exam 3 endocrine Flashcards
(96 cards)
1
Q
thyroid produces and secretes
A
T4, T3 and calcitonin
2
Q
necessary for the synthesis thyroid hormones
A
iodine
3
Q
most common form of hyperthyroidism
A
graves disease
4
Q
causes of hyperthyroidism
A
excess iodine intake, thyroid cancer, pituitary tumors.
5
Q
hyperthyroidism complication
A
thyroid storm
6
Q
symptoms of thyroid storm
A
severe tachy, anxiety, HTN, hyperthermia, restlessness
7
Q
tx for thyroid storm
A
fever reduction, fluid replacement, reduce circulating thyroid hormone levels
8
Q
diagnostics for hyperthyroidism
A
low TSH, high T3 T4
9
Q
metabolism and heart rate
A
t3 and t4
10
Q
tx for hyperthyroidism
A
drugs: ptu, tapazole, betablocker, ssri, radioactive therapy, thyroidectomy
11
Q
if payathyroid glands are removed what is the risk
A
tetany!! muscle spasms
12
Q
post thyroid surgery mnemonic
A
Bleeding; beware of thyroid storm Open airway Whisper Trach set Incision Emergency
13
Q
post thyroid surgery
A
avoid flexion of neck
monitor for signs of tetany
laryngeal nerve damage, STRIDOR
14
Q
most common cause of hypothyroidism
A
iodine ; Hashimotos thyroiditis
15
Q
meds for hypothyroid
A
lithium-blocks hormone production
amniodorone- contains iodine
16
Q
s/s of hypothyroid
A
weight gain intolerance to cold constipation bradycardia anorexia
17
Q
Extreme form of hypothyrodism
A
Myxedema
18
Q
Subnormal temp, bradycardia, decreased LOC, Respiratory failure, hypotension,hyponatremia
A
myxedema
19
Q
tx for myxedema
A
levothyroxine/synthroid given IV due to paralytic ileus
20
Q
hypothyroid diagnostic
A
increase TSH decrease t3 t4
21
Q
cushings and addisons are complications of what organ
A
adrenal glands
22
Q
Results from excessive adrenocortical activity
A
cushings
23
Q
what can cause cushing
A
chronic use of corticosteriods or tumors
24
Q
Truncal obesity Moon facies Abdominal straie Hirsutism in women Amenorrhea Edema, Poor wound healing, easy bruising Acne (severe) Hypertension
A
cushings
25
acth levels in cushings
elevated
26
lab findings – hyperglycemia, hypernatremia, hypokalemia, glycosuria, leukocytosis,
cushings
27
post op adrenalectomy
monitor bp, hr, rr
28
Adrenocortical insufficiency (hypofunction of the adrenal cortex)
addisons disease
29
acth addisons
low
30
which one is autoimmune addisons or cushings
addisons
31
progressive weakness, fatigue, weight loss, and anorexia, bronze pigmentation, dehydration,
addisons
32
NA and k in addisons
low Na high K
33
na and k in cushings
high Na low K
34
addison crisis
```
Hypotension
Tachycardia
Dehydration
Fever, weakness
Confusion
Severe N/V/D
```
35
tx for addison crisis
fluids, monitor electrolytes, high dose of hydrocorticoid replacement
36
hyperkalemia, hypoglycemia, anemia, hyponatremia, hypochloremia
addisons
37
normal hemoglobin
12-18
38
mild anemia
10-14
39
moderate anemia
6-10
40
severe anemia
less than 6
41
represents the weight, color, and size of RBC
hemoglobin
42
heme
iron
43
globin
protein
44
bleeding; dont have enough platelet plugs
thrombocytopenia
45
low platelet count
less than 150,000
46
what can cause thrombocytopenia
infecitons, ETOH, antibiotics, heparin, infection drug induced
47
thrombocytopenia internal bleeding
check hr, bp, and blood in stool
48
where does ITP happen
platelet destruction in the spleen
49
Most common type of acquired thrombocytopenia
ITP
50
itp acute
post viral infection
51
itp chronic
Most common in females, essential thrombocytopenia, autoimmune
52
ITP treatment
corticosteriods
splenectomy
platelet transfusion- rare and can cause more problems
53
s/s decreased platelets
nose bleeding
Oral bleeding
Purpura
Petechia
54
HITTS
allergic reaction to heparin
Platelets will get destroy- causes bleeding
Endothelial damage
Bleeding and clotting at the same time but clotting is WORSE
55
what to do in HITTS
stop heparin call physician. state that they are allergic to anything with heparin from now on
56
tx for HITTS
Lepirudin (Refludan)
57
factor VIII deficiency
hemophilia a
58
Christmas disease factor IX
hemophilia b
59
deficiency of Von Willebrand’s coagulation protein
von willebrands
60
s/s of hemophilia
```
Hemarthrosis
neuro signs
GI bleed
epitaxis
persistent prolonged bleeding
uncontrolled hemorrhage
```
61
med tx for hemophilia
ddavp -vasopressin
62
what kind of meds to avoid for person with hemophilia
NSAIDS or any other drugs that can affect bleeding
63
play a key role in the front-line defense against invading pathogens
neutrophils
64
what Is considered neutropenic
less than 1000 to 1500/ml
65
what should people with neutropenia avoid
anything fresh, sushi, no well water because they can carry things that cause infection
66
immunocompromised patients what needs to be reported
low grade temperature; SEPSIS- infection.
67
neutropenic fever
100.4
68
before giving blood what do you need
VITALS
69
hyperkalemia, hypoglycemia, anemia, hyponatremia, hypochloremia
addisions
70
what to do for a person with addisons
fluids, steriods, daily weights,
71
symptoms of severe anemia
fainting, chest pain, angina, heart attack
72
what to do for a patient post op surgery is having signs of hypocalcemia
calcium gluconate IV
73
causes of thrombocytopenia
decreased platelet production- infection, ETOH abuse
increased platelet destruction- infection drug induced
abnormal platelet production-antibiotics, heparin
74
corticosteriods affect
blood glucose levels
75
adrenal hormones
sugar-glucocorticoids (cortisol)
salt-mineral corticoids (aldosterone)
sex- androgens
76
BIGUANIDES
metformin; monitor creatinine
77
Reduces rate of insulin production by the liver – improves glucose transport into the cells
BIGUANIDES
78
Stimulates the release of insulin by the beta cells of the pancreas and causes tissues to take up and store glucose more readily
SULFONYLUREAS
79
major side effect of SULFONYLUREAS
hypoglycemia
80
Glucatrol (Glypizide)
Diabeta/Micronase/Glynase (Glyburide)
Tolinase (Tolazamide)
Amaryl (Glimepiride)
-ide
| SULFONYLUREAS
81
Lowers blood glucose by stimulating beta cells in pancreas to release insulin
meglitinide
82
pt teaching for meglitinide
take 30 mins before each meal ; if skip meal do not take
83
types of meglitinides
Repaglinide (Prandin) & Starlex
84
causes of anemia
```
bone marrow failure
lack rbc production
nutrient deficiency
rbc damage
family history
blood loss
```
85
triangle for diabetes
exercise, diet, and medication
86
all counter regulatory hormones
increase glucose
87
most common complication of diabetes
hypoglycemia
88
dka needs
Hydration
Insulin
Electrolyte replacement
89
What level of blood glucose during DKA treatment do you switch from NS to D5 1/2 NS?
• Blood glucose of 250 mg/dL
• So that you can continue to give them insulin without worrying about hypoglycemia
o So you can continue treating the acidosis and anion gap, etc.
90
high calcium levels
could indicate kidney stones
91
what med do you administer first for thyroid storm
beta blocker
92
rebound of too much insulin causing hypoglycemia in PM and hyperglycemia in the AM
som effect
93
hyperglycemia often due to growth hormone
dawn
94
what to do for pt with som and dawn
assess glucose at night because pt is often hypoglycemia and may need to eat a snack before bed
95
levothyrox
take bp and apical pulse before giving med
increases metabolic rate ; before meals
it increases the workload of the heart
96
adverse reactions
Anxiety, Insomnia, Tremors, Tachycardia, Palpitations, Angina, Dysrhythmias.
