week 1: endocrine Flashcards
which hormone does the posterior pituitary secrete
ADH
which drug would you give if there was too little ADH in the body
vasopressin
which drug would you give if there was too much ADH in the body
tolvaptan
what happens if you have too little thyroid hormone
hypo metabolism
which drug would you give if your patient had too little thyroid hormone
levothyroxine
which drugs would you give if your patient had too much thyroid hormone
tapazole and beta blockers
what does the adrenal gland secrete
corticosteroids
what disease happens with too little corticosteroids
Addisons
which disease happens with too much corticosteroids
cushingswhat
drug would treat addisons
prednisone
which drug treats cushings
drugs that interfere with ACTH production
why would one want to optimise hormone levels before a thyroidectomy
because if you have too much T4 it may cause high HR and BP which is not what you want going into surgery
what are the 4 main complications of a thyroidectomy
hemmorhage, swelling, loss of function around surrounding tissue, thyroid storm
when is a patient who just underwent a thyroidectomy be most at risk for hemmorhage
within the first 24 hours
why would you need to check lipids and Hgb with a hypothyroidism patient
because theyre at high risk for CAD and anemia
what is myedema coma
hypothyroid crisis, basically a major decrease in cardiopulmonary and neurological functioning
what type of labs would you see with hypothyroidism
TSH will be high, T4 will be low, and TPO(thyroid antibody) will be high
what type of symptoms would you see with hypothyroidism
fatigue, poor appetite, constipation, dry skin, brittle nails, overall decrease in metabolism
what symptoms would you see in myxoedema coma
decrease in temperature, decrease in LOC, decrease in BP and Hr
what types of things cause myxoedema coma
infection, medication, exposure to cold, trauma
lathargy
hypotension
hypothermia
hypoventilation
what would be the primary assessment for a patient with myxoedema coma
vitals and LOC
what can we do to help myxedema coma
send to ICU, give them oxygen, IV fluid, BP meds to raise BP, cardiac monitoring, IV fluid replacement
which types of patients would have hypoglycaemic unawareness
patients with neropathy, older adults, those taking beta blockers
what is the worst case scenario of something that could happen with a patient with diabetes
type 1: Diabetic Ketoacidosis (DKA)
- will cause metabolic acidosis and dehydration
type 2: hyperosmolar hyperglycaemic state (HHS)
- will cause severe dehydration
which two medications should you hold if a patient is hpoglucemic
insulin and secretagogues
how do we fix hypoglycaemia
If blood sugar is below 4 we give oral glucose tabs
if blood sugar is below 4 WITH decreased LOC we give 1 amp of D50 (IV) or glucagon if no IV access
what are 3 things you must monitor in patients with DKA and HHS
- blood glucose levels
- mental status
- vital signs
why does DKA cause cardiac dysrhythmias
because acid pushes potassium out of the cells which will cause hypokalaemia.
how come you don’t get ketoacidosis with HHS
because you have enough insulin to prevent it but not enough to control blood sugar
