ENDOCRINE QUICK REVIEW
Endocrinology Quick Review
Adrenal Glands (corticosteroids, catecholamines)
Addison’s Disease
Patho: adrenal insufÏciency, hypocortisolism/hypoadrenalism.
S/S: fatigue, weakness, weight loss, anorexia, increased skin pigmentation, painful muscles/joints,
inability to cope with stress, cold intolerance, hyponatremia (crave salt), hyperkalemia (cardiac/muscular
effects)
Interventions: cortisol treatments for life.
What if it gets worse?
Addisonian crisis
Patho: medical emergency, cortisol levels become dangerously low, often triggered by infection or
stress.
S/S: hypotension, nausea, vomiting, fever, chills, skin rash
Interventions: immediate cortisol administration.
Cushing’s Syndrome
Patho: elevated cortisol levels, hypercortisolism/hyperadrenalism
S/S: weight gain, central obesity (abdominal gain), moon face, thin skin (fragile and easily
bruised/damaged), fatigue, muscle weakness and decreased muscle mass (particularly in extremities),
depression, anxiety, hypertension, hypernatremia (polydipsia), hypokalemia
Interventions: stop steroid medications, adrenalectomy (surgically remove adrenal glands)
Parathyroid Gland
Hyperparathyroidism
Patho: Excessive release of parathyroid hormone, Hypercalcemia cause by decalcification of bones due
to metabolic changes (body pulls calcium).
S/S: CNS effects (irritability, fatigue, confusion), kidney stone development, osteopenia/osteoporosis
(can lead to bone fractures)
Interventions: Pharmacological therapy (calcitonin, bisphosphonates), surgical resection of the
parathyroid
Page 1 of 7
Michael Grace, MSN, RN. Copyright 2023, All Rights Reserved
, ENDOCRINE QUICK REVIEW
Hypoparathyroidism
Patho: decreased production of parathyroid hormone leading to hypocalcemia, is a common
complication due to surgical injury post-thyroidectomy
S/S: muscle tetany, cramping, parasthesias, Chvostek’s sign/Trousseau’s sign
Interventions: Pharmacological (calcitriol, vitamin D, calcium gluconate), decrease intake of phosphorus.
Thyroid Gland (T3, T4 values)
Hyperthyroidism
Patho: Decreased TSH (Thyroid Stimulating Hormone) from the brain, excessive release of thyroid
hormones, Radioactive Iodine uptake test (diagnostic)
S/S: nervousness, anxiety, increased perspiration, heat intolerance, hyperactivity, and palpitations. Body
function changes (metabolism increases), weight loss, thyrotoxicosis (thyroid storm) is a possible
complication that is a medical emergency.
Interventions: Pharmacological therapies (such as methimazole, propylthiouracil, iodine), radioactive
iodine (results in ablation of thyroid & function), and surgical thyroidectomy
What if it gets worse?
Thyrotoxicosis (AKA thyrotoxic crisis)
Patho: a hypermetabolic condition due to excessive synthesis and secretion of thyroid hormones. Most
common type include diffuse toxic goiter (Graves disease), toxic multinodular goiter (Plummer disease),
and toxic adenoma. Most common cause is excessive intake of thyroid hormone medication or
temporary excess release of TH due to subacute thyroiditis.
S/S: tachycardia and/or atrial arrhythmia, systolic hypertension with wide pulse pressure,
warm/moist/smooth skin, lid lag, stare, hand tremor, muscle weakness, weight loss despite increased
appetite typically (though can gain weight if overeating), reduction of menstrual flow or oligomenorrhea.
NOTE: Some variations of presentation include: 1) younger patients tend to exhibit symptoms of
sympathetic activation (e.g., anxiety, hyperactivity, tremor), 2) older patients have more cardiovascular
symptoms (e.g., dyspnea, a-fib) and unexplained weight loss, 3) patients with Grave’s Disease often have
more marked symptoms than those with thyrotoxicosis from other causes, 4) Ophthalmopathy (e.g.,
periorbital edema, diplopia, or proptosis) and pretibial mysedema dermopathy specifically occur with
Graves disease, 5) elevated thyroid hormone elvels associated wih subacute thyroiditis may occur as part
of a post-viral syndrome ro within a year of the end of a pregnany.
Interventions: symptom relief, antithyroid hormone drugs, radioactive iodine-131, or thyroidectomy.
Thyrotoxicosis from subacute thyroiditis is temporary and self-resolving with symptomatic treatment.
What if it gets worse again?
Page 2 of 7
Michael Grace, MSN, RN. Copyright 2023, All Rights Reserved
Endocrinology Quick Review
Adrenal Glands (corticosteroids, catecholamines)
Addison’s Disease
Patho: adrenal insufÏciency, hypocortisolism/hypoadrenalism.
S/S: fatigue, weakness, weight loss, anorexia, increased skin pigmentation, painful muscles/joints,
inability to cope with stress, cold intolerance, hyponatremia (crave salt), hyperkalemia (cardiac/muscular
effects)
Interventions: cortisol treatments for life.
What if it gets worse?
Addisonian crisis
Patho: medical emergency, cortisol levels become dangerously low, often triggered by infection or
stress.
S/S: hypotension, nausea, vomiting, fever, chills, skin rash
Interventions: immediate cortisol administration.
Cushing’s Syndrome
Patho: elevated cortisol levels, hypercortisolism/hyperadrenalism
S/S: weight gain, central obesity (abdominal gain), moon face, thin skin (fragile and easily
bruised/damaged), fatigue, muscle weakness and decreased muscle mass (particularly in extremities),
depression, anxiety, hypertension, hypernatremia (polydipsia), hypokalemia
Interventions: stop steroid medications, adrenalectomy (surgically remove adrenal glands)
Parathyroid Gland
Hyperparathyroidism
Patho: Excessive release of parathyroid hormone, Hypercalcemia cause by decalcification of bones due
to metabolic changes (body pulls calcium).
S/S: CNS effects (irritability, fatigue, confusion), kidney stone development, osteopenia/osteoporosis
(can lead to bone fractures)
Interventions: Pharmacological therapy (calcitonin, bisphosphonates), surgical resection of the
parathyroid
Page 1 of 7
Michael Grace, MSN, RN. Copyright 2023, All Rights Reserved
, ENDOCRINE QUICK REVIEW
Hypoparathyroidism
Patho: decreased production of parathyroid hormone leading to hypocalcemia, is a common
complication due to surgical injury post-thyroidectomy
S/S: muscle tetany, cramping, parasthesias, Chvostek’s sign/Trousseau’s sign
Interventions: Pharmacological (calcitriol, vitamin D, calcium gluconate), decrease intake of phosphorus.
Thyroid Gland (T3, T4 values)
Hyperthyroidism
Patho: Decreased TSH (Thyroid Stimulating Hormone) from the brain, excessive release of thyroid
hormones, Radioactive Iodine uptake test (diagnostic)
S/S: nervousness, anxiety, increased perspiration, heat intolerance, hyperactivity, and palpitations. Body
function changes (metabolism increases), weight loss, thyrotoxicosis (thyroid storm) is a possible
complication that is a medical emergency.
Interventions: Pharmacological therapies (such as methimazole, propylthiouracil, iodine), radioactive
iodine (results in ablation of thyroid & function), and surgical thyroidectomy
What if it gets worse?
Thyrotoxicosis (AKA thyrotoxic crisis)
Patho: a hypermetabolic condition due to excessive synthesis and secretion of thyroid hormones. Most
common type include diffuse toxic goiter (Graves disease), toxic multinodular goiter (Plummer disease),
and toxic adenoma. Most common cause is excessive intake of thyroid hormone medication or
temporary excess release of TH due to subacute thyroiditis.
S/S: tachycardia and/or atrial arrhythmia, systolic hypertension with wide pulse pressure,
warm/moist/smooth skin, lid lag, stare, hand tremor, muscle weakness, weight loss despite increased
appetite typically (though can gain weight if overeating), reduction of menstrual flow or oligomenorrhea.
NOTE: Some variations of presentation include: 1) younger patients tend to exhibit symptoms of
sympathetic activation (e.g., anxiety, hyperactivity, tremor), 2) older patients have more cardiovascular
symptoms (e.g., dyspnea, a-fib) and unexplained weight loss, 3) patients with Grave’s Disease often have
more marked symptoms than those with thyrotoxicosis from other causes, 4) Ophthalmopathy (e.g.,
periorbital edema, diplopia, or proptosis) and pretibial mysedema dermopathy specifically occur with
Graves disease, 5) elevated thyroid hormone elvels associated wih subacute thyroiditis may occur as part
of a post-viral syndrome ro within a year of the end of a pregnany.
Interventions: symptom relief, antithyroid hormone drugs, radioactive iodine-131, or thyroidectomy.
Thyrotoxicosis from subacute thyroiditis is temporary and self-resolving with symptomatic treatment.
What if it gets worse again?
Page 2 of 7
Michael Grace, MSN, RN. Copyright 2023, All Rights Reserved
