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Final NSG 667
Endocrine
| Question | Answer |
|---|---|
| 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 |
| stopped at page 848 of 904 |
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MissyGirl3971
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