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Apex Review > Endocrine 2 > Flashcards

Endocrine 2 Flashcards

1
Q

Anesthetic considerations for the patient with diabetes insipidus include:
a. sodium restriction
b. DDAVP
c. three percent sodium chloride
d. demeclocycline

A

b. DDAVP

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2
Q

The most common cause of diabetes insipidus is

A

pituitary surgery

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3
Q

Syndrome of inappropriate ADH secretion is caused by

A

an excessive level of ADH in the blood

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4
Q

Diabetes insipidus is caused by

A

too little ADH in the blood

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5
Q

The most common cause of SIADH is

A

traumatic brain injury

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6
Q

Describe urine output for SIADH

A

low urine output

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7
Q

Describe urine output for DI.

A

high urine output

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8
Q

Treatment of SIADH includes

A

fluid restriction, demeclocycline, and hypertonic saline if the patient is severely hyponatremic

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9
Q

Treatment of DI includes

A

DDAVP or vasopressin along with supportive measures

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10
Q

__________ can complicate airway management

A

Acromegaly

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11
Q

Considerations with acromegaly include

A

distorted facial features (difficult mask)
large tongue, teeth, and epiglottis (difficult laryngoscopy
subglottic narrowing and vocal cord enlargement (difficult ETT placement)
turbinate enlargement (risk of epistaxis)

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12
Q

Comorbidities associated with acromegaly include

A

glucose intolerance
OSA
CAD
skeletal muscle weakness
entrapment neuropathies

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13
Q

Other conditions that can cause SIADH include

A

cancer (small-cell lung carcinoma)
noncancerous lung disease
carbamazepine

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14
Q

Other conditions that can cause DI include

A

TBI
SAH

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15
Q

Acromegaly results from

A

over secretion of growth hormone after adolescence

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16
Q

Nearly all cases of acromegaly are caused by

A

pituitary adenoma

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17
Q

When compared to T4, which statements BEST describe T3? (select 2)
a. shorter half-life
b. higher concentration in the blood
c. more protein-bound
d. higher potency

A

a. shorter half-life
d. higher potency

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18
Q

The thyroid gland stores and secretes three hormones:

A

T4= thyroxine
T3= triiodothyronine
calcitonin

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19
Q

Thyroxine is a

A

prohormone synthesized from tyrosine

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20
Q

Triiodothyronine is an

A

active thyroid hormone

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21
Q

Calcitonin leads to

A

reduced serum Ca2+

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22
Q

The thyroid requires ______ to synthesize T3 and T4

A

iodine

23
Q

When iodine is not available due to __________, the thyroid gland cannot

A

dietary deficiency; produce enough T3 and T4

24
Q

The recurrent laryngeal nerve courses along

A

the lateral border of each thyroid lobe

25
Q

RLN is at risk for injury during

A

thyroid or parathyroid surgery

26
Q

Describe the source of T4 & T3

A

T4 is directly released from the thyroid
T3 is mostly extra-thyroid conversion of T4 to T3

27
Q

Which has more protein binding T4 or T3

A

T4

28
Q

Which has more potency T4 or T3?

A

T3

29
Q

Which has a shorter half-life?

A

T3

30
Q

In the patient with hypoactive thyroid, there

A

isn’t enough thyroid hormone to suppress TSH so TSH remains chronically elevated–> goiter

31
Q

The following are consequences of excess thyroid hormone EXCEPT:
a. vasodilation
b. diarrhea
c. hypoventilation
d. tremors

A

c. hypoventilation

32
Q

Increased thyroid hormone–> ___BMR–> ______O2 consumption –> ______ Co2 production

A

increases all of them

33
Q

Thyroid hormone increases

A

myocardial performance independent of ANS input- increased HR, increased contractility, increased lusitropy, and decreased SVR

34
Q

Thyroid disorders ______ MAC

A

do NOT

35
Q

Instead of affecting MAC, thyroid disorders affect

A

cardiac output which impacts the speed of anesthetic onset

36
Q

How do hypothyroidism and hyperthyroidism affect the speed of anesthetic onset?

A

hypothyroidism–> increases speed of onset
hyperthyroidism–> reduces the speed of onset

37
Q

_________ is the most common cause of hyperthyroidism

A

Grave’s disease

38
Q

____________ is the most common cause of hypothyroidism

A

Hashimoto’s thyroiditis

39
Q

Etiologies of hyperthyroidism include

A

Grave’s disease
MG
multinodular goiter
carcinoma
pregnancy
pituitary adenoma
amiodarone

40
Q

Diagnosis of hyperthyroidism includes

A

Low TSH
high T3 & T4

41
Q

Cardiac symptoms of hyperthyroidism include

A

hypertension
tachyarrhythmias
atrial fibrillation

42
Q

Pulmonary symptoms of hyperthyroidism include

A

increased minute ventilation

43
Q

General findings of hyperthyroidism include

A

goiter
weight loss
muscle weakness
moist and warm skin
heat intolerance
fine hair
diarrhea
tremor
exophthalmos
hypercalcemia

44
Q

Etiologies of hypothyroidism include

A

Hashimoto’s thyroiditis
iodine deficiency
hypothalamic-pituitary dysfunction
neck radiation
thyroidectomy
amiodarone

45
Q

Diagnosis of hypothyroidism includes

A

high TSH and low T3 and T4

46
Q

Cardiac symptoms of hypothyroidism include

A

peripheral vasoconstriction
decreased heart rate
decreased contractility
heart failure
pericardial effusion

47
Q

Pulmonary symptoms of hypothyroidism include

A

decreased minute ventilation
reduced response to hypoxia
reduced response to hypercarbia
pleural effusion

48
Q

General findings with hypothyroidism include

A

goiter
weight gain
muscle fatigue/lethargy
dry and thick skin
cold intolerance
dry, brittle hair
constipation
delayed gastric emptying
large tongue

49
Q

What is thyroid storm?

A

in response to stressful events the thyroid glands increase hormone output

50
Q

When can thyroid storm occur?

A

hyper and euthyroid patients

51
Q

During the perioperative period, thyroid storm is most likely to happen

A

6-18 hours after surgery

52
Q

_________ is a complication of severe hypothyroidism

A

myxedeme coma

53
Q

_______ is a complication of neonatal hypothyroidism that leads to limited physical and mental development

A

Cretinism

Apex Review (224 decks)

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