Endocrine Flashcards Preview

Pathophysiology > Endocrine > Flashcards

Flashcards in Endocrine Deck (46)
Loading flashcards...
1
Q

Diabetes Insipidus

  • related to what hormone imbalance
  • what happens?
A
  • Undersecretion of ADH

- cannot hold onto water

2
Q

DI

Etiology

  • Renal
  • CNS
A

-“sick” kidneys cause decreased response of renal tubules to ADH

  • pituitary lesion/tumor causes diminished ADH production
  • head injury puts pressure on pituitary
3
Q

DI

4 S&S

A
  1. Dilute urine in excess (Polyuria)
  2. Excessive thirst
  3. Dehydrated cells due to polyuria - high serum Osmo
    (T to B)
  4. Dehydration - dry mucous membranes & poor skin turgor
4
Q

SIADH

Which hormone imbalance?

What overall effect?

A

Oversecretion of ADH

“Hold onto” water

5
Q

SIADH

Etiology (3)

A
  1. Ectopically produced ADH by small cell cancer(outside usual)
  2. General anesthetic reactions
  3. Brain trauma that puts pressure on pituitary
6
Q

SIADH

S&S (3)

A
  1. oliguria (decreased urine output)
  2. Low serum osmo (B to T)
  3. Peripheral and pulmonary edema (pitting skin, crackles in lungs)
7
Q

HYPERthyroidism

Etiology

MOST common cause

A

Excess T3 & T4 production

Graves Disease (autoimmune disorder and where antibodies attack TSH receptors on thyroid by mimicking TSH, causing over secretion)

8
Q

HYPERthyroidism

S&S

  • Labs
  • CV
  • GI
A
  • High serum T4; low serum TSH
  • tachycardia
  • increased appetite w/ diarrhea
9
Q

HYPERthyroidism

S&S

  • Hair
  • appearance (2)
  • body changes
A
  1. Sensitive hair follicles
    - alopecia
  2. Exophthalamus (bulging eyed from fat tissues behind eyes)
  3. Goiter caused by overactive T4 cells
  4. Fatigue & weight loss
  5. High body temp & heat intolerance
  6. Flushed skin w/ excessive sweating
10
Q

HYPERthyroidism

-Extreme State

S&S

  • neuro
  • circulatory
  • other
A

Thyrotoxic Crisis

“Thyroid storm”

  1. Extreme restlessness, agitation, delirium, seizures, coma
  2. Tachycardia, HF, shock
  3. Diaphoresis, hyperthermia (103-105 F)
11
Q

HYPERthyroidism

Dx

(2)

A
  1. Antithyroid meds to inhibit thyroid hormone production

2. Surgery - thyroidectomy

12
Q

HYPOthyroidism

-Hormone imbalance?

A

Undersecretion of T3 & T4

13
Q

HYPOthyroidism

Etiology (5)

A

Loss of function thyroid tissue by:

  1. Congenital defect
  2. Removal or destruction of tissue
  3. Hashimoto’s thyroiditis
  4. Iodide deficiency
  5. Overactive antithyroid drugs
14
Q

Hashimoto’s Thyroiditis

A

Autoimmune disorder

-thyroid tissue slowly replaced by lymphocytes & scar tissue

15
Q

Cretinism

A

Congenital HYPOthyroidism w/ stunted mental & physical growth caused by lack of iodide in Mother’s diet in utero

16
Q

HYPOthyroidism

S&S

LABS

A

Low serum T4; high serum TSH

17
Q

HYPOthyroidism

S&S

(8)

  • neuro
  • circulatory
  • pulmonary
  • GI
  • hair
  • skin
  • other (3)
A
  1. Confusion, memory loss, depression
  2. Anemia, bradycardia, decreased CO
  3. Dyspnea, hypoventilation, CO2 retention
  4. Decreased appetite, constipated
  5. Dry, brittle hair. Alopecia
  6. Myxdema, dry and coarse skin
  7. Goiter
    - compensatory response to create more T4, scar tissue in HT
  8. Weight gain
    - decreased body temp & cold intolerance
18
Q

Calcitonin & PTH

-Functions

A
  • Calcitonin secreted by thyroid gland and moved calcium from blood into bone
  • PTH secreted by parathyroid and stims resorption of calcium from bone to blood
19
Q

How does PTH move CA from bone to blood?

A

Stims osteoclastic activity

20
Q

Calcitonin & PTH

Relationship

A

Negative Feedback:

  • hypocalcemia increases PTH secretion and suppresses calcitonin
  • hypercalcemia increases calcitonin and decreases PTH
21
Q

Osteoporosis

  • Etiology
  • Tx
  • sequela
A

‘Porous Bone’

  • Dramatic bone density decreases due to increased osteoclastic activity
  • Age related (Women over Men)
  • Bone breakage
22
Q

Osteopenia

A

Moderate decrease in bone density.

** The rest is same as Osteoporosis**

23
Q

Osteoporosis/-penia

Dx

A
  • Surgery for bone breakages

- Rx to decrease osteoclastic activity (nasal calcitonin and biphosphonates - Fosamax)

24
Q

Other CA related problems (3)

A
  • Electrical: hyper/hypo polarization of cells affects RMP
  • Clotting issues due to hypocalcemia
  • Kidney Stones
25
Q

Hyerglycemia

A

stimulates secretion of insulin, activates glycogenesis to store unneeded glycogen.

26
Q

HYPOglycemia

A

secretion of counterregulatory hormones.
When one doesn’t eat GH is released from pituitary gland and glucagon released from the pancreas and stimulated glycogenesis and g

27
Q

Cushing’s Syndrome

-Imbalance

A

hypercortisolism and hyperaldosteronism

28
Q

Cushing’s Syndrome

-Etiology (3)

A
  1. Pathologic oversecretion of adrenocorticopathic hormone (ACTH) from the pituitary gland
  2. adrenal cortex tumor
  3. Hyperadosteronism by adrenal cortex
29
Q

Cushing’s Syndrome
-S&S
Physical Appearance (lipids)

A

abnormal breakdown of adipose tissue deposits:

  • truncal obesity
  • moon face
  • buffalo hump
  • High levels of LDL & artherosclerosis risk
30
Q

Cushing’s Syndrome

-Muscles

A
  • Weakness & Wasting (thin arms and legs)
  • short stature
  • weakened collagen fibers = skin tears= purple striae
31
Q

Cushing’s Syndrome

Tx

A
  • decrease steroids if possible.
  • remove cause of exogenous cortisol hypersecretion
  • drugs that block the effect of aldosterone
32
Q

Addison’s Disease

Overview

A

hypocortisolism and hypoaldosteronism

33
Q

Addison’s Disease

-S&S

A

hypoglycemia
anorexia
body can’t hang on to water
decreased bloodvolume

34
Q

Addisonian crisis

A

Severe hypotension due to fluid loss

35
Q

Addison’s Disease

tX

A

prednisone, aldosterone, fluids, high NaCl diet

36
Q

Diabetes Mellitus

Type 1

A
  • Juvenile Onset

- TOTAL lack of insulin secretion

37
Q

Diabetes Mellitus

Type 2

A

Adult onset

  1. abnormally low insulin production
  2. impaired insulin utilization
38
Q

Type I

Sequela

A

hyperglycemia due to glucose not getting into cells. Stims Gluconeogenesis = high ketones in blood

39
Q

Type I DM

Extreme State: DKA

A

Diabetic Ketoacidosis

  • Metabolic acidosis, Kussmaul respirations, can progress to diabetic coma
  • Give insulin
40
Q

Type II DM

S&S

A
  • obesity
  • hyperglycemia, hyperinsulinemia
  • pancreatic overdrive = decreased insulin secretion
  • fatigue, mild polydipsia, polyuria
41
Q

Type II DM

Extreme State - HHNKS

A

Hyperglycemic-hyperosmolar-nonketotic syndrome

  • VERY high serum osmo, extreme polyuria, extreme dehydration
  • can progress to diabetic coma
42
Q

Type II DM

tX (4)

A
  1. weight loss
  2. oral medications
  3. insulin
  4. IV fluids for HHNKS
43
Q

Type I & II DM
S&S
(6)

A
  1. macroangiopathy - due to glucose txicity
  2. microangiopathy - damage to small vessels
  3. peripheral neuropathy
  4. autonomic neuropathy (autonomic system nerve damage)
  5. Bladder control
  6. Silent MI
44
Q

Hypoglycemia

A

Weakness, fatigue, apathy, confusion, shakiness, irritability, and swearing

45
Q

Hypoglycemia

Extreme State

A

Hypoglycemic shock or coma and seizures

46
Q

Hypoglycemia

tX

A

OJ, sugar, or cracker.

IV glucose od IM orsubQ glucagon