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Final NSG 667


What is carpopedal spasm? A violent painful contraction of the hands or feet caused by decreased calcium and a significant sign of tetany.
Acute transient causes of hypocalcemia are: burns, severe sepsis, pregnancy, extensive blood transfusions, acute pancreatitis, acute renal failure
What is trousseau's sign? The first neuromuscular sign or carpal spasm. Indicative of hypocalcemia
What is Chvostek's sign? 2nd neuromuscular sign assoc. with hypocalcemia. Abnormal unilateral spasm of facial muscle
Name some s/s of hypercalcemia. confusion, abdominal pain, dehydration, weakness, polydipsia, anorexia, HTN n/v/constipation, PUD, pancreatitis, polyuria
Name GI manifestations of hypocalcemia include? dysphasia, nausea, vomiting, abd. pain, cramping, biliary colic
Cardiovascular symptoms of hypocalcemia incude? hypotension, bradycardia, chf, dysrhythmias, and prolonged QT intervals.
How does hypocalcemia affect the skin, nails, and hair? dry, coarse, scaly skin, nails are rigid, brittle, and thin with grooves. alopecia may include thinning hair, eyebrows, lashes.
Gynecomastia results from an imbalance in what? androgen and estrogen, or increase in prolactin
Name some medications implicated in gynecomastia. highly antiviral therapy, CCB's, tricyclic antidepressants, SSRI's
What is hirsutism? Increase in terminal hair growth on the face, chest, back, lower abdomen, pubic area, axilla, and inner thighs
What is vellus hair? fine, soft, unpigmentedhair found all over the body
What is terminal hair? dark, coarse, pigmented, thick. found on scalp, brows, axillary, pubic areas
A testosterone level of greater than ___ indicates the need for an ovarian tumor workup 200ng/dL
If the DHEA-S level is above _____, an adrenal tumor workup is indicated 700ng/dL
The LH/FSH levels are ______, in ___% of cases of polycystic ovarian disease Increased 75
Women of _____ and _____ descent are likely to have increased terminal hair growth. European / Mediterranean
Treatment of idiopathic hirsutism results from POCS polycystic ovarian syndrome
Name some symptoms of laryngeal cancer. cervical lymphadenopathy, increased neck size, pain, dyspnea, dysphagia, hemoptysis, stridor, hoarseness
Management of the pt. with increased neck size is to _____________ treat the underlying cause.
Elevated T4 levels increase __________ causing _________ metabolism, polyphagia
Name some differential diagnoses for polydipsia, polyuria, polyphagia. DM, DI, diuretic abuse, head trauma, psychiatric disorders
Accompanying symptoms that indicate diabetes mellitis include: weight loss, fatigue, increased susceptibility to infections and nocturia
True or false. unintentional weight loss of >5% within 6-12 mos. may reflect a physical or psychological illness. True
True or False. Underweight is defined as being 40% or more below ideal body weight. False. 15-20%
True or False. BMI of 18 or lower is considered underweight. True
True or False. a loss of 10% in 1-2 months is predictive of a poor clinical outcome. True
Long term effects of hyperthyroidism include: heart disease, osteoporosis, mental illness, and infertility
What age does hyperthyroidism peak? 20-40 years
True or False. Hyperthyroidism is more prevalent in men than in women. False. (8:1) Women
What disease is by far the most common cause of spontaneous hyperthyroidism in the US. Graves Disease
What is Graves Disease? An autoimmune disorder characterized by autoreactive, anonistic antibodies to the TSH receptor.
What is Plummer Disease? A toxic multinodular goiter accounting for 15-20% of thyrotoxicosis cases
Other causes of hyperthyroidism, not so common, are: iodine-containing drugs such as certain expectorants, amiodarone, seaweed-containing health food supplements, hydatiform molar pregnancy, ovarian teratomas, testicular cancinoma
Name some manifestations of thyrotoxicosis. palpitations, diaphoresis, heat intolerance, anxiety
Symptoms of thyrotoxicosis in younger people. tremors, anxiety, hyperactivity
Symptoms of thyrotoxicosis in older people. afib, dyspnea, weight loss
What test demonstrates scattered areas of both increased & decreased iodine uptake. nuclear scintigraphy
What is the Jod-Basedow effect? autoregulation of the thyroid normally prevents thyrotoxicosis in the face of dietary iodine excess.
Radiation of the head and neck can increase the risk for what? thyroid cancer
Cardiovascular manifestations of hyperthyroidism may include what? tachycardia, irregular pulse, systolic murmurs, widening of the pulse pressure
What is thyroid storm? severe, sometimes fatal form of hyperthyroidism, and requires immediate emergency medical care
Name some progressive symptoms of thyroid storm. severe agitation, occasional psychosis, elevated temp, diaphoresis, tachycardia, heart failure, afib, aflutter, confusion, malignant expoththalmos, elevated free T4
Initial symptoms of thyroid storm fever >100.4, nausea, vomiting. abdominal pain
contributing factors for thyroid storm. acute infection, trauma, stress in patient with hyperthyroidism, uncontrolled DM, severe drug reaction, following withdrawal of antithyroid medication or radioactive iodine therapy
management of thyroid storm includes: hospitalization and reversal of thyrotoxins: to block thyroid hormone synthesis, PTU is given daily in 2-4 divided doses. Methiamazole is generally not given during storm bc it does not prevent peripheral conversion of T4 to T3
What is the preferred test to assess for ophthalmopathy resulting from Graves Dx? MRI. It is expecially helpful to r/o an orbital tumor
What is the goal of treatment for hyperthyroidism? euthyroid
Patients intolerant of beta blockers can be treated with -------- CCB's as an alternate therapy
What are the 3 treatment options for Graves disease? antithyroid drugs, radioactive iodine, surgery. None of which alters the underlying autoimmune process of Graves disease
2 Antithyroid drugs are being used at present. Name these. l. PTU (propylthiouracil) 2. MMI (methimazole)
On findings of multi/uninodular goiters, what is the next step? referral to an endocrinologist for possible malignancy
What is the preferred treatment in patients without significant thyroid gland enlargement? Antithyroid drugs
Once a patient has achieved a euthyroid state, how often should they be seen? every 4-6 weeks for 3-4 months
Common adverse reactions to antithyroid medications include what? rash, urticaria, arthralgias
Rare but serious adverse reactions include: agranulocytosis, aplastic anemia, hepatitis
How long are antithyroid drugs used after achievement of euthroid state? 6-24 months
How long should women wait before becoming pregnant after receiving radioactive iodine therapy? 4 months
What is subacute thyroiditis? A self limiting condition treated with anti-inflammatory agents and prednisone
Patients need to be instructed that it takes how long to notice an improvement in symptoms bc of the amt. of stored hormone in the thyroid gland 4 to 6 weeks
Persons receiving radioactive iodine, should avoid contact with what population? infants, children, pregnant women
What is hypothyroidism? a common treatable disorder in which there is a slow progression of thyroid hypofunction, followed by s/s indicating thyroid failure
Thyroid hormone deficiency beginning in early infancy and childhood is characterized by: growth retardation, mental deficiency, and delayed dentition
Incidence of hypothyroidism is greater in men or women? women 2-8 times higher
What is Hashimoto's thyroiditis? A type of primary hypothyroidism; the most common form of autoimmune thyroid disease
Failure of the pituitary gland, hypothalamus, or both is called? central hypothyroidism
Common symptoms of hypothyroidism include? hoarseness, deafness, confusion, frank psychosis, dementia, ataxia, depression, cold intolerance, dry skin, hair loss
What is an iodine-containing antiarrhythmic drug that is a leading offender due to its effects directly on the thyroid gland? Amiodarone
Early classic symptoms of hypothyroidism include: dry skin, fatigue, slight weight gain, cold intolerance, constipation, & heavy menses.
What symptom/manifestation is seen with hypothyroidism? a thick tongue
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Created by: MissyGirl3971