Week 6 - Endocrine System Flashcards
Explain the pathophysiology of Hyperthyroidism:
Hyperthyroidism (Graves’ Disease) can be caused by:
- Thyroid Stimulating Hormone (TSH) immunoglobulin antibodies that bind to TSH receptors, which may develop as a result of autoimmune reaction against thyroid tissue.
- Thyroid tumours, (most common cause of hyperthyroidism)
- Causes decreased body weight, increase CO, increased minute volume, CNS stimulation leading nervousness
Explain the pathophysiology of Addison’s disease:
Caused by insufficient amounts of hormones from your adrenal glands.
- Primary cause is autoimmune destruction
- Secondary adrenocortical insufficiency from ACTH deficiency from pituitary and hypothalamic disease
- Other: hypothalamic - pituitary - adrenal gland suppression from exogenously administered corticosteroid
- Presentation: hypotension unresponsive to fluids, dehydration, weakness
- Precipitating factors: acute infection, AMI, PE, trauma
Explain the pathophysiology of Cushing’s Syndrome:
Caused by high levels of cortisol, this may be from a tumour or steroid use.
Explain the pathophysiology of Phaechromocytoma:
Caused by benign tumour releasing hormones in an adrenal gland.
- Adrenomedullary hyper function caused by tumour of adrenal medulla (chromaffin cells), which secretes catecholamines (adrenaline/ noradrenaline) on a continual or episodic basis.
Explain the pathophysiology of Hyperpituitarism:
Caused by Pituitary adenoma (benign tumour)
- Gigantism - young - epiphyseal / grown plates open > enlarged long bones
- Acromegaly - older - epiphyseal / grown plates fussed > enlarged face, hands & feet.
- Prolactinoma - overproduces prolactin, decrease in levels of some sex hormones.
S/S - Female - breast discharge, irregular menstrual periods.
S/S - Male - Decreased sexual drive, breast enlargement.
List the S/S and demonstrate the Pre-hospital treatment for Hyperthyroidism:
S/S: weight loss, rapid HR, sweating, irritability
- Intolerance to heat, Fine, straight hair, Bulging eyes, Facial flushing, Enlarged Thyroid, Increased systolic BP, Breast enlargement, Muscle wasting, Localised edema, Finger clubbing, Tremors, Diarrhoea, Menstrual Changes
- Prehospital Treatment – Recognition, supportive care and transport if required.
List the S/S and demonstrate the Pre-hospital treatment for Addison’s disease:
S/S: fatigue, nausea, darkening of skin, dizziness
- Changes in distribution of body hair, GI disturbances, Hypoglycaemia, Postural hypotension, Weight loss
- Rx: supportive care, O2 if required, fluids, some systems provide hydrocortisone/dexamethasone
List the S/S and demonstrate the Pre-hospital treatment for Cushing’s syndrome:
S/S: fatty hump between shoulders, rounded face, purple striations
- Personality changes, Moon face, Increased susceptibility to infection, Osteoporosis, Hyperglycaemia, CNS irritability, NA and fluid retention (edema), Thin extremities, GI distress
- Prehospital Treatment – Supportive care, manage symptoms, transport, rarely an emergency.
List the S/S and demonstrate the Pre-hospital treatment for Phaechromocytoma:
Persistent hypertension Severe headache Diaphoresis Tachycardia Palpitations Pallor Nausea and vomiting Epigastric / chest pain - Prehospital Treatment – Supportive care, manage symptoms, transport.
Explain the pathophysiology of hypothyroidism:
- Autoimmune reaction that destroys the gland
- Iodine deficiency (goiter) where uninhibited TSH production leads to increase in precursor molecule (thyroglobulin) but without iodine T3 and T4 cannot be formed.
List the S/S and demonstrate the Pre-hospital treatment for hypothyroidism:
S/S: Intolerance to the cold, fatigue, constipation, dry skin, weight gain
- Receding hairline, Facial and eyelid edema, Dull-blank expression, Thick tongue, Slow speech, Anorexia, Brittle nails and hair, Menstrual disturbances, Hair loss, Muscle aches and weakness
- Prehospital Treatment – Recognition, supportive care and transport if required.
What is a Thyroid Storm?
- Untreated hyperthyroidism leading to dangerously high HR, BP and temp, which is often fatal without treatment.
- Thyroid storm may occur in 1% of patients with hyperthyroidism which may be precipitated by:
Surgery, Trauma, Infection, Thyroxine ingestion - S/S: abrupt onset, restlessness, confusion, fever, tachycardia with extreme high rates
Administered propranolol in hospital
What is the cause and what are the S/S of hypopituitarism and pre-hospital Rx:
- Cause: low levels of hormones made by pituitary gland
S/S: Fatigue, weight loss, sensitivity to cold, decreased appetite, facial puffiness, anaemia, irregular or no periods, short stature in children.
What is Diabetes Insipidus?
Caused by decreased levels of vasopressin (antidiuretic hormone) which is made by the hypothalamus and stored in the posterior pituitary gland.
What are the S/S of Diabetes Insipidus?
large amount of dilute and odourless urine
increased thirst
large fluid intake
