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Co-Existing Disease 1 > Thyroid And Adrenal Disorders > Flashcards

Thyroid And Adrenal Disorders Flashcards

(52 cards)

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1
Q

The thyroid are 2 lobes joined by what?

A

Isthmus

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2
Q

2 hormones produced by the thyroid?

A

T3 (triiodothyronine) and T4 (tetraiodothyronine)

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3
Q

Iodine plus tyrosine makes up what percent of T3 and T4?

A

T3: 20%
T4: 80%

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4
Q

Goiter (enlarged thyroid) is the first sign of what?

A

Iodine deficiency

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5
Q

What is the most common cause of hyperthyroidism?

A

Graves’ disease

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6
Q

In Graves’ disease, what is the TSH level?

A

Decreased

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7
Q

Common sign of hyperthyroidism?

A

Exophthalmos

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8
Q

4 other causes of hyperthyroidism?

A
  1. Toxic multi modular goiter
  2. Thyroiditis (hashimoto’s thyroid nodule)
  3. Pituitary tumors secrete TSH
  4. Overdose of replacement hormone
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9
Q

Increased T3 effect on minute oxygen consumption, beta adrenergic sensitivity, cardiac cholinergic receptors, CO and BP?

A

Increase minute oxygen consumption
Increased number and sensitivity to beta adrenergic
Decreased cardiac cholinergic receptors
Increase CO but BP remains unchanged

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10
Q

Medical treatments for hyperthyroidism (4)

A
  1. Iodine
  2. Radio ablation
  3. Propylthiouracil (PTU), methimazole
  4. BB (propranolol)
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11
Q

What drug should be avoided for thyroidectomy?

A

Anticholinergics

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12
Q

Preop testing in musculoskeletal will should what 2 things?

A
  1. Myalgia and elevated creatine kinase (CK)

2. Increased urine myoglobin indicating muscle damage

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13
Q

What is best vasopressor for hyperthyroidism?

A

Direct acting as indirect acting can cause exaggerated response

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14
Q

Hyperthyroidism causes Increased minute oxygen consumption effect of thyroid hormones occurs in nearly all tissues but what?

A

Brain

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15
Q

Is intraop paralysis routine for intraop anesthetic for hyperthyroidism?

A

NO

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16
Q

For tracheomalacia, the trachea normal does what during inspiration and expiration?

A

Inspiration: dilates slightly
Expiration: narrows slightly

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17
Q

The usual symptom of tracheomalacia is what?

A

Expiratory stridor or laryngeal crow

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18
Q

Horner’s syndrome is characterized by what 4 things?

A
  1. Mitosis (constrict pupil)
  2. Partial ptosis (weak, droopy eyelid)
  3. Apparent anhirosis (decreased sweating)
  4. Apparent enophthalmos (inset eyeball)
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19
Q

For horner’s syndrome, the s/s occur on what side of the lesion of the sympathetic trunk?

A

Same side

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20
Q

A combo of symptoms that arises when the sympathetic trunk is damaged?

A

Horner’s syndrome (oculo-sympathetic paresis)

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21
Q

Electrodes are designed to make contact with the pts vocal cords to facilitate EMG monitoring of the recurrent laryngeal nerve when connected to the multi channel EMG monitoring device

Study These Flashcards
A

NIM nerve monitoring

22
Q

During NIM nerve monitoring, red and blue wire pair is contacted with what?

Study These Flashcards
A

Red: anterior and posterior of right true vocal cord
Blue: anterior and posterior of left true vocal cord

23
Q

What drug inhibit accurate EMG readings?

24
Q

What 4 things are different between MH and thyroid storm?

Study These Flashcards
A
  1. No muscle rigidity
  2. No lactic acidosis
  3. No hypercapnia
  4. Occurs in PACU after emergent surgery
25
Commons hypothyroidism disease?
Hashimoto’s
26
Hashimoto’s disease with CO?
Decrease 50% by reduce of SV and HR
27
Term used synonymously with sever hypothyroidism and also used to describe a dermatological change that can occur to deposition of mucopolysaccharides in the dermis, which results in swelling of the affected area (non-pitting edema)
Myxedema
28
Is myxedema necessarily seen in myxedema coma?
No
29
Myxedema coma is seen because of what?
Decompensated hypothyroidism
30
Standard treatment for hypothyroidism? (2)
Levothroid and synthroid
31
Condition that affects only female, results when one of the X chromosomes is missing or partially missing. Can cause short ht, failure of the ovaries to develop and heart defects
Turner syndrome
32
Hypothyroidism hypotension is best treated how?
Directly: ephedrine, dopamine, Epi (not neo )
33
Is ketorolac good for post op pain control in hypothyroidism?
Yes
34
What is the sole purpose of parathyroid gland?
Control Ca++ within blood in very tight range between 9-10
35
What is a post op complication due to parathyroid surgery?
Hungry bones because extremes hypocalcemia resulting in tetany, hypomagnesemia
36
During major surgery cortisol release may increase from 15-25 /day to what with plasma cortisol levels of 30-50?
75-150/day
37
How often is ACTH dependent?
80%; pituitary tumors and lung cancers
38
How often is ACTH independent?
20%; benign adrenal tumors (adenoma) and malignant adrenal tumors (adrenal cell carcinoma)
39
What is the cause of Cushing’s syndrome?
Chronic glucocorticoid administration
40
What has been described as a complication of almost any type of laparoscopic surgery for cushing’s disease?
Pneumothorax
41
What is Addison’s disease?
Combined mineral and glucocorticoid deficiency
42
Steroid replacement therapy for Addison’s disease?
5mg of prednisone
43
Acute hemodynamic instability especially in those unresponsive to fluids and pressers; lack of cortisol for stress of surgery-poor response
Addisonian crisis
44
What is the primary hyperaldosteronism?
Conn’s syndrome
45
Catecholamine secreting tumor generally on the adrenal medulla and has a chronic state of vasoconstriction and hypovolemia (HTN, diaphoresis, headache, tachycardia, wt loss)
Pheochromocytoma
46
Pheochromocytoma stimulation of alpha1, alpha2, beta1, beta2, beta3:
Alpha 1: vasoconstriction Alpha2: decrease Beta 1: increase HR/contractility, lipolysis, renin secretion Beta 2: vasodilation, bronchodilation, glycogenolysis Beta 3: increase lipolysis and brown fat thermogenesis
47
Main symptoms different between pheochromocytoma and MH:
Sever headache | Chest and abdominal pain
48
Preop pheochromocytoma treatment: (4)
1. Alpha blockers (phenoxybenzamine; dibenzyline) 2. BB AFTER alpha blocker 3. CCB 4. Adequate volume replacement LR
49
Intraop pheochromocytoma treatment for HTN and arrhythmias?
HTN: nipride Arrhythmias: BB or lidocaine
50
What to avoid for intraop pheochromocytoma? (7)
Avoid sympathetic NS stimulation, inhibitors of parasympathetic NS, histamine releasing drugs 1. Ephedrine 2. ketamine 3. hypoventilation 4. pancuronium 5. sux 6. glyco 7. atropine
51
What disease deals with pituitary hormone deficiencies?
Acromegaly
52
Norma blood sugar levels but kidneys are not able to balance fluid in the body?
Diabetes insipidus

Co-Existing Disease 1 (8 decks)

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