Ch. 25 Endocrine Disorders
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| What are the two categories of endocrine problems? | An excessive amount of hormones and a defecit of a hormone.
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| What can cause an excess amount of hormones? | Tumor produces high levels, Excretion by liver or kidney is impaired, and a congenital condition produces excess hormone
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| What can cause a defecit of a hormone? | Tumor produces too little hormone, Inadequate tissue receptors present, Antagonistic hormone production is increased, Malnutrition, Atrophy, surgical removal of gland, and congenital defects
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| Diagnostic used for Endocrine Disorders | Blood tests, Urine tests, Stimulation or Suppression tests, Scans, Ultrasounds, and MRI's.
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| Treatment for a hormone defecit is? | Replacement Therapy
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| Treatment for an excess amount of a hormone is? | Medications, Surgery, and Radiation
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| Diabetes Mellitus basic problem is? | Inadequate insulin effects in receptor tissues.
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| Diabetes Mellitus is caused by? | Deficit of insulin secretion, Production of insulin antagonists
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| Diabetes results in? | Abnormal carbohydrate, protein, and fat metabolism.
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| Type 1 Diabetes is caused by? | An autoimmune destruction of beta cells in pancreas.
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| Type 1 Diabetes is found more commonly in? | Children and Adolescents
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| Treatment for Type 1 Diabetes requires? | Insulin replacement
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| Type 1 Diabetes is? | Insulin Dependent Diabetes Mellitus
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| Type 2 Diabetes is? | Non Insulin Dependent Diabetes Mellitus
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| Type 2 Diabetes is caused by? | A decrease effectiveness of insulin, a relative defecit of insulin, decrease insulin production from beta cells, increased resistance to insulin and increased production of glucose
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| Type 2 Diabetes is found more commonly in? | Elders, and obese people.
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| Treatment for Type 2 Diabetes requires? | Oral hypoglycemic medication
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| General Manifestations of Diabetes include | Polyphagia, Polydipsia, Polyuria, Glucosuria, and Hyperglycemia
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| Insulin defecit results in? | Decreased transportation and use of glucose in many cells of the body
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| Polyuria | An abnormally large volume of urine excreted
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| Polydipsia | Dehydration
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| Polyphagia | Increased appetite from a lack of nutrients that enter the cells and stimulate your appetite
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| Diabetes Diagnostic Tests include? | Fasting blood glucose levels, glucose tolerance tests, Glycosylated hemoglobin test
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| The most important way to treat Diabetes is? | To maintain normal blood glucose levels in order to minimize the complications
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| The three ways to control blood glucose are? | Diet and excersize, Oral medication, and insulin replacement
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| Diet and Excersize results in? | Reduced blood glucose as skeletal muscles use glucose
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| Oral Medication results in? | Increase insulin secretion, and reduced blood glucose levels
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| Insulin replacement results in? | Increased amount of insulin that meets the required amount the body needs
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| The metabolic changes of Type 1 Diabetes are? | Catabolism of fats and proteins, Ketonuria, and decompensated metabolic acidosis
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| Catabolism of fats and proteins causes? | Excessive amounts of fatty acids and metabolites, and ketones in the blood
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| Ketonuria causes? | Decreased serum bicarbonate; decrease in pH of body fluids
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| Complications of Diabetes are related to? | The duration and extent of abnormal blood glucose levels
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| The factors lead to fluctuations in serum glucose levels are? | Variations in diet and alcohol use, change in physical activit, infection and vomitting
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| Acute complications include? | Hypoglycemia, Diabetic Ketoacidosis, and Hyperglycemic Hyperosmolar Non-Ketotic coma
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| Hypoglycemia is? | Insuling Shock
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| Hypoglycemia is more common with? | Insulin replacement therapy
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| Hypoglycemia occurs when? | There is an excess amount of insulin in circulation
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| Hypoglycemia can be caused by? | A glucose defecit in the blood, strenuous excersize, a dosage error, vomitting, and skipping a meal after taking insulin
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| Signs and Symptoms for Hypoglycemia include? | Disorientation and change in behavior May appear impaired Anxiety or decreased responsiveness Decreased blood glucose Decreased BP, increased heart rate Decreasing level of consciousness
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| Diabetic Ketoacidosis results from? | An insufficient amount of insulin the blood which leads to high blood glucose levels and mobilization of lipids
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| Diabetic Ketoacidosis is more commonly found in? | Insulin-Dependent clients
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| Diabetic Ketoacidosis can be caused by? | Infection or stress, an error in dosage, infection, change in diet, alcohol intake, or exercise
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| Signs and Symptoms for Diabetic Ketoacidosis include? | Dehyrdration Metabolic Acidosis Electrolyte Imbalances Rapid - Deep respirations Acetone breath ( sweet and fruity)
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| Dehydration | Thirst, dry, rough oral mucosa Warm, dry skin
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| Rapid, deep respiration – acetone breath | Lethargy and decreased respoviness
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| Metabolic acidosis | May lead to a loss of consciousness
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| Electrolyte Imbalances | Abdominal cramps, nausea, vomiting; lethargy, weakness
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| Hyperglycemic Hyperosmolar Non-Ketotic Coma (HHNC) results in? | Severe dehydration and electrolyte imbalances
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| HHNC is more commonly found in? | Type 2 diabetics and elders
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| Signs and Symptoms for HHNC include? | Hyperglycemia, Severe Dehydration, and Electrolyte Imbalances
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| Electrolyte imbalances result in? | Neurologic deficits
Muscle weakness
Difficulties with speech
Abnormal reflexes
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| Chronic complications include? | Vascular problems, Microangiopathy, Macroangiopathy, Peripheral neuropathy, Infections, Cataracts, and Pregnancy
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| Vascular problems inlcude? | Increased risk of atherosclerosis, and changes in small and large arteries
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| Microangiopathy | Changes in microcirculation due to an obstruction or rupture of small capillaries and arteries
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| Microangiopathy leads to? | Tissue necrosis and loss of function
Neuropathy and loss of sensation
Retinopathy – leading cause of blindness
Chronic renal failure – degeneration in glomeruli of kidney
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| Macroangiopathy | Affects large arteries
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| Macroangiopathy leads to? | High incidence of heart attacks, strokes, peripheral vascular disease
May result in ulcers on feet and legs – slow healing
Frequent infections and gangrenous ulcers
Amputation may be necessary.
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| Peripheral neuropathy is? | Common complication due to ischemia in microcirculation to peripheral nerves
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| Peripheral neuropathy leads to? | Impaired sensation, numbness, tingling, weakness, muscle wasting
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| Infections include | Infections in feet and legs due to vascular and neurologic impairment
Fungal infections
Urinary tract infections
Dental caries
Gingivitis and periodontitis
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| Ways to control type 2 diabetes are? | Diet containing an increased amount of fiber and a reduction of lipids and simple carbohydrates
Regular exercise to reduce glucose levels
Reduce insulin resistance by reducing BMI to normal range.
Monitoring blood glucose levels
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| Ways to control type 2 diabetes are? | Medications to stimulate the beta cells
Proper administration of insulin
Routine Follow up
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| Hypoparathyroidism is caused by? | Tumor Congenital lack of parathyroid Surgery or radiation in neck region Autoimmune disease
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| Hypoparathyroidism leads to? | Hypocalcemia
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| Hypocalcemia causes? | Weak cardiac muscle contractions
Increased excitability of nerves
Spontaneous contractions of skeletal muscle
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| Hyperparathyroidism is caused by? | Tumor Secondary to renal failure Paraneoplastic syndrome
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| Hyperparathyroidism leads to? | Hypercalcemia
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| Hypercalcemia causes? | Forceful cardiac contractions Osteoporosis Predisposition to kidney stones
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| What is the most common cause for pituitary disorders? | Benign Adenomas
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| The two different effects are? | The effect of the mass The effect on hormone secretion
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| The effect of the mass may cause? | Pressure in the skull causing Headaches, seizures, drowsiness, visual deficits
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| The effect on hormone secretion may cause? | An excessive or decreased release of hormones
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| Dwarfism | Deficit in growth hormone production/release
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| Gigantism | Excess GH prior to puberty and fusion of epiphysis
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| Acromegaly | Excess GH secretion in adults Often associated with adenoma Bones become broader and heavier
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| Diabetes Insipidus | Defecit of ADH and may orignate in the neurohypophysis
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| Inappropriate ADH syndrome | Excess ADH and may be temporary
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| Diabetes Insipidus results from? | Head injury or surgery Possible genetic problem
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| What kind of treatment is required for Diabetes Insipidus? | Replacement Therapy
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| Inappropriate ADH syndrome results from? | Stress Ecess secretion from a tumor
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| What kind of treatment is required for Inappropriate ADH syndrome? | Diuretics and Sodium supplements
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| Thyroid disorders include | Goiter, Hyperthyroidism and Hypothyroidism
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| Goiter | Enlargement of thyroid gland
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| What are the three different types of goiters? | Endemic goiter, Goitrogens and Toxic goiters
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| Endemic Goiter | Hypothyroid condition in regions with low iodine levels in soil and food
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| Goitrogens | Foods that contain elements to block synthesis of T3 and T4
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| Toxic Goiters | Results from hyperactivity of thyroid gland
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| Hyperthyroidism is? | Graves Disease and is related to an autoimmune factor
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| Signs and Symptoms for hyperthroidism are? | Hypermetabolism Increased body temperature Sweating Soft silky hair and skin Reduced BMI Insomnia Hyperactivity Toxic Goiter Exophthalmos
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| Exophtalmos is? | Presence of protruding, staring eyes, decreased blink and eye movement Result of increased tissue mass in the orbit May result in visual impairment
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| Different types of hypothyroidism include? | Hashimoto thyroiditis Myxedema Cretinism
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| Cretinism | Results in short stature and severe cognitive deficits Untreated congenital hypothyroidism May be related to iodine deficiency during pregnancy
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| Signs and Symptoms for Hypothyroidism are? | Intolerance to cold Increased BMI Lethargy and fatigue Decreased appetite Myxedema in severe untreated hypothyroidism
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| Myxedema | Non-pitting edema in face, thickened tongue
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| Myexedema Coma | Results in hypotension, hypoglycemia, hypothermia and is life threatening
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| An Adrenal Medulla disorder is? | Pheochromocytoma
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| Pheochromocytoma is? | A benign tumor of the adrenal medulla that secretes epinephrine, norepinephrine, and possibly other substances
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| Signs of pheochromocytoma are? | Headache, heart palpations, sweating, intermittent or constant anxiety
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| An Adrenal Cortex disorder is? | Cushings Syndrome and Addisons Disease
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| Cushings syndrome is caused by? | An excessive level of glucocorticoids
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| An excessive level of glucocorticoids results from? | Adrenal adenoma Pituitary adenoma Ectopic carcinoma Iatrogenic conditions Substance abuse
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| What changes occur with cushings syndrome? | Round face with ruddy color Truncal obesity with fat pad between scapulae Thin limbs Thin hair Fragile skin
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| Cushings Syndrome causes? | Retention of sodium and water Suppression of the immune response Stimulation of erythrocyte production Emotional lability and euphoria Increased catabolism of bone and protein Delayed healing Increased insulin resistance
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| Addisons Disease is? | A deficiency of adrenocorticoid secretions from an autoimmune reaction causing the gland to be destroyed by hemmorage or infection
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| Signs and Symptoms for Addisons Disease include? | Decreased blood glucose levels Inadequate stress response Fatigue Weight loss; frequent infections Low serum sodium concentration
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