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27 Cards in this Set
- Front
- Back
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What is the DESC script?
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A means of resolving disagreement and conflict
Putting emphasis on patient needs and goals to get around conflict in the team |
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What is a big contributor to misunderstanding the skills and abilities of other team members?
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high staff turnover
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What brain tumours can involve the hypothalamus?
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craniopharyngioma, glioma, meningioma, teratoma, germ cell tumour, metastasis
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What are signs of a hypothalamic tumour?
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lack of satiety, hyperphagia, reduced physical activity, sleep disturbances
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What is Genetic Prader Willi Syndrome and what is its hypothalamic effects?
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chromosome 15 deletion
altered temperature sensation, hypogonadism, failure to thrive (hypotonia), absent satiety, cryptorchidism, growth hormone deficient, temper tantrums, inability to vomit |
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What is Bardet Biedl Sydnrome and what is its hypothalamic effects?
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autosomal recessive disorder
signs - intellectual disability, early childhood obesity, polydactyly |
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What are the effects of 50% food restrictio n for 6 months (Minnesota Starvation Study)?
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physical discomfort, cold intolerance, food obessions, x
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What is cancer cachexia?
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when the adaptive feeding response to under-nutrition is absent or impaired, due to cytokines from tumours (TNF-alpha, interleukins, interferons). these cytokines are present in the hypothalamus
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A lesion to what part of the hypothalamus results in hyperphagia and obesity?
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medial ventromedial nucleus
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What symptoms are involved in a lateral ventromedial nucleus lesion?
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anorexia and death
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What is the relationship between food intake and energy expenditure?
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inversely related - animals were sluggish when replete and inappropriately active when starved
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What are the effects of leptin?
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reduces food intake, stimulates energy expenditure, reduces expression of neurotransmitters that stimulate food intake (eg. NPY, AGRP), effects of reproduction
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Which hormones act on the arcuate nucleus and NTS, and what do they do?**
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ghrelin (orexigenic, increase food intake)
GLP-1, cholecystokinin, x (anorexigenic, decreases food intake) |
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Ghrelin
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x
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What important anorexigenic singla is released from POMC, and what receptor does it act on?
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alpha-MSH, it acts on MC4R on the VMN
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Where is POMC produced and into what does it degrade?
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POMC is produced in pituitary corticotrophs (proconvertase 1 (PC1)), and degrades into ACTH
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When must hydrocortisone be given in pan hypopituitarism?
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Immediately after oral dosing does not work
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T/F... insulin can be given orally
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False. insulin requires injection. Steriod and thyroid hormones can be given orally
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How is DDAVP dosing given?
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intranasal spray, solution or orally
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Which pituitary hormones can be given as replacement therapy?
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GH, FSH, LH, ADH
As well as Parathyroid H, insulin, aldosterone |
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What are the normal glucocorticoid replacement doses for ACTH deficiency?
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Hydrocortisone (2-4 times/day); 20mg
Cortisone acetate (2 times/day); 25mg Prednisolone (2 times/day); 5mg Dexamethosone (once a day); 0.75mg |
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What must be worn for patients undergoing glucocorticoid replacement therapy in ACTH deficiency?
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Medicalert bracelet (or have a higher dose of Cortisol (100mg/L) on hand for stress)
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What is the usual dosing of oestrogen to induce puberty in girls?
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0.25mg - half a 1mg progynova tablet every second day
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What is the short acting treatment to induce puberty in boys?
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Sustanon
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What is the risk of over-replacement of testosterone in hypogonadism in boys?
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aggression and painful, longstanding erections (2-3 hours)
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What hormone replacement is given for diabetes insipidus?
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DDAVP
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What is a risk of hormone over-replacement hypoparathyroidism?
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necrocalcinosis (and vomiting and thirst)
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