Medical Emergencies Test 3

Front 1

This system is a network of glands that produce and secrete hormones, maintains homeostasis and promotoes permanent structural change in the body.

Back 1

Endocrine system

Front 2

Endocrine glands secrete chemicals that are used _______ the body, whereas exocrine glands secrete chemicals for ________.

Back 2

Endocrine: used inside the body

Exocrine: for elimination

Front 3

Endocrine hormones are released directly into _______ where they travel to _________, while exocrine secretions are carried in ________.

Back 3

Endocrine: the bloodstream; target tissues

Exocrine: ducts carry secretions

Front 4

This binds to a cell's recepter and triggers a response.

Back 4

an agonist

Front 5

This binds to a cell's receptor and thereby blocks any other stimulation.

Back 5

An antagonist

Front 6

Hormones operate within loops called ___________ to maintain an optimal operating environment.

Back 6

feedback systems

Front 7

Release of hormones is regulated by these 2 entities:

Back 7

1) chemical/hormonal factors
2) neural control

Front 8

In a negative feedback system, rising hormone levels __________ further release of that hormone.

Back 8

inhibit

Front 9

The three types of stimuli that affect the regulation of hormone secretion are:

Back 9

1) hormonal
2) humoral
3) neural

Front 10

The endocrine system regulates hormone secretion through which type of feedback loop?

Back 10

Negative feedback

Front 11

Release of epinephrine in response to stress is regulated by what type of feedback loop?

Back 11

Negative feedback loop

Front 12

When a body experiences stress, the _________ nervous system is stimulated to release the endocrine hormone ____________, which continues to be released until the stressor ceases.

Back 12

Sympathetic

epinepherine

Front 13

The hypothalamus has 2 pituitary lobes called the:

Back 13

1) anterior pituitary
2) posterior pituitary

Front 14

The posterior pituitary gland secretes these 2 hormones:

Back 14

oxytocin
Antidiuretic hormone (ADH)

Front 15

The anterior pituitary gland secretes these 7 hormones:

Back 15

1) Follicle-stimulating hormone (FSH)
2) Luteinizing hormone (LH)
3) Adrenocorticotropic hormone (ACTH)
4) Thyroid-stimulating hormone (TSH)
5) Growth hormone (GH)
6) Melanocyte-stimulating hormone (MSH)
7) Prolactin

Front 16

When affected by disease, normal cell signaling is interrupted. This means that ________ feedback ceases, and ________ feedback is given instead.

Back 16

negative feedback ceases

positive feedback is given

Front 17

This hormone regulates metabolic processes related to growth and adaptation to physical and emotional stressors.

Back 17

Growth hormone (GH)

Front 18

Sweat glands, salivary glands, and the liver are examples of _________ glands

Back 18

exocrine glands

Front 19

Hormones act on the body’s cells by increasing or decreasing the ___________.

Back 19

rate of cellular metabolism

Front 20

What gland secretes epinephrine and norepinephrine?

Back 20

Following stimulation from the hypothalamus, the adrenal medulla secretes small amounts of norepinephrine and large amounts of epinephrine.

Front 21

Norepinephrine raises blood pressure by causing ________________.

Back 21

blood vessels and skeletal muscles to constrict.

Front 22

The _________ is a digestive gland that is considered both an endocrine gland and an exocrine gland.

Back 22

Pancreas

Front 23

The exocrine component of the pancreas is responsible for the secretion of _____________.

Back 23

digestive enzymes. It secretes digestive enzymes into the duodenum through the pancreatic duct.

Front 24

The endocrine component of the pancreas comprises the ____________.

Back 24

islets of Langerhans.

These cell groups within the pancreas act like “an organ within an organ.” The main hormones they secrete are glucagon, secreted by the alpha cells, and insulin, secreted by the beta cells. Glucagon and insulin are responsible for the regulation of blood glucose levels. Somatostatin, secreted by delta cells, is responsible for the inhibition of insulin and glucagon secretion in cellular metabolism.

Front 25

What are the three Ps that indicate the body’s ability to metabolize simple carbohydrates (glucose) is impaired?

Back 25

Polyphagia
Polydipsia
Polyuria

Front 26

Define 'Polyphagia' in the context of glucose metabolism

Back 26

an increased appetite caused by the inability of glucose to be transported across the cell membrane.

Front 27

Define 'Polydipsia' in the context of glucose metabolism

Back 27

a significant thirst caused by dehydration brought about by an increase in diuresis.

Front 28

define 'polyuria' in the context of glucose metabolism.

Back 28

the passage of large quantities of urine containing glucose. Excess glucose is excreted and attracts water, resulting in excessive diuresis.

Front 29

This hormone increases production and secretion of thyroid hormones.

Back 29

Thyroid-stimulating hormone (TSH).

Front 30

Thyroid-stimulating hormone (TSH) is secreted by the _________.

Back 30

Anterior pituitary gland.

Front 31

Growth Hormone (GH) is secreted by the ___________.

Back 31

Anterior pituitary gland.

Front 32

Adrenocorticotropic hormone (ACTH) is secreted by the___________.

Back 32

anterior pituitary gland

Front 33

This hormone stimulates the adrenal cortex gland to secrete cortisol and adrenal proteins that contribute to the maintenance of the adrenal gland.

Back 33

Adrenocorticotropic hormone (ACTH)

Front 34

Luteinizing Hormone (LH) is secreted by the ________.

Back 34

anterior pituitary gland

Front 35

This hormone....

In women, affects ovaries: ovulation, progesterone production
In men, affects testes: regulates spermatogenesis, testosterone production

Back 35

Luteinizing Hormone (LH)

Front 36

Follicle-stimulating hormone (FSH) is secreted by the ___________.

Back 36

anterior pituitary gland

Front 37

This hormone affects....

in women, affects ovaries: follicle maturation, estrogen production
in men, affects testes: spermatogenesis

Back 37

Follicle-stimulating hormone (FSH)

Front 38

The 2 gonadotropic hormones secreted by the anterior pituitary gland are:

Back 38

1.) Follicle-stimulating hormone (FSH) and Luteinizing
2.) hormone (LH)

Front 39

This hormone affects mammary glands and milk production, but has no effect on the uterine muscles.

Back 39

prolactin

Front 40

Prolactin is secreted by the ___________

Back 40

anterior pituitary gland

Front 41

anti-diuretic hormone (ADH) is secreted by the ___________.

Back 41

anterior pituitary gland

Front 42

This hormone controls plasma osmolality; increases the permeability of the distal renal tubules and collecting ducts, which leads to an increase in water reabsorption.

Back 42

antidiuretic hormone (ADH)

Front 43

Oxytocin is secreted by the ________

Back 43

posterior pituitary gland

Front 44

this hormone contracts the muscles of the uterus during childbirth and stimulates mammary glands for milk production.

Back 44

Oxytocin.

Front 45

Melanocyte-stimulating hormone (MSH) is secreted by the _________.

Back 45

anterior pituitary gland

Front 46

This hormone affects the melanocytes in the skin.

Back 46

Melanocyte-stimulating hormone (MSH)

Front 47

The hypothalamus and the pituitary gland are related through the _________ system, and the united hypothalamic-pituitary system controls the ___________ organs.

Back 47

vascular system;

peripheral endocrine organs

Front 48

The hormones that regulate the hypothalamus are ____________.

Back 48

produced by the hypothalamus itself.

Front 49

The hypothalamus helps control _______ and _____.

Back 49

body functions and emotions

Front 50

The pineal gland is located in the ______________; it synthesizes and secretes _______.

Back 50

posterior of the brain's third ventricle;

melatonin

Front 51

True or false?

The hypothalamus-pituitary gland system is part of the endocrine system.

Back 51

True.

Front 52

Thyroxine and calcitonin are secreted by what gland?

Back 52

thyroid gland

Front 53

This hormone is the body's major metabolic hormone.

It stimulates energy production in the cells, which increases the rate at which the cells consume oxygen and use carbs, fats, and proteins.

Back 53

Thyroxine (T4)

Front 54

The hypothalamus links the ________ system and the ______ system.

Back 54

endocrine; nervous

Front 55

The hormone secreted by the thyroid gland that helps maintain normal calcium levels in the blood.

Back 55

calcitonin

Front 56

This gland helps the immune system identify and destroy pathogens, disease-causing pathogens, and various pathogenic processes, such as cancer.

Back 56

Thymus gland

Front 57

define lymphocyte

Back 57

white blood cells that assist the lymphatic system with immunity

Front 58

What are the 3 types of specialized lymphocytes (white blood cells) that arise from the stem cells in the thymus gland?

Back 58

Killer T cells
Helper T cells
Suppressor T cells

Front 59

This gland helps regulate blood calcium levels by secreting _______ hormone, which directs specialized cells to dissolve bone, thereby releasing calcium.

Back 59

Parathyroid gland; Parathyroid hormone (PTH)

Front 60

parathyroid hormone (PTH) decreases the amount of ______ released in the urine.

Back 60

calcium

Front 61

The adrenal glands, located atop the kidneys, consist of two sections, the ______ and the _____.

Back 61

adrenal cortex (the outer layer)

adrenal medulla (the inner layer)

Front 62

Adrenal hormones also help the body cope with stress by ____________ pulse, respiratory rate, and blood pressure.

Back 62

increasing

Front 63

the adrenal medulla produces a class of hormones called ___________, and their function is stimulation of the sympathetic nervous system receptors.

Back 63

catecholamines (epinephrine and norepinepherine)

Front 64

The adrenal cortex secretes these 2 hormones:

Back 64

aldosterone and cortisol

Front 65

This hormone is a glucocorticoid, and its function is to increase metabolic rate, using fat and protein for energy.

Back 65

cortisol

Front 66

This hormone is a mineralocorticoid, and its function is to reabsorb sodium and water from the urine, and excrete excess potassium.

Back 66

aldosterone

Front 67

True/false.

The adrenal medulla and adrenal cortex produce the same hormones.

Back 67

FALSE.

Front 68

Alpha cells of the islets of langerhans produce ________

Back 68

glucagon

Front 69

Beta cells of the islets of langerhans produce ________

Back 69

insulin

Front 70

Delta cells of the islets of langerhans produce ________

Back 70

somatostatin

Front 71

define glycogenolysis

Back 71

biochemical breakdown of glycogen to glucose

Front 72

define gluconeogenesis

Back 72

The formation of glucose, especially by the liver, from noncarbohydrate sources, such as amino acids and the glycerol portion of fats

Front 73

When blood glucose falls, _______ is secreted in the pancreas..

Back 73

BG Falls: glucagon

Front 74

This hormone is produced by the pancreas, and stimulates the breakdown of glycogen to glucose (glycogenolysis).

Back 74

Glucagon

Front 75

This hormone is secreted by the pineal gland and affects patterns of sleep and wakefulness.

Back 75

melatonin

Front 76

This pancreatic hormone decreases insulin and glycogen secretion, slows the absorption of nutrients.

Back 76

somatostatin

Front 77

You have a hypoglycemic patient.

You expect the hormone ______ to be released from the _____ cells in the _____. That hormone will go on to target the _______, to cause _______.

Back 77

glucagon;
from the alpha cells of the pancreas;
target the liver;
trigger glycogenolysis and an increase in blood sugar.

Front 78

You have a hyperglycemic patient.

You expect the hormone _____ to be secreted from the ____ cells of the ______. That hormone will go on to cause _______, thereby decreasing blood sugar.

Back 78

Insulin

Beta cells of the pancreas

uptake of glucose from the blood, and storing as glycogen in the liver.

Front 79

The ________ are the main source of sex hormones.

Back 79

The gonads --- testes in men; ovaries in women

Front 80

This hormone inhibits insulin and glucagon secretion by the pancreas. It is produced by delta cells.

Back 80

somatostatin.

Front 81

This hormone is the main sex hormone in males and causes the secondary sex characteristics such as deep voice, facial hair, muscle development, pubic hair, growth spurts.

Back 81

testosterone

Front 82

This hormone is responsible for the secondary sex characteristics found in women, such as breast growth, fat accumulation at hips and thighs, pubic hair, growth spurts. It is also involved in pregnancy and regulation of menstrual cycle.

Back 82

estrogen

Front 83

This hormone is involved in pregnancy, regulation of menstrual cycle and prevents maturation of additional eggs during ovulation

Back 83

progesterone.

Front 84

In a hormonal emergency patient, administer oxygen if the rate is less than _____ breaths/min or greater than _____ breath/min.

Back 84

<8 breaths/min

>24 breaths/min

Front 85

It is important to ask all female patients about _________.

Back 85

last menstrual period.

Front 86

Goals with comatose endocrine emergency patients include these 2:

Back 86

determine level of consciousness
look for the source of coma

Front 87

You should immediately initiate treatment if the blood glucose level is less than _____ mg/dL.

Back 87

60 mg/dL

Front 88

The proper transport position/packaging for an intubated comatose patient is:

Back 88

supine with a cervical collar

Front 89

The proper transport position/packaging for an comatose patient that is NOT intubated is:

Back 89

stable side position

Front 90

The proper transport position/packaging for a comatose patient with increasing intracranial pressure is:

Back 90

head elevated 30-45º and midline

Front 91

Glucose metabolic derangements are caused by disfunction of what organ?

Back 91

pancreas

Front 92

Most endocrine *emergencies* result in these 4 symptoms.

Back 92

1) compromise of the ABCs
2) improper fluid balance
3) deteriorating mental status
4) abnormal vitals and BG levels

Front 93

This is the "fuel for cellular metabolism"

Back 93

glucose

Front 94

This disease is characterized by the body's inability to metabolize glucose and is comes with the "three P's".

Back 94

Diabetes Mellitus

Front 95

The function of insulin is to:

Back 95

transport glucose into the cells for metabolism

Front 96

Hypoglycemia is defined as sugar level less than ___mg/dL.

Back 96

80 mg/dL

Front 97

Treatment of a hypoglycemic patient includes:

Back 97

maintain ABCs
determine BG level to be less than 60 mg/dL
Establish IV access and administer 50% dextrose IV. (If unable to establish IV, administer glucagon IM or IV)
monitor cardiac rhythm/vitals
expedite transport

Front 98

If you are unable to administer 50% dextrose by IV for a hypoglycemic patient, you should instead administer ____________ by _____

Back 98

glucagon by IM or IV

Front 99

define microangiopathy

Back 99

microscopic deterioration of vessel walls caused primarily by adherence of blood lipids to vessel walls.
It is associated with cerebrovascular disease, stroke.

It can be a life altering complication of diabetes.

Front 100

This type of diabetes generally affects children.

Back 100

Type 1 Diabetes Mellitus

Front 101

In ________, most patients do not produce insulin. They require daily insulin injections throughout their lives to control blood glucose levels.

Back 101

Type 1 diabetes

Front 102

In type 1 diabetes, the ______ cells in the ________ have been destroyed and no longer produce insulin. Blood glucose must be monitored closely and insulin administered at least daily by injection or pump.

Back 102

beta cells; islets of langerhans

Front 103

The most common form of diabetes is:

Back 103

type 2 diabetes

Front 104

"adult-onset diabetes" is which type?

Back 104

type 2 diabetes

Front 105

when blood glucose rises, ______ is secreted in the pancreas.

Back 105

insulin

Front 106

In kidney failure as a result of diabetes, glomeruli become _________, and there is necrosis of the _____________,likely following nephropathy and renal failure.

Back 106

glomeruli become sclerotic

necrosis of the papillary tissue

Front 107

Eye damage as a complication of diabetes occurs as high blood glucose damages vessels, and because cataracts form due to ______ and _____ in the ______ of the eye.

Back 107

fructose and sorbitol

in the lens of the eye

Front 108

Many life-altering complications of diabetes can be delayed or prevented by __________.

Back 108

making lifestyle changes and continuous management.

Front 109

What is neuropathy?

Back 109

disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness.

it can be a life-altering complication from diabetes.

Front 110

List 7 life-altering complication from diabetes.

Back 110

1) Kidney failure
2) Heart disease
3) stroke
4) cerebrovascular disease
5) HTN
6) Cataracts, eye problems
7) Neuropathy

Front 111

In diabetic ketoacidosis, you should expect your patient's blood glucose level to be _______, due to a lack of ________, and the acidosis is caused by _______.

Back 111

blood glucose level will be high (hyperglycemic);

due to lack of insulin;

Ketones cause acidosis;

Front 112

When assessing a patient's history with type 1 diabetes mellitus, you should be sure to ask about ________?

Back 112

compliance with disease management

Front 113

When assessing a patient with a history of type 1 diabetes mellitus, and is currently suffering altered mental status, what should you suspect?

Back 113

suspect low blood glucose level

Front 114

When *physically* assessing a patient with type 1 diabetes mellitus, you should be looking for ______?

Back 114

sores or infections

Front 115

How does the respiratory rate and tidal volume change when a patient suffers hyperglycemia?

Back 115

Respiratory rate, tidal volume are elevated

Front 116

Hyperosmolar nonketotic coma/hyperosmolar hyperglycemic nonketotic coma (HONK/HHNC) is a metabolic derangement that occurs principally in patients with which type of diabetes?

Back 116

type 2 diabetes.

Front 117

Hyperosmolar nonketotic coma/hyperosmolar hyperglycemic nonketotic coma (HONK/HHNC) is characterized by these 3 things:

Back 117

hyperglycemia

hyperosmolarity (Severe volume depletion)

an absence of significant ketosis.

Front 118

Treat Hyperosmolar nonketotic coma/hyperosmolar hyperglycemic nonketotic coma (HONK/HHNC) with these 2 things:

Back 118

Fluid therapy, insulin

Front 119

The following history/physical findings are indicative of what illness?

Severe volume depletion, CNS
Warm, dry skin
Dry mucous membranes
Poor skin turgor
Tachycardia
Weakness
Polyuria
Polydipsia
Polyphagia
Orthostatic hypotension
Supine hypotension
Altered mental status
Lethargy
Coma

Back 119

Hyperosmolar nonketotic coma/hyperosmolar hyperglycemic nonketotic coma (HONK/HHNC)

Front 120

This type of diabetes may be related to metabolic syndrome, typically develops later in life, may be insulin resistant, and presents with elevated BG levels.

Back 120

type 2 diabetes mellitus

Front 121

These symptoms are indicative of what disease?

Frequent urination
Thirst
Blurred vision
Frequent infections
Unresponsiveness

Back 121

Type 2 Diabetes Mellitus

Front 122

Patient own management of Type 2 Diabetes Mellitus can include these 4 things:

Back 122

Weight loss.
Food intake spread throughout the day.
Medication/insulin required daily.
Oral medications are used with some patients.

Front 123

This disease is a form of glucose intolerance during pregnancy

Back 123

Gestational Diabetes

Front 124

Gestational Diabetes increases risk for which form of diabetes?

Back 124

Type 2 diabetes

Front 125

When does Gestational Diabetes typically resolve itself?

Back 125

before delivery for most women

Front 126

Which type of diabetes can result in pregnant women delivering large infants?

Back 126

Gestational Diabetes

Front 127

You have a pregnant patient with a history of gestational diabetes, and delivery is imminent.

You should quickly transport this patient, because:

Back 127

Patients suffering Gestational Diabetes often requires cesarean sections

Front 128

Patient's self-management of Gestational Diabetes includes:

Back 128

Stabilize blood glucose levels.
Diet, exercise, blood glucose testing

Front 129

In persons with insulin-dependent diabetes, hypoglycemia often results from:

Back 129

Too much insulin
Too little food
Both

Front 130

You have a trembling diabetic patient with a rapid pulse. He is sweaty, and complains of hunger.

Additional complaints include Headache, Incoordination
Slurred speech and Irritability.

What is this patient likely suffering from?

Back 130

Hypoglycemia

Front 131

In any diabetic patient with Bizarre behavior, Neurologic signs or Coma, you should suspect they are suffering from:

Back 131

hypoglycemia

Front 132

In any diabetic patient who has suffered a stroke, you should be very cautious about administration of glucose, because:

Back 132

It may exacerbate cerebral damage.

Front 133

The typical adult dose of D50 is:

Back 133

12.5g to 25 g over at least 3 minutes, slow IV

Front 134

You have a hypoglycemic patient who needs an advanced airway.

Should you first place the advanced airway, or administer D50 first?

Back 134

Do not use an advanced airway until you have given the patient D50.

12.5 to 25 g, over at least 3 minutes

Front 135

In a conscious & alert, hypoglycemic patient, should you first administer sugars orally or by IV?

Back 135

Administer sugar orally if alert and able to swallow.

Front 136

You've tried unsuccessfully to obtain IV access and administer D50 to a hypoglycemic patient, your next course of action is to:

Back 136

administer glucagon via IM

Front 137

Which type of diabetes requires oral carbohydrates or additional glucose administration.

Back 137

Type 1 diabetes

Front 138

This is a classic symptom of diabetes

Back 138

Hyperglycemia

Front 139

What diseases are these two symptoms early signs of:

excessive thirst and urination

Back 139

Hyperglycemia and Diabetic Ketoacidosis

Front 140

Hyperglycemia is defined as blood sugar greater than _____ mg/dL

Back 140

Occurs when blood glucose exceeds 120 mg/dL

Front 141

At what rate of onset does Hyperglycemia and Diabetic Ketoacidosis occur?

Back 141

Onset may be rapid or gradual.

Hyperglycemia usually progresses slowly.

Front 142

Untreated hyperglycemia will progress to _______.

Back 142

Diabetic Ketoacidosis

Front 143

Diabetic Ketoacidosis occurs when certain acids accumulate because _______ is not available.

Back 143

insulin

Front 144

What diabetic emergency should you anticipate at Blood glucose level < 40 mg/dL

Back 144

Insulin Shock

Front 145

What diabetic emergency should you anticipate at Blood glucose level 40 - 80 mg/dL

Back 145

Hypoglycemia

Front 146

You will likely see neurological deficiencies and altered mental status, including coma, at a blood glucose level of _____ mg/dL or lower.

Back 146

45 mg/dL

Front 147

What diabetic status should you anticipate at Blood glucose level 80 - 120 mg/dL

Back 147

normoglycemia

Front 148

What diabetic emergency should you anticipate at Blood glucose level 120 - 400 mg/dL

Back 148

Hyperglycemia

Front 149

What diabetic emergency should you anticipate at Blood glucose level >800 mg/dL

Back 149

diabetic coma

Front 150

Something to keep in mind when your patient is in DKA and comatose is that the degree to which your patient is comatose is _______.

Back 150

not very deep.

Patients in DKA are seldom deeply comatose.

Front 151

The following signs and symptoms are indicative of what disorder?:

Polyuria, polydipsia, polyphagia
Fruity odor on the breath
Abdominal pain

Back 151

Diabetic Ketoacidosis

Front 152

You have a hyperglycemic patient with history of DKA. The cardiac monitor shows sharply peaked T waves.

You should consider administering what drug?

Back 152

sodium bicarbonate

Front 153

You have a hyperglycemic patient with history of DKA. The cardiac monitor shows a sine wave.

You should consider administering what drugs?

Back 153

calcium chloride or gluconate.

Front 154

Hyperosmolar Nonketotic (HONK) Coma occurs primarily with which type of diabetes?

Back 154

type 2 diabetes

Front 155

You have a comatose patient with a history of diabetes.
Patient is hyperglycemic, but exhibiting no significant ketosis.
Patient was complaining of drowsiness and lethargy prior to falling comatose.
Patient suffers from (focal or generalized) seizures.

What type of coma is this likely to be?

Back 155

Hyperosmolar Nonketotic (HONK) Coma

Front 156

You have a Hyperosmolar Nonketotic (HONK) Coma patient. Patient is dehydrated and has altered mental status. BG level is less than 60 mg/dL.

How should you treat this patient?

Back 156

Address dehydration and altered mental status.
A bolus of NS is appropriate for nearly all who are clinically dehydrated.
Administer D50 if the glucose level is less than 60 to 80 mg/dL.

Front 157

Adrenal Insufficiency is due to decreased function of the ___________, which causes underproduction of these 2 chemicals:

Back 157

adrenal cortex
cortisol and aldosterone

Front 158

This disorder results in weakness, dehydration, and inability to maintain blood pressure. It is usually well tolerated.

Back 158

Adrenal Insufficiency

Front 159

Addison Disease is also known as:

Back 159

Primary Adrenal Insufficiency

Front 160

Describe Primary Adrenal Insufficiency (Addison Disease)

Back 160

Both adrenal glands atrophied or destroyed, which
leads to deficiency of steroid hormones.

Occurs when 90% of the adrenal cortex has been destroyed

Front 161

Signs of this chronic disease include:

Fatigue
Anorexia
Salt craving
Muscle, joint pain
Increased pigmentation

Back 161

Primary Adrenal Insufficiency (Addison Disease)

Front 162

In Primary Adrenal Insufficiency (Addison Disease), how do Blood volume and pressure, Sodium concentration of the blood, and Blood potassium change?

Back 162

Blood volume and pressure fall.
Sodium concentration of the blood falls.
Blood potassium rises.

Front 163

Primary Adrenal Insufficiency (Addison Disease) management includes these 3 things:

Back 163

Assess and manage ABCs.
Initiate aggressive fluid replacement.
Hydrocortisone is indicated in the acute management of a crisis.

Front 164

Secondary Adrenal Insufficiency is characterized by:

Back 164

a lack of ACTH secretion from the pituitary gland

Front 165

Secondary Adrenal Insufficiency may result if a patient abruptly stops taking _________.

Back 165

corticosteroids

Front 166

An 'Addisonian crisis' is defined as:

Back 166

an acute onset of Adrenal insufficiency (addison disease)

Front 167

The chief manifestation of Adrenal Insufficiency (addison disease) is:

Back 167

shock

Front 168

In a patient with Adrenal Insufficiency or an Addisonian Crisis, you would expect to see the chief manifestation of shock, but you might also see these 3 symptoms:

Back 168

Confusion
Low blood pressure
Severe pain and/or vomiting

Front 169

Prehospital management of Secondary Adrenal Insufficiency includes:

Back 169

Maintain ABCs, and have suction ready.
Rehydrate and correct abnormalities.
Check glucose level and cardiac rhythm.

Front 170

Cushing Syndrome is characterized by:

Back 170

Excess cortisol production or use of corticosteroid hormones

Front 171

The following changes are very characteristics of what syndrome?

Blood glucose level rises.
Protein synthesis is impaired.
Bones become weaker.

Back 171

Cushing Syndrome

Front 172

These Signs and symptoms are indicative of what syndrome?:
hyperglycemia, weak bones, impaired protein synthesis
Weakness and fatigue
Increased thirst and urination
Low blood glucose
Thinning and/or darkening of the skin

Back 172

Cushing Syndrome

Front 173

Prehospital management of Cushing Syndrome includes:

Back 173

Assess and manage ABCs.
Prehospital treatment is generally supportive.
Obtain blood glucose level, and administer D50 if indicated.

Front 174

Define Pheochromocytoma

Back 174

Adrenal Gland Tumor

Front 175

Where do you usually find a Pheochromocytoma?

Back 175

Usually in the adrenal medulla

Front 176

A Pheochromocytoma usually causes what changes in the release of hormones?

Back 176

Causes excessive release of hormones

Front 177

Congenital Adrenal Hyperplasia (CAH) is caused by what?

Back 177

Inadequate production of cortisol and aldosterone

Front 178

Congenital Adrenal Hyperplasia (CAH) will present in male and female babies in what way?

Back 178

Enlarged vagina in female infants
Signs of puberty in male infants
Short stature and severe acne

Front 179

If Congenital Adrenal Hyperplasia (CAH) is diagnosed in a pregnant woman they may be prescribed what medication?

Back 179

Dexamethasone

Front 180

Non-prehospital treatment for Congenital Adrenal Hyperplasia (CAH) includes:

Back 180

Usually requires cortisol and/or aldosterone replacement therapy
Surgery can correct genital deformities.

Front 181

Describe the cardiovascular, metabolic, neuromuscular, mental/emotional, GI, and skin effects caused by hypothyroidism.

Back 181

slow pulse, reduced CO
Decreased metabolism, cold skin, WEIGHT GAIN
weakness, sluggish reflexes,
sluggish mental process, personality placid
constipated
cold, dry skin

Front 182

Describe the cardiovascular, metabolic, neuromuscular, mental/emotional, GI, and skin effects caused by hyperthyroidism.

Back 182

rapid pulse, increased CO
increased metabolism, hot skin, WEIGHT GAIN
tremor, hyperactive reflexes,
restlessness, irritability, emotional liability
diarrhea
warm, moist skin

Front 183

Two diseases that are common causes of hyperthyroidism

Back 183

Graves Disease

Hashimoto Disease

Front 184

This is an autoimmune disorder in which the thyroid gland hypertrophies as its activity increases (excessive amounts of thyroxine is secreted).

Back 184

Graves Disease

Front 185

This disease is the most common cause of hyperthyroidism

Back 185

Graves Disease

Front 186

Signs & Symptoms of this disease includes:
visible mass in neck
Agitation, emotional changeability, insomnia, poor heat tolerance, weight loss, weakness, dyspnea.
Tachycardia and new-onset atrial fibrillation.
Protrusion of the eyeballs or goiters.

Back 186

Graves Disease

Front 187

Define exopthalmos

Which endocrine disorder do you often see it with?

Back 187

a protruding eyeball anteriorly out of the orbit ( eye socket).

Commonly seen with hyperthyroidism.

Front 188

What is Hashimoto disease?

Back 188

This is an autoimmune disease in which the thyroid gland is enlarged as a result of the infiltration of T lymphocytes and plasma cells.

Affects TSH receptors.

Is a cause of hyperthyroidism

Front 189

What is myxedema?

Back 189

adult hypothyroidism.
Often presents with accumulations of mucinous material in the skin
Slowing of metabolic processes
Iodine deficiency

Front 190

What disorder are these Signs & symptoms indicative of?

Signs & Symptoms
Fatigue, slowed mental function
Cold intolerance, constipation, lethargy
Absence of emotion, thinning hair, enlarged tongue
Cool, pale doughlike skin
Coma, hypothermia, and bradycardia

Back 190

Myxedema (can be Coma)

Front 191

The severity of Myxedema is consistent with _________.

Back 191

degree of deficiency of iodine and thyroid gland.

Front 192

Myxedema coma can be caused by __________, is often precipitated by _______.

Back 192

dropping hormone levels;
triggers

Front 193

The hallmark sign of Myxedema Coma is __________, and a consistent finding in these patients is __________.

Back 193

deterioration of mental status

hypothermia

Front 194

Prehospital treatment of Myxedema Coma includes:

Back 194

Supplemental oxygen for hypoxia
Intubation, ventilation may be indicated
Monitor cardiac status.
Passive rewarming for hypothermia
Avoid sedatives, narcotics, anesthetics

Front 195

What medications should you avoid when treating a patient with a Myxedema coma?

Back 195

Avoid sedatives, narcotics, anesthetics

Front 196

Thyrotoxicosis is caused by:

Back 196

a toxic condition caused by excessive levels of circulating thyroid hormone, which can be caused by Hyperthyroidism, Goiters or Autoimmune disorders.

Front 197

What rare and life-threatening disorder is indicated by the following signs:

May occur in patients suffering thyrotoxicosis.
Normal signs, symptoms of hyperthyroidism
Fever
Severe tachycardia
Vomiting

Back 197

Thyroid Storm

Front 198

The most common cause of Hyperparathyroidism is:

Back 198

adenoma

Front 199

What is Hyperparathyroidism?

Back 199

Increased parathyroid hormone level

Front 200

What are the primary and secondary causes of hyperparathyroidism?

Back 200

Primary causes result from the gland
Secondary causes occur elsewhere

Front 201

What is the definitive treatment of Hyperparathyroidism?

Back 201

Definitive management: remove gland

Front 202

What are the signs & symptoms, and the prehospital treatment of Hyperparathyroidism?

Back 202

Signs and symptoms can be vague, but may include fatigue, weakness, vomiting.

Manage ABCs, provide supportive care

Front 203

Continued decrease of thyroid hormone levels in hypothyroidism may lead to:

Back 203

myxedema coma

Front 204

What is Panhypopituitarism?

How does it present?

Back 204

Inadequate production or absence of pituitary hormones

Clinical presentation varies.

Front 205

Diabetes Insipidus is the inability to regulate fluid due to these two factors:

Back 205

Lack of ADH (central diabetes insipidus)
Kidneys unable to respond appropriately (nephrogenic diabetes insipidus)

Front 206

define "Central diabetes insipidus"

Back 206

Diabetes insipidus due to lack of ADH

Front 207

define "Nephrogenic diabetes insipidus"

Back 207

Diabetes insipid us due to kidneys being unable to respond appropriately

Front 208

Management of Diabetes Insipidus may include synthetic __________.

Back 208

ADH

Front 209

These are two categories of Inborn Errors of metabolism.

Back 209

Toxic accumulations
Energy production or utilization

Front 210

With regard to Inborn Errors of Metabolism, sufferers cannot _______________.

Back 210

Cannot transform food to energy

Front 211

How does a patient contract Inborn Errors of Metabolism?

Back 211

They are Hereditary diseases, so patients acquire it before birth.