Test 4 Flashcards
Which hormone indicates to the pituitary to adjust thyroid hormones/stimulating hormones?
T4
What is the most common cause of hyperthyroidism?
Graves Disease
A dysfunction of the thyroid, you would expect to see what levels of TSH and T3/T4?
High TSH and low T3/T4
A dysfunction of the pituitary, you would expect to see what levels of TSH and T3/T4?
Low levels of both
How is hyperthyroidism managed?
- Antithyroid drugs (methimazole, PTU)
- Ablation (radioactive, surgery)
- Iodides (SSKIs-decrease symptoms)
- Beta blockers (decrease twitchy symptoms)
What is the worst case scenario of hyperthyroidism?
Thyrotoxicosis or Thyroid Storm
Which lab value should be monitored post op thyroidectomy?
Calcium- hypocalcemia can occur if the parathyroid glands are taken out unintentionally with the thyroid
What is the most common cause of hypothyroidism? What is the etiology?
Hashimotos thyroiditis- autoimmune destruction of gland
What is the worst case scenario of hypothyroidism?
Myxedema coma
What disease is associated with high levels of adrenal hormones (hypercortisolism)?
Cushing’s Disease
What disease is associated with low levels of adrenal hormones (hypocortisolism)?
Addison’s Disease
ACTH stimulates what to produce what?
Adrenal cortex to produce cortisol
What role does cortisol play in blood sugar regulation?
Cortisol allows the sugar to be available for the body to utilize it (gluconeogenesis)
What are the functions of cortisol/glucocorticoid?
- Gluconeogenesis (blood sugar stuff)
- Converts proteins into carbs
- Enhances centralized fat deposition
- Depresses immune response
- Fluid and electrolyte balance
What is a complication of high aldosterone levels?
Increased Na and water retention
What level of ACTH would you expect to see in a patient who is taking prednisone (steroids in general)?
Low ACTH- body sees high levels of cortisol and thinks it doesn’t need to produce more
What is a major complication of Cushing’s?
Infection
Which life threatening lab value can be increased from adrenal insufficiency (Addison’s)?
Potassium (as a result of low Na)
Pheochromocytoma can often be confused with what? And why?
Panic attacks because they present similarly except for an extremely high BP
What is the primary fasting hormone which affects BG?
Glucagon
What is the main difference of clinical presentation in Diabetic Ketoacidosis and HHNS?
HHNS: no Ketones in urine and normal pH
Normal GFR
125 mL/min
Define RIFLE acronym for AKI
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
What is the most common AKI?
Prerenal
Describe the three causes of AKI
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)
What are indications for renal replacement therapy?
Acidosis (pH <7.25)
Electrolytes (hyperkalemia, hyperphos, hypermag)
Ingestions (limited salt)
Overload volume
Uremia complications (ALOC, pericarditis)
Which type of organ rejection is reversible?
Acute
