Cortisol And Thyroid Disorders

Question 1

What is the disease name for Hypercortisolism?

Answer 1

Cushing’s disease

Question 2

What is the name of the disease for Hypocortisolism?

Answer 2

Addison’s disease

Question 3

Individuals with hypercortisolism will manifest with a rise in plasma ___________ levels.

Answer 3

Glucose

Question 4

Why do individuals with Cushing disease or syndrome develop a thinning of the dermis that leads to skin ulcerations?

Answer 4

Elevated cortisol promotes the breakdown of collagen in the dermis.

Question 5

The most common cause of hypocortisolism is:

Answer 5

autoimmune destruction of adrenal cortex .

Question 6

What are life threatening manifestations of severe hypocortisolism?

Answer 6

Hypoglycemia

Hypotension

Question 7

A patient is diagnosed with secondary hyperthyroidism manifested by elevated T3/T4 and elevated TSH. What is a possible cause of this condition?

Answer 7

Pituitary gland adenoma

A pituitary gland tumor can over secrete TSH which leads to secondary hyperthyroidism.

Question 8

What correctly describes the pathophysiology of Graves disease?

Answer 8

Production of antibodies that mimic TSH function

Question 9

Which metabolic change is indicative of hyperthyroidism?

Answer 9

Weight loss

Increased T3/T4 levels causes a corresponding increase in the body’s metabolic rate, which leads to symptoms such as weight loss.

Question 10

Which clinical consequences are associated with long term, untreated hypothyroidism?

Answer 10

weight gain.
diminished reflexes.
myxedema.

Question 11

Which problem is a consequence of Hashimoto’s disease?

Answer 11

Hypothyroidism

Hashimoto’s disease or thyroiditis is caused by the production of antibodies that block TSH activity. This results in hypothyroidism.

Question 12

A 46-year old woman is hospitalized following surgery to remove her thyroid gland (i.e., a thyroidectomy) due to thyroid cancer. Which assessment finding would the nurse be monitoring for immediately following the surgery?

Answer 12

Hypotension

A thyroidectomy is a surgery that results in the removal of the thyroid gland. Without a thyroid, the body cannot produce thyroid hormone (T3/T4). This puts the post-operative patient in a state of hypothyroidism until supplemental thyroid hormone (e.g. levothyroxine) can be started. Normally, thyroid hormone stimulates the sympathetic nervous system to raise blood pressure. Without thyroid hormone, the patient can become become dangerously hypotensive.

Question 13

A patient is admitted to a medical surgical unit with a diagnosis of Addisonian crisis (i.e., severe Addison’s disease). Which findings should the interprofessional healthcare team focus on?

Answer 13

Hypoglycemia

Hypotension

Question 14

The nurse is preparing a client with a new diagnosis of Graves disease for discharge. the nurse determines that the client understands the discharge instructions if the client states that which signs and symptoms are associated with this diagnosis?

Answer 14

Insomnia

Rapid heart rate and palpitations

Tremors

Question 15

What are the clinical consequences of Hypercortisolism?

Answer 15

Hyperglycemia
Collagen breakdown in skin and blood vessels
Hypertension
Immunosuppression

Question 16

What are the physical body changes that Hypercortisolism causes?

Answer 16

weight gain; round face/fat pad development on upper back, central obesity, thin extremities.

Question 17

What is the primary hypocortisolism?

Answer 17

Atrophy or destruction of adrenal cortex leads to decreased cortisol and aldosterone secretion

Question 18

What causes hypocortisolism?

Answer 18

Autoimmune destruction of adrenal cortex
Genetic conditions (e.g., familial adrenal insufficiency
Tuberculosis

Question 19

What causes Secondary Hypocortisolism?

Answer 19

Injury to the anterior pituitary leading to decreased ACTH secretion (e.g., tumor, stroke…)

Question 20

What are the clinical consequences of hypocortisolism?

Answer 20

Hypoglycemia
Fatigue
Hypotension

Question 21

Which condition is a clinical consequence of hypercortisolism (Cushing disease or syndrome)?

Answer 21

Increased risk for infection

Question 22

Which condition a clinical manifestation of hypocortisolism (i.e., Addison disease)?

Answer 22

Hypoglycemia (low blood sugar)

Question 23

What is Secondary hyperthyroidism?

Answer 23

Excessive production of thyroid stimulating hormone (TSH) from the anterior pituitary gland leads to excess T3/T4 production.

Question 24

What causes Primary Hyperthyroidism?

Answer 24

Thyroiditis (viral or autoimmune injury)
Toxic nodular or multinodular goiter (Plummer disease)
Thyroid adenoma (benign tumor)
Thyroid cancer

Question 25

What causes Secondary Hyperthyroidism?

Answer 25

TSH-secreting pituitary benign or cancerous tumors Graves Disease Overdose of thyroid replacement medication (thyrotoxicosis)

Question 26

What are the clinical consequences of Hyperthyroidism?

Answer 26

Increased metabolic rate • Increased body temperature • Weight loss Increased neuromuscular activity • Hyperactive reflexes • Tremors, anxiousness, insomnia Increased SNS stimulation • Tachycardia (increased heart rate) • Hypertension (increased blood pressure)

Question 27

What is Graves’ disease?

Answer 27

An autoimmune disease causing hyperthyroidism

Question 28

What does grave disease causes?

Answer 28

Overproduction of thyroid autoantibodies called thyroid stimulating immunoglobulin (TSI) TSIs mimic effect of thyroid stimulating hormone (TSH) Elevated levels of TSI’s stimulate excess T3/T4 secretion

Question 29

What are the clinical consequences of Graves disease?

Answer 29

Exopthalamus Degeneration of extraocular muscles and edematous fluid accumulation in orbit leads to protruding eye ball Possible optic nerve and retina damage

Question 30

What is Primary hypothyroidism?

Answer 30

Loss of thyroid tissue leads to decreased T3/T4

Question 31

What is Secondary hypothyroidism?

Answer 31

Failure of pituitary to synthesize adequate TSH.

Question 32

What causes Primary Hypothyroidism?

Answer 32

Iodine deficiency (enlarged thyroid gland (goiter)) Congenital lack of thyroid tissue Surgical removal of the thyroid (thyroidectomy) Hashimoto’s thyroiditis

Question 33

What causes Secondary Hypothyroidism?

Answer 33

Stroke to hypothalamus or pituitary Pituitary tumor (benign or cancerous) Postpartum pituitary necrosis

Question 34

What are the clinical consequences of decreased T3/T4?

Answer 34

Decreased metabolic rate • Decreased body temperature • Weight gain Decreased neuromuscular activity • Hypoactive reflexes • Fatigue • Confusion, decreased level of consciousness (with severe hypothyroidism) • Balance problems and increased risk for falls Decreased SNS stimulation • Bradycardia (decreased heart rate) • Hypotension (decreased blood pressure)