W4 Endocrine Disorders Flashcards
(219 cards)
1
Q
What is the primary function of the endocrine system?
A
The endocrine system coordinates messages from the brain to balance and regulate all bodily functions, known as homeostasis.
2
Q
What can result from the inability to maintain homeostasis?
A
Illness, disease, and potentially death.
3
Q
Where is the pituitary gland located?
A
Within the sella turcica of the sphenoid bone of the skull.
4
Q
What are the two main relationships of the hypothalamus in relation to the pituitary gland?
A
Anterior pituitary gland and posterior pituitary gland.
5
Q
What is the role of exocrine pancreatic cells?
A
Secrete pancreatic juice.
6
Q
What hormones do alpha and beta endocrine cells of the pancreatic islets secrete?
A
- Alpha cells: glucagon
- Beta cells: insulin
7
Q
What structures are labelled in the anterior view of the thyroid and parathyroid glands?
A
- Hyoid bone
- Thyroid cartilage
- Cricoid cartilage
- Isthmus
- Right lobe of thyroid gland
- Left lobe of thyroid gland
- Trachea
8
Q
What happens when there is hypersecretion in the endocrine system?
A
Too much hormone secretion.
9
Q
What is hyposecretion in the context of the endocrine system?
A
Not enough hormone secretion.
10
Q
What is the effect of alterations in circulating hormone level concentration in the blood?
A
Leads to symptoms experienced by the patient.
11
Q
Fill in the blank: Disorders of the endocrine system are usually described as _______ or hyposecretion.
A
[hypersecretion]
12
Q
What are the recommended videos for revising endocrine anatomy and physiology?
A
- Endocrine System Part 1: Glands & Hormones
- Endocrine System Part 2: Hormone Cascades
13
Q
What is the title of the reference book by Craft & Gordon discussing the endocrine system?
A
Understanding Pathophysiology: ANZ edition (4th edition).
14
Q
What is the page range for Chapter 10 in the reference book about the endocrine system?
A
234-255.
15
Q
What is Diabetes?
A
A group of metabolic disorders characterized by abnormally high levels of blood glucose over a prolonged period of time.
Blood glucose is often referred to as blood sugar.
16
Q
What are the two main pathophysiological mechanisms that lead to diabetes?
A
- Insulin resistance (ineffective response to insulin at target cells)
- Insufficient insulin secretion by the Islets of Langerhans in the pancreas.
17
Q
What is the function of insulin?
A
A hormone that shifts glucose from the bloodstream into the cells for energy, enhancing glucose absorption and serving as the body’s main fuel storage hormone.
18
Q
What is Type 1 Diabetes Mellitus (T1DM)?
A
A lifelong chronic pancreatic disorder considered an autoimmune disease where islet cells in the pancreas are destroyed, leading to absolute insulin deficiency.
19
Q
What are the two main peaks for diagnosis of T1DM?
A
- 4-7 years old
- 10-14 years old.
20
Q
What triggers the autoimmune destruction of beta cells in T1DM?
A
The exact cause is unknown but is linked to genetic susceptibility and environmental factors such as viral exposure.
21
Q
What are the key clinical manifestations of T1DM?
A
- Polyphagia (increased hunger)
- Polyuria (increased urine volume)
- Polydipsia (increased thirst).
22
Q
What is Type 2 Diabetes Mellitus (T2DM)?
A
A lifelong chronic pancreatic disorder that is a silent but progressive condition, representing 85-90% of all diabetes cases globally.
23
Q
What are the two possible pathophysiological explanations for T2DM?
A
- Insulin deficiency (relative shortage of insulin supply)
- Insulin resistance (ineffective response to insulin from target cells).
24
Q
What are some non-modifiable risk factors for developing T2DM?
A
- Certain ethnicities (e.g., Aboriginal, Pacific Islander, Indian, Chinese)
- Genetic risk factors.
25
What are some modifiable risk factors for T2DM?
* Hypertension
* Dyslipidaemia
* Obesity
* Sedentary lifestyle
* Poor diet
* Smoking.
26
What happens when a T2DM patient eats food?
BGL rises, leading to insufficient insulin production, excessive glucagon build-up, and continued rise in BGL, causing metabolic alterations.
27
What are some clinical manifestations of T2DM aside from the three main presentations?
* Chronic hyperglycaemia
* Fatigue
* Recurrent infections
* Poor wound healing
* Vision changes
* Peripheral neuropathy.
28
What is HbA1c?
A measure of glucose binding to hemoglobin, reflecting average blood glucose levels over the past 2-3 months.
29
What is the normal physiological range for fasting blood glucose levels?
5.5 - 6.9 mmol/L.
30
What is the diabetic range for fasting blood glucose levels?
≥ 7.0 mmol/L.
31
What should never be withheld in patients with T1DM?
Insulin.
32
What is a critical condition associated with untreated hyperglycaemia in T1DM?
Diabetic Ketoacidosis (DKA).
33
What is the overall treatment goal for diabetes management?
Restore normal blood glucose levels (normoglycaemia or euglycaemia).
34
Fill in the blank: The pancreas cannot produce any insulin in T1DM due to the absence of _______.
beta cells.
35
What is the role of Wound Care Specialist nurses?
To manage patients with pre-existing wounds, particularly on their lower extremities.
36
What is included in a focused integumentary assessment?
Assessment of skin integrity and implementation of pressure area care to prevent additional wounds.
37
What is the minimum requirement for BGL monitoring during hospital admission for stable diabetic patients?
QID (four times a day).
38
What are the two types of diabetes mellitus discussed?
* Type 1 Diabetes Mellitus (T1DM)
* Type 2 Diabetes Mellitus (T2DM)
39
True or False: T2DM patients typically have no insulin production.
False.
40
What are some nursing considerations for diabetes management?
* Start discharge planning early
* Care of wounds
* Falls risk assessment
* Skin integrity assessment
* Fluid balance chart
* Documentation
41
Fill in the blank: The management of patients with diabetes mellitus focuses on BGL _______ and the prevention of complications.
[stability]
42
What should be initiated promptly for patients exhibiting hypoglycaemia?
Escalation of care, including a MET call if necessary.
43
What are the three major acute complications of diabetes?
* Hypoglycaemia
* Hyperglycaemia
* Hyperosmolar hyperglycaemic state (HHS)
44
Define hypoglycaemia.
Low blood glucose levels, typically less than 4 mmols/L.
45
What are some causes of hypoglycaemia?
* Imbalance between blood glucose and insulin
* Reduced food intake
* Increased exercise
* Stress
46
What are clinical manifestations of hypoglycaemia?
* Confusion
* Seizures
* Coma
* Death
47
What is the first step in managing a conscious hypoglycaemic patient?
Administer 15-20 grams of quick-acting carbohydrate.
48
What is hyperglycaemia?
High blood glucose levels, greater than 15 mmol/L.
49
What are the clinical manifestations of hyperglycaemia?
* Thirst
* Increased urination
* Blurred vision
* Irritability
50
What can long-term hyperglycaemia lead to?
* Heart disease
* Stroke
* Renal impairment
* Neuropathy
51
What is Diabetic Ketoacidosis (DKA)?
A severe complication of T1DM characterized by severe hyperglycaemia and ketoacidosis.
52
What does the SINBAD Wound Classification System assess?
Diabetic foot ulcers based on five clinical features.
53
What percentage of diabetic patients will develop a foot ulcer?
Approximately 15%.
54
What is the critical importance of understanding diabetic foot ulcers?
To prevent serious disability and potential amputations.
55
What is the first step in managing diabetic foot problems?
Assess all people with diabetes for risk of developing foot complications.
56
What are two key elements in the management of diabetic foot ulcers?
* Regular assessments of high-risk feet
* Education of patients and their support persons
57
What is the primary goal for patients with diabetic foot ulcers (DFUs)?
To heal the ulcers and prevent amputation through a person-centred care plan
## Footnote
Healing majority of DFUs is possible with appropriate care.
58
List the six key elements for the prevention of diabetic foot problems.
* Assess all people with diabetes for foot complication risk
* Perform regular focused assessments on high-risk individuals
* Educate patients and their support persons
* Ensure routine wearing of appropriate footwear
* Treat pre-ulcerative signs
* Make early referrals to the interprofessional team
59
What are the main focuses of the interprofessional team in treating DFUs?
* Relief of pressure and protection of the ulcer
* Restoration of skin perfusion
* Treatment of infection
* Metabolic control and treatment of co-morbidity
* Local wound care
* Education for patient and support persons
60
True or False: There is a widely accepted superior dressing type for managing DFUs.
False
## Footnote
There is insufficient evidence to demonstrate the superiority of any one type of dressing.
61
Factors to consider when choosing a dressing for a diabetic foot ulcer include _______.
* Type of dressing required for healing
* Comfort to prevent pain
* Infection management needs
* Frequency of dressing change
* Access to dressings for home management
62
What should foot care education for people with diabetes include?
* Importance of appropriate footwear and foot care
* Regular self-monitoring schedule
* Action plan for early problems
* Importance of annual foot screens
* When to seek further footwear advice
63
What is exogenous insulin?
Insulin that is injected from outside the person's body
## Footnote
It is used to stabilize diabetes mellitus.
64
What are the indications for using exogenous insulin?
* No insulin production in the individual
* Treatment of Type 1 Diabetes Mellitus (lifelong administration)
* Treatment of Type 2 Diabetes Mellitus when uncontrolled by diet or other agents
65
What are the types of insulin based on their action duration?
* Ultra Short-Acting or Rapid-Acting
* Short-Acting
* Intermediate-Acting
* Long-Acting
66
What is the correct method of insulin administration?
Subcutaneous injection is the standard method
## Footnote
Intravenous administration is only for emergencies.
67
What are common adverse effects of insulin?
* Hypoglycaemia
* Weight gain
* Local injection site reactions
68
What are the three main types of medications used in the treatment of diabetes mellitus?
* Insulin
* Oral hypoglycaemic agents
* Glucose-elevating agents
69
What is the mechanism of action for oral hypoglycaemic agents (OHAs)?
* Stimulate insulin release from beta cells
* Lower insulin resistance
* Improve binding to insulin receptors
* Reduce glucose production in the liver
70
Which type of diabetes are OHAs not effective for?
Type 1 Diabetes Mellitus
## Footnote
OHAs depend on residual insulin secretion.
71
List the types of oral hypoglycaemic agents.
* Biguanides (e.g., Metformin)
* SGLT2 Inhibitors (e.g., Dapagliflozin)
* DPP-4 Inhibitors (e.g., Sitagliptin)
* Sulfonylureas (e.g., Glimepiride)
* Thiazolidinediones (e.g., Pioglitazone)
72
What are glucose-elevating agents used for?
To treat hypoglycaemic events
## Footnote
They increase blood glucose levels rapidly.
73
What are the routes and dosages for glucose administration?
* 10-20 grams orally for adults
* 50 mL of 50% glucose solution IV
* 50 mL of 10% glucose solution IV for children
74
What are some adverse effects of glucose-elevating agents?
* Gastrointestinal upset
* Vascular effects
75
What should be considered when using glucose-elevating agents?
Caution in individuals with hepatic dysfunction or cardiovascular disease
## Footnote
Contraindicated in pregnancy and breastfeeding.
76
What should be avoided if there is a known allergy to glucose elevating agents?
Glucose elevating agents
## Footnote
These agents can trigger allergic reactions in sensitive individuals.
77
Which drug class interferes with glucose-elevating agents?
Thiazide diuretics
## Footnote
Thiazide diuretics can affect blood sugar levels.
78
What is the primary pharmacological intervention required for diabetics?
Insulin
## Footnote
Insulin is critical for managing blood glucose levels in diabetes.
79
Who should be referred to for dietary changes in diabetic patients?
Dieticians
## Footnote
Dieticians help manage dietary needs and educate patients on diabetic-friendly foods.
80
What is the role of Diabetes Nurse Educators (DNEs) in a hospital setting?
Provide holistic, diabetes-focused care and refer patients to other specialists
## Footnote
DNEs are essential for coordinating comprehensive care for diabetes patients.
81
True or False: Social workers are important for the support of the family of a diabetic patient.
True
## Footnote
Social workers help assess and support family dynamics and community resources.
82
What are the clinical manifestations of Type 3c diabetes?
Nausea, diarrhoea, malabsorption, weight loss
## Footnote
These symptoms are related to exocrine dysfunction of the pancreas.
83
Fill in the blank: Type 3 diabetes typically refers to a condition where _______ is associated with insulin resistance in the brain.
Alzheimer's disease
## Footnote
Recent research suggests a link between Alzheimer's disease and insulin signaling.
84
What causes Type 3c diabetes?
Pancreatitis, pancreatectomy, trauma, pancreatic carcinoma, cystic fibrosis, haemochromatosis
## Footnote
These conditions lead to damage of the exocrine pancreas.
85
What is a key aspect of managing Type 3c diabetes?
Insulin therapy
## Footnote
Insulin is necessary due to pancreatic trauma or injury.
86
What role do pharmacists play in the care of diabetic patients?
Manage medication transitions and ensure smooth admission and discharge processes
## Footnote
Pharmacists help maintain the insulin-glucose balance during patient care.
87
How can physiotherapists assist diabetic patients during recovery?
Strengthening muscles and promoting exercise to maintain normal blood glucose levels
## Footnote
Exercise can also enhance overall well-being and recovery.
88
What is the significance of referring patients to Wound Care Nurses?
They assist with wound healing and choosing appropriate dressings
## Footnote
Wound care is crucial for diabetic patients who may have poor healing.
89
What is the focus of the interprofessional team when caring for complex diabetic patients?
Holistic support addressing multi-organ involvement
## Footnote
Collaboration among various healthcare professionals is essential for optimal patient outcomes.
90
True or False: Type 3c diabetes is characterized by symptoms typical of Type 1 or Type 2 diabetes only.
False
## Footnote
Type 3c also includes additional symptoms due to exocrine dysfunction.
91
What is the new classification of diabetes related to Alzheimer's disease?
Type 3 Diabetes Mellitus
## Footnote
This term links Alzheimer's disease with insulin resistance in the brain.
92
What is Cushing Syndrome?
A group of manifestations caused by chronic exposure to excessive circulating levels of cortisol (hypercortisolism)
## Footnote
Cushing Syndrome is rare in childhood and mainly affects adults.
93
What are some known causes of Cushing Syndrome?
* Tumours on the adrenal glands
* Pituitary adenomas
* Lung Cancer
* Pancreatic Cancer
* Long-term use of exogenous steroids, like prednisolone
## Footnote
The 'cushingoid appearance' from steroids is usually reversible once treatment ceases.
94
Why do steroids require 'weaning off'?
Allows the anterior pituitary gland to secrete increased amounts of ACTH, stimulating adrenal glands to secrete cortisol naturally again
## Footnote
Gradual withdrawal is necessary to prevent acute adrenal insufficiency.
95
What are some clinical manifestations of Cushing Syndrome?
Clinical manifestations can vary but often include physical changes such as 'Moon face', acne, and general swelling
## Footnote
A thorough head-to-toe assessment is essential due to potential effects on multiple body systems.
96
How is Cushing Syndrome diagnosed?
Through patient history, physical exam, and grouping subjective and objective data
## Footnote
Key clinical manifestations and focused assessments aid in diagnosis.
97
What tests are used to diagnose Cushing Syndrome?
* Cortisol Blood Levels and/or saliva swab
* 24-hour urine collection testing
* Dexamethasone Suppression Test
## Footnote
Patients may have false positives due to high alcohol consumption or certain medications.
98
What imaging techniques are used in the diagnosis of Cushing Syndrome?
CT scan or MRI of adrenal glands and/or pituitary gland
## Footnote
Imaging helps identify possible tumours or abnormalities.
99
What is the primary treatment goal for Cushing Syndrome?
To normalize hormone secretion
## Footnote
Treatment varies based on whether hypersecretion is caused by a tumour or not.
100
What are the treatment options if hypersecretion is caused by a tumour?
* Excision of the tumour via surgical removal
* Radiotherapy to shrink the tumour
## Footnote
These interventions target the root cause of hypercortisolism.
101
What nursing assessments are important for a patient with Cushing Syndrome?
* Fluid Balance Chart (FBC)
* Blood Glucose Levels (BGLs)
* Skin Integrity Chart & Wound Assessments
* Psychological & Emotional Support
* Targeted Education
## Footnote
Regular monitoring is crucial due to risks like delayed wound healing.
102
What role do pharmacists play in the management of patients with Cushing Syndrome?
Pharmacists assist with weaning off steroids and provide supporting medication for symptoms related to steroid withdrawal
## Footnote
Early pharmacy involvement is encouraged for patients with long-term steroid use.
103
True or False: Cushing Syndrome can develop in childhood.
False
## Footnote
Cushing Syndrome is incredibly rare to develop in childhood.
104
Fill in the blank: The hormone causing the signs and symptoms of Cushing Syndrome is _______.
cortisol
105
What should be monitored closely in patients with Cushing Syndrome due to risk of delayed wound healing?
Skin Integrity and existing wounds
## Footnote
Regular pressure area care and skin checks are important.
106
What educational topics should be covered with patients frequently visiting the hospital for Cushing Syndrome?
* Medication education
* Importance of good skincare
* Wound care when discharged
## Footnote
Targeted education helps in managing ongoing health needs.
107
What is Adrenocortical Insufficiency?
A condition characterized by hyposecretion of hormones from the adrenal or pituitary glands
## Footnote
It is essentially the opposite of Cushing Syndrome.
108
What is the primary cause of Adrenocortical Insufficiency?
Addison's Disease
## Footnote
Addison's Disease is a form of primary adrenal insufficiency.
109
What is a secondary cause of Adrenocortical Insufficiency?
Hyposecretion of adrenocorticotropic hormone (ACTH) from the pituitary gland
## Footnote
This disrupts communication with the adrenal glands.
110
Which gender is more commonly affected by Adrenal Insufficiency?
Women
## Footnote
This is a non-modifiable risk factor.
111
What age group is most commonly affected by Adrenal Insufficiency in women?
30-50 years
## Footnote
This is another non-modifiable risk factor.
112
What is the most common cause of Addison's Disease?
Autoimmune adrenalitis
## Footnote
80% of Addison's Disease patients have this pathophysiology.
113
What happens to the adrenal cortex in Addison's Disease?
It undergoes inflammation and destruction
## Footnote
This leads to decreased production of cortisol and aldosterone.
114
What infections can cause primary adrenocortical insufficiency?
Tuberculosis
## Footnote
Such infections can destroy the adrenal glands.
115
What are some causes of secondary adrenocortical insufficiency?
* Diseases or dysfunction of the hypothalamus
* Diseases or dysfunction of the pituitary gland
* Suppression of pituitary function due to exogenous corticosteroid administration
116
What is Addison's Crisis?
Life-threatening complications from critically low blood cortisol levels
## Footnote
It can arise if Addison's Disease goes untreated.
117
What are critical symptoms of Addison's Crisis?
* Loss of consciousness
* Alterations in mental status
* Visual and auditory hallucinations
* High fever >39°C
* Sudden onset pain in lower back, abdomen, or legs
* Death
118
What are common clinical manifestations of Adrenocortical Insufficiency?
* Extreme fatigue
* Weight loss
* Hyperpigmentation
* Low blood pressure
* Salt cravings
* Nausea and vomiting
* Muscle pain
* Hyperkalaemia and Hyponatraemia
119
What is the ACTH Stimulation Test?
A test where synthetic ACTH is given to check cortisol levels
## Footnote
↓ cortisol levels post-test suggest adrenal insufficiency.
120
What is the primary treatment goal for patients with adrenal insufficiency?
To normalize hormone secretion
## Footnote
This involves managing the underlying cause.
121
What medications are commonly used for hormone replacement in adrenal insufficiency?
* Hydrocortisone
* Prednisolone
* Fludrocortisone
122
What are the indications for Hydrocortisone?
* Endocrine disorders
* Rheumatic conditions
* Allergic disorders
* Gastrointestinal conditions
123
What are some adverse effects of glucocorticoids?
* Dizziness
* Headaches
* Oedema
* Fatigue
* Increased risk of infection
124
What is the brand name for Fludrocortisone?
Florinef
## Footnote
Fludrocortisone is a mineralocorticoid used for chronic replacement.
125
What are common adverse effects of Fludrocortisone?
* Weight gain
* Hypertension
* Oedema
* Hypokalaemia
126
What should nursing care consider when administering glucocorticoids?
* Administer with food
* Gradually titrate doses
* Monitor blood glucose levels
* Be cautious with NSAIDs
127
True or False: Glucocorticoids can be ceased abruptly.
False
## Footnote
Abrupt cessation can lead to adrenal crisis.
128
What is a 24-hour urine collection used for?
To test for cortisol levels
## Footnote
Normal levels are 80-120 mcg/24 hours.
129
What is the role of pharmacists in managing adrenal insufficiency?
To assist with medication management
## Footnote
They help when adding or removing medications.
130
What is the role of pharmacists in managing medications for patients with adrenal disorders?
Pharmacists are involved in the weaning or initiation of new medications, particularly steroids. They ensure a smooth transition of medications during admission and discharge.
131
How can pharmacists prevent signs and symptoms of adrenal disorders?
Good pharmacological management can prevent many signs, symptoms, and causes of adrenal disorders. Referral to pharmacists is vital when a patient requires steroids.
132
What is the importance of dieticians in managing patients with thyroid disorders?
Dieticians help patients discuss necessary dietary changes, particularly in managing increased metabolism and energy needs during recovery.
133
How do physiotherapists contribute to the recovery of patients with adrenal disorders?
Physiotherapists assist in recovery by addressing muscle weakness and fatigue, helping patients strengthen their muscles during their hospital stay.
134
What role do occupational therapists play in the transition of patients back to the community?
Occupational therapists work with physiotherapists to gather equipment for home use, aiding in the transition of patients post-discharge.
135
Fill in the blank: Social workers can help patients with a new diagnosis manage their _______.
[life sentence]
136
What supports can social workers establish for patients upon discharge?
Social workers can establish community supports such as meal services, at-home physiotherapy, and more.
137
What is the role of wound care nurses in managing patients with poor wound healing?
Wound care nurses assist in choosing the right bandages, sourcing anti-bacterial options, and supporting wound healing during recovery.
138
True or False: Physiotherapists only help with physical recovery and do not assist with discharge preparation.
False
139
What equipment might occupational therapists help gather for patients transitioning back home?
They might gather bathroom assist devices, handles for steps, etc.
140
What is the thyroid gland's shape and location?
Butterfly-shaped gland anterior to the oesophagus, below the 'Adam's apple'.
141
What two hormones does the thyroid produce using dietary iodine?
* Thyroxine (T4)
* Tri-iodothyronine (T3)
142
What is hypothyroidism?
Under-secretion of thyroid hormones leading to metabolic changes.
143
What are the primary consequences of hypothyroidism on the body?
Progressive and general slowing of the metabolic rate affecting all organs.
144
What are the common causes of hypothyroidism?
* Hashimoto's Thyroiditis
* Iodine Deficiency
* Treatment for hyperthyroidism
* Medications like lithium and amiodarone
145
How prevalent is hypothyroidism in the population?
Affects approximately 3% of the population.
146
What characterizes primary hypothyroidism?
Destruction of thyroid tissue or defective hormone synthesis.
147
What distinguishes secondary hypothyroidism?
Decreased Thyroid Releasing Hormone (TRH) from the hypothalamus or decreased Thyroid Stimulating Hormone (TSH) from the pituitary gland.
148
What is Hashimoto's Thyroiditis?
An autoimmune disorder where antibodies attack the thyroid gland, leading to insufficient hormone secretion.
149
List clinical manifestations of Hashimoto's Thyroiditis.
* Hypercholesterolaemia
* Myxoedema Coma
* Symptoms leading to cardiovascular collapse and death
150
What are some systemic symptoms of hypothyroidism?
* Loss of consciousness
* Apathy
* Lethargy
* Weight gain
* Brittle nails and hair
* Cold intolerance
* Receding hairline
* Oedema
* Dry skin
* Menstrual disturbances
* Constipation
* Muscle weakness
151
What is the focus of nursing assessment for hypothyroidism?
Taking patient history and performing a thorough physical exam.
152
What does an increased TSH level indicate?
Likely a primary cause of hypothyroidism.
153
What might decreased TSH levels suggest?
Likely a secondary cause of hypothyroidism.
154
What is the first line of treatment for hypothyroidism?
Medication to regulate hormone levels.
155
What is a key nursing consideration for administering Thyroxine Sodium?
Should be taken on an empty stomach, preferably before breakfast.
156
What is the mechanism of action for Thyroxine Sodium?
Converted to T3, which acts physiologically at end-organs.
157
What are common laboratory findings in hypothyroidism?
* ↑ TSH
* ↓ Free T4
* ↑ Cholesterol and Triglycerides
* ↓ Red Blood Cells (RBC)
* ↑ Creatinine
158
What clinical manifestation is associated with myxoedema coma?
Changes in physical appearance with puffiness, lethargy, and potential cardiovascular collapse.
159
Fill in the blank: The most common cause of hypothyroidism is _______.
[Hashimoto's Thyroiditis]
160
What should be monitored in patients with hypothyroidism to manage constipation?
Stool Chart.
161
True or False: Hypothyroidism is more common in men than women.
False
162
What is the significance of a skin integrity chart in patients with hypothyroidism?
It helps monitor dry skin and wound healing.
163
What condition is characterized by hyperactivity of the thyroid gland?
Hyperthyroidism
## Footnote
Hyperthyroidism results in sustained elevated levels of circulating thyroid hormones, impacting metabolism and energy use.
164
What are some risk factors for developing hyperthyroidism?
* Being born female
* Aged between 20 - 40 years
* Family history of thyroid disease
* Comorbidities such as pernicious anaemia, T1DM, primary adrenal insufficiency
* Low dietary intake of iodine
* Pregnancy in the last 6 months
## Footnote
These factors contribute to an increased likelihood of developing hyperthyroidism.
165
What is the primary cause of Primary Hyperthyroidism?
Graves' Disease, an autoimmune disease
## Footnote
Graves' Disease causes the thyroid glands to secrete too much T3 and T4 due to antibodies mimicking TSH.
166
What type of hyperthyroidism occurs due to elevated release of TSH from the hypothalamus or pituitary gland?
Secondary Hyperthyroidism
## Footnote
This results in the thyroid gland excessively secreting T3 and T4.
167
List some clinical manifestations of Graves' Disease.
* Headaches
* Nervousness
* Emotional instability
* Weight loss
* Tremors
* Exophthalmos
* Goiter
* Increased perspiring
* Cardiac arrhythmias
* Increased respiratory drive
* Nausea and diarrhoea
* Muscle weakness
## Footnote
The symptoms impact multiple organ systems due to the role of thyroid hormones in metabolism.
168
What is the primary goal of nursing management for hyperthyroidism?
To normalise hormone secretion
## Footnote
This includes managing the underlying cause, symptom management, and preventing long-term complications.
169
What are the first-line treatment options for hyperthyroidism?
* Medication to regulate hormone levels
* Radio-iodine Therapy
* Thyroid Surgery
## Footnote
Treatment plans are individualized based on severity, causes, ages, and comorbidities.
170
What medication class do Thioamides belong to?
Antithyroid Drugs
## Footnote
Thioamides are used to manage hyperthyroidism by inhibiting thyroid hormone synthesis.
171
What is a common brand name for the Thioamide drug Carbimazole?
Neo-Mercazole
## Footnote
This drug is used to depress thyroid hormone synthesis.
172
What is the mechanism of action for Iodine in the treatment of hyperthyroidism?
Inhibits T3 and T4 synthesis and blocks their release
## Footnote
High doses of iodine also decrease vascularity of the thyroid gland.
173
What is the role of Beta Blockers in managing hyperthyroidism symptoms?
To manage cardiac symptoms like arrhythmias and tachycardia
## Footnote
Beta Blockers do not prevent thyroid hormone production.
174
Fill in the blank: The diagnosis of hyperthyroidism involves taking the patient's history and performing a _______.
physical exam
## Footnote
A thorough assessment helps in identifying key clinical manifestations.
175
What imaging techniques can be used in the diagnosis of hyperthyroidism?
* CT scan
* MRI of the thyroid gland
## Footnote
These imaging techniques help visualize the thyroid gland.
176
What are some adverse effects of Thioamides?
* Rash
* Itchy skin
* ↓ White Blood Cell count
* Liver failure with prolonged use
* Weakness
* Fatigue
* Fever
* Sore throat
* Nausea
## Footnote
Adverse reactions typically occur after 8 weeks of treatment.
177
What is a potential outcome of successful Radio-iodine Therapy for hyperthyroidism?
Development of Hypothyroidism
## Footnote
While this is a common outcome, hypothyroidism is easier to treat and stabilize.
178
True or False: Graves' Disease has a known aetiology.
False
## Footnote
While some precipitating factors exist, the exact cause remains unknown.
179
180
Q1: What is the main hormone deficient in Type 1 Diabetes Mellitus?
A. Glucagon
B. Cortisol
C. Insulin
D. Amylin
Q1: What is the main hormone deficient in Type 1 Diabetes Mellitus?
A. Glucagon
B. Cortisol
C. Insulin ✅
D. Amylin
181
Q2: Which clinical symptom is NOT commonly seen in initial diagnosis of T1DM?
A. Polyuria
B. Polydipsia
C. Bradycardia
D. Polyphagia
Q2: Which clinical symptom is NOT commonly seen in initial diagnosis of T1DM?
A. Polyuria
B. Polydipsia
C. Bradycardia ✅
D. Polyphagia
182
Q3: Which pancreatic cells produce insulin?
A. Alpha cells
B. Delta cells
C. Gamma cells
D. Beta cells
Q3: Which pancreatic cells produce insulin?
A. Alpha cells
B. Delta cells
C. Gamma cells
D. Beta cells ✅
183
Q4: What is the pathophysiological hallmark of T2DM?
A. Destruction of beta cells
B. Absolute insulin deficiency
C. Insulin resistance
D. Glucagon excess
Q4: What is the pathophysiological hallmark of T2DM?
A. Destruction of beta cells
B. Absolute insulin deficiency
C. Insulin resistance ✅
D. Glucagon excess
184
Q5: Which lab result confirms diabetes if found on two separate occasions?
A. Random BGL of 6.0 mmol/L
B. HbA1c of 5.0%
C. Fasting BGL of 7.1 mmol/L
D. HbA1c of 5.9%
Q5: Which lab result confirms diabetes if found on two separate occasions?
A. Random BGL of 6.0 mmol/L
B. HbA1c of 5.0%
C. Fasting BGL of 7.1 mmol/L ✅
D. HbA1c of 5.9%
185
Q6: What does HbA1c reflect?
A. Current insulin levels
B. 24-hour glucose levels
C. Average glucose over 2–3 months
D. Liver function
Q6: What does HbA1c reflect?
A. Current insulin levels
B. 24-hour glucose levels
C. Average glucose over 2–3 months ✅
D. Liver function
186
Q7: Which of the following is a symptom of diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Fruity-smelling breath
C. Hypertension
D. Hypernatremia
Q7: Which of the following is a symptom of diabetic ketoacidosis (DKA)?
A. Bradycardia
B. Fruity-smelling breath ✅
C. Hypertension
D. Hypernatremia
187
Q8: Which condition is associated with hypercortisolism?
A. Addison’s disease
B. Cushing’s syndrome
C. Hashimoto’s thyroiditis
D. Diabetes insipidus
Q8: Which condition is associated with hypercortisolism?
A. Addison’s disease
B. Cushing’s syndrome ✅
C. Hashimoto’s thyroiditis
D. Diabetes insipidus
188
Q9: Which hormone is most elevated in Cushing's Syndrome?
A. Thyroxine
B. Insulin
C. Cortisol
D. Aldosterone
Q9: Which hormone is most elevated in Cushing's Syndrome?
A. Thyroxine
B. Insulin
C. Cortisol ✅
D. Aldosterone
189
Q10: What is a hallmark feature of Addison’s crisis?
A. Hyperglycaemia
B. Hypertension
C. Altered mental state
D. Excess cortisol
Q10: What is a hallmark feature of Addison’s crisis?
A. Hyperglycaemia
B. Hypertension
C. Altered mental state ✅
D. Excess cortisol
190
Q11: Which symptom is common in hypothyroidism?
A. Weight loss
B. Cold intolerance
C. Tachycardia
D. Exophthalmos
Q11: Which symptom is common in hypothyroidism?
A. Weight loss
B. Cold intolerance ✅
C. Tachycardia
D. Exophthalmos
191
Q12: What lab finding would support a diagnosis of primary hypothyroidism?
A. ↑ TSH, ↓ T4
B. ↓ TSH, ↑ T4
C. ↑ TSH, ↑ T4
D. ↓ TSH, ↓ T4
Q12: What lab finding would support a diagnosis of primary hypothyroidism?
A. ↑ TSH, ↓ T4 ✅
B. ↓ TSH, ↑ T4
C. ↑ TSH, ↑ T4
D. ↓ TSH, ↓ T4
192
Q13: What causes the hyperpigmentation seen in Addison’s Disease?
A. Elevated T3
B. Low ACTH
C. Excess melanin
D. Increased ACTH
Q13: What causes the hyperpigmentation seen in Addison’s Disease?
A. Elevated T3
B. Low ACTH
C. Excess melanin
D. Increased ACTH ✅
193
Q14: What medication is used for long-term management of hypothyroidism?
A. Insulin
B. Prednisolone
C. Levothyroxine
D. Hydrocortisone
Q14: What medication is used for long-term management of hypothyroidism?
A. Insulin
B. Prednisolone
C. Levothyroxine ✅
D. Hydrocortisone
194
Q15: What hormone is produced by the adrenal cortex?
A. Insulin
B. Cortisol
C. TSH
D. Prolactin
Q15: What hormone is produced by the adrenal cortex?
A. Insulin
B. Cortisol ✅
C. TSH
D. Prolactin
195
Q16: Which is a symptom of hyperthyroidism?
A. Constipation
B. Weight gain
C. Tremors
D. Cold intolerance
Q16: Which is a symptom of hyperthyroidism?
A. Constipation
B. Weight gain
C. Tremors ✅
D. Cold intolerance
196
Q17: What is a major nursing consideration when administering insulin?
A. Must be taken with food
B. Administered orally
C. Store in freezer
D. Rotate injection sites
Q17: What is a major nursing consideration when administering insulin?
A. Must be taken with food
B. Administered orally
C. Store in freezer
D. Rotate injection sites ✅
197
Q18: Which is the emergency treatment for severe hypoglycaemia in an unconscious patient?
A. Metformin
B. Oral glucose
C. Glucagon injection
D. Beta blocke
Q18: Which is the emergency treatment for severe hypoglycaemia in an unconscious patient?
A. Metformin
B. Oral glucose
C. Glucagon injection ✅
D. Beta blocke
198
Q19: What is a classic symptom of diabetic peripheral neuropathy?
A. Blurred vision
B. Chest pain
C. Tingling in the feet
D. Seizures
Q19: What is a classic symptom of diabetic peripheral neuropathy?
A. Blurred vision
B. Chest pain
C. Tingling in the feet ✅
D. Seizures
199
Q20: What role does amylin play in glucose regulation?
A. Raises blood glucose
B. Enhances insulin absorption
C. Suppresses glucagon release
D. Stimulates cortisol
Q20: What role does amylin play in glucose regulation?
A. Raises blood glucose
B. Enhances insulin absorption
C. Suppresses glucagon release ✅
D. Stimulates cortisol
200
Q21: What is the best first-line oral agent for T2DM?
A. Glipizide
B. Metformin
C. Sitagliptin
D. Dapagliflozin
Q21: What is the best first-line oral agent for T2DM?
A. Glipizide
B. Metformin ✅
C. Sitagliptin
D. Dapagliflozin
201
Q22: What is the mechanism of action for SGLT2 inhibitors?
A. Stimulate insulin production
B. Enhance muscle glucose uptake
C. Reduce renal glucose reabsorption
D. Decrease gastric emptying
Q22: What is the mechanism of action for SGLT2 inhibitors?
A. Stimulate insulin production
B. Enhance muscle glucose uptake
C. Reduce renal glucose reabsorption ✅
D. Decrease gastric emptying
202
Q23: What is a potential adverse effect of thioamide drugs like carbimazole?
A. Hyperglycaemia
B. Liver failure
C. Hypotension
D. Bradycardia
Q23: What is a potential adverse effect of thioamide drugs like carbimazole?
A. Hyperglycaemia
B. Liver failure ✅
C. Hypotension
D. Bradycardia
203
Q24: What type of insulin has the fastest onset of action?
A. Long-acting
B. Intermediate-acting
C. Short-acting
D. Rapid-acting
Q24: What type of insulin has the fastest onset of action?
A. Long-acting
B. Intermediate-acting
C. Short-acting
D. Rapid-acting ✅
204
Q25: What electrolyte imbalance is associated with Addison’s disease?
A. Hypernatremia
B. Hypokalaemia
C. Hyponatraemia
D. Hypercalcaemia
Q25: What electrolyte imbalance is associated with Addison’s disease?
A. Hypernatremia
B. Hypokalaemia
C. Hyponatraemia ✅
D. Hypercalcaemia
205
Q26: Which hormone is deficient in Addison’s disease?
A. T3
B. Insulin
C. Cortisol
D. Glucagon
Q26: Which hormone is deficient in Addison’s disease?
A. T3
B. Insulin
C. Cortisol ✅
D. Glucagon
206
Q27: Which finding is characteristic of myxoedema coma?
A. Hyperactivity
B. Lethargy and facial puffiness
C. Sweating
D. Weight loss
Q27: Which finding is characteristic of myxoedema coma?
A. Hyperactivity
B. Lethargy and facial puffiness ✅
C. Sweating
D. Weight loss
207
Q28: What is the priority intervention for a conscious hypoglycaemic patient?
A. IV insulin
B. 50 mL IV glucose
C. 15–20g fast-acting carbohydrate
D. IM glucagon
Q28: What is the priority intervention for a conscious hypoglycaemic patient?
A. IV insulin
B. 50 mL IV glucose
C. 15–20g fast-acting carbohydrate ✅
D. IM glucagon
208
Q29: Which condition is characterised by exophthalmos and goitre?
A. Hashimoto’s
B. Cushing’s
C. Graves’ disease
D. Addison’s
Q29: Which condition is characterised by exophthalmos and goitre?
A. Hashimoto’s
B. Cushing’s
C. Graves’ disease ✅
D. Addison’s
209
Q30: What symptom is common in both T1DM and T2DM?
A. Bradycardia
B. Polyphagia
C. Hair loss
D. Hypercalcaemia
Q30: What symptom is common in both T1DM and T2DM?
A. Bradycardia
B. Polyphagia ✅
C. Hair loss
D. Hypercalcaemia
210
Q31: Which test is used to differentiate Graves’ from other hyperthyroid conditions?
A. HbA1c
B. ACTH stimulation
C. Radioactive iodine uptake
D. Cortisol saliva swab
Q31: Which test is used to differentiate Graves’ from other hyperthyroid conditions?
A. HbA1c
B. ACTH stimulation
C. Radioactive iodine uptake ✅
D. Cortisol saliva swab
211
Q32: What is the primary treatment for hyperthyroidism?
A. Thyroxine
B. Insulin
C. Carbimazole
D. Prednisolone
Q32: What is the primary treatment for hyperthyroidism?
A. Thyroxine
B. Insulin
C. Carbimazole ✅
D. Prednisolone
212
Q33: What is a common chronic complication of diabetes?
A. Respiratory acidosis
B. Retinopathy
C. Hypercalcaemia
D. Jaundice
Q33: What is a common chronic complication of diabetes?
A. Respiratory acidosis
B. Retinopathy ✅
C. Hypercalcaemia
D. Jaundice
213
Q34: Which insulin should be given before meals?
A. Intermediate-acting
B. Rapid-acting
C. Long-acting
D. Basal insulin
Q34: Which insulin should be given before meals?
A. Intermediate-acting
B. Rapid-acting ✅
C. Long-acting
D. Basal insulin
214
Q35: What is the key action of glucagon?
A. Lowers blood glucose
B. Breaks down glycogen
C. Increases insulin release
D. Stimulates the thyroid
Q35: What is the key action of glucagon?
A. Lowers blood glucose
B. Breaks down glycogen ✅
C. Increases insulin release
D. Stimulates the thyroid
215
Q36: What condition does fludrocortisone treat?
A. T1DM
B. Hyperthyroidism
C. Adrenocortical insufficiency
D. Cushing’s syndrome
Q36: What condition does fludrocortisone treat?
A. T1DM
B. Hyperthyroidism
C. Adrenocortical insufficiency ✅
D. Cushing’s syndrome
216
Q37: Which side effect is associated with high-dose prednisolone?
A. Hypoglycaemia
B. Weight loss
C. Osteoporosis
D. Bradycardia
Q37: Which side effect is associated with high-dose prednisolone?
A. Hypoglycaemia
B. Weight loss
C. Osteoporosis ✅
D. Bradycardia
217
Q38: Which is a symptom of hyperthyroidism, but not hypothyroidism?
A. Dry skin
B. Weight gain
C. Tachycardia
D. Cold intolerance
Q38: Which is a symptom of hyperthyroidism, but not hypothyroidism?
A. Dry skin
B. Weight gain
C. Tachycardia ✅
D. Cold intolerance
218
Q39: What is the goal of diabetes management in hospital?
A. Prevent weight loss
B. Maintain normoglycaemia
C. Reduce insulin resistance
D. Maximise oral intake
Q39: What is the goal of diabetes management in hospital?
A. Prevent weight loss
B. Maintain normoglycaemia ✅
C. Reduce insulin resistance
D. Maximise oral intake
219
Q40: What is the most appropriate nursing intervention for a patient on insulin experiencing infection?
A. Hold insulin until fever resolves
B. Increase fluid intake only
C. Monitor BGL closely and adjust dose with team
D. Give glucagon daily
Q40: What is the most appropriate nursing intervention for a patient on insulin experiencing infection?
A. Hold insulin until fever resolves
B. Increase fluid intake only
C. Monitor BGL closely and adjust dose with team ✅
D. Give glucagon daily
