NURS 642 Exam 3 Endocrine Exam Questions and Verified Answers/Accurate Solutions|
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What are the signs and symptoms of adrenal crisis? The main presenting problem is shock
But there also may be other nonspecific symptoms like nausea, vomiting, decreased appetite,
abdominal pain, fatigue, fever, confusion, weakness or lethargy
what are the precipitating factors for adrenal crisis ? - Deficiencies in mineralocorticoids and
glucocorticoids
- Acute stress or serious infection in patients with primary adrenal insufficiency
- Insufficient doses of glucocorticoid/mineralocorticoid in those with adrenal insufficiency
- Acute destruction of adrenal gland secondary to hemorrhage of adrenal infarction
- Secondary cause due to abrupt cessation of glucocorticoid
Common feature of primary adrenal insufficiency? Fatigue
Weight loss
N/V abdominal pain
Muscle and joint pain
Skin hyperpigmentation
Postural hypotension
Salt craving
Hyponatremia
Hyperkalemia
Anemia
Thyroiditis? -inflammation of the thyroid gland
-autoimmune (hashimoto's) most common
-high antithyroperoxidase or antithyroglobulin
-often progresses to hypothyroidism
,- elevated ESR, leukocytosis, fever (infectious)
-middle age or older women
-common in hepatitis C
-dietary iodine supplements increase risk of developing
-lithium, amiodarone, thalidomide can trigger it
-painful subacute thyroiditis occurs after viral URI (low antithyroid antibodies, painful large
thyroid, dysphagia)
-low TSH and elevated T4
-US shows diffuse heterogenous density with reduced echogenicity
-low uptake with radioiodine (subacute)
-uneven or high uptake with radioiodine (hashimoto)
Hypothyroidism? *under activity of the thyroid gland
*causes:
-thyroid gland failure
-thyroid resection
-pituitary deficiency of TSH
-Hashimoto's is the most common cause
-medications
-high iodine intake
-malignancies "consumptive hypothyroidism"
-Hep C
*clinical findings and symptoms
- Goiter may be present
- wt gain, fatigue, lethargy, depression, weakness, myalgia, exertional dyspnea, cramps,
constipation, dry skin, headache, paresthesia, cold intolerance, carpal tunnel, Raynaud, thin
brittle nails, hair thinning, edema, puffy face and eyelids, skin pallor or yellowing
, - bradycardia
- diastolic HTN
- delayed DTR
*Labs
- Primary (high TSH, normal to low FT4, anemia with normal to elevated MCV, hypoglycemia
can occur, hyponatremia is common)
- subclinical (high TSH, normal FT4, more common age >65)
- Euthyroid sick syndrome (normal TSH with low FT4, seen with surgery, severe illness, calorie
deprivation, major surgery)
What medications can lead to hypothyroidism? - Amiodarone (can also cause thyrotoxicosis
and will have low to normal T4 with high TSH)
- Lithium
- Sulfa
- PPU, methimazole
- interferon alpha, beta
- interleukin 2
- prolonged dopamine infusion
Complications of hypothyroidism? -susceptibility to bacterial pneumonia (severe)
-megacolon
-psychosis with paranoid delusions
-adrenal crisis (precipitated by thyroid therapy)
-infertility and miscarriage if untreated
-pre-existing CAD and HF may be exacerbated by levothyroxine
-myxedema crisis
Already Graded A+
What are the signs and symptoms of adrenal crisis? The main presenting problem is shock
But there also may be other nonspecific symptoms like nausea, vomiting, decreased appetite,
abdominal pain, fatigue, fever, confusion, weakness or lethargy
what are the precipitating factors for adrenal crisis ? - Deficiencies in mineralocorticoids and
glucocorticoids
- Acute stress or serious infection in patients with primary adrenal insufficiency
- Insufficient doses of glucocorticoid/mineralocorticoid in those with adrenal insufficiency
- Acute destruction of adrenal gland secondary to hemorrhage of adrenal infarction
- Secondary cause due to abrupt cessation of glucocorticoid
Common feature of primary adrenal insufficiency? Fatigue
Weight loss
N/V abdominal pain
Muscle and joint pain
Skin hyperpigmentation
Postural hypotension
Salt craving
Hyponatremia
Hyperkalemia
Anemia
Thyroiditis? -inflammation of the thyroid gland
-autoimmune (hashimoto's) most common
-high antithyroperoxidase or antithyroglobulin
-often progresses to hypothyroidism
,- elevated ESR, leukocytosis, fever (infectious)
-middle age or older women
-common in hepatitis C
-dietary iodine supplements increase risk of developing
-lithium, amiodarone, thalidomide can trigger it
-painful subacute thyroiditis occurs after viral URI (low antithyroid antibodies, painful large
thyroid, dysphagia)
-low TSH and elevated T4
-US shows diffuse heterogenous density with reduced echogenicity
-low uptake with radioiodine (subacute)
-uneven or high uptake with radioiodine (hashimoto)
Hypothyroidism? *under activity of the thyroid gland
*causes:
-thyroid gland failure
-thyroid resection
-pituitary deficiency of TSH
-Hashimoto's is the most common cause
-medications
-high iodine intake
-malignancies "consumptive hypothyroidism"
-Hep C
*clinical findings and symptoms
- Goiter may be present
- wt gain, fatigue, lethargy, depression, weakness, myalgia, exertional dyspnea, cramps,
constipation, dry skin, headache, paresthesia, cold intolerance, carpal tunnel, Raynaud, thin
brittle nails, hair thinning, edema, puffy face and eyelids, skin pallor or yellowing
, - bradycardia
- diastolic HTN
- delayed DTR
*Labs
- Primary (high TSH, normal to low FT4, anemia with normal to elevated MCV, hypoglycemia
can occur, hyponatremia is common)
- subclinical (high TSH, normal FT4, more common age >65)
- Euthyroid sick syndrome (normal TSH with low FT4, seen with surgery, severe illness, calorie
deprivation, major surgery)
What medications can lead to hypothyroidism? - Amiodarone (can also cause thyrotoxicosis
and will have low to normal T4 with high TSH)
- Lithium
- Sulfa
- PPU, methimazole
- interferon alpha, beta
- interleukin 2
- prolonged dopamine infusion
Complications of hypothyroidism? -susceptibility to bacterial pneumonia (severe)
-megacolon
-psychosis with paranoid delusions
-adrenal crisis (precipitated by thyroid therapy)
-infertility and miscarriage if untreated
-pre-existing CAD and HF may be exacerbated by levothyroxine
-myxedema crisis
