class 16 hormonal regulation Flashcards

1
Q

what are the thyroid hormones

A

T3 (more rapid and potent)
T4
calcitonin

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2
Q

how is thyroid hormone produced

A

TSH from anterior pituitary controls he release of thyroid hormone
-TRH from the hypothalamus controls the release of TSH
-calcitonin is secreted in response to high plasma calcium levels and increases calcium deposition in bone

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3
Q

what does thyroid hormone do

A

controls cellular metabolism activity of all cells

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4
Q

thyroid diagnostic tests

A

-thyroid-stimulating hormone (TSH)
-serum free T4
-T3 and T4
-T3 resin uptake
-thyroid antibodies
-radioactive iodine uptake
-fine needle aspiration biopsy
-thyroid scan, radio scan, or scintiscan
-serum thyroglobulin

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5
Q

what is hypothyroidism

A

-autoimmune thyroiditis (Hashimoto’s disease) is most common cause
-affects approx 2/100 people (increases with age)
-affects women 5x more than men

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6
Q

manifestations of HYPO thyroidism

A

-fatigue
-anemia
-brittle nails/hair loss/dry skin
-decrease gastric motility
-numbness/tingling in fingers
-menstrual disturbances
-subnormal temp and pulse
-weight gain
-subdued emotional and mental responses
-slow speech
-myxedema
-menorrhagia

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7
Q

HYPOthyroidism treatment

A

-restore normal metabolic state
-prevention of disease progression and complications
-synthetic levothyroxine replacement therapy
-assess for medication interactions (esp of hypnotics and sedatives; dec dosage)
-support of cardiac function and respiratory function
-prevent complications

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8
Q

what is HYPERthyroidism

A

-second most prevalent endocrine disorder
-excessive output of thyroid hormone
-grave’s disease (most common cause, body thinks a protein is TSH when it’s not)
-affects women 8x more than men
-“more troublesome”

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9
Q

HYPERthyroidism manifestations

A

-nervousness/palpitations/rapid pulse
-increased respiratory rate
-diarrhea
-goitre
-poor heat tolerance (sweating)
-tremors
-skin is flushed
-exophthalmos
-INCREASED appetite with weight LOSS
-elevated systolic BP (prone to cardiac issues i.e. afib, atherosclerosis, CAD)

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10
Q

HYPERthyroidism treatment

A

-lifelong medications; propylthiouracil and methimazole, sodium and potassium iodine solutions, beta-adrenergic blockers
-depends on underlying cause
-radioactive therapy (causes permanent thyroid damage)
-subtotal thyroidectomy (may have surge of T3, T4 after)
-relapse of disorder is common
-high calorie diet
-tx may result in HYPOthyroidism

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11
Q

what is a thyroid storm

A

-thyrotoxic crisis
-SEVERE HYPERthyroidism
-abrupt onset
-untreated: almost always fatal, usually seen in long standing untreated hyperthyroidism
-requires astute observation and aggressive and supportive nursing care

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12
Q

manifestations of thyroid storm

A

-increased temp
-exophthalmos
-weakness, fatigue, muscle atrophy
-decreased fertility
-extreme tachycardia
-rapid weight loss/diarrhea
-edema, chest pain, dyspnea, palpitations
-delirium
-psychosis

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13
Q

what is benign prostate hyperplasia

A

-benign, noninflammatory enlargement of prostate gland
-most common urological problem in male adults
-50% will develop BPH in their life
-can occlude the urethra

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14
Q

etiology of BPH

A

-not completely understood
may be:
-imbalance of growth factors
-local inflammation
-hormonal changes with aging (testosterone decrease)

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15
Q

clinical manifestations of BPH

A

-gradual onset
-early symptoms usually minimal b/c bladder can compensate
-s&s can worsen as obstruction increased
-s&s can be obstructive or irritative

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16
Q

obstructive symptoms of BPH

A

-usually d/t urinary retention
-decrease in caliber and force of the urinary stream
-difficulty in initiating voiding
-intermittency (stopping and starting while peeing)
-dribbling at the end of urination (not completely emptying bladder)

17
Q

irritative symptoms of BPH

A

-symptoms associated with inflammation or infection
-urinary frequency, urgency, dysuria
-bladder pain (pain, bleeding, back pain)
-nocturia
-incontinence

18
Q

complications of BPH

A

-related to urinary obstruction
-acute urinary retention
-urinary tract infection and sepsis
-incomplete bladder emptying
-calculi may develop in bladder d/t alkalinization of residual urine
-renal failure caused by hydronephrosis
-pyelonephritis
-bladder damage

19
Q

diagnostic studies for BPH

A

-history and physical examn
-digital rectal exam
-urinalysis w/culture
-serum creatinine
-prostate-specific antigen
-postvoid residual urine
-uroflowmetry
-transrectal ultrasonography
-cystourethroscopy

20
Q

nonsurgical management of BPH

A

-drug therapy; 5a-reductase inhibitors, a-adrenergic receptor blockers, erectogenic medications
-alternative therapies
-prostate massage
-freq intercourse/masturbation
-avoid drinking large amts of fluid
-avoid alcohol/diuretics/caffeine/antihcolinergic
-void as soon as get the urge
-may need CBI

21
Q

invasive surgical interventions of BPH

A

-open prostatectomy
-transurethral incision of the prostate (TUIP)
-transurethral resection of the prostate (TURP)

22
Q

minimally invasive surgical interventions of BPH

A

-intraprostatic urethral stents
-laser prostatectomy
-transurethral electrovaporization of the prostate(TUVP)
-transurethral microwave thermotherapy (TUMT)
-transurethral needle ablation(TUNA)