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50 Cards in this Set
- Front
- Back
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Endocrine disorders
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- too much or too little hormones secreted by glands
- most common disorder - hypothyroidism |
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Hormones
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Chemical messengers of endocrine system
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Endocrine glands
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Ductless glands which dump there hormone products directly into the blood stream
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Pituitary Gland
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Master gland which controls other glands, housed in the hypothalamus
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Anterior Pituitary gland
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Related to puberty
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Cause SIADH
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Excess anti-diuretic hormone
- opposite of DI - Both are fairly rare - ordinarily a secondary condition - leads to increased weight and decreased Na+ concentration |
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Ectopically
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abnormally
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Most common cause of SIADH
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- i.e adenocancer of lung, oat cell cancer due to ectopically produced ADH
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Clinical manifestations of SIADH
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Increased total body water,weight gain and hypoatremia, increased urine concentration and specific gravity
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High specific gravity of urine
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Dense, thick, amber colored urine
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S/sx of hypoatremia
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Confusion and lethargy
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1st Treatment of hypoatremia -
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Water restriction (less than 1L/day) for chronic conditions
- For acute post-op pts – fluid bolus to kick start urine output |
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2nd Treatment of hypoatremia -
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Isotonic fluids then gradually replace Na+ with hypertonic solutions. If administered quickly, BP increases and cells shrink.
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3rd Treatment of hypoatremia -
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demeclocycline - blocks ADH effect and increases Na+ levels
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Cause of diabetes insipidus
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Insufficient action of anti-diuretic hormone
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Neurogenic cause of diabetes inspidus
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Hypothalamus lesions, brain tumors or lesions
- most common, and can be caused by head trauma – accidental or surgical |
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Nephrogenic cause of diabetes insipidus
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Kidney dysfunction
Tubules don’t reabsorb water |
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Which cause of diabetes insipidus can be treated with ADH
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Neurogenic, because that means that there is deficience of the hormone
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Clinical manifestations of Diebetes Insipidus
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- Lower TBW
- NA 0 more than 145 meq/L - hydronephrosis - high Na value and the constant need to pee - clear water lost through the bladder |
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Polydipsia
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Excess thirst
-fluid replacement is necessary with diabetes insipidus - if deprived of water and still peeing like crazy, DI it is - demopressin is an ADH |
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ADH replacement
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Can be used to prevent Nocturia
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Thyroid gland
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-plays role in metabolism
- sits in front of the trachea |
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Hyperthyroidsm
(Grave Disease) |
- 10% of thyroid diseases
Increased thyroid hormone - Autoimmune disease - antibodies bind to and stimulate TSH receptors - thyroid cancer could play a role - exophthalmos – buldging eyes |
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Complications of exophthalmos
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Buldging eyes = dry eyes & eye infections
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S/sx of Graves disease
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Hyperthermia, tachycardia, delirium, nausea, emlarges thyroid, exophthalmos, increased BP and pulse
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Treatment for hyperthyroidism -
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Drugs – corticosteroids (which suppress immune system)
- radioactive iodine - thyroidectomy |
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Hypothyroidism
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- 90% of thyroid disease
- cause – deficiency of thyroxine (of TSH) - autoimmune - detected when pt make too much TSH and not enough thyroxine, or too little TSH and too little thyroxine |
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Clinical Hypothyroidisn
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Slow, sluggish, fat and constipated person with headaches, depression and coarse hair
“C” symptoms – coarse hair, constipation, coldness, chubbiness, cranial pain, sluggish |
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Myxedema coma
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Hypothyroidism progresses to coma
- can happen with the withdrawal of thyroid meds - worst case scenario – pt cant function and fills w/ fluid |
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Hypothyroism –
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Low TSH Something wrong with pituitary
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Hypothyroidism – High TSH
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Something wrong with thyroid gland
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Hypothyroisim treatment
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Thyroid replacement - forever
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Parathyroid gland
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Regulates serum Ca, low calcium leads to more TPH
Ca+ needed for nerve conduction as it regulates the Na+/K pump Kidney failure = increased parathyroid activity |
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Location of parathyroid gland
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4 glands located around thyroid gland
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Causes of Hyperparathyroidism
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Renal failure
- the parathyroid glands enlarge and pull Ca. from bones |
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Clinical manifestations of hyperparathyroidism
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Brittle bones
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Treatment of Hyperparathyroidism
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Removal of parathyroid glands
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Consequence of Parathyroid removal
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Ca+ supplements forever
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Diabetes Mellitus –Type1
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-Pancreas makes no insulin
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Diabetes Mellitus –Type2
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Insufficient insulin made by islet cells of pancreas
Cells that require sugar, don’t allow insulin to do its job |
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Type 1 causes
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Auto immune condition occur due to environmental and heredity factors
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Clinical Manifestations Type I
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Three Ps
- polydipsia, polyuria, very hungry Tire easily because cells don’t have the sugar needed to operate |
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Type 2 causes
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Pancreatic cells get overworked with age and obesity
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Type 2 Clinical manifestation
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Subtle and slow to develop, recurrent infections and visual changes
- more subtle 3 p’s |
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Complications of Chronic hyperglycemia
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Neuropathy (poor nerve transmission)
Nephropathy (kidney dysfunction) Fat deposits in coronary arteries Blindness CAD Stroke |
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Effects of diabetes
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Stroke, retinopathy, CAD
-Chronic effects due to increased amouts of sugar flowing to certain cells that do not rely on insulin - Cells take in extra sugar, which draws in extra water which causes cell injury and damage. |
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Severe complications Type 1
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Diabetic ketoacidosis (DKA)
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Severe Complications
Type 2 |
Hyperosmolar hypoglycemic nonketotic syndrome HHNS
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DKA -
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Insulin deficiency – hyperglycemia – polyuria, cellular starvation – ketones produced in cellular starvation – ketoacidosis
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Evaluation of Diabetes
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Fasting blood sugars - >126
Glucose tolerance tests >140 HbA1C- three month |
