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54 terms

Med Surg Endocrine Disorders

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bloodstream
endocrine glands secrete directly into ____________ to connect with targeted tissues
hypothalamus, pituitary, thyroid, parathyroid, adrenals, islets of pancreas, ovaries, testes
what are the glands of the endocrine system (8)
hypothalamus
this is part of the diencephalon - linked to the pituitary - regulates body temp, sexual behaviour, appetite, fluid balance, arousal, emotions
pituitary
this gland is connected to the hypothalamus - it is the "master gland" - produces 6 hormones and stores 2 of them
gh, tsh, acth, prolactin, fsh, lh
what hormones does the pituitary gland produce
adh, oxytocin
what hormones does the pituitary store
thyroid, reproductive organs, adrenal cortex
wha does the pituitary target
hyperpituitarism
this is usually associated with gh release - responsible for gigantism and acromegaly
acromegaly
this is an increased bone thickness and soft tissue hypertrophy due to hyperpituitarism
gigantism
this is exagerated growth of long bones prior to adulthood due to hyperpituitarism
gh secretion
treatment for hyperpituitarism is surgery or drug therapy to reduce ____ ____________
hypopituitarism
this causes short stature, delayed growth, delayed puberty - decreased or absent release of GH from pituitary gland - dwarfism tends to be more of a genetic link than pituitary link
thyroid
this gland is located below the larynx, anterior to the trachea - requires iodine to produce the hormones - regulates metabolism
thyroid
this gland is able to store hormones for up to 30 days - targets all body systems - regulates metabolism - disorders common in females and closely related to pituitary and hypothalamus
hyperthyroidism
with this the thyroid secretes too much thyroid hormone - increases body's overall metabolism
graves disease
with this autoantibodies circulate and stimulate hyper excretion of thyroid hormones - increases the body's sympathetic nervous system reaction - therefore increase metabolism and depletes the body's needed absorbed nutrition
a-fib, chf, cad, exopthalmos
with graves disease the pt will present with mild goiter, nervousness, mood swings, tremor, heat intolerance, weight loss with increased appetite, diaphoresis, diarrhea, heart palpations, muscle weakness, flushed skin, rapid pulse, polyuria, amenorrhea - potential detrimental effects are
radioactive iodine, surgery, anti thyroid drugs
what are the treatments for graves disease
hypothyroidism
this is a deficiency of thyroid hormone that results in decreased overall metabolism - either from decreased thyroid size/ hormone synthesis or from decreased stimulation of the thyroid gland due to a pituitary/hypothalamic disorder
hypothyroidism, hormone replacement
what is the most common thyroid disorder? what is the treatment?
cad, fibromyalgia, inflammatory arthritis
pt with hypo thyroidism can present with fatique, sensitivity to cold, fluid retention, forgetfulness, depression, dry skin, slowed pulse, tenosynovitis, muscle weakness and trigger points, goiter - possible detrimental effects include (4)
hashimotos disease
this is most common form of hypothyroidism - chronic thyroiditis - women have more often than men - it is an autoimmune disease that destroys the function of and enlarges the thyroid gland
tsh
hashimotos disease is caused by the pituitary gland secreting too much ______ - treatment is hormone replacement to reduce the release of this hormone
parathyroid
these are four small glands located behind the thyroid - regulates calcium and phosphate metabolism - it is not related to the pituitary or hypothalamus - targets the bone, kidneys, and intestines
hyperparathyroidism
this is high levels of pth in blood - causes calcium to leave bone and deposit kidneys, tendons, etc... - causes hyper calcemia - causes arrhythmias with forceful cardiac contractions, coma, lethargy, skeletal muscle weakness, constipation, vomiting, kidney stones, osteoporosis, arthralgia, tendonitis, hypercalcuria - requires surgery, drugs less effective
hypoparathyroidism
what causes hypo calcemia - low levels of pth in blood - causes axiety, confusion, seizures, arrhythmias, fatigue, paresthesia, hyperreflexia, muscle spasms/tetany
adrenal
these glands are located above kidneys - involved in hr & bp regulation, salt and potassium levels, metabolic functions (processing of carbs, proteins, fats)
addisons disease
this is due to primary adrenal insufficiency - a problem with the adrenal gland itself in that it doesn't release enough cortisol - idiopathic and autoimmune - used to be a complication after TB
addisons disease
the following are symptoms of what ? hypoglycemia, weakness, exhaustion, hypotension, weight loss from anorexia, vomiting, emotional changes, bronzing of skin
replinish fluids, electrolytes, glucose, cortisol, medication
what is the treatment for addisons disease
cushings disease
this is due to a secondary adrenal insufficiency - excess release of acth from the pituitary gland causes abnormal stimulation fo the adrenal gland - can happen after overdose of cortisols - symptoms include; htn, hyperglycemia, proximal muscle weakness, osteoporosis, protruding abdomen w stretch marks, poor wound healing, moon face
islets of langerhans
this performs both hormonal and digestive functions - located in right upper abdominal quadrant - responsible for glucose homeostasis, produces insulin - targets all major body systems
diabetes mellitus
this ia a chronic, systemic disorder that is triggered by hyperglycemia and incorrect metabolism fo fats, carbs, and proteins - caused by a defect in either the production or processing of insulin
glucosuria
this is when excess glucose is not absorbed by kidneys ,therefore excreted in urine
heart, eyes, kidneys, nerves, blood vessels
what parts of the body are commonly affected by diabetes mellitus
insulin dependent diabetes mellitus (iddm)
type 1 diabetes is also know as
insulin
with type 1 diabetes _________ production and secretion is affected
pancreas
_____________ produces insulin in the islet of langerhans
glycogen
insulin is a hormone that transports glucose to the cell to be used for energy and storage of ____________ - also stimulates protein synthesis and fat storage
peripheral neuropathy, loss of sight, ulcers, disorders of feet, amputation
it is important for type 1 patients to check glucose levels frequently, take insulin regularly - what are some common complications of type 1 diabetes
frequent urination, thirst, insatiable, weight loss, blurred vision, weakness, fatigue, dizziness
what are the clinical presentations of type 1 diabetes
80, 120
normal glucose is between ___ and ____ mg/dl
diabetic ketoacidosis
this is severe insulin deficiency - usually from an interruption in regular insulin administration schedule - treat as a medical emergency - present with high glucose (>300), dehydration, fruity acid breath, weak pulse, deep/rapid breathing, mild nausea, can lead to diabetic coma - can be a quick or gradual onset
non insulin dependent diabetes mellitus (type 2)
what does NIDDM stand for
type 2
this is adult onset - insulin is produced in pancreas but not effectively utilized by the body - commonly affects patients with obesity - at least 80% of all patients are obese and sedentary
type 1 diabetes
what patients would the following apply to - exercise causes blood glucose to drop - do not exercise your patient before eating or just after an injection
insulin injections, diet, regular excercise
what are the treatments for type 1 diabetes
headache, weakness, irritability, loss of coordination, psychosis, shaking, tachycardia
what are the indications of a hypoglycemic reaction - the treatment would be to give high carb food such as orange juice, hard candy, honey
glucose
type 2 diabetes can occur in obese children - insulin receptors are ineffective, therefore insulin does not accurately bring down ___________ levels and help with metabolism
atherosclerosis
chronic diabetes condition will increase
cad
diabetes increases risk of ________ between 1.5 to 4 times that of a non-diabetic individual
retinopathy
after 20 years with diabetes, almost all type 1 and >60% of all type 2 patients will develop diabetic _____________
esrd (end stage renal disease)
diabetes is leading cause of _____________ - requires dialysis or transplant
testosterone, progesterone, estrogen
the reproductive glands release what (3) - they affect growth and sexual maturity