Endocrine Disease Flashcards
(57 cards)
When is the highest levels of cortisol produced?
in the morning
How does aldosterone regulate bp?
Fluid and sodium retention
Action of ______
Kidneys –distal tubules
Intravascular volume and RAA system
Regulates Na and H20 balance –affects BP
Aldosterone
Action of ______
• Increases contractility and vascular reactivity to vascoconstriction
(results in BP)
• Antagonizes insulin
• Activates lipolysis –increased FFA
• Stimulates gluconeogenesis - (results in sugar, insulin
intolerance and cholesterol)
• Muscle catabolism –increases glucose
• Decreases calcium absorption and activates osteoclasts
- (results in osteoporosis)
• *Inhibits PLA2 and mobilization, migration, function of leukocytes -
- (results in immune response)
• Increases appetite, suppresses sleep, regulates emotion and
memory
• Increases intraocular pressure
Cortisol
Action of _______
Fight or flight - stress response
Increases BP, peripheral resistance, cardiac output
Norepi and Epi
• ↑Aldosterone, cortisol, androgen, estrogen isolated or in combination
Hyperadrenalism
• Hypertension, hypokalemia, edema
Hyperaldosteronism
Glucocorticoid excess • MOST COMMON • High levels of cortisol ➢ Cushing disease (pituitary or adrenal tumor) ➢ Cushing syndrome (exogenous corticosteroids) ➢ Complications Jameson et al. Harrison’s Principles of Internal Medicine 20th ed. (2018) oDiabetes oHypertension oWeight gain oMoon facies oBuffalo hump oHirsutism oAcne oHeart failure Adrenal oOsteoporosis oDelayed wound healing oSusceptibility to infection oirregular menses Insomnia oPsychiatric disorders oPeptic ulcers oGlaucoma and cataracts oStunted growth
Glucocorticoid excess
Findings in ______:
Increased central adiposity (moon facies and buffalo hump) with thinning of extremities
- Diabetes
- Hypertension
- Osteoporosis
- Irregular menses
Management:
-Appropriate endocrine and surgical consultation
- Surgical removal of pituitary or adrenal tumor
- Adrenal enzyme inhibitors
- Radiation therapy
Cushing syndrome
The following drugs are used to treat\_\_\_\_\_\_\_\_: Prednisolone Triamcinolone Methylprednisolone Dexamethasone Betamethasone
Cushings
➢ Destruction of adrenal cortex o↓Cortisol and ↑ACTH (adrenocorticotropic hormone) ➢ Etiology oMost commonly autoimmune ❑ What does this mean? oChronic infectious disease and sepsis ❑ HIV, CMV, fungal infection oDrugs ➢ Cannot tolerate stress (emotional or physical) oAdrenal crisis ➢ Requires cortisol replacement oSurgery and stress may require supplemental corticosteroids oPain control is important
• Addison Disease
Related features of _____:
- Postural hypotension
- Anorexia and weight loss
- Fatigue
- Shock, coma, and death, if untreated
- Hyperpigmentation of skin and mucous membranes
Addison’s
Hyperpigmentation and adrenal crisis do not usually occur/less likely with
______ and ________ adrenal insufficiency
secondary and tertiary
Can hyperadrenalism pts be given NSAIDs or aspirin?
No
_________ may be a consequence of both hyperadrenalism and
adrenal insufficiency
Impaired wound healing
signs of ________
oHypotension - Monitor BP –vasopressors, patient position, fluid
replacement
oAbdominal pain
oMyalgia
oFever
oSupplement with 100 mg of hydrocortisone and send to ED
adrenal crisis
• Involved in developmental and metabolic processes • Depends on iodide • produces 3 hormones ➢ T3 and T4 oControlled by TSH (pituitary) ➢ Calcitonin oRegulates circulating calcium and phosphorus levels oAlso influenced by actions of PTH and Vit D
Thyroid function
oRegulates circulating calcium
and phosphorus levels
oAlso influenced by actions of
PTH and Vit D
Calcitonin
\_\_\_\_\_\_\_ functions: Heart -Increases number of B-adrenergic rcs - Enhanced responses to circulating catechloamines -Increased contraction Adipsoe tissue -Stimulates lipolysis Muscle -Increased protein breakdown Bone -Promote normal growth and skeletal development Lipoprotein Formation of LDL receptors Other -Stimulates oxygen consumption by metabolically active tissues
Thryoid
Hyperthryoidism goiter
–Graves disease
Hypothyroidism goiter –
Hashimoto thyroid
Symptoms of \_\_\_\_\_\_\_\_: Unintentional weight loss Heat intolerance/ sweating Multiple daily loose stools Weakness Oligomenorrhea C
Hyperthyroidism/ Graves
Clinical findings and complications of _______:
Goiter
tachycardia
Atrial fibrillation
Fine tremor
Ophthalmopathy
Thyroid storm with fever, confusion, dehydration, and possible death
Hyperthyroidism
What drug is used to inhibit thyroid hormone metabolism and conversion from t4 to t3
Propylthiouracil (B-blocker)
