NURS 5463 LATEST COMPREHENSIVE EXAMINERS
QUESTIONS AND ANSWERS SURE A+
✔✔Cushing Disorder: Diagnosing - ✔✔- 24 hour urine cortisol level
- Saliva cortisol in the evening
- Dexamethasone suppression test
- MRI/CT for pituitary tumor
✔✔Cushing Disorder: Treatment - ✔✔- Manage HTN and DM
- Lowest dose of exogenous steroids
- Surgery for tumors
✔✔Thyroid Storm: Signs & Symptoms - ✔✔- Fever
- Profuse sweating
- GI symptoms (Nausea/vomiting, diarrhea, abdominal pain, jaundice)
- Neurological symptoms (Anxiety, psychosis, agitation, seizures, coma)
- Cardiac symptoms (Tachycardia, arrhythmias, CHF, hypo/hypertension)
- Goiter, thyroid nodules, thyroid enlargement
*Think HYPER metabolic state*
✔✔Thyroid storm: Diagnosing - ✔✔- Based on clinical features
- Low TSH
, - CBC (Mild leukocytosis)
- T3, T4 elevated
- Elevated LFTs
- Hyperglycemia
- Hypercalcemia
- EKG
- Chest x-ray
✔✔Thyroid Storm: Treatment - ✔✔- Suppression of thyroid hormone synthesis
- Preventing T3, T4 release
- IV fluid resuscitation with D5
- Correct electrolyte abnormalities
- Decrease core temp
- Antiadrenergic drugs such as propranolol, atenolol, metoprolol
- Thionamides (PTU, or methimazole)
- Iodine compounds
- Bile acid sequestrants
✔✔Myxedema Coma: Signs & Symptoms - ✔✔- Hypothermia
- Bradycardia, QT prolongation
- Hypotension
- Hypoventilation, congestion, pleural effusions
- Distended abdomen, absent bowel sounds, ileus
- Delayed reflexed
- Cold, nonpitting edema of the hands and feet
- Lethargy, somnolence, confusion
- Seizures
- Goiter
✔✔Myxedema Coma: Diagnosing - ✔✔- TSH elevated
- T3 T4 low or undetectable
- Elevated creatinine
- Hypoglycemia
- EKG
- Chest x-ray
- ABG
✔✔Myxedema Coma: Treatment - ✔✔- IV thyroid replacement
- Pulse dose steroids if adrenal is suspected
- Passive rewarming
- Treat infection
- Electrolyte balance
- Fluid resuscitation with D5 containing fluid
✔✔SIADH: Signs & Symptoms - ✔✔- Hyponatremia
- Nausea
QUESTIONS AND ANSWERS SURE A+
✔✔Cushing Disorder: Diagnosing - ✔✔- 24 hour urine cortisol level
- Saliva cortisol in the evening
- Dexamethasone suppression test
- MRI/CT for pituitary tumor
✔✔Cushing Disorder: Treatment - ✔✔- Manage HTN and DM
- Lowest dose of exogenous steroids
- Surgery for tumors
✔✔Thyroid Storm: Signs & Symptoms - ✔✔- Fever
- Profuse sweating
- GI symptoms (Nausea/vomiting, diarrhea, abdominal pain, jaundice)
- Neurological symptoms (Anxiety, psychosis, agitation, seizures, coma)
- Cardiac symptoms (Tachycardia, arrhythmias, CHF, hypo/hypertension)
- Goiter, thyroid nodules, thyroid enlargement
*Think HYPER metabolic state*
✔✔Thyroid storm: Diagnosing - ✔✔- Based on clinical features
- Low TSH
, - CBC (Mild leukocytosis)
- T3, T4 elevated
- Elevated LFTs
- Hyperglycemia
- Hypercalcemia
- EKG
- Chest x-ray
✔✔Thyroid Storm: Treatment - ✔✔- Suppression of thyroid hormone synthesis
- Preventing T3, T4 release
- IV fluid resuscitation with D5
- Correct electrolyte abnormalities
- Decrease core temp
- Antiadrenergic drugs such as propranolol, atenolol, metoprolol
- Thionamides (PTU, or methimazole)
- Iodine compounds
- Bile acid sequestrants
✔✔Myxedema Coma: Signs & Symptoms - ✔✔- Hypothermia
- Bradycardia, QT prolongation
- Hypotension
- Hypoventilation, congestion, pleural effusions
- Distended abdomen, absent bowel sounds, ileus
- Delayed reflexed
- Cold, nonpitting edema of the hands and feet
- Lethargy, somnolence, confusion
- Seizures
- Goiter
✔✔Myxedema Coma: Diagnosing - ✔✔- TSH elevated
- T3 T4 low or undetectable
- Elevated creatinine
- Hypoglycemia
- EKG
- Chest x-ray
- ABG
✔✔Myxedema Coma: Treatment - ✔✔- IV thyroid replacement
- Pulse dose steroids if adrenal is suspected
- Passive rewarming
- Treat infection
- Electrolyte balance
- Fluid resuscitation with D5 containing fluid
✔✔SIADH: Signs & Symptoms - ✔✔- Hyponatremia
- Nausea
