Unit 5 - Endocrine

Question 1

Adrenal Hormones

Answer 1

• Cortisol (corticosteroids)
  *Hydrocortisone, prednisone
  *HPA axis. ACTH –> cortisol
  -Aldosterone (mineralocorticoids)
  *Fluticasone
  *RAAS pathway
  -Non-epinephrine and epinephrine aka catecholamines.

Question 2

Posterior Pituitary Hormones

Answer 2

-ADH
*Vasopressin; desmopressin
*“pressin’ on vein”
-Oxytocin

Question 3

Anterior Pituitary Hormones

Answer 3

-ACTH
-LH
-FSH
-TSH
-GH
-PL

Question 4

Hypothalamus Hormones

Answer 4

-Oxytocin
-CRH
*CRH –> ATCH –> cortisol. Adrenal: “salt, sugar, sex”
-TRH
* TRH –>TSH –> …

Question 5

Thyroid Hormones

Answer 5

-T3
*Levothyroxine
-T4

Question 6

Parathyroid Hormones

Answer 6

-PTH
*Calcitonin

Question 7

Addison’s disease

Answer 7

• Addison’s = absence of steroids

L- Low!!: wt, BP, hair, energy, mood, energy. High!! hyperpigmentation. Crave salt
A- Hypotension. Hypoglycemia. Hyponatremia. Hyperkalemia.
Test-
Tx- Steroid treatment. Ex. prednisone
E- ADDI* A “sone”. Let clinician know abt stressful events to increase steroid dose. Diet high in K. Na, and Carbs. Don’t stop steroid suddenly. Indefinite lifelong therapy.
*7 steroids S’s: sepsis, swollen from wt gain, sugar increased, skinny, sight - cataracts, slowly taper off, stress/surgery increase dose.

Question 8

Addisonian Crisis

Answer 8

Severely low cortisol. Low sugar paired with no coritosol reserves.

Question 9

Cushing’s Disease

Answer 9

L- Edematous - moon face, trunk neck, buffalo hump. Hirtuism “hairy suit”. Skin has purple strain.
A- HTN. Hyperglycemia. High sodium.
T - Cortisol levels. Hypernatremia. Hyperglycemia..
T - Hair removal surgery. Surgical removal of adrenal gland or ACTH creating CA.
E - Avoid anything else w steroids ex. steroid meds.

Question 10

Myxedema Coma

Answer 10

!Severe hypothyroidism.

L- Comatose.
A- Low RR –> resp failure
T- Intubation set up; endotrach

Question 11

Thyroid Storm

Answer 11

L - Agitation. Confusion. Wt loss
A - High temperature. High HR. High BP. diaphoresis,

Question 12

Hypothyroidism

Answer 12

L - Skinny. Depressed. Edematous in lower extremities. Cold intolerance. Fatigue. Wt gain. Constipation. Amenorrhea, alopecia, ALOC.
A - Hypotension. Low RR.
T -TSH, T3 and T4
T- Levothyroxine. Low calories w cholesterol. Frequent rest periods.
E- LEVO - Lifelong tx. Early in morning. Very hyper = S/S of thyroid storm. “Oh, baby’s are ok”, pregnancy friendly.

Question 13

Hyperthyroidism/Grave’s Disease

Answer 13

L- Bulging eyes. ! May be from iodine excess- diet. Goiter.
A- Hypertension. Over 180/100 considered crisis. Diarrhea. Heat intolerance.
T- TSH, T3 and T4
T- Eye drops AM and lubricating drops HS. Surgical removal of thyroid. Tape eyes closed at night.
*Watch Ca r/t potential removal of parathyroids w surgery.

E- Wear sunglasses. Frequent snacks high in calories, protein ! no fiber.
* Methamazole “SSK” - Shrinks the thyroid, Stains the teeth, K separate from meds.
* PTU
*RAI - avoid ppl for a week. Flush toilet 3 times.

Question 14

Hyperaldosteronism

Answer 14

L-
A-
T-
T-
E-

Question 15

DI - diabetes insidious

Answer 15

*DI = “Dry Inside!”

L- Thirsty. Polydipsia.
A- Hypotension. ! Headache r/t hypernatremia
T- Low ADH. Low specific gravity. “High & dry labs”: hyperosmolaity, hypernatremia.
T- Encourage 2-3 L. Strict wt and I/Os
E- Taking vasopressin or desmopressin. Lifelong tx.

Question 16

SIADH - symptom of inapproitae ADH

Answer 16

*“Soaked inside”

L- Edemetous. Oliguria. Low Na. Cause - Lung CA, brain trauma.
A- Heartaches S/S of hyponatremia. ! Seizure precautions. High BP
T- ADH high. High specific gravity
T- Fluid restriction. Add salt: 3% NaCl and diuretics. Strict wt and I/Os
E- Fluid restriction. Do daily wt.

Question 17

Hypoparathyroidism

Question 18

Hyperparathyroidism

Question 19

Pheochromocytoma

Answer 19

High Catecholamines.

Question 20

Acromegaly/ Giantism (kids)

Question 21

Dwarfism

Question 22

HHHS

Answer 22

!Just like DKA, but no abd px cuz no ketones. BS more around 600+
Tx: “HS”. Hydration w 0.9 NaCL. Stabilize sugar with ONLY regular insulin (only insulin allowed IV)

Question 23

DKA

Answer 23

L- Lethargic. Kussmaul breathing. Fruity breath.
A- Low RR. Abd pain.
T- Ketone positive. BG 250-500. pH less then 7.35
T- “DKA” - Dehydration tx w 0.9NaCl. Kill sugar slowly w insulin and add D50 when sugar under 250. Add k during infusion
E- BS management.

Question 24

Regular Insulin

Answer 24

Short Acting
-Onset: 30-60 minutes
-Peak: 2-5 hours
-Duration: 5-8 hours

Question 25

NPH Insulin

Answer 25

Intermediate
-Onset: 1 to 1.5 hours
-Peak: 4-8 (6) hours
-Duration: 12-18 hours

Question 26

Lantus Insulin

Answer 26

Long Acting
-Onset: 1-4 hours
-Peak: –
-Duration: 24 hours

Question 27

Humalog Insulin

Answer 27

Rapid acting
-Onset: 15 min
-Peak: 30 min
-Duration: 4 hours

Question 28

PTU

Question 29

RAI

Question 30

Methimazole

Answer 30

hyperthyroidism tx

Question 31

Somatropin

Question 32

Vasopressin/Desmopressin