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Endocrine/Hypothyroi
Hypothyroidism Pathophy Exam 2
| Question | Answer |
|---|---|
| Name the PRIMARY LOSS reasons for Hypothyroidism. | Congenital, OR, Rx, Tx for hyperthyroidism, Decrease Iodine, thyroiditis. |
| Name the SECONDARY LOSS for Hypothyroidism. | Pituitary disease |
| Name the TERTIARY LOSS for Hypothyroidism. | Hypothalmic disease |
| What happens when there is a decrease in thyroid tissue? | Decrease production of T3 & T4 causing a negative feedback of increase TSH. |
| What is another name for Hashimoto's disease (hypothyroidism)? | Autoimmune Thyroiditis |
| What do the hypothalamus and the Anterior Pituitary both release? | TRH and TSH respectively. |
| What does TSH stimulate? | They thyroid gland to release T3 & T4. |
| What does T3 & T4 do to the hypothalamus? | They inhibit it from releasing anymore TRH so as to not release more than the body needs. |
| In HYPOTHYROIDISM, what does the Anterior Pituitary do to TSH? | It over releases TSH causing PRIMARY thyroid damage thereby causing a decrease in T3 & T4 WHICH DECREASE INHIBITORY FEEDBACK. |
| What does the anterior pituitary gland affect TSH in HYPERTHYROIDISM? | It releases a decreased amount of TSH causing Autoimmune Thyroid Gland Growth causing an increase in T3 & T4 production. |
| What does the NORMAL ENDOCRINE MECHANISM inhibit vs. HYPO/HYPERTHYROIDISM? | It inhibits the HYPOTHALAMUS rather than TSH and in HYPER/HYPOTHYROIDISM. |
| In which thyroid abnormality is GOITER found in? | Both in Hyper and Hypothyroidism |
| Where is an increase in TSH seen? Hypo or Hyperthyroidism? | Hypothyroidism b/c this causes a decrease in T3 & T4. |
| HA, lethargy, confusion, and decreased memory are manifestations of hyper or hypothroidism? | Hypothyroidism |
| Increased pulse, dysrhythmia, HTN, angina, and CHF are manifestations of hyper or hypothroidism? | Hyperthyroidism |
| Increased cholesterol and cool skin are manifestations of hyper or hypothroidism? | Hypothyroidism |
| Decreased pulse and cardiomegaly are manifestations of hyper or hypothroidism? | Hypothyroidism |
| Cold intolerance is a manifestation of hyper or hypothroidism? | Hypothyroidsim |
| Increased blood sugar is a manifestation of hyper or hypothroidism? | Hyperthyroidism |
| Diaphoresis and fine, soft hair are manifestations of hyper or hypothroidism? | Hyperthyroidism |
| Constipation is a manifestation of hyper or hypothroidism? | Hypothyroidism |
| Dyspnea is a manifestation of hyper or hypothroidism? | Hyperthyroidism |
| Increased appetite, diarrhea, and vitamin deficiencies are manifestations of hyper or hypothroidism? | Hyperthyroidism |
| Anemia is a manifestation of hypo or hyperthyroidism? | Hypothyroidism |
| Non-pitting edema, dry, coarse skin, and thinning hair are manifestations of hyper or hypothroidism? | Hypothyroidism |
| Myxedema is a manifestation of hyper or hypothyroidism? | Hypothyroidism |
| Impotence is a manifestation of hyper or hypothyroidism? | Both |
| Anovulation is a manifestation of hypo or hyperthyroidism? | Hypothyroidism |
| Decreased glomerular filtration is a manifestation of hypo or hyperthyroidism? | Hypothyroidism |
| When do you usually see a "Thyroid Storm"? | Usually post OP. |
| What is a Thyroid Storm? | When you have too much T3 & T4 from a lack/insufficient TX of hyperthyroidism. |
| What are they complications of a Thyroid Storm? | Hyperthermia, cardiac dysrhytmias, heart failure, agitation, delirium, NVD (nausea, vomiting, diarrhea), cardiac collapse and death. |
| What are the complications of Myxedema? | Non-pitting edema of the eyes, hands, feet. Swollen lips and tongue. Thickened nose, pharynx and larynx. |
| How do you get Myxedema? | Due to severe hypothyroidism and an altered composition of the dermis and tissues, where large amounts of protein build up and bind H2O. |
| Name two adrenal disorders associated with Hypocortisolism. | Addison's Disease and Secondary Hypocortisolism |
| Name two adrenal disorders associated with Hypercoritisolism. | Cushing's Disease and Cushing's syndrome. |
| Name the disease that is a rare primary disorder, idiopahtic, genetic, autoimmune, and has DECREASED cortisol and aldosterone. | Addison's Disease. |
| Name the disease that is rare, pituitary dependant, and usually involves a tumor. | Cushing's disease |
| What is MORE COMMON, Cushing's Disease or Cushing's Syndrome? | Cushing's Syndrome |
| What is more common, Addison's Diesease or Secondary Hypocortisolism? | Secondary Hypocortisolism |
| Name the disease that is chronic, has increased release of ACTH or exogenous use of cortisol. | Cushing's Syndrome |
| Name the disease that is do to exogenous use of cortisol causing adrenal atrophy thereby decreasing cortisol. | Secondary Hypocortisolism |
| What adrenal disease is hypotension and dysrhythmia associated with? | Hypocortisolism |
| What adrenal disease is low SODIUM and increase POTASSIUM associated with? | Hypocortisolism |
| What adrenal disease is thinning of the dermis/epidermis, easy bruising, skin tears, delayed wound healing, striae, and incresed fat pads associated with? | Hypercortisolism |
| What adrenal disease is WEAKNESS associated with? | Hypothcortisolism |
| What adrenal disease has decreased NA, increase K, hypoglycemia and fatigue? | Hypocortisolism |
| What adrenal disease is associated with HTN (high NA) and dysrhytmia (low K)? | Hypercortisolism |
| Which adrenal disease is associated with a DECREASED response to stress? | Both hypercortisolism and hypocortisolism |
| Addisonian tan and vitiligo are seen in hypo or hypercortisolism? | Hypocortisolism |
| Hyperglycemia, altered fat metabolism, moon face, buffalo hump, and truncal obesity is seen in which disorder hypo or hypercortisolism? | Hypercortisolism |
| Nausea, vomiting, and anorexia is seen in hypo or hypercortisolism? | Hypocortisolism |
| Protein wastings, weakness, thin extremities and osteoporosis is seen in hypo or hypercortisolism? | Hypercortisolism |
| What are the complications of hypocortisolism? | Severe hyponatremia, severe hypoglycemia, and Addisonian Crisis. |
| What is HYPONATREMIA? | Low Na in the blood. |
| What does HYPONATREMIA cause? | Dehydration and hypovolemia causing a decrease in Cardiac Output thereby lowering Blood Pressure causing reflex tachycardia and shock. |
| Hypercalciuria or increase in kidney stones is a manifestation of hypo or hypercortisolism? | Hypercortisolism |
| What is the key to preventing an Addisonian Crisis? | Prevention by decreasing stressors. |
| What are complications of Hypercortisolism? | Suicide,infections, and poor wound healing. |
| Steroid induced hyperglycemia is a complication of hypo or hypercortisolism? | Hypercortisolism |
| What manifestation can be seen in the reproductive system by Hypercortisolism? | Androgenic effects, menstrual changes, Virilism. |
| What Psychological manifestation can be seen in Hypercortisolism? | Depression, delusions, hallucinations, altered body image, insomnia. |
| Altered immunity is a manifestation of hypo or hypercortisolism? | Hypercortisolism |
| What does SIADH stand for and what is its main characteristic? | Syndrome of Inappropriate ADH; An increase of ADH |
| What are the two diseases related to abnormal ADH? | SIADH and Diabetes Insipidus |
| What Pathology is seen in SIADH? | Water retention, water intoxication, hyponatremia. |
| What Pathology is seen in Diabetes Insipidus? | Inability to concentrate urine, extreme polyuria leading to decresed specific gravity and polydipsia. |
| A neurogenic etiology is seen in SIADH or Diabetes Insipidus? | Diabetes Isipidus |
| In which disease are sodium levels below 115 seen? | SIADH |
| What are normal Na levels? | Between 135-145 |
| What are the etiologies of SIADH? | Surgery, pulmonary disease, mental illness, medications, or a disease of the posterior pituitary gland. |
| What are the etiologies of Diabetes Insipidus? | Neurogenic, nephrogenic, and psychogenic |
| Paraneoplastic syndrome is a disease of the pituitary gland, where is this seen, in SIADH or Diabetes Insipidus? | SIADH |
| CNS brain alteration of the hypothalamus or posterior pituitary seen in SIADH or Diabetes Insipidus? | Diabetes Insipidus |
| What is the main characteristic of Diabetes Insipidus? | Decreased ADH |
| Increased specific gravity is seen in SIADH or Diabetes Insipidus? | SIADH |
| When is Altered Growth Hormone Acromegaly seen? | Usually after age 40. |
| What is the most common etiology of Altered Growth Hormone Acromegaly? | A GH secreting pituitary adenoma. |
| What does an increase in GH do to children? | It causes GIGANTISIM. |
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