class 16 hormonal regulation Flashcards
what are the thyroid hormones
T3 (more rapid and potent)
T4
calcitonin
how is thyroid hormone produced
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
what does thyroid hormone do
controls cellular metabolism activity of all cells
thyroid diagnostic tests
-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
what is hypothyroidism
-autoimmune thyroiditis (Hashimoto’s disease) is most common cause
-affects approx 2/100 people (increases with age)
-affects women 5x more than men
manifestations of HYPO thyroidism
-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
HYPOthyroidism treatment
-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
what is HYPERthyroidism
-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”
HYPERthyroidism manifestations
-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)
HYPERthyroidism treatment
-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
what is a thyroid storm
-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
manifestations of thyroid storm
-increased temp
-exophthalmos
-weakness, fatigue, muscle atrophy
-decreased fertility
-extreme tachycardia
-rapid weight loss/diarrhea
-edema, chest pain, dyspnea, palpitations
-delirium
-psychosis
what is benign prostate hyperplasia
-benign, noninflammatory enlargement of prostate gland
-most common urological problem in male adults
-50% will develop BPH in their life
-can occlude the urethra
etiology of BPH
-not completely understood
may be:
-imbalance of growth factors
-local inflammation
-hormonal changes with aging (testosterone decrease)
clinical manifestations of BPH
-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
