Endocrine Disorders Flashcards

Flashcards for Endocrine Disorders

Endocrine Disorders

Too much or too little hormone activity, can be a primary or secondary disorder.

Diabetes Insipidus (DI)

Insufficient ADH leading to increased urine output; kidneys do not reabsorb water resulting in excessive diuresis (3 to 15 liters per day).

Signs and Symptoms of Diabetes Insipidus

Polyuria, polydipsia, nocturia, dilute urine, dehydration, hypovolemic shock, decreased level of consciousness, and potentially death.

Diagnostic Tests for Diabetes Insipidus

Urine specific gravity <1.005 and increased plasma osmolality.

Therapeutic Interventions for Diabetes Insipidus

Hypotonic IV fluids, hypophysectomy if tumor, IV or subcutaneous vasopressin, DDAVP (synthetic vasopressin).

Syndrome of Inappropriate ADH (SIADH)

Too much ADH, leading to water retention, hyponatremia, and decreased serum osmolality.

Signs and Symptoms of SIADH

Weight gain without edema, dilutional hyponatremia (

Therapeutic Interventions for SIADH

Eliminate cause, fluid restriction, hypertonic saline IV, furosemide (Lasix), conivaptan (Vaprisol).

Growth Hormone Deficiency

Deficient growth hormone (GH) in childhood, leading to short stature; may be caused by pituitary tumor, heredity, psychosocial factors, or malnutrition.

Signs and Symptoms of Growth Hormone Deficiency

Grow only to 3 to 4 feet (5th percentile), slowed sexual maturation; in adults: fatigue, weakness, excess body fat, hypercholesterolemia, decreased muscle and bone mass, sexual dysfunction, risk for cardiovascular/cerebrovascular disease, decreased quality of life.

Acromegaly

Excess GH in adults, leading to bones growing in width not length, organ and connective tissue enlargement; caused by pituitary hyperplasia/tumor or hypothalamic dysfunction.

Signs and Symptoms of Acromegaly

Change in shoe or ring size, nose/jaw/brow enlargement, teeth displacement, difficulty speaking/swallowing, sleep apnea, headaches, visual changes, diabetes mellitus, arthritis, sexual dysfunction.

Hypophysectomy

Surgical removal of the pituitary gland, often via minimally invasive endoscopic surgery.

Hypothyroidism

TH deficiency, leading to a reduced metabolic rate; can be primary (not enough TH) or secondary (not enough TSH).

Signs and Symptoms of Hypothyroidism

Fatigue, bradycardia, constipation, mental dullness, cold intolerance, hypoventilation, dry skin and hair, weight gain, heart failure, hyperlipidemia, myxedema.

Diagnostic Tests for Hypothyroidism

Low T3 and T4, TSH high in primary hypothyroidism, TSH low in secondary hypothyroidism; elevated serum cholesterol and triglycerides.

Therapeutic Interventions for Hypothyroidism

Oral levothyroxine (Synthroid); for myxedema coma: monitor vital signs, warming blanket, mechanical ventilation, IV fluids, IV levothyroxine.

Hyperthyroidism

Increased metabolic rate and increased beta receptors; can be primary (too much TH) or secondary (too much TSH).

Signs and Symptoms of Hyperthyroidism

Heat intolerance, increased appetite, weight loss, frequent stools, nervousness, tachycardia, palpitations, tremor, heart failure, warm smooth skin, exophthalmos (Graves disease).

Diagnostic Tests for Hyperthyroidism

Elevated T3 and T4, TSH low in primary hyperthyroidism, TSH high in secondary hyperthyroidism.

Therapeutic Interventions for Hyperthyroidism

Methimazole (Tapazole), beta blockers, radioactive iodine (I-131 or RAI), thyroidectomy.

Goiter

Enlarged thyroid gland, often due to elevated TSH and hyperplasia; can be caused by low TH, iodine deficiency, virus, genetics or goitrogens.

Cancer of the Thyroid Gland

Tumor of the thyroid gland; can be benign or malignant.

Hypoparathyroidism

Decrease in parathyroid hormone (PTH) leading to hypocalcemia and hyperphosphatemia; can be caused by heredity or accidental removal during thyroidectomy.

Signs and Symptoms of Hypoparathyroidism

Neuromuscular irritability, numbness and tingling of fingers and perioral area, muscle spasms, cardiac arrhythmias, positive Chvostek and Trousseau signs.

Therapeutic Interventions for Hypoparathyroidism

IV calcium gluconate for acute cases; oral calcium with vitamin D for long-term management.

Hyperparathyroidism

Overactivity of the parathyroid gland leading to increased PTH, hypercalcemia, and hypophosphatemia; caused by parathyroid hyperplasia, benign tumor, or heredity.

Signs and Symptoms of Hyperparathyroidism

Fatigue, depression, confusion, nausea and vomiting, kidney stones, joint pain, pathological fractures, arrhythmias, coma, cardiac arrest.

Diagnostic Tests for Hyperparathyroidism

Serum calcium elevated, phosphate decreased, PTH elevated.

Pheochromocytoma

Tumor of the adrenal medulla that secretes epinephrine and norepinephrine, leading to fight or flight symptoms.

Signs and Symptoms of Pheochromocytoma

Hypertension, tachycardia, palpitations, tremor, diaphoresis, anxiety, headache, vision changes.

Diagnostic Tests for Pheochromocytoma

24-hour urine for metanephrines and VMA, CT scan or MRI to find tumor. Avoid caffeine or medications before the urine test.

Therapeutic Interventions for Pheochromocytoma

Avoid high-tyramine foods, calcium channel blockers, alpha blockers, beta blockers, adrenalectomy.

Addison Disease

Deficient cortisol, aldosterone, and/or androgens; caused by autoimmune, AIDS, cancer, pituitary/hypothalamus problems, or abrupt discontinuance of long-term steroids.

Signs and Symptoms of Addison Disease

Hypotension, sodium loss, potassium retention, hypoglycemia, weakness, fatigue, bronze skin, nausea and vomiting.

Diagnostic Tests for Addison Disease

Serum and urine cortisol level, blood glucose, electrolytes, BUN, hematocrit, ACTH stimulation test.

Therapeutic Interventions for Addison Disease

Glucocorticoids and mineralocorticoids daily for life, high-sodium diet; double/triple dose during times of stress.

Cushing Syndrome

Excess adrenal cortex hormones (cortisol, aldosterone, androgens); caused by hypersecretion of ACTH/cortisol, or prolonged use of exogenous glucocorticoids.

Signs and Symptoms of Cushing Syndrome

Thinning hair, red cheeks, moon face, buffalo hump, striae, easy bruising, pendulous abdomen, slow wound healing, osteoporosis, thin extremities.

Diagnostic Tests for Cushing Syndrome

Based on appearance, plasma and urine cortisol, ACTH, dexamethasone suppression test.

Therapeutic Interventions for Cushing Syndrome

Surgery if tumor, reduce dose of steroid, change schedule of administration, symptom control, diabetes treatment, low-sodium/high-potassium diet.