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Stack #127253
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 |
Created by:
rpclothier
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