Endocrine Ch 28

Question 1

panhypopituitarism

Answer 1

involves all the hormones of the pituatary gland

Question 2

hypoglycemia

Answer 2

less than 60
hunger
lightheaded
pallor, cool skin
diaphoretic
decreasing LOC
HA, blurred vision
tachycardia
irritability

Question 3

hyperglycemia

Answer 3

above 250
thirst
early- polyuria
late- oliguria
warm dry skin
weak pulse
kussmaul respirations with fruity breath (rapid deep)

Question 4

diabetes dx

Answer 4

fasting glucose of 8 hrs above 126
expected HbA1c= 4-6%

Question 5

type 1 diabetes

Answer 5

autoimmune destruction of pancreatic beta cells
most common in juvenilles
pancreas cannot make insulin - insulin deficient
symptoms appear more quickly
treat: insulin

Question 6

type 2 diabetes

Answer 6

acquired (poor lifestyle)
insulin resistant
symptoms appear slower
can become prediabetic first
treat: lifestyle changes (exercise and diet), medications

Question 7

insulin pump

Answer 7

atraumatic
catheter changed every 3 days, rotate sites

Question 8

continuous glucose monitor

Answer 8

$$$
can read glucose levels on app

Question 9

hypopituitarism

Answer 9

growth hormone deficiency
dysfunction of hypothalamus resulting in decreased growth hormone releasing hormone and less GH for bone growth
CM: short (less than 10th%)
dx: GH stimulating test (blood draw), skeletal survey in younger than 3yrs
treat: daily GH SQ injections

Question 10

acromegaly

Answer 10

excess GH after epiphyseal closure (postpuberty)
commonly caused by tumor
CM: really tall, overgrowth of facial features, separation and malocclusion of the teeth, increased facial hair, thickened creased skin
dx: excessive GH via blood sample
manage: emotional support, oncology if r/t tumor

Question 11

precocious puberty

Answer 11

sexual development before 8 yrs in girls and 9 yrs in boys
(occurs more in girls)
cause: t

Question 12

diseases of growth hormone

Answer 12

GH deficiency
Acromegaly

Question 13

diseases of ADH

Answer 13

KIDNEYS
DI
SIADH

Question 14

diseases of ACTH

Answer 14

ADRENAL GLANDS
Addison’s disease
Cushing’s disease
Pheochromocytoma

Question 15

diseases of LH and FSH

Answer 15

OVARIES AND TESTIES
precocious puberty

Question 16

diseases of TSH

Answer 16

THYROID
hyperthyroidism
hypothyroidism

Question 17

precocious puberty

Answer 17

sexual development before 8yrs in girls, 9yrs in boys
r/t tumor, infection, idiopathic
CM: growth spurt and secondary sex characteristics early
treat: LH releasing hormone injection until normal appropriate time for puberty

Question 18

diabetes insipidus (DI)

Answer 18

undersecretion of antidiuretic hormone (ADH) by posterior pituitary resulting in extreme diuresis
CM: polyuria and polydipsia! (peeing up to 15L per day)
dx: water deprivation test
manage: synthetic ADH (desmopressin), monitor for heart dysrthymias and confusion from abnormal labs r/t dehydration

Question 19

SIADH

Answer 19

hypersecretion of ADH causing kidneys to reabsorb too much water
can be r/t complication of MS
DECREASES ELECTROLYTES
CM: excessive thirst, fluid retention, anorexia, N/V, irritability
manage: fluid restriction (1200-1800mL/day), ADH antagonists, sodium replacements, monitor for respiratory distress, neuro assess, seizure precautions, telemetry

Question 20

normal thyroid function

Answer 20

pituatary releases TSH, releasing thyroid hormone (T3 and T4) and calcitonin

Question 21

calcitonin

Answer 21

prevents Ca from getting too high
works to keep it between 8.5-10

Question 22

thyroid hormone

Answer 22

T3 and T4
regulates basal metabolic rate

Question 23

juvenile hypothyroidism

Answer 23

deficiency in thyroid function
congenital(hypoplastic thyroid), acquired(r/t radiation, thyroidectomy), iodine deficiency
dx: decreased T3 and T4 (TH) and elevated TSH
CM: dry skin, sparse hair, periorbital edema, constipation, mental decline
treat: synthroid
can lead to intellectual disability if not treated early enough

Question 24

lymphocytic thyroiditis

Answer 24

Hashimotos disease
autoimmune, antibodies attack thyroid
most common cause of juvenile hypothyroidism
CM: goiter, hypothyroidism symptoms
treat: daily thyroid replacement, steroids (NO surgery, autoimmune)

Question 25

Graves disease

Answer 25

hyperthyroidism, autoimmune, antibodies attack and overstimulate thyroid CM: goiter, exophthalmos, hyperactivity, tremors, insomnia, weight loss r/t increased BMR, warm moist skin, heat intolerance dx: increased T3 and T4 (TH), low TSH treat: antithyroid drugs, radiation to thyroid, thyroidectomy

Question 26

thyrotoxicosis

Answer 26

thyroid crisis/storm sudden release of TH medical emergency CM: extreme HTN, hyperthermia (104+), tachycardia, delirium treat: stabilize pts with propranolol, antithyroid drugs

Question 27

normal parathyroid function

Answer 27

4 parathyroid glands on back of thyroid raises Ca levels in blood to keep between 8.5 and 10

Question 28

hypoparathyroidism

Answer 28

deficient PTH resulting in hypocalcemia CM: muscle cramps, brittle hair, tetany, HA, chovstek sign- tap facial nerve and face will spasm trousseau sign- squeeze carpal tunnel nerve and hand will contract dx: hypocalcemia, decreased PTH, increased phosphorus treat: calcium and vit D supplements

Question 29

calcium and phosphorus relationship

Answer 29

inverse!

Question 30

hyperparathyroidism

Answer 30

excessive PTH, hypercalcemia CM: kidney stones, excessive thirst, N/V, joint pain, abd pain, fatigue dx: hypercalcemia, increased PTH, decreased phosphorus treat: remove tumor, vit D supplement

Question 31

normal adrenal gland function

Answer 31

ACTH from pituitary stimulates adrenal glands on top of kidneys medulla= catecholamines (epi + norepi) cortex= cortisol+ aldosterone

Question 32

addison's disease

Answer 32

adrenocortical insufficiency decreased cortisol and aldosterone resulting in hypovolemia and hypotension caused by autoimmune response, cancer, infection CM: hypotension, hair loss, skin darkening, weight loss, anorexia, muscle pain, abd pain, depression irritability treat: cortisol and aldosterone replacement

Question 33

cushing's syndrome

Answer 33

too much cortisol released by adrenal glands usually r/t tumor or prolonged steroid therapy CM: excessive hair growth, moon face, red cheeks, weight gain, red striae on abdomen, poor wound healing, bruising treat: cannot be treated if r/t steroids, adrenalectomy if r/t tumor

Question 34

pheochromocytoma

Answer 34

adrenal tumor increasing epi and norepi (catecholamines) CM: tachycardia, sweating, flushing, HTN, HA dx: 24 hr urine collect, high levels of metanephrines (byproduct of epi and norepi) treat: resect tumor