Lecture 15B Endocrine management Flashcards Preview

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

Metabolic syndrome

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

Metabolic syndrome - diagnosis

*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

Metabolic syndrome - management

Focus on *root causes*:
1. Reduce risk factors and maintain a therapeutic lifestyle.
2. Nutritional management.
3. *Slow, moderate* weight loss.

4

Hyperthyroidism

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

Hyperthyroidism - signs and symptoms in older adults

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

6

The most common sign of hyperthyroidism in older adults is _

Atrial fibrillation.

7

Goiter

Chronic enlargement of the *thyroid gland*.

8

Graves' disease

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

9

Thyroid storm

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

10

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

Hyperthyroidism.

11

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

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

12

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

The cause of the disorder.

13

Drugs that may cause hypothyroidism in older adults

1. Lithium carbonate.
2. *Amiodarone.*
3. Iodine (deficiency).

14

Hypothyroidism - signs and symptoms

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

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

Hypothyroidism.