Nsg 213 Endocrine
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| What 7 hormones are produced in the anterior pituitary? | show 🗑
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| What 2 hormones are produced in the posterior pituitary? | show 🗑
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| What is hypopituitarism? | show 🗑
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| show | trauma, tumors, vascular abnormalities, surgery, anorexia, most often idiopathic
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| Clinical manifestations of hypopituitarism | show 🗑
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| What can occur with hypopituitarism if it is not caught in time? | show 🗑
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| How is hypopituitarism managed? | show 🗑
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| show | successful tx in 80% of children, early diagnosis can reach normal adult heights, just later
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| What is hyperpituitarism? | show 🗑
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| show | most often pituitary adenoma(benign tumor), abnormal stimulation of the hypothalamus
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| show | Gigantism- before closur of epiphyseal plates, overgrowth of long bones, can be 8ft or more
Acromegaly- after closure of epiphyseal plates, overgrowth of facial features, increased facial hair,thick, deeply creased skin
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| Management of hyperpituitarism | show 🗑
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| show | tumor removal halts abnormal growth
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| Diagnostics of Growth hormone abnormalities | show 🗑
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| show | Syndrome of inappropriate ADH, increased secretion of ADH- vasopressin- kidney saves water. Water intoxication r/t increased circulatory volume w/out edema- decreased Na levels- irratibility, decreased urine output, anorexia, N/V, cramps, stupor/ seizures
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| Management of SIADH | show 🗑
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| show | Deficiency of ADH, vasopressin = persistent diuresis
polyuria and polydipsia, older children spend their time drinking and voiding, enuresis often 1st sign. Infants irritability is relieved by water- dehydration, hyperthermia, electrolyte imbalances
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| What 7 hormones are produced in the anterior pituitary? | show 🗑
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| show | ADH and Oxytocin
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| What is hypopituitarism? | show 🗑
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| show | trauma, tumors, vascular abnormalities, surgery, anorexia, most often idiopathic
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| show | short stature with normal skeletal proportions, normal growth 1st year of life, growth drops below established percentile 2nd year of life, subsequet growth measuremnt below 5th percentile, appear well nourished, inactive
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| show | dental abnormalities, late eruption of permanent teeth, delayed sexual development, dwarfism or growth delay
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| How is hypopituitarism managed? | show 🗑
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| Prognosis of hypopituitarism | show 🗑
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| What is hyperpituitarism? | show 🗑
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| show | most often pituitary adenoma(benign tumor), abnormal stimulation of the hypothalamus
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| show | Gigantism- before closur of epiphyseal plates, overgrowth of long bones, can be 8ft or more
Acromegaly- after closure of epiphyseal plates, overgrowth of facial features, increased facial hair,thick, deeply creased skin
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| Management of hyperpituitarism | show 🗑
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| show | tumor removal halts abnormal growth
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| show | family hx, growth pattern and health hx, birth weight, nutritional state, MRI of brain, serum level of GH, levels of other hormones, X-ray
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| show | Syndrome of inappropriate ADH, increased secretion of ADH- vasopressin- kidney saves water. Water intoxication r/t increased circulatory volume w/out edema- decreased Na levels- irratibility, decreased urine output, anorexia, N/V, cramps, stupor/ seizures
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| Management of SIADH | show 🗑
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| show | Deficiency of ADH, vasopressin = persistent diuresis
polyuria and polydipsia, older children spend their time drinking and voiding, enuresis often 1st sign. Infants irritability is relieved by water- dehydration, hyperthermia, electrolyte imbalances
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| What is the difference between diabetes mellitus and diabetes insipidus? | show 🗑
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| How is diabetes insipidus managed? | show 🗑
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| show | deficiency in circulating T3 and T4, thyroid stores depelete during childhood = slowed growth
2 types- acquired (thyroidectomy, irradiation for hodgkin's disease) congenital (dx in infancy = mental retardation, goiter, underdevelopment of thyroid gland)
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| show | decelerated growth, constipation, sleepiness, dry skin, sparse hair, low on forehead, periorbital edema
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| show | puffy face, swollen tongue, hoarse cry, cold extremeties, mottled skin, low muscle tone, poor feeding, large fontanel, prolonged jaundice, described as "good baby". Risk of mental retardation if not caught by 3 mos- metabolic assay required at birth
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| show | levothyroxine
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| An autoimmune disease that leads to destruction of thyroid gland (low TH=increased TSH- increase size of gland) | show 🗑
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| Manifestations of Hashimoto disease | show 🗑
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| show | Graves disease
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| How is does graves disease cause transient fetal hyperthyroidsm? | show 🗑
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| show | emotional liability, restlessness, fatigue, decrased school perfomance, voracious appetite with weight loss, fine hair, goiter, exophtalmus
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| Tx and Nsg management of a pt with Graves disease | show 🗑
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| show | thyroid storm or crisis
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| show | Autoimmune- familial, autosomal recessive, low PTH, low Ca
Psuedo- failure of parathyroid hormone to work properly- Ca and Phos can be normal, no end organ response
hereditary
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| show | Albright's hereditary Osteodystrophy- round face, flat nasal bridge, short fingers/toes, bony swelling, bowing of bones
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| What is primary and secondary hyperparathyroidism usually caused by? | show 🗑
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| show | decreasd calcium
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| symptoms of high levels of Ca | show 🗑
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| Group of inherited disorders, leack of enzyme activity that leads to decreased production of cortisol and aldosterone and the overproduction of androgen- decreased sodium, chloride, and incresed potassium | show 🗑
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| symptoms of girls with congenital adrenal hyperplasia | show 🗑
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| Girls with congenital adrenal hyperplasia, do they have normal internal female reproducive organs, or are they affected too? | show 🗑
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| When do signs of congenital adrenal hyperplasia appear for boys? | show 🗑
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| How is height affected with boys and girls with congenital adrenal hyperplasia? | show 🗑
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| show | sex assignment- karotype-bar body, US to visualize internal organs
cortisol- increased need when stressed
adosterone replacement- increased dietary salt
RISK of wrong sex assignment
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| What is a pheochromoacytoma? | show 🗑
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| show | adrenalectomy, glucocorticoid and mineralocordicoid replacement life long- DO NOT PALPATE MASS, may lead to increased catecholemine release
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| show | destruction of beta cells, absoulute insulin deficiency, typically onset in childhood or early adolescence
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| show | pancreas kicks in causing falsehood of cure- type 1
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| show | Insulin resistance- sufficient insulin production but no response to insulin, rare in childhood
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| show | Diabetes mellitus type 1
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| Signs of diabetes in infants and toddlers | show 🗑
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| tx for type 1 diabetes | show 🗑
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| show | Cystic fibrosis
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| show | chronic bronchial pneumonia, obstructive emphysema
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| What can occur with the GI tract in cystic fibrosis? | show 🗑
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| What can occur with the pancreas in cystic fibrosis? | show 🗑
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| What can occur with the liver in cystic fibrosis? | show 🗑
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| show | Nutrition and lung health are closely linked, need extra calories to compensate for malabsorption of nutrients, extra calories needed to meet greater energy needs of breathing
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| Hallmark sign of CF in a newborn | show 🗑
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| What can be seen in a pulmonary assessment of a patient with CF? | show 🗑
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| Diagnosics for CF | show 🗑
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| collaborative management for CF | show 🗑
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