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a MCPHS- Provider I- Ch 42- Assessment & Management of Pts w/Endocrine Disorders
Question | Answer |
---|---|
Other tissues which produce hormones | GI mucosa, Kidneys, WBC's |
Endocrine glands vs. Exocrine glands r/t Secretion | Endo:secrete directly into bloodstream, Exo:secrete through ducts onto epithelial surfaces or into GI tract |
Chemicals secreted by endocrine glands | Hormones |
Hormones regulate | Organ function |
Nervous system vs. Hormones r/t Action potential | NS:rapid, H:slower |
Hormone concentration vs. Hormone production | Production increases, Concentration decreases, Inverse relationship |
Mechanism which regulates hormone concentration in bloodstream | Negative feedback |
Peptide hormones vs. Protein hormones vs. Steroid hormones r/t Receptor sites | Pep & Pro:receptor sites on cell surface, S:penetrate cell and interact w/intracellular receptors |
Time r/t Steroid hormone action | Hours |
Common S/Sx r/t Endocrine imbalances | Changes in energy level, Fatigue, Tolerance to heat and cold, Recent changes in weight, Changes in sexual function, Secondary sex characteristics |
3 common diagnostic tests r/t Endocrine disorders | Blood, Urine, Stimulation & suppression tests |
Stimulation tests vs. Suppression tests | Stimulation:determine gland response to stimulating hormones released by hypothalamus/pituitary gland, Suppression:determines if negative feedback mechanisms are intact |
Secretes hormones that control secretion of hormones by other glands | Pituitary |
Controls pituitary | Hypothalamus |
Hormones secreted by posterior lobe of pituitary gland | Vasopressin (ADH), Oxytocin |
S/Sx r/t Hypopituitarism | Extreme weight loss, Weight loss, Emaciation, Atrophy of all endocrine glands & organs, Hair loss, Impotence, Hypometabolism, Hypoglycemia |
Acromegaly | Excess growth hormone in adults |
Gigantism vs. Dwarfism r/t Children | G:oversecretion of growth hormone, D:insufficient secretion of growth hormone |
Most common disorder r/t Posterior lobe dysfunction | Diabetes insipidus |
3 types of pituitary tumors | Eosinophilic, Basophilic, Chromophobic |
Eosinophilic vs. Basophilic vs. Chromophobic r/t Pathology | E:Gigantism, B:Cushing's syndrome, C:Hypopituitarism |
Hypophysectomy | Removal of pituitary gland |
Manifestations r/t Diabetes insipidus | Polydipsia, Polyuria w/dilute urine, Inability to increase specific gravity/osmolality of urine |
Manifestations r/t Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion | Retain fluids, Na deficiency |
Dilutional hyponatremia | Na deficiency r/t SIADH |
Essential for thyroid gland to synthesize its hormones | Iodine |
Thyroid hormone production w/in normal limits | Euthyroid |
Primary function r/t Thyroid hormones | Cellular metabolic activity |
Calcitonin function | Reduce plasma level of Ca by increasing its deposition into bone |
Pathology r/t Goiter | Iodine deficiency causes goiter, Goiter causes oversecretion of thyroid hormone |
Abnormal finding r/t Enlarged thyroid gland | Bruit |
Best screening test r/t Thyroid function | Serum TSH function |
Hypothyroidism vs. Hyperthyoidism r/t Values | Hypo:value > 6.15, Hyper:value < 0.4 |
Current recommendations r/t TSH screening | All adults 35+ and every 5 years after |
T3 vs. T4 r/t Normal ranges | T3:70 - 220, T4:4.5 - 11.5 |
Most common cause r/t Hypothyroidism | Hashimoto's disease (autoimmune thyroiditis) |
Most severe stage r/t Hypothyroidism/Hashimoto's | Myxedema coma |
S/Sx r/t Myxedema coma | Hypothermia, Unconscious, Depressed respiratory drive, Progressive CO2 retention |
Analgesic, sedative, anesthetic effects r/t Hypothyroidism | Prolonged d/t altered metabolism and excretion |
Heating pad & electric blanket usage r/t Myxedema coma | Do not use d/t risk for peripheral vasodilation |
Most commmon type r/t Hyperthyroidism | Graves' disease |
Most severe form of hyperthyroidism | Thyoid storm |
S/Sx r/t Thyroid storm | High fever & Extreme tachycardia |
Common precipating event r/t Thyroid storm | Stress such as injury, infection, DKA et cetera |
Management r/t Thyroid storm | Hypothermia mattress, Humidified oxygen, IV fluids w/dextrose, Iodine administration |
Cause r/t Acute thyroiditis | Infection of thyroid gland |
Aspirin r/t Subacute thyroiditis | Avoided b/c it increases amount of circulating thyroid hormone |
Synonym r/t Chronic thyroiditis | Hashimoto's disease |
Chronic vs. Acute thyroiditis r/t Pain & thyroid activity | C:pain, pressure & fever are not normal, Thyroid activity is normal/low, A:pain, pressure & fever are normal, Thyroid activity is increased |
Most common type of goiter | Simple/colloid d/t Iodine deficiency in diet |
Parathormone (parathyroid hormone) regulates | Ca & phosphorus metabolism |
Ca absorption r/t Increased parathormone | Increased parathormone = Increased Ca absorption = Increased serum calcium levels |
Characteristics r/t hyperparathyroidism | Bone decalcification, Development of renal calculi |
Secondary hyperparathyroidism occurs d/t | Chronic renal failure |
Management r/t Hyperparathyroidism | Hydration, Mobility, Diet, Medication |
Diet r/t Hyperparathyroidism management | Nutritional needs met but avoid diets that restrict/excess Ca |
Treatment r/t Acute hypercalcemic crisis | Rehydration w/large volumes of IV fluid, Diuretics to excrete excess Ca, Phophate therapy to promote Ca deposition |
Tetany | General muscle hypertonia |
Assessment/diagnostic findings r/t Hypoparathyroidism | Positive Trousseau's & Chvostek's signs |
Trousseau's sign vs. Chvostek's sign | T:carpopedal spasm caused by occluding blood flow to arm for 3 minutes, C:sharp tapping of facial nerve causes twitch of mouth, nose & eye |
Restricted foods r/t Hypoparthyroidism diet | Milk products, egg yolk & spinach d/t high levels of phosphorus |
Adrenal medulla vs. Adrenal cortex r/t Hormone secretion | M:middle of gland which secretes catecholamines(epinephrine/norepinephrine), C:outer portion which secretes steroid hormones |
Effects r/t Catecholamines | Release free fatty acids, Increase basal metabolic rate, Elevate blood glucose levels |
3 types of hormones released by adrenal cortex | Glucocorticoids, Mineralocorticoids, Androgens |
Increased glucocorticoids (hydrocortisone) r/t Blood glucose levels | Increased blood glucose levels |
Mineralocorticoids mainly effect | Electrolyte metabolism |
Mineralocorticoid pathology | Act on renal tubule & GI epithelium, Increase Na absorption, Excrete K |
Mineralocorticoid excretion r/t Angiotensin II | Excreted as response to presence of Antiotensin II |
Form of HTN cured by surgery | Pheochromocytoma |
Pheochromocytoma r/t Adrenal medulla | Benign tumor found on medulla |
Caused d/t inadequate adrenal cortex function | Addison's disease |
Most common cause r/t Adrenocortical insufficiency | Corticosteroid therapy |
S/Sx r/t Addison's disease | Cyanosis & Signs of circulatory shock |
Provide information regarding fluid status | Orthostatic VS |
Caused d/t excessive adrenocortical activity | Cushing's syndrome |
S/Sx r/t Cushing's syndrome | Central obesity, Buffalo hump, Appearance of masculine traits |
Serum Na vs. Serum K vs. Blood glucose r/t Cushing's vs. Addison's | C:increased Na and glucose w/decreased K, A:decreased Na and glucose w/increased K |
Diet r/t Cushing's syndrome | Foods high in protein, Ca, Vitamin D |
Manifestations r/t Aldosteronism | Hypokalemia, Alkalosis, Increased serum bicarbonate, Inability to concentrate urine, Blood serum abnormally concentrated |
Most prominent sign r/t Aldosteronism | HTN |