Endocrine Disorders

Question 1

Hyperactivity of the anterior pituitary gland is associated w what disorder?

Answer 1

Cushing’s syndrome

Question 2

Hyper activity of the posterior pituitary gland is associated w what disorder?

Answer 2

SIADH

Question 3

Hypo activity of the posterior pituitary gland is associated w what disorder?

Answer 3

Diabetes insipidus

Question 4

What is secreted from the thyroid gland in response to high plasma calcium levels?

Answer 4

Calcitonin

Question 5

Calcitonin is secreted from the thyroid in response to what?

Answer 5

high plasma calcium levels

Question 6

Calcitonin increase calcium deposits in what?

Answer 6

Bone

Question 7

Parathormone does what to calcium?

Answer 7

increases it by absorbing it from the kidneys, intestine, and bones

Question 8

What is tested by sharply tapping on the cheek?

Answer 8

Chvostek sign

Question 9

What is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff?

Answer 9

Trousseau sign

Question 9

What are the s/s of hyperparathyroidism?

Answer 9

asymptomatic
apathy
fatigue
muscle weakness
N/V/constipation
Hypertension
Dysrhythmias

Question 10

How is hyperparathyroidism managed?

Answer 10

Surgical removal
Hydration therapy - 2000 ml or more daily
Maintain mobility
Restrict calcium

Question 11

Causes of hypoparathyroidism

Answer 11

abnormal development
destruction of glands
vit D deficiency

Question 12

What are s/s of hypoparathyroidism?

Answer 12

Tetany
Numbness
Tingling in extremities
Stiffness of hands and feet
Bronchospasm
Laryngeal spasm
Carpopedal spasm
Anxiety
Irritability
Depression
Delirium
ECG changes

Question 13

How is hypoparathyroidism managed?

Answer 13

Increase calcium level to 9-10
Give IV calcium gluconate
Pentobarbital to decrease neuromuscular irritability
Admin parathormone
Quiet environment
Diet high in calcium and low phosphorus
Vit D

Question 14

What does a hypercalcemic crisis result in?

Answer 14

neurologic, cardiovascular, and kidney symptoms that can be life threatening

Question 15

How is a hypercalcemic crisis managed?

Answer 15

Rapid rehydration with large volumes of isotonic saline
Admin calcitonin and corticosteroids to increase calcium absorption into bone

Question 16

Disease caused by adrenal suppression by exogenous steroid use

Answer 16

Addison’s disease

Question 17

S/s of Addison’s disease

Answer 17

muscle weakness
anorexia
GI distress
fatigue
dark pigmentation of skin and mucosa
hypotension
low blood glucose
low serum sodium**
high serum potassium**
apathy
emotional liability

Question 18

What diagnostic tests are used for Addison’s disease?

Answer 18

adrenocortical hormone levels, ACTH levels, ACTH stimulation test

Question 19

What is the most common cause of Addison’s disease?

Answer 19

corticosteroid use

Question 20

Does Addison’s cause elevated WBCs?

Answer 20

Yes

Question 21

Does Addison’s cause hypoglycemia?

Answer 21

Yes

Question 22

How is Addison’s disease assessed?

Answer 22

Note any illness or stressors that precipitate problems
F&E status
VS and orthostatic BP
Weight changes
Muscle weakness and fatigue
Medications
Monitor s/s of Addisonian crisis

Question 23

How is Addison’s disease managed?

Answer 23

Place patient in recumbent position with legs elevated**
Monitor s/s fluid volume deficit
Encourage intake of fluids and high sodium foods
Admin hormone replacement as ordered
Avoid stress and activity until stable
Total care when pt is in crisis**
Hydrocortisone followed by 5% dextrose in NS
Vasopressors

Question 24

Immediate treatment of Addison's disease is directed toward combating what?

Answer 24

circulatory shock

Question 25

What position should a patient with Addison's disease be placed in?

Answer 25

Recumbent position with legs elevated

Question 26

What will the patient need if adrenal function is not regained?

Answer 26

Lifelong replacement of corticosteroids and mineralocorticoids Patient or family member must administer hormone replacement

Question 27

What is very important about steroid replacement treatment?

Answer 27

Same time every time No skipping doses

Question 28

Disorder characterized by excessive adrenocortical activity or corticosteroid medications

Answer 28

Cushing's Syndrome

Question 29

What are s/s of Cushing's syndrome?

Answer 29

Hyperglycemia Central obesity with buffalo hump Think trunk w thin extremities Osteoporosis Acne Moon face from steroid use Slow healing Increased serum sodium** Decreased serum potassium**

Question 30

What test is used to diagnose Cushing's syndrome?

Answer 30

Dexamethasone suppression test

Question 31

How is Cushing's syndrome managed?

Answer 31

Maintain CO Decrease risk of injury and infection Promote skin integrity Improve body image Improve coping Monitor for complication like Addisonian crisis

Question 32

What medication blocks synthesis of thyroid hormone?

Answer 32

Methimazole