Endocrine

Question 1

Thyroid

Answer 1

Regulates Metabolism so change all thyroids to metabolism

Question 2

Hyperthyroidism

Answer 2

HyperMeabolism
s/sx:
weight loss
increased HR & BP
Hyperpersonality (inrritable)
Heat intolerance (hyper=hot)
Cold tolerance
exophthalmos (bulging eyes)
Graves Disease: Hyper people run, run themselves into the grave

Question 3

Hyperthyroid Tx

Answer 3

1. Nuke it w/ Radioactive Iodine
   2.PTU(propylithouracil)
   3.Thyroidectomy (most common)

Question 4

Radioactive Iodine

Answer 4

-private room/no visitors for first 24 hrs
-flush 3 times after peeing
-Hazmat team called if urine spills

Question 5

PTU

Answer 5

-PTU: Puts Thyroid Under
-primary use of drug is for cancer so monitor WBC b/c pt is immunosupressed

Question 6

Thyroidectomy

Answer 6

Total vs Sub/partial
Total:
-lifelong hormone replacement
-risk for hypocalcemia

Sub/partial:
-temp hormone supplement but not lifelong tx
-THYROID STORM RISK: Medical emergency

Question 7

Thyroid Storm

Answer 7

s/sx:
temp of 105+
High BP, stroke level
severe tachycardia
psychotically delirious

tx: Get body temp down and O2 up
FIRST step is ice pack
BEST step is cooling blanket
Give o2 at 10L
stay with pt

Question 8

Postop Thyroidectomy risks

Answer 8

first 12 hrs: risk are same for total & sub
-Top priority is AIRWAY b/c of edema
-HEMORRHAGE b/c its a vascular endocrine gland
12-48 hrs: risks are diff for total & sub
-total: TETANY due to low calcium can close of airway with a spasm (total = tetany)
-sub: THYROID STORM (subtotal = storm)
after 48 hrs: risk is infection

Question 9

Hypothyroidism

Answer 9

Hypometabolism
s/sx:
obesity
decreased HR &BP
Personality: flat/ dull/boring
Cold intolerance
Heat tolerance
Academically challenged

severe case:
myxedema: pt presents with skin involvement
myxedema coma: MED EMERGENCY - slowing of multiple organ functions

Question 10

Hypothroidism Tx

Answer 10

Levothyroxine (synthroid)
-take in morning 30min-1 hr before breakfast
-take on empty stomach w/ water
NEVER sedate pts theyre already super low
NEVER hold if undergoing surgery b/c w/o it increases anesthesia affects and person will die

Question 11

Adrenal Cortex Disease

Answer 11

All adrenal cortex disease star with A or C

Question 12

Addison disease

Answer 12

under secretion of steroids
PERSON IS TICKING TIME BOMB
They cannot adapt to any type of stress and go into SHOCK
s/sx: hyperpigmented (tan)
shock
tx: Steroids (glucocorticoids)
-drugs that end in SONE
IN ADDISON YOU ADD A SONE

Question 13

Cushings Syndrome

Answer 13

Cushy tushy -> over secretion of steroids

Question 14

Cushings s/sx

Answer 14

ALL s/sx of cushings are the S/e of steroids
-moon face
-hirstutism: lots of hair
-central/truncal obesity w/ extremity muscle atrophy (really big body with tiny little legs)
-Bump on front & back (gynecomastia:big breast & buffalo hump)
-stretch marks
-easy bruising
-retain water & sodium & looses K (full & salty…K bye)
-mad because they have an infection (roid rage and immunosuppressed
-HIGH SERUM GLUCOSE ; look like diabetics, checks q6h

Question 15

Cushings Tx

Answer 15

Adrenalectomy
-now has addisons disease so ADD A SONE
-s/e of steroids will result in th s/sx of cushings and will regulate after a year