Lecture 15B Endocrine management Flashcards Preview

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Flashcards in Lecture 15B Endocrine management Deck (15)
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1
Q

Metabolic syndrome

A
  1. Common (incidence 26 per 1000) multifactorial syndrome of aging; associated with abdominal obesity.
  2. Varies among racial and ethnic groups.
  3. Primary risk factors: Abdominal obesity; insulin resistance; physical inactivity; hormonal imbalance (e.g., increased cortisol).
2
Q

Metabolic syndrome - diagnosis

A
  • Abdominal obesity* plus two of the following:
    1. BP over 129/94 or taking antihypertensives.
    2. Plasma triglyceride level over 149 mg/dL, or taking medication.
    3. HDL-C (“good cholesterol”) level below 40 mg/dL in men, below 50 mg/dL in women, or taking medication.
    4. Fasting glucose above 99 mg/dL.
3
Q

Metabolic syndrome - management

A

Focus on root causes:

  1. Reduce risk factors and maintain a therapeutic lifestyle.
  2. Nutritional management.
  3. Slow, moderate weight loss.
4
Q

Hyperthyroidism

A
  1. Primary hyper-secretion of thyroid hormones (T₃ and T₄).
  2. Thyroid hormone is stimulatory - increases sympathetic nervous system activity.
  3. Causes: Multi-nodular and uni-nodular toxic goiter (90% of thyroid nodules in older adults are benign); Graves’ disease; thyroiditis.
5
Q

Hyperthyroidism - signs and symptoms in older adults

A
  1. Atrial fibrillation - most common.
  2. Tachycardia.
  3. Fatigue.
  4. Tremors.
  5. Nervousness.
  6. Heat intolerance.
6
Q

The most common sign of hyperthyroidism in older adults is _

A

Atrial fibrillation.

7
Q

Goiter

A

Chronic enlargement of the thyroid gland.

8
Q

Graves’ disease

A
  1. Autoimmune disease resulting in diffuse goiter and hyperthyroidism.
  2. Other symptoms include exophthalmos, heat intolerance, and anxiety.
9
Q

Thyroid storm

A

A life-threatening syndrome consisting of fever, severe tachycardia, altered mental status, dehydration, and irritability.

10
Q

Weight loss over the previous 3-6 months, serum albumin levels, fatigue, tachycardia, and dysphagia are all focus areas relevant to the assessment of _

A

Hyperthyroidism.

11
Q

Between hyperthyroidism and hypothyroidism, _ is more common among older adults.

A

Hypothyroidism (16-21% vs. 2.5-6% for hyperthyroidism).

12
Q

In hypothyroidism, the thyroid gland may be absent (surgically removed), small, or large, depending on _

A

The cause of the disorder.

13
Q

Drugs that may cause hypothyroidism in older adults

A
  1. Lithium carbonate.
  2. Amiodarone.
  3. Iodine (deficiency).
14
Q

Hypothyroidism - signs and symptoms

A

Usually atypical, subclinical, and often misattributed to the normal aging process:

  1. Fatigue.
  2. Cold intolerance.
  3. Weight gain.
  4. Muscle cramps.
  5. Confusion.
15
Q

Depression, fatigue, TSH levels, and weight gain are all focus areas relevant to the assessment of _

A

Hypothyroidism.