adrenal insufficiency (Addison’s)?

A

Potassium (as a result of low Na)

19
Q

Pheochromocytoma can often be confused with what? And why?

A

Panic attacks because they present similarly except for an extremely high BP

20
Q

What is the primary fasting hormone which affects BG?

A

Glucagon

21
Q

What is the main difference of clinical presentation in Diabetic Ketoacidosis and HHNS?

A

HHNS: no Ketones in urine and normal pH

22
Q

Normal GFR

A

125 mL/min

23
Q

Define RIFLE acronym for AKI

A

R isk- first stage of AKI - Creatinine ↑x1.5 or GFR ↓25%
I njury- second stage - Creatinine ↑x2 or GFR ↓50%
F ailure- third stage - Creatinine ↑x3 or GFR ↓75% or Creatinine >4mg/dL
L oss- fourth stage - persistent AKI >4wk
E SRD- complete loss of kidney function >3 months

24
Q

What is the most common AKI?

A

Prerenal

25
Q

Describe the three causes of AKI

A

Prerenal: sudden and severe drop in BP or interruption of blood flow to the kidneys from severe injiry or illness (BP)
Intrarenal: Direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply (Kidney)
Postrenal: Sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury (organs below the kidneys)

26
Q

What are indications for renal replacement therapy?

A

Acidosis (pH <7.25)
Electrolytes (hyperkalemia, hyperphos, hypermag)
Ingestions (limited salt)
Overload volume
Uremia complications (ALOC, pericarditis)

27
Q

Which type of organ rejection is reversible?

A

Acute

Critical Care (6 decks)

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