Endocrine disorder part 1

Endocrine General Information (beginning)

Pituitary gland is known as “hypophysis” and governs:

• Antidiuretic hormone (ADH): holds water in blood and less urine output

• thyroid stimulating hormone (TSH): regulating hormone that produve, release and store thyroid hormones

• adrenocorticotropic hormone

Diabetes Inspidus

Characteristic

• Too much diluted urine and flavorless

• Low ADH

• Pituitary Problem

Etiology:

1. Sick Kidneys: the kidneys have decreased response to renal tubules to ADH

2. CNS related issue

   • Head injury can cause cerebral edema (swelling) and press against the pituitary gland to stop ADH

   • Pituitary tumor cause gland to diminish ADH secretion

Manifestation (S/S)

• polyuria (too much urine)

• constant thirst

• high serum osmolality (concentrated)

• S/S dehydration: Sunken eye and dry mucous

Syndrome Inappropriate ADH (SIADH)

Characteristic:

• High ADH

• Decrease urine and high vascular fluid volume

• Pituitary problem

Etiology:

1. ectopic bronchogenic cancer (tumor outside lung) that produce ADH

2. anesthetics in post recovery (sleeping patients obviously holds urine in)

3. head injury or brain tumor can press pituitary gland and secrete more ADH

Manifestation (S/S)

• oliguria (too little urine)

• low serum osmolality (concentrated)

• cause Pulmonary and peripheral edema (cause crackles)

Thyroid Gland overview

TSH is responsible for 3 hormones

• T3 ( triiodothyronine ) and T4 (thyroxine): regulates metabolic activity

  • Relies on essential component (Iodine)

• Calcitonin: increase calcium movement from blood to bone (tone it).

Depends on Negative feedback

• Ex: if thyroid hormone is low, TSH increase secretion.

• Ex: calcitonin is regulated by negative feedback.

Hyperthyroidism Description

Characteristic:

• excessive T3 and T4 production that can commonly cause graves disease

• Thyroid Problem

Grave’s Disease

• autoimmune disorder with antibodies attacking TSH receptors and mimicking TSH to secrete more T3 and T4

Diagnose

• T4 high and TSH Low

Treatment

• Anti-thyroid meds to inhibit thyroid synthesis

• Surgery— thyroidectomy to remove mass

Hypothyroidism

Characteristic

• low thyroid problem

Etiology

• Hashimoto’s thyroiditis: an autoimmune disease in which autoantibodies directly destroy tissue → scarring, nonfunctional tissue

• endemic iodide deficiency

• If mother is iodide deficient, her fetus won’t develop properly and child is born with stunted mental and physical growth called “cretinism”

Diagnoses

• T4 low and TSH high

Treatment

• Synthetic thyroid medication—levothyroxine (Synthroid)

Hyperthyroidism S/S

Metabolism Overdrive

• patient is nervous, irritable and can be psychosis or hallucinations

Cardiovascular

• Tachycardia

Gastro Intestinal

• Increase appetite

• Stays thing and fatigue due to the disease

Exophthalmos

• Tissue building behind eyes (Googly eyes)

Alopacia: hair thins out and falls off

Sweating and warm skin (increase body temp > 98.6 F)

Goiter (large neck)

Thyroxic Crisis (Extreme Version stage)

• Circulatory: extreme tachycardia, heart failure, shock

• Neuro: extreme restlessness, agitation, delirium, seizure, coma.

Hypothyroidism S/S

Hypometabolic state

CNS

• Confusion and depression

• Sluggish, memory loss, slow speech/thinking.

Circulatory

• anemia, bradycardia, and decrease CO

Pulmonary

• dyspnea, hypoventilation, and CO2 retention

Gastro-intestinal

• decreased appetite, constipation

Hair is dry and brittle (Alopecia) or “bald spot”

Goiter

• Neck Swollen due to hyperplasia as compensatory response from autoimmune attack

Weight gain despite low appetite

decrease body temp and cold intolerance

Skin

• Myxedema: water trapped under skin looking puffy (coarse and dry)
  

Hypothyroidism Complication (extreme)

Myxedema coma

• Caused by infection, drug, exposure to cold, trauma

Signs and Symptoms

• sluggishness

• drowsiness

• sudden impaired consciousness

• hypotension

• hypoventilation

Hyperthyroidism complication (extreme)

Thyrotoxic Crisis

• Triggered by infection, trauma or surgery

Signs and Symptoms

• Neuro: extreme restlessness, agitation, delirium, seizures, coma

• Circulatory: severe tachycardia, heart failure, and shock.

Calcium Movement General Info

Parathyroid Hormone

• Largely responsible for calcium movement

• Stimulates resorption

Calcitonin