Endocrine System Flashcards Preview

HP II > Endocrine System > Flashcards

Flashcards in Endocrine System Deck (55):
1

Endocrine Glands

Go directly into the blood

2

Types of Glands

Pituitary
Thyroid
Parathyroid
Adrenal
Pancreatic
Ovaries / Testes

3

Hypothalamus Hormones

Releasing / Inhibiting
Negative feedback

4

Anterior Pituitary Hormones with Location

GH (bone)
ACTH (adrenal cortex)
TSH (thyroid)
FSH (gonads)
LH (gonads)
Prolactin (mammary)

5

Posterior Pituitary Hormones with Location

ADH (kidney tubules)
Oxytocin (uterus / mammary)

6

Types of Hormones

Amines / Amino acids (single)
Peptides / polypeptides / proteins / glycoproteins (many)
Steroids (cholesterol)
Fatty acid derivatives (fat)

7

Paracrine Action

Acts on cells around it

8

Autocrine Action

Acts on cell that made it

9

Lipid Soluble Hormones

Bind to proteins for transport

10

Fat Soluble Targets / Receptors

Steroid / thyroid
In cell

11

Water Soluble Hormones

Outside of membrane (blood)

12

Diurnal Fluctuations

Within daily life

13

Complicated Cyclic Regulation

Menses

14

Feedback Mechanism

Negative vs Postivie
*HPA axis based on other hormones

15

Simple Feedback

One substance regulated secretion of hormones

16

Negative Feedback

Most common
If ↓, it ↑
If ↑, it ↓

17

Positive Feedback

Increases target organ action above normal (oxytocin)
If ↑, it ↑

18

Complex Feedback

Thyroid system
Inhibits TSH production and releases T3 / T4 (metabolism)

19

Diagnostic Tests

Blood test (momentary)
Urine (24h)
Stimulation / suppression test
Imaging (tumor)
Genetic

20

Palpable Glands

Testes
Thyroid

21

Primary Endocrine Disorder

Originates in target gland (thyroid)

22

Secondary Endocrine Disorder

Defective levels of stimulating / releasing hormones (pituitary gland)

23

Tertiary Endocrine Disorder

Hypothalamic dysfunction

24

Pituitary Adenoma

Hyperpituitarism and Hypopituitarism

25

Hyperpituitarism

Acromegaly (GH)
Gigantism

26

Hypopituitarism

Dwarfism (GH)

27

↓ ACTH

Most dangerous
Can be fatal
Secondary adrenal insufficiency

28

Acromegaly Diagnostic Tests

Age 40-45
H/P
OGTT
GH Tests
MRI
CT

29

Oral Glucose Tolerance Test (OGTT)

Usually ↓
Stabilizes or ↑ in acromegaly

30

Acromegaly Collaborative Care

Surgery (Transsphenoidal hypophysectomy)

31

Octreotide

Somatostatin analog
SQ 3x/wk
Monitor GH Q2wk

32

Acromegaly Nursing Management

↓ ICP
HOB elevated
Mouth care Q4h
Neuro assessment
No sneezing / strainging
10 days no tooth brushing (sutures)
Hormone replacement
Assess nasal drainage (CSF: glucose)

33

Acromegaly ↑ Risk of...

Diabetes insipidus
Watch ↑ UO

34

Most Common Hypopituitarism

LH
FSH
GH

35

Life threatening Hypopituitarism

ACTH
TSH

36

Hypopituitarism Manifestations

Headache
Depends on hormone

37

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

Excess ADH
Fluid retention
↓ UO, Na
↑ concentration, osmolarity

38

Diabetes Insipidus

Deficiency in ADH
After head injury
Mimics DM
↑ thirst, HR, Na
↓ BP, H2O, Gravity
Up to 20L urine / day

39

Nursing Care for Diabetes Insipidus

Monitor / replace fluids
Neuro status
VS
Mucous membranes

40

Cortisol

Regulates sugar
FFA regulation

41

Corticosteroids

Inhibit inflammation

42

Aldosterone

Renal tubules
↑ Na
↓ H, K
Regulated by Angiotensin II

43

Androgens

Sex hormones
DHEA, androstenedione

44

Cushing’s Syndrome

Hyperfunction of Adrenal cortex
Pituitary tumor
20-45 YO F
High Dose steroids

45

Cushing’s Syndrome Manifestations

Hyperglycemia (diabetic)
Fat round face
Fat in abdomen / back of neck
Thin extremities / skin
Osteoporosis
Purple striae

46

Cushing’s Syndrome Diagnostics

24h urine
Blood test
Dexamethosone production test
CT / MRI

47

Addison’s Disease

Hypofunction of Adrenal Cortex
Autoimmune dysfunction
Slow onset

48

Addison’s Disease Manifestations

↑ ACTH = bronze skin
N/V/D
Weight loss
Hypoglycemia
Postural hypotension
Weakness

49

Adrenal Crisis

Sudden drop in corticosteroids
Life threatening
Fatigue
Dehydration
Vascular collapse
↓ Na, ↑ K (renal shut down)

50

Diagnostic Studies

24h urine
Plasma cortisol
Dexamethosone suppression test
BMP

51

BMP in Cushing’s Syndrome

↓ K
↑ Na, sugar

52

Management of Care

Lifetime replacement therapy
ADH, cortisol, TSH, FSH, LH

53

Normal Aging with Endocrine System

↓ thyroid, hormones
Atrophy
↓ response to target organs
Biologic changes (circadian rhythms)

54

Objective Assessment

Integument / hair (distribution)
Neck (gland)
Abdomen (fat / striae)
Extremities (atrophy)

55

Hyperparathyroidism leads to... (signs)

↓ calcium
Chvostek’s / Trousseau’s