Week 13 - Hormonal Regulation

Question 1

Which hormones in this unit can affect every cell in the body? (3)

Answer 1

• thyroxine
• Triiodothyronine
• Corticosteroids (cortisol, hydrocortisone, etc_

Question 2

When performing nursing assessment, why is the endocrine system “muddy?” (4)

Answer 2

• often non-specific manifestations like fatigue, altered mood, sleep pattern
• Non-specific changes should raise a red flag for possible endocrine etiology
• Clinical manifestations may be system wide
• Lack of clear manifestations makes a detailed health hx very important (ROS)

Question 3

The thyroid gland is ____ (posterior/anterior) to the trachea

Answer 3

Anterior

Question 4

Where is TRH (thyroid-releasing hormone) secreted, and what does it do?

Answer 4

• TRH secreted by hypothalamus
• stimulates the release of TSH from the anterior pituitary, which stimulates release of thyroid hormones from thyroid gland

Question 5

What is the function of the thyroid gland? (2)

Answer 5

1. Produce T4, T3, and calcitonin
2. Major function is production, storage and release of T4 and T3

Question 6

Why is iodine needed for the thyroid?

Answer 6

• needed for synthesis of thyroid hormones (that is its only use)

Question 7

What are the effects of thyroid hormones on our body? (7)

Answer 7

Heart - increase HR + contractility
Muscles
GI - Contractility
Fat
Bones - Stops formation and uptakes Ca2+ in them, always allows energy to be used in bones
skin
Nerves - increased fight of flight
Cholesterol - Helps over process cholesterol

Question 8

Thyroid disorders arrow map

Answer 8

Question 9

What are the clinical manifestations of hyperthyroidism related to?

Answer 9

• increased metabolism and sensitivity to stimulation from SNS

manic presentation

Question 10

What are the clinical manifestations of hyperthyroidism? (7)

Answer 10

Think “fast”
- HR rapid and strong
- Nervous, insomnia, rapid thoughts/speech
- Weak (muscle cannot keep up with energy demands)
- increased temp
- Weight loss
- Menstrual irregularties/infertility

Question 11

One clinical manifestation of hyperthyroidism is exopthalmos, which is bulging of the eyes. Why does it occur? (3)

Answer 11

• in 20-50% of younger Graves patients
• Impaired drainage from orbit, increasing fat and edema in retro-orbital tissues = increased pressure and forces eyes out
• corneal surfaces become dry and irritated

Question 12

How is hyperthyroidism diagnosed? (3)

Answer 12

• Hx and physical exam
• Blood test for TSH, T4, and if needed , T3
  Other diagnostics:
• RAIU (radioactive Iodine Uptake test)

Note that T4 is inactive version and becomes active inside cells