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Endocrine-PN 102-II
Endocrine Disorders
| Question | Answer |
|---|---|
| What is the most commonly over secreted hormone by the anterior pituitary? | Growth Hormone (GH) |
| What is the overproduction of a pituitary hormone called | hyperpituitarism |
| What is the under production of a pituitary hormone called? | hypopituritarism |
| What is the main cause of over or under production of pituitary hormones? | usually slow growing pituitary adenomas |
| What is disorder is caused by hyperpituitarism before puberty? | Gigantism. It takes place before the epiphyseal plates of the bones close. |
| What disorder is cause by hypopituritarism in childhood? | Dwarfism |
| What disorder is caused in adulthood from hyperpituitarism? | Acromegaly-enlargement of the bones and connective tissues. |
| What are three symptoms of Acromegaly | enlarged forehead, protruding jaw, enlargement of the hands and feet |
| What three types of tests are important in the dx of pituitary disorders? | CAT scan, MRI, blood work measuring GH levels |
| What is serum osmolarity? | The concentration of particles in the blood. |
| What surgical intervention is usually used to tx pituitary tumors? | Transsphenoidal hypophysectomy |
| What hormone controls serum osmolarity and where is it produced? | ADH-produced by the posterior pituitary. |
| What is increased osmolarity called? | hyperosmolarity |
| What is decreased osmolarity called? | hyposmolarity |
| When is ADH released? | during hyperosmolarity |
| What happens when ADH is released? | ADH causes renal water to be reabsorbed and urine output is decreased. |
| What happens when ADH is decreased? | Hyposmolarity causes ADH to be decreased and urine output increases. |
| What condition is associated with ADH insufficiency? | Diabetes insipidus (DI) |
| What are the two types of diabetes insipidus and their causes? | Neurogenic DI-usually the result of damage to the pituitary.Nephrogenic DI-Failure of the kidney to respond to ADH. Renal failure |
| What are the 6 symptoms of DI? | Extreme thirst, polyuria, urine specific gravity < 1.005, pale urine, weakness, dehydration |
| What is SIADH? | Syndrome of Inappropriate ADH Secretion |
| What are the 7 symptoms of SIADH? | Headache, anorexia, muscle weakness, decreased urine output, dark yellow urine, weight gain W/O edema |
| What are the 6 possible causes of SIADH? | Lung tumors, head injury, pituitary surgery, barbiturates, anesthetics, diuretics. |
| What electrolyte is low with SIADH? | Sodium |
| WHat are the four possible intervention of SIADH? | fluid restriction, diurectics, Tx of underlying cause of disorder, for severe cases of hyponatermia -hypertonic saline IV |
| What is another name for hypertyroidism? | thyrotoxicosis |
| What is the most common cause of hyperthyroidism? | autoimmune disease-Graves' Disease |
| What group is most vunerable to Grave's disease? | Women under the age of 40. |
| What is the cause of a throtoxic crisis (thyroid storm)? | The over secretion of TH. |
| What are 6 signs of a throtoxic crisis? | Rapid rise in metabolic rate, fever>102F, tachycardia, hypertension, restlessness, tremors. |
| What medication is used to tx thyrotoxic crisis? | Propyl-Thyracil- given to reduce hormone production. |
| What medication should never be given during thyroid crisis and why? | Aspirin because it can increase thyroid hormone levels. |
| What 3 tests are performed to dx hyperthyroidism? | Blood work for T3-T4 (which would be elevated), TSH levels (which would be reduced) and radioactive iodine uptake (which would be increased) |
| What is the goal of radioactive thyroid therapy? | To destroy thyroid cells so they cannot over produce. |
| How long does tx for radioactive thyroid therapy? | 6-8 weeks outpatient. |
| What is a possible outcome of radioactive treatment? | hypothyroidism and the need for life long thyroid hormone replacement. |
| How long does it take for radioactive iodine to leave the body and is it removed? | 2-3 days and it is excreted in urine, saliva and feces. |
| What is a Subtotal Thyroidectomy? | Particle removal of the thyroid gland. |
| What is the goal of a Subtotal Thyroidectomy? | To leave enough of the thyroid gland to produce TH. |
| When is a Total Thyroidectomy usually performed? | To tx thyroid cancer. |
| What are five common complications following thyroid surgery? | hemorrhage, respiratory distress, laryngeal nerve damage, tetany, thyroid storm |
| What is hypothyroidism? | The production of insufficient TH. |
| In what group is the disease most common? | Women between the ages of 30-60. |
| What is hypothyroidism commonly confused with during dx? | Normal manifestations of aging. |
| What are two goiters form? | 1)The thyroid enlarges in an attempt to produce more hormone 2) lack of iodine in the diet. |
| What is Hashimoto's thyroiditis? | It is an autoimmune disease that comes about when antibodies attack the thyroid gland. |
| In what group is Hashimoto's thyroiditis most common? | Women ages 30-50 and those with a family history of throid diease. |
| What is the primary manifestation of Hashimoto's thyroiditis? | a goiter |
| What is myxedema coma? | A coma brought about by critically low levels of TH |
| Name 4 thing that can cause a myxedema crisis in a pt with hypothroidism? | cold temperatures, infection, surgery, trauma, use of CNS depressants such as narcotics and traquilzers. |
| In what group is myxedema crisis most common? | Women over the age of 60. |
| What are 4 symptoms of myxedema crisis? | lethargy, coma, seizures, hypothermia |
| What TH is particular important in dx hypothyroidism? | Lack of T4. |
| What is the tx for hypothyroidism? | Replacement TH. |
| What are 6 symptoms of hypothyroidism? | weight gain, constipation, joint pain, intolerance to cold, changes in memory, goiter |
| What does PTH do in the body? | It regulates the levels of Ca and Phosphorous |
| What changes to blood serum does hyperparathroidim cause | hypercalcemia |
| How is hyperparathyroidim diagnosed? | Blood work showing elevated serum calcium, PTH and alkaline phosphatase. |
| What follow up testing is important for hyperparathroidim? | Bone density to monitor bone loss. |
| How is hyperparathroidim treated? | Diet low in Ca, drink at least 2000ml of fluid per day, exercise, bone strengthening meds, surgery if a tumor is present. |
| What is the most common cause of hypoparathyroidism? | Accidental removal or damage to the parathyroid gland during thyroid surgery. |
| How is hypoparathyroidism dx? | Blood work showing low PTH, Low serum Ca |
| What are 7 symptoms of hypoparathyroidism? | muscle spasms, tremors, abdominal cramps, numbness and tingling in hands and feet, positive Chvostek's and Trousseau sign. |
| What important precasution should nurses be aware with pt with hypoparathyroidism | Muscle spasms that close off the airway. Keep 02, suctioning equipment and a tracheostomy set by the bedside |
| How is hypoparathyroidism treated? | Diet high is Ca and low is phosphorous, Vit D supplementation |
| What causes Cushing's syndrome? | Too much cortisol produced by the adrenal cortex |
| What are 4 possible causes of Cushing's? | 1)adrenal tumors leading to excess cortisol production 2)pituitary tumor causing excess ACTH production, chronic glucocorticoid therapy, ACTH released from a lung or pancreatic tumor |
| What are five symptoms of Cushing's? | Large stomach with thin extremities,buffalo hump, moon face, purple striae, supraclavicular fat pad,excess facial hir in women |
| What 2 tests are performed to dx Cuching's? | 1)blood work showing elevated cortisol 2) 24 hr. urine test for 17-ketosteriods and 17-hydroxycorticosteriods |
| What is the surgical tx for Cushing's? | An adrenalectomy. Usually only one adrenal gland is taken when ever possible. When the pituitary gland is the cause a hypophysectomy. |
| What is a possible side effect of an adrenalectomy? | Addison's Disease (aka adrenal crisis) |
| What are the two types of Addison's and what are the causes? | 1)Primary Addison's caused by hypofuntion of the adrenal glands 2) Secondary Addison's caused by lack of ATCH production by the pituitary. |
| What are 6 symptoms of Addison's? | bronzing of the skin on the knuckles, knees and elbows, salt craving, irregular pulse, muscle weakness, dizziness, n/v |
| What 3 tests are performed to dx Addison's? | blood tests showing low levels of cortisol and aldosterone as well as high K and low glucose and Na levels, urine test for 17 ketosteroids, CAT and MRI |
| What are Addison's pts particularly at risk for? | fluid volume deficit |
Created by:
3perfectcats
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