Unit 1 Flashcards
What is the pathophysiology for Addison’s disease?
A response to a stressful event, reducing adrenocortical steroids causes loss of aldosterone and cortisol action
What is the pathophysiology of Cushing’s disease?
Excessive tissue exposure to cortisol/glucocorticoids. Benign pituitary gland tumor increasing adrenocorticotropic hormone stimulating overproduction of cortisol in the body.
What is the pathophysiology of thyroid diseases?
Decrease or increase production of T3 and T4 in the thyroid.
What is the pathophysiology of SIADH?
Vasopressin is secreted even when osmolarity is low resulting in water retention and fluid overload
What is the pathophysiology of Diabetes Insipidus (DI)?
Disorder of the posterior pituitary gland leading to water loss due to an inability to respond to vasopressin (deficiency in production or a deficiency in response)
What are the s/s of Addison’s?
Hypoglycemia
Excessive BUN lvls (anorexia, weight loss)
Hyperkalemia
Dehydration
Acidosis
Decreased body hair in women
What is the s/s of Cushing’s?
Acne
Increased body hair
Oligomenorrhea
Clitoral hypertrophy
Moon face
Hump
Emotional instability
Weight gain
Increased appetite
What is the s/s of hypothyroidism?
Goiter
Thick tongue
Edema
Myxedema coma (hypothermia, hypotension, swelling of face, lips, and tongue, slow pulse, decreased mental status)
Grey skin
Bradycardia
What is the s/s of hyperthyroidism?
Goiter - do not palpate
Increased appetite
Weight loss
Globe lag
Eyelid retraction
Chest pain
Tachycardia
Heat intolerance
What is the s/s of SIADH?
N/V
Hyponatremia
Headache
Hypothermia
Bounding pulse
LOC
Decreased urination
What is the s/s of DI?
Polyuria
Dehydration
Fluid/electrolyte imbalances
Hypernatremia
Nocturia
Polydipsia
What is the treatment for Cushings?
Restore volume balance - stop overload from worsening, monitor for pulmonary edema, ketoconazole, monitor weight gain
Prevent injury
Prevent infection
What is the treatment for Addison’s?
Promote fluid balance, monitor fluid deficit, prevent hypoglycemia, and administer prednisone
What is the treatment of SIADH?
Restrict fluid intake
Promote the excretion of water
Replace sodium
Interfere with ADH
Tolvaptan or conivaptan
What is the treatment for DI?
Control the symptoms
Desmopressin
What is the difference between hyper and hypo thyroidism?
Hyper has too much T3 and T4 production
Hypo has absent/reduced hormone secretion, causing a decreased metabolism
What are the lab values for SIADH?
Hyponatremia - greater sodium loss in urine due to increased blood volume in kidney filtration inhibiting renin and aldosterone release
What are the lab values for DI?
Hypernatremia - due to water loss, plasma and sodium levels increase, which stimulates thirst. A compromised thirst mechanism can lead to dehydration (in older adults especially) and leads to death.
What are the risk factors of SIADH?
Pulmonary diseases (COPD) - vasoconstriction and antidiuresis
Recent head trauma
Cerebrovascular disease
Tuberculosis
Cancer
Drug use
Decrease in sodium levels
What are the risk factors for DI?
Surgery
Head trauma
Drug use
What are risk factors for Cushing’s?
Use of adrenocorticotropic hormone or glucocorticoids
What are risk factors for Addison’s?
Autoimmune disease
TB
Metastatic cancer
AIDS
Hemorrhage
Gram-negative sepsis
Abdominal radiation
Drugs
Toxins
What are risk factors for thyroid disease?
Hashimoto
Radioactive iodine treatment
Thyroid surgery
What do ADH medications do? What are they?
Vasopressin - limits urine output with restricting sodium loss
Desmopressin - limits urine output
DDAVP - like vasopressin
What do sodium medications do?
Provides patient with sodium. Can be PO or IV
What are thyroid medications?
Levothyroxine - produces thyroid hormones
Hyperthyroidism:
Methimazole - preffered ; report pregnancy
Propylthiouracil - toxic to the liver, report darkening urine
What is Addison’s Crisis? Treatment?
When the body’s need for cortisol and aldosterone is greater than production
Tx: intravenous fluids and glucocorticoid medications, such as hydrocortisone or dexamethasone
