endocrine system

antidiuretic hormone

• secreted from pituitary gland

• causes anti-diuresis… BODY HOLDS ON TO WATER (but not salt)

• ADH= vasopressin/ desmopressin

thyroid hormone

• T3 and T4

• energy!!

• release is controlled by the thyroid stimulating hormone… inverse relationship

  • decreased T3/T4 = HIGH TSH

  • increased T3/T4 = LOW TSH

parathyroid hormone

• causes calcium to be pulled out of bones

• INCREASES SERUM CA+

calcitonin

• produced by thyroid gland

• released when serum ca+ levels increase

• inhibits osteoclasts → stops bones from releasing calcium and opposes PTH

addisons disease

• not enough steroids

• LIKE A RAISIN

• fatigue, confusion

• wt. loss

• hypoglycemia

• hypotension

• dehydrated, hyponatremia, hyperkalemia

cushings disease

• too much steroids

• LIKE A GRAPE

• immunosuppression, hyperglycemia

• altered mood

• moon face, acne/ oily skin

• fluid volume excess, hypernatremia, hypokalemia

tx of addisons disease

• THINK SHOCK

• ivf

• increase Na+ intake

• I&Os, daily weights

• replace steroids - prednisone, fludrocortisone

tx of cushings disease

• adrenalectomy (could remove both if needed)

• avoid infection… WILL BE ON STEROIDS LIFELONG

pheochromocytoma

• tumor on adrenal gland causing excess secretion of epi/norepi

• DO NOT PALPATE ABDOMEN… can stimulate release

• severe HA

• tachycardia, palpitations

• HTN

• abdominal/ chest pain

• diaphoresis

diabetes insipidus

• not enough ADH

• no ADH to tell the body to hold onto water… kidneys produce MASSIVE AMOUNTS OF URINE

• leads to fluid volume deficit → hypotension, shock

• lack of concentration/ memory/ focus, lightheaded

• dry mouth

• excessive thirst, dry mouth, dry eyes

• tachycardia, hypotension

• muscle cramps

syndrome of inappropriate antidiuretic hormone

• body is making too much ADH

• kidneys STOP EXCRETING WATER AND HOLD ONTO IT

• wt gain, NO peripheral edema, anorexia

• N/V

• low Na+ (<125) → irritability, confusion, seizures

• hemodilution and increased USG

hypothyroidism

• TSH is high, so body doesn’t think it needs to make more T3/T4

• HIGH TSH, LOW T3/T4

• everything slooooooooows

• poor memory

• thinning hair

• puffy face

• dry skin, cool extremities/ swelling

• enlarged thyroid

• bradycardia

• poor appetite, wt. gain

• heavy periods

• carpal tunnel

hyperthyroidism (graves disease)

• autoimmune disease with antibodies attacking the thyroid

• TOO MUCH T3/T4 SO LOW TSH

• body is go go go!

• goiter, exopthalamus

• tachycardia, arrhythmias

• nausea/ diarrhea

• muscle weakness/ tremors

• wt loss

• anxiety/ diaphoresis

tx of SIADH

• hypertonic fluids

• fl restriction

• sodium replacement

• seizures precautions

tx of Graves’ disease

• anti thyroid - methimazole

• iodine compounds

• radioactive iodine therapy

• thyroidectomy

hypoparathyroidism

• thyroid glands do not secrete enough PTH

• hypocalcemia so hyperphosphatemia (inverse relationship)

• seizures

• paresthesias, muscle cramps, myopathy

• arrhythmias

• anxiety, depression

• dry skin, thin hair

• cataracts

hyperparathyroidism

• too much PTH so low T3/T4

• hypercalcemia so hypophosphatemia

• calcium acts as a sedative so THINGS ARE SLOWING DOWNNNN

• loss of appetite

• n/v, constipation

• fatigue, depression, confusion

• bone/ joint aches

• increased thirst

• Increased urination

hyperglycemic hypersmolar nonketonic syndrkme (HHNS)

• exacerbation of DMT1

• extremely high BG → blood becomes hyperosmolar → kidneys start producing more urine d/t the hyperosmolarity of the blood

• polyuria → dehydration → shock

• symptoms begin over days to weeks

• NO KETONES