Exam 3 - alterations in regulation and metabolism

Question 1

what is the feedback mechanism?

Answer 1

• body sends message to hypothalamus
• hypothalamus stimulates the pituitary
• pituitary sends to primary
• primary releases hormone

Question 2

what is the complex feedback mechanism

Answer 2

Cns receives stimulus

Hypothalamus releases

Inhibiting factor or

Releasing factor which travels to

Pituitary gland. when then sends hormone to

Target tissue

Question 3

what gland can override others?

Answer 3

pituitary

Question 4

what are the endocrine glands

Answer 4

pitutary
thyroid
parathyroid
adrenals
gonads
pancreas
hypothalamus

Question 5

what does the thyroid control

Answer 5

metabolism and growth

Question 6

what does the parathyroid control

Answer 6

calcium and phosphorus metabolism

Question 7

what does the adrenals control

Answer 7

sodium, electrolyte balance, reproduction, immune, fight or flight

Question 8

what does the hypothalamus control

Answer 8

hormones are releasing factors or inhibiting

Question 9

what are the types of endocrine disorders?

Answer 9

primary
seconday
tertiary
ectopic
hypofunction
hyperfunction

Question 10

what is a primary endocrine disorder?

Answer 10

problem with gland itself in releasing or creating hormone

Question 11

what is a secondary endocrine disorder?

Answer 11

problems with pituitary and releasing factors

Question 12

tertiary endocrine disorder

Answer 12

problems with cellular receptors or cells themselves

Question 13

ectopic endocrine disorder

Answer 13

tumor (other than normal site of hormone production)

Question 14

intolerance to heat
tremor
sweating
weight loss
increase in appetite
palpitations
nervousness
exopthalmia 
decrease in fluids and sex drive

Answer 14

hyperthyroidism (systems speed up except wt loss)

Question 15

what is the autoimmune version of hyperthyroidism?

Answer 15

graves disease

Question 16

what labs should be looked at for thyroid disorders?

Answer 16

t3, t4, TSH

Question 17

if the thyroid is the problem(primary), what should the labs look like?

Answer 17

TSH would be decreased and t3 and t4 would be increased

Question 18

nurse interventions for hyperthyroidism

Answer 18

increase calories
o2
cool down

Question 19

treatment that stops t3 and t4 production

Answer 19

radioactive iodine

Question 20

high fever
disaphoresis
restlessness
agitation
tachy, dysrhytmia and tremor
CHF
delirium
coma

Answer 20

thyroid storm!

Question 21

what causes a thyroid storm

Answer 21

acute stress
infection
surgery

Question 22

how should you treat a thyroid storm symptoms?

Answer 22

sedation, cooling, steroids, IV fluids

Question 23

what are the meds you should administer in a thyroid storm

Answer 23

strong iodine solutions
propylthiouracil
inderal (propranol) beta block
NO ASPIRIN

Question 24

myxedema

Answer 24

mucousy edema - hard to get rid of

Question 25

hypothyroidism

Answer 25

deficient t3 and t4 release

Question 26

what is the treatment of hypothyroidism

Answer 26

levothyroxine

Question 27

how should you take levothyroxine?

Answer 27

on an empty stomach

Question 28

``` bradycardia hair dry and course and sparse cold intolerance fatigue weight gain anorexia lifelong treatment ```

Answer 28

hypothyroidism

Question 29

what is the autoimmune version of hypothyroidism

Answer 29

hashimoto's

Question 30

what should be done if hypothyroidism exacerbates

Answer 30

``` support airway o2, iv fluid and levothyroxine hyponatremia hypoglycemia COMA ```

Question 31

what type of labs should be tested in an assessment of a patient with hypothyroidism?

Answer 31

cholesterol levels

Question 32

elderly thyroid medication therapy

Answer 32

smaller doses | smaller increments at longer intervals

Question 33

cinacalet

Answer 33

suppresses PTH secretion

Question 34

hyperparathyroidism

Answer 34

elevation of serum calcium levels and excessive secretion of phosphorus by kidneys

Question 35

symptoms of hyperparathyroidism

Answer 35

asymptomatic | may not realize until kidney stones

Question 36

what are we worried about with hyperparathyroidism?

Answer 36

osteoporosis | fall risk

Question 37

cause of hypoparathyroidism

Answer 37

damage to parathyroid glands during thyroid surgery

Question 38

``` nerve and muscle excitation muscle spasms hyperreflexia clonic tonic convulsions paresthesia ```

Answer 38

hypoparathyroidism

Question 39

what should we do in the case of hypoparathyroidism?

Answer 39

give calcium

Question 40

hyper function of the adrenals

Answer 40

cushing's disease

Question 41

what is conn's disease

Answer 41

hyper secretion of mineral corticosteroids

Question 42

what is cushing's disease

Answer 42

hyper secretion of ACTH, leading to stimulated adrenal glands increase in cortisol

Question 43

``` moon face buffalo hump and fat pads truncal obesity broad purple striae bruising slow wound healing thin limbs muscle wasting excessive hair growth in women decreased inflammatory response ```

Answer 43

cushing's

Question 44

what type of CV issue may you see in cushings

Answer 44

hypertension

Question 45

what may you see in cushing's disease related to glucose?

Answer 45

glucose intolerance

Question 46

addison's disease

Answer 46

hypo function of the adrenal glands - aldosterone and cortisol

Question 47

what is the treatment of addisons

Answer 47

lifelong corticosteroids

Question 48

``` hypoglycemia nausea vomitting diarrhea weight loss muscle weakness fatigue headache sweating mood changes tanning of skin folds bluish mucous membranes hypotension vitiligo hyperkalemia hyponatremia ```

Answer 48

addisons

Question 49

when does the treatment of addisons change?

Answer 49

corticosteroid doses should be increased in periods of stress

Question 50

addisonian crisis

Answer 50

severe hypotension and volume depletion severe electrolyte abnormalities hypoglycemia inability to respond to stress

Question 51

how to treat addisonian crisis

Answer 51

iv fluids iv steroids electrolyte replenish

Question 52

how does one get addisonian crisis

Answer 52

does not adjust dosage

Question 53

mental status changes and muscle weakness in people with addisons disease is primarily causes by

Answer 53

hypoglycemia

Question 54

pheochromocytoma

Answer 54

tumor on adrenals

Question 55

manifestations of pheochromocytoma

Answer 55

``` sweating hypertension headaches palpitations chest pain stroke ```

Question 56

treatment of pheochromocytoma

Answer 56

surgery and removal

Question 57

metabolic syndrome

Answer 57

fat syndrome (pancreas) high bp central obesity insulin resistance

Question 58

pituitary dwarfism

Answer 58

hypo pituitary and growth hormone

Question 59

gigantism in children and acromegaly in adults

Answer 59

hyper pituitrary growth hormone

Question 60

acromegaly

Answer 60

hands feet and mandible over grown | growth plates build up - bone

Question 61

what is something growth hormone monitors?

Answer 61

glucose!