Adult Endocrine

Question 1

Hypothyroidism (myxedema)

Answer 1

• low T4; high TSH
• flattened affect
• constipation
• weight gain
• pedal edema
• low HR and BP

Question 2

Myxedema coma

Answer 2

• severely low thyroid levels

Question 3

Hyperthyroidism

Answer 3

• excessive T3 and T4
• agitation
• weight loss
• insomnia
• HR and BP up
• heat interlorance
• injected (red) cojunctiva

Question 4

Cushing’s disease

Answer 4

• Hypersecretion of ACTH from the pituitary gland
• excessive corticosterioids
  
  • causes suppresion of white blood cells
  • immune suppresion

Question 5

Cushing disease symptoms

Answer 5

• sodium and water retention
• weight gain
• fatigue
• hyperglycemia
• thirst
• delayed wound healing
• sexual dysfunction
• acne

Question 6

Cushing disease care

Answer 6

• modify diet to low glycemic and sodium foods
• increasing potassium rich foods
• Low impact, weight bearing exercises to increase bone density

Question 7

pathophysiology of diabetes mellitus

Answer 7

Destruction of pancreatic beta-cells

Question 8

Main symptom?

Addison’s disease

Answer 8

• decrease in androgens (sex hormones) and glucocorticoids
• shock and hypoglycemic**
• hyper-pigmented (very tan)
• do not adapt to stress
• hyponatremia

Question 9

Give what?

Addisons Crisis

Answer 9

• Add a SONE (give steroids)

Question 10

Pheochromocytoma

Answer 10

• Tumor in adrenal glands
• too much of epinephrine and norepinephrine

Question 11

pheochromocytoma high risk for

Answer 11

• hypertensive emergency
• avoid diet that can raise BP like cheese
• cardiac dysrhythmias
• panic (sweating, headache)

Question 12

Regular Insulin peak

Answer 12

• IV
  
  • 15-30 min
• Sub Q
  
  • 2-3 hours

Question 13

Most common cause of hyperthyroidism

Answer 13

Grave’s disease

Question 14

Myxedema

Answer 14

• severe, non-pitting edema
• puffy face and periorbital area (around eyes)
• coarse facial features
• dry skin and hair (coarse)

hypothyroidism w/ skin involvement

Question 15

Hypophysectomy

Answer 15

• neurosurgical technique for removing pituitary tumors
• urine output greater than 300 mL/hr is alarming
• Semi-Fowlers/Fowlers position is appropriate
• prophylactic nausea vomiting needed
  
  • Ondansetron!
• CSF leakage is serious
• risk for meningitis!
• increased ICP
• decreased smell is expected for a few months
• do not brush teeth = foul-smelling breath

Question 16

severe complication from neurosurgery around the pituitary

Answer 16

• Diabetes insipidus
• daily weights
• too much urine output can lead to shock

Question 17

Diabetic nephropathy

Answer 17

• proteinuria > 300 mg
• kidney fails
• monitor high BP

Question 18

Hyperglycemia causes

Answer 18

excessive thirst

Question 19

Jaundice in dark-skin

Answer 19

• examine
  
  • mucous mebranes
  • hard palate
  • sclera

Question 20

BMI + waist size

Answer 20

• BMI
  
  • 25-30 = overweight
  • 30+ = obese
• obese waist size
  
  • men
    
    • 40 inches (102 cm) or greater
  • women
    
    • 35 inches (88 cm) or greater

Question 21

Acanthosis nigricans

Answer 21

• darkening patches in skin folds
• happens with insulin resistance
• can indicate diabetes mellitus

Question 22

Thyroid panel test

Answer 22

• given for
  
  • constipation
  • decreased sex drive
  • reduced activity tolerance

Question 23

PSA test

Answer 23

• test for potential prostate cancer
• start at age 55

Question 24

Metabolic syndrome

Answer 24

• hypertension
• hyperglycemia
• hyperlipidemia
• obesity
• precursor to acute coronary syndrome and diabetes type 2

Question 25

Serum cardiac enzymes

Answer 25

• diagnose acute coronary syndrome
• given with angina

Question 26

C-reactive protein

Answer 26

• diagnose atherosclerosis

Question 27

Adrenal crisis

Answer 27

• abrupt end to steriods (prednisone)
• severe dehydration (fluid volume deficit)
  
  • tachycardia
  • hypotension
  • hyponatremia
  • weakness/fatigue
• hyperkalemia
  
  • peaked T wave
  • give sodium polystyrene