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FNP~Thyroid/Endocrin
Diagnosis & Treatment
| Question | Answer |
|---|---|
| Another name for Hyperthyroidism | Graves Disease |
| Some causes of Hyperthyroidism | toxic adenoma, subacute thyroiditis, TSH secreting tumor of the pituitary, high dose amiodarone |
| What would the following labs TSH, T3, T4, serum ANA usually show in Hyperthyroidism? | TSH = low, T3 ^, T4^ or normal, serum ANA usually elevated |
| High iodine uptake is consistent with? | Graves Dz |
| Low iodine uptake is consistent with? | subacute thyroiditits |
| What medication and dosage is used for symptomatic relief? | Propranolol (Inderal) starting at 10 mg p.o., may go up to 80 mg q.i.d.; relieves "shakes" |
| What medication inhibits T3, T4? | Propylthiouracil (PTU) 300-600 mg/day in 4 divided doses |
| What medication destroys "goiters"? | Radioactive Iodine 131-I |
| What solution is used to reduce vascularity to the gland? | Lugol's Sol 2-3 gtts p.o. qd x10 days |
| What medication can exacerbate a "thyroid storm"? | ASA |
| What are some causes of Hypothyroidism? | disease of the gland itself, deficiency of pituitary TSH or hypothalmic TRH, iodine deficiency, deficient pituitary, destruction of the gland by surgery or external radiation...*most often due to autoimmune thyroiditis or Hashimoto's |
| What would the following labs TSH, T3, T4, Na+, glucose usually show in Hypothyroidism? | TSH = ^, T3 decreased (not reliable test), T4 low or low normal, Na+ low, glucose low |
| What medication is used to treat Hypothyroidism? | Levothryoxine (Synthroid) 50-100 mcg qd, increasing doseage by 25 mcg q 1-2 weeks until sx's stabilize |
| Define Cushing's Syndrome? | manifestations of hypercorticolism due to numerous causes~ACTH secretion by pituitary, adrenal tumors, chronic administration of glucocorticoids (steroids) {transplants, COPD, AIDS} |
| What are the 3 most common s/sx's of Cushings? | vasoconstriction (HTN, impotence), immobilization of fat distribution ("buffalo hump"), prevention of uptake of glucose (polyuria and thirst, labile mood, frequent infections |
| What are the 3 key labs in Cushing's? | Hyperglycemia, Hypernatremia, Hypokalemia |
| Primary Adrenocortical Insufficiency (Addison's Disease) | deficient cortisol, androgens, and aldosterone as the result of destruction of the adrenal cortices |
| What are some causes of Addison's? | Autoimmune destruction of adrenal gland, metastatic cancer (brain or endocrine), bilateral adrenal hemorrhage, pituitary failure resulting in decreased ACTH |
| What are the 3 key labs in Addison's? | Hypoglycemia, Hyponatremia, Hyperkalemia |
| What is the management of Cushing's? | Depending on cause~D/C meds, resection of a pituitary adenoma, removal of adrenal tumors, resection of ACTH secreting tumors, manage electrolytes |
| What is the management of Addison's? | Specialist referral>>Glucorticoid (Hydrocortisone) and mineralcorticoid (Fludrocortisone acetate/Florinef) |
| Common etiology of "Thyroiditis" is... | viral, autoimmune, post partum, often transient |
Created by:
KimmiNP
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