Endocrine Rapid Review

Question 1

what systems maintain homeostasis?

Answer 1

nervous system and endocrine system

Question 2

what links CNS to endocrine system?

Answer 2

hypothalamus

Question 3

another name for post. pituitary gland

Answer 3

neurohypophysis

Question 4

pathophys of DI

Answer 4

either decreased ADH production

or

renal tubules dont respond to ADH

Question 5

most common cause of DI

Answer 5

pituitary surgery

Question 6

DI tx

Answer 6

DDAVP or vasopressin

Question 7

most common cause of SIADH

Answer 7

TBI

Question 8

SIADH tx

Answer 8

fluid restriction
demeclocycline
hypotonic saline (if severe hyponatremia)

Question 9

airway considerations in Acromegaly

Answer 9

distorted facial features
large tongue, teeth, and epiglottis
subglottic narrowing and vocal cord enlargement
turbinate enlargement (risk of epistaxis)

Question 10

common comorbid contions associated with acromegaly

Answer 10

glucose intolerance
OSA
CAD
skeletal muscle weakness
entrapement neuropathies

Question 11

is T4 or T3 more bioavailable?

Answer 11

T3 is more available.

T4 is prohormone that gets converted to T3

Question 12

how does T3 compare to T4

Answer 12

higher potency
shorter 1/2 life
less protein bound
smaller concentration in teh blood

Question 13

another name for T4

Answer 13

thyroxine

Question 14

another name for T3

Answer 14

triiodothyronine

Question 15

thyroid gland secretes what three hormones?

Answer 15

T4
T3
calcitonin

Question 16

what is required to synthesize T4 and T3

Answer 16

iodine

Question 17

thyroid effects on the body can be deduced with what main basici understanding?

Answer 17

^thyroid > ^BMR > ^ CO2 production and ^ VO2

Question 18

^ O2 consumption leads to?

Answer 18

vasodilation to increase blood supply

Question 19

^ CO2 production leads to?

Answer 19

^ minute ventilation

Question 20

^ thyroid effect on spinal cord and the clinical effect?

Answer 20

^ sensitivity of neuronal synapses in spinal cord > tremors

Question 21

^ thyroid effect on GI tract

Answer 21

intestinal hypermotility > diarrhea

Question 22

^ thyroid effect on heart?

Answer 22

increased myocardial performance independent of ANS

^ HR, contractility, luistropy,

decreased SVR

Question 23

thyroid effect on MAC?

Answer 23

no effect but ^ thyroid ^ CO

Question 24

most common cause of hyperthyroidism?

Answer 24

graves disease

Question 25

most common cause of hypothyroidism?

Answer 25

hashimotos thyroiditis

Question 26

should you proced with surgery in patient with hyperthyrodism?

Answer 26

no, wait until patient is euthyroid. may take 6-8 weeks.

Question 27

NMB consideration in the setting of hyperthyroidism?

Answer 27

be careful, risk of myasthenia gravis and myopathy

Question 28

when does hypcalcemia from parathyroid resection most commonly occur?

Answer 28

24-48hrs after surgery

Question 29

hypocalcemia can cause?

Answer 29

larngospasm muscle spasms HoTN prolonged QT interval mental status changes

Question 30

under GA thyroid storm can mimic what other conditions?

Answer 30

MH pheochromocytoma NMS light anesthesia

Question 31

4 Bs to treat thyroid storm

Answer 31

block synthesis PTU metimazole block release radioactive iodine/potasium iodine bock T4-T3 conversion (PTU, block beta receptors

Question 32

can you give aspirin in hyperthyroidism?

Answer 32

no, it can dislodge T4 from plasma proteins

Question 33

how does myxedema coma affect the body?

Answer 33

affects all organ systems

Question 34

myxedema coma effects on the heart?

Answer 34

decrased HR contractility, CO

Question 35

myxedmea coma effects on lungs and heart

Answer 35

pleural and pericardial effusions are common

Question 36

myxedema effect on metabolism

Answer 36

slowed metabolism and biotransformation reactions

Question 37

what other endocrine disorder can be present with myxedma coma? what are its effects?

Answer 37

SIADH is common, retention of free water > diluational hyponatremia and EDEMA