Endocrine - Temperature Regulation - Quiz 1

Question 1

What usually causes Endocrine Diseases?

Answer 1

Abnormal amounts of Hormones

Question 2

What are Hormones?

Answer 2

Substances made by one cell type that signals a response from another cell type

Question 3

What are considered Peptide/Protein Hormones?

Answer 3

Insulin

Growth Hormone

ADH

Most Common

Question 4

What are considered Steroid Hormones?

Answer 4

Cortisol & Aldosterone

Question 5

Which types of hormones are water soluble?

Answer 5

Peptide/Protein & Catecholamines

Question 6

What types of hormones are Lipid Soluble?

Answer 6

Steroid & Thyroid

Question 7

Where do hormones work?

Answer 7

On specific receptors on the surface or inside the cell to start a cascade of reactions

Question 8

How does the body control hormonal response?

Answer 8

Positive and Negative Feedback

Question 9

What is Metabolic Rate?

Answer 9

Rate of Heat Liberation during chemical reactions

Question 10

What is the difference b/t Direct & Indirect Calorimetry?

Answer 10

• Direct: Direct measure of heat made; difficult to peform, used in research
• Indirect:Measures O₂ Consumption & CO₂ Production

Question 11

What increases Metabolic Rate?

Answer 11

Thyroxine (T4)

Testosterone

Growth Hormone

Fever

Question 12

What decreases Metabolic Rate?

Answer 12

Inadequate Thyroxine (T4)

Sleep

Malnutrition

Question 13

Which monitoring sites are defined as core body temperature?

Answer 13

Esophagus

Nasopharynx

External Auditory Meatus

Pulmonary Artery Catheter

Question 14

How does Skin, Axillary, and Rectal temperature compare to core body temperature?

Answer 14

Skin: 3-4 C lower

Axilla: 1 C lower

Rectum: 1 C higher

Question 15

Which part of the brain regulates body temperature and is the “Set-Point”?

Answer 15

Hypothalamus/Preoptic Nuclei

Question 16

What are the Cardiac effects of Hypothermia?

Answer 16

↑O₂ Consumption d/t Shivering

Arrhythmias

Ischemia

Can’t Defib < 30 C

Question 17

What are the Pulmonary effects of Hypothermia?

Answer 17

↑Pulm. Vascular Resistance

Depressed Ventilatory Drive

↓Blood CO₂

Question 18

What are the Renal effects of Hypothermia?

Answer 18

Cold Diuresis & ↓Plasma Volume

Question 19

How is the CNS effected by Hypothermia?

Answer 19

↓Cerebral O2 Consumption 7% per 1°C

↓MAC 5-7% per 1°C

Delayed Emergence

Question 20

How does Hypothermia affect coagulation?

Answer 20

Decreases Coagulation and Platelets

Question 21

Why does Hypothermia prolong NMBs and Delay Emergence?

Answer 21

50% Metabolism Reduction @ 30°C

60% Metabolism Reduction @ 25°C

Increased Plasma Concentration of Propofol & Fentanyl

Question 22

How does Hypothermia contribute to Wound Infection?

Answer 22

Directly impairs immune system

Vasoconstriction = poor tissue perfusion

↓ABX Penetration

↓Phagocytic & Neutraphil Function

Question 23

What are the Two Compartments of Body Temperature

Answer 23

Peripheral: limbs, skin, subq tissue - 1/3 of body’s heat

Core: thoracic & abdominal organs, brain - 2/3 of body’s heat

Question 24

What are the temperature ranges for the core vs. peripheral?

Answer 24

Core: 36.6 - 37.4°C

Peripheral: 0 - 40°C

Maintained by Vasoconstriction

Question 25

What is the normal Basal Heat production?

Answer 25

1.2°C per hour

Question 26

How effective is shivering in producing heat?

Answer 26

Increases heat production by 300%

Question 27

In what ways is Heat Loss?

Answer 27

* **Radiation** - 60% - pt. to environment * **Convection** - 25% - air near skin moves heat away * **Evaporation** - skin prep, open abdomen, respiration * **Conduction** - 5% - direct contact b/t pt. & table

Question 28

When would you see the biggest drop in temperature in the OR?

Answer 28

1st hr. after induction d/t vasodilation Anesthesia inhibits vasoconstriction and decreases metabolic rate by 20-40%

Question 29

1 unit of cold PRBC or 1 L of Fluid can decrease core temperature by \_\_\_\_\_\_?

Answer 29

0.25°C

Question 30

Which population would heat loss be more pronounced?

Answer 30

**Elderly:** decreased BMR & autonomic neural fxn **Neonates**: decreased autonomic neural fxn & increased surface area

Question 31

Which med used to be the most commonly used for Post-Op Shivering?

Answer 31

Meperidine (Demerol) 25-50 mg - works on Mu & Kappa receptors

Question 32

What are causes of Hyperthermia?

Answer 32

Thyrotoxicosis Pheochromocytoma Hypothalamic Injury Neuroleptic Malignant Syndrome

Question 33

What is the treatment for Malignant Hyperthermia?

Answer 33

**Dantrolene:** 2.5mg/kg q5min