week 1: endocrine

Question 1

which hormone does the posterior pituitary secrete

Answer 1

ADH

Question 2

which drug would you give if there was too little ADH in the body

Answer 2

vasopressin

Question 3

which drug would you give if there was too much ADH in the body

Answer 3

tolvaptan

Question 4

what happens if you have too little thyroid hormone

Answer 4

hypo metabolism

Question 5

which drug would you give if your patient had too little thyroid hormone

Answer 5

levothyroxine

Question 6

which drugs would you give if your patient had too much thyroid hormone

Answer 6

tapazole and beta blockers

Question 7

what does the adrenal gland secrete

Answer 7

corticosteroids

Question 8

what disease happens with too little corticosteroids

Answer 8

Addisons

Question 9

which disease happens with too much corticosteroids

Answer 9

cushingswhat

Question 10

drug would treat addisons

Answer 10

prednisone

Question 11

which drug treats cushings

Answer 11

drugs that interfere with ACTH production

Question 12

why would one want to optimise hormone levels before a thyroidectomy

Answer 12

because if you have too much T4 it may cause high HR and BP which is not what you want going into surgery

Question 13

what are the 4 main complications of a thyroidectomy

Answer 13

hemmorhage, swelling, loss of function around surrounding tissue, thyroid storm

Question 14

when is a patient who just underwent a thyroidectomy be most at risk for hemmorhage

Answer 14

within the first 24 hours

Question 15

why would you need to check lipids and Hgb with a hypothyroidism patient

Answer 15

because theyre at high risk for CAD and anemia

Question 16

what is myedema coma

Answer 16

hypothyroid crisis, basically a major decrease in cardiopulmonary and neurological functioning

Question 17

what type of labs would you see with hypothyroidism

Answer 17

TSH will be high, T4 will be low, and TPO(thyroid antibody) will be high

Question 18

what type of symptoms would you see with hypothyroidism

Answer 18

fatigue, poor appetite, constipation, dry skin, brittle nails, overall decrease in metabolism

Question 19

what symptoms would you see in myxoedema coma

Answer 19

decrease in temperature, decrease in LOC, decrease in BP and Hr

Question 20

what types of things cause myxoedema coma

Answer 20

infection, medication, exposure to cold, trauma
lathargy
hypotension
hypothermia
hypoventilation

Question 21

what would be the primary assessment for a patient with myxoedema coma

Answer 21

vitals and LOC

Question 22

what can we do to help myxedema coma

Answer 22

send to ICU, give them oxygen, IV fluid, BP meds to raise BP, cardiac monitoring, IV fluid replacement

Question 23

which types of patients would have hypoglycaemic unawareness

Answer 23

patients with neropathy, older adults, those taking beta blockers

Question 24

what is the worst case scenario of something that could happen with a patient with diabetes

Answer 24

type 1: Diabetic Ketoacidosis (DKA)
- will cause metabolic acidosis and dehydration
type 2: hyperosmolar hyperglycaemic state (HHS)
- will cause severe dehydration

Question 25

which two medications should you hold if a patient is hpoglucemic

Answer 25

insulin and secretagogues

Question 26

how do we fix hypoglycaemia

Answer 26

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

Question 27

what are 3 things you must monitor in patients with DKA and HHS

Answer 27

• blood glucose levels
• mental status
• vital signs

Question 28

why does DKA cause cardiac dysrhythmias

Answer 28

because acid pushes potassium out of the cells which will cause hypokalaemia.

Question 29

how come you don’t get ketoacidosis with HHS

Answer 29

because you have enough insulin to prevent it but not enough to control blood sugar