3 Endocrine Flashcards Preview

Undeleted > 3 Endocrine > Flashcards

Flashcards in 3 Endocrine Deck (47):
1

function: pituitary gland

many

2

function: thyroid & parathyroid

metabolism, bones

3

function: adrenals

stress response, sugar, electrolytes

4

function: testes

male characteristics

5

function: ovaries

female characteristics

6

function: pancreas

glucose

7

function: thymus

immune response

8

function: pineal

body rhythms

9

hypothalamus

master gland!
- integration of neuroregulatory
- critical link between CNS and endocrine
- major controller of anterior, posterior pituitary

10

HP & POA

hormones, pituitary & posterior: oxytocin ADH

11

hypopituitarism: GH

children: small stature
adults: osteoporosis

12

somatomedin c

stimulated by GH
bone and cartilage maintenance

13

hypopituitarism: LH, FSH

men
- decreased facial & body hair, libido, muscle mass
- impotence
- facial wrinkles

women
- amenorrhea, anovulation
- breast atrophy
- decreased libido, axillary and pubic hair
- loss of bone density

14

*hypopituitarism assessment

*LOOK AT CLIENT*
some hormones measured directly
indirectly: T3 & T4 for TSH
- stimulation tests: insulin > increased GH, ACTH
- changes in sella turcica: MRI, CT
- hormone replacement necessary for the rest of their lives

15

hyperpituitarism most common cause

pituitary adenoma (benign tumor)
- tumor grows, neurological & endocrine issues emerge (HA, visual changes, intracranial pressure)

16

hyperpituitarism: GH

gigantism before puberty
acromegaly: adult (high blood sugar = red flag)

antagonist to insulin

17

hyperpituitarism: GH manifestations

- organomegaly (larger larynx = deeper voice, larger tongue = dysphagia)
- hypertension

18

hyperpituitarism interventions

- drug therapy
- radiation therapy
- surgery

19

*bromocriptine mesylate

Parlodel
- *dopamine agonist given for hyperpituitarism
- side effects: GI, orthostatic hypotension

20

disorders of posterior pituitary

remember; HP & POA (oxytocin, ADH)
- ADH deficiency: diabetes insipidus, polyuria -> dehydration, skin dry/turgor change
-- neuro: irritability, lethargy > coma
-- manage with vasopressin

- ADH excess: SIADH, GI disturbances, hyponatremia due to free water retention
-- neuro: lethargy > coma
-- manage with diuretics, NaCl

21

*Addison's Disease

adrenal cortical hypofunction
- *requires 90% destruction of gland
- bronze skin, hirsutism

22

Addison's Disease causes

- idiopathic atrophy (autoimmune) - 60 to 70% of US cases
- granulomatous disease (TB most common in 3rd world)
- metastases (especially lung and melanoma)

23

reduced cortisol results

HYPOGLYCEMIA (decreased gluconeogenesis)
- seizures, confusion, combative
- GFR, gastric acid production decreases -> increased BUN, anorexia, weight gain
- muscle weakness, fatigue

24

reduced aldosterone

HYPOKALEMIA (K excretion decreased)
- K retention promotes reabsorption of H+ > acidosis
- Na+, H20 excretion increased > hyponatremia, hypovolemia

25

Addisonian Crisis

life-threatening event in which physiologic need for gluco and mineralocorticoid hormone is greater than supply
- usually result of stressful event

26

Addisonian Crisis s/s

- profound fatigue
- dehydration
- vascular collapse
- renal shutdown
- hyponatremia
- hyperkalemia

27

Florinef

fluocortisone
- treatment for hypoaldosteronism, Addison's Disease
- counterproductive effect with diuretics
DO NOT GIVE WITH DIURETICS
- always assess cardiovascular status, ESPECIALLY elderly

28

adrenal insufficiency: diagnostic assessments

ACTH stimulation test = most definitive

29

*Cushing's disease

adrenal gland hyperfunction

30

*Cushing's syndrome

hypercortisol

31

*hyperaldosteronism

excessive mineralocorticoid OR excessive androgen production

32

*pheochromocytoma

tumor = hyperstimulation of adrenal medulla
- excessive secretion of catecholamines (80% epi, 20% norepi): HR, BP
- *HYPERTENSION hallmark of disease (doesn't resolve with dose of anti-hypertensive)
- do NOT palpate abdomen

33

Cushing's Syndrome causes

- pituitary adenoma (Cushing's disease)
- adrenal cortical adenoma, carcinoma
- ACTH-producing non-adrenal, non-pituitary tumor (lung, others)
- iatrogenic (anti-inflammatory therapy)
- self-administered (body builders, etc)

34

Cushing's Syndrome s/s

- increased fat due to low turnover of plasma fatty acids: moonface, central adiposity + striae
- increased breakdown of protein
- decreased production of lymphocytes
- htn, hyperpigmentation, hypokalemia, hyperglycemia

35

pheochromocytoma treatment

adrenalectomy
corticosteroids for rest of life

36

assessing thyroid function

TSH - best screening test in outpatient setting

37

Grave's Disease

hyperthyroidism
- toxic, diffuse goiter
- exopthalmia
- heat intolerant
- tachycardia, dysrhythmias
- SOB w/ w/o exertion
- weight loss, increased appetite, diarrhea

increase protein to prevent neg nitrogen!
increase calories and carbs!

38

thyroidectomy complications

- damage to laryngeal nerve
- hypoparathyroidism - hypocalcemia

39

hypoparathyroidism

hypocalcemia
- increased neuromuscular activity > tetany

IV CALCIUM GLUCONATE!

40

hypothyroidism

- main cause (US): thyroid surgery, radioactive iodine treatment for HYPER
- most common in women 30-60
- decreased metabolic rate!

41

myxedema coma

usually in hypothyroid patients subject to stress
- clinical features: CHF!, hypothermia, stupor/coma, hypoventilation/respiratory failure, hyponatremia, hypotension, seizures, hypoglycemia

42

levothyroxine

(synthroid) treatment for hypothyroidism
- synthetic T4
- converts to T3
- speeds up metabolism
- be careful not to induce THYROTOXICOSIS

43

PTH normal function

increased:
- bone resorption
- Ca resorption (urine)
- calcitrol (Ca absorption from gut)

stimultates:
- new osteoid formation ready for calcification during increase of dietary calcium

44

hyperparathyroid

HYPERCALCEMIA!
- increased bone resorption
- depressed serum P
- hypercaluria
- decreased neuromuscular irritability

45

hypoparathyroid

- decreased bone resorption
- depressed Ca serum
- elevated serum P
- increased neuromuscular activity = TETANY

46

hyperparathyroid management

- diuretic + fluid therapy
- drugs
- surgical management

47

hypoparathyroid management

- focus on correcting hypocalcemia, vitamin D deficiency
- avoid P (milk, yogurt, processed cheese)

Decks in Undeleted Class (79):