Mvu Nurs 623 Exam 2 Questions With
Answers
Common endocrine problems - ANSWER- Hirsutism
Alopecia
Gynecomastia
Increased neck mass
Polydipsia
Polyphagia
Polyuria
Unexplaned weight gain/loss
Organize endocrine disorders - ANSWER- Glandular Disorders
Thyroid
parathyroid
pituatary
adrenal
Diabetes
DM1
DM@
hypoglycemia
Metabolic disorders
Obesity
Gout
Pituatary gland - ANSWER- the endocrine system's most influential gland. Under the
influence of the hypothalamus, it regulates growth and controls other endocrine glands.
When thyroid hormone levels in the blood are low, the pituitary releases more TSH.
When thyroid hormone levels are high, the pituitary decreases TSH production.
When theres a problem in the pituatary you will see tsh and T4 both down.
How to differentiate hypothyroid and hyperthyroidism. - ANSWER- What differentiates
one from the other
•Causes
•Clinical presentation
•Diagnostic tests
•Treatment
,Hyperthyroidism - ANSWER- •Excess secretion & synthesis of one or both: Thyroxine
(t4)
triiodothroinine (t3)
Long term effects without treatment:
Heart disease
osteoporosis
Mental disease
infertility
Hyperthyroidism clinical findings - ANSWER- "Hot/buldging/fast"
-intolerance to heat
-thin fine hair
-bulging eyes (exopthalmus)
-thryomegaly
-tachycardia
-HTN
-weight loss
-Tremors.
-pretibial myxedema (thickening of skin on shins usually)
-decreased visual acuity
-photophobia.
Hypothyroid clinical manifestations - ANSWER- "cold/slow/tired"
-Intolerance to cold, coarse hair/ hair loss, extreme -fatigue, lethargy, slow speech,
constipation, brittle -hair/ nails.
-High TSH
-Low free T4 levels
-Once confirmed diagnosis of hypothyroidism, -thyroid peroxidase antibody (TPO) to
confirm
-Hashimoto's thyroiditis (gold standard for diagnosis of Hashimoto's)
hyperthyroidism causes - ANSWER- Graves disease (diffuse toxic goiter) is most
common. Subacute or painless thyroiditis. Toxic nodular goiter. Factitious
hyperthyroidism.
Hypothyroidism causes - ANSWER- Hashimoto thyroiditis (90% of cases)
Subacute painless lymphocytic thyroiditis
Hypopituitarism, iodine deficiency, enzyme deficiency
Drugs: Amiodarone, lithium, sulfonamides, phenylbutazone
Hypothalamic dysfunction/hypopituitarism
Diagnostic tests for thyroid problems - ANSWER- TSH
, Free T 4
- meds can alter labs: Steroids, adrogens, estrogens, salicylates, heparine, iodine
containing coumpounds.
If Ft4 normal, then do FT3
Also do CBC and LFT
Further testing after initial thyroid testing - ANSWER- TSH receptor antibody
Nuc med scan
24 hour iodine uptake
ultrasound
fine needle biopsy
Hyperthyroid (graves disease) Labs
TSH level would be __
T3/T4 would be ___ - ANSWER- TSH would be low
Serum free T3 and T4 would be elevated.
Remember the knocking on the door analogy:
the pituitary gland recognizes that the t3 and t4 are elevated, so it will not send anyone
to knock on the thyroids door to increase it (aka will not send out any more TSH)
Hypothyroidism (hashimotos's) labs
TSH level would be __
T3/T4 would be ___ - ANSWER- TSH level is high
T3& T4 are low.
This is because the TSH is trying to get the thyroid to produce more T3 and T4, but the
thyroid cant. Hence the patient will need synthetic T4. (synthroid)
Pituitary abnormality labs
TSH would be
and T3/T4 would be - ANSWER- TSH would be elevated
T3/T4 would also be elevated
This is how you know its the pituitary because the negative feedback system is failing.
Treatment of hyperthyroidism - ANSWER- TREATMENT: Hyperthyroidism
First treat patients symptoms (potentially beta blockers)
Then:
●Anti-Thyroid Medications: Importance for timely dosing and Side effect of drowsiness
● Methimazole
Answers
Common endocrine problems - ANSWER- Hirsutism
Alopecia
Gynecomastia
Increased neck mass
Polydipsia
Polyphagia
Polyuria
Unexplaned weight gain/loss
Organize endocrine disorders - ANSWER- Glandular Disorders
Thyroid
parathyroid
pituatary
adrenal
Diabetes
DM1
DM@
hypoglycemia
Metabolic disorders
Obesity
Gout
Pituatary gland - ANSWER- the endocrine system's most influential gland. Under the
influence of the hypothalamus, it regulates growth and controls other endocrine glands.
When thyroid hormone levels in the blood are low, the pituitary releases more TSH.
When thyroid hormone levels are high, the pituitary decreases TSH production.
When theres a problem in the pituatary you will see tsh and T4 both down.
How to differentiate hypothyroid and hyperthyroidism. - ANSWER- What differentiates
one from the other
•Causes
•Clinical presentation
•Diagnostic tests
•Treatment
,Hyperthyroidism - ANSWER- •Excess secretion & synthesis of one or both: Thyroxine
(t4)
triiodothroinine (t3)
Long term effects without treatment:
Heart disease
osteoporosis
Mental disease
infertility
Hyperthyroidism clinical findings - ANSWER- "Hot/buldging/fast"
-intolerance to heat
-thin fine hair
-bulging eyes (exopthalmus)
-thryomegaly
-tachycardia
-HTN
-weight loss
-Tremors.
-pretibial myxedema (thickening of skin on shins usually)
-decreased visual acuity
-photophobia.
Hypothyroid clinical manifestations - ANSWER- "cold/slow/tired"
-Intolerance to cold, coarse hair/ hair loss, extreme -fatigue, lethargy, slow speech,
constipation, brittle -hair/ nails.
-High TSH
-Low free T4 levels
-Once confirmed diagnosis of hypothyroidism, -thyroid peroxidase antibody (TPO) to
confirm
-Hashimoto's thyroiditis (gold standard for diagnosis of Hashimoto's)
hyperthyroidism causes - ANSWER- Graves disease (diffuse toxic goiter) is most
common. Subacute or painless thyroiditis. Toxic nodular goiter. Factitious
hyperthyroidism.
Hypothyroidism causes - ANSWER- Hashimoto thyroiditis (90% of cases)
Subacute painless lymphocytic thyroiditis
Hypopituitarism, iodine deficiency, enzyme deficiency
Drugs: Amiodarone, lithium, sulfonamides, phenylbutazone
Hypothalamic dysfunction/hypopituitarism
Diagnostic tests for thyroid problems - ANSWER- TSH
, Free T 4
- meds can alter labs: Steroids, adrogens, estrogens, salicylates, heparine, iodine
containing coumpounds.
If Ft4 normal, then do FT3
Also do CBC and LFT
Further testing after initial thyroid testing - ANSWER- TSH receptor antibody
Nuc med scan
24 hour iodine uptake
ultrasound
fine needle biopsy
Hyperthyroid (graves disease) Labs
TSH level would be __
T3/T4 would be ___ - ANSWER- TSH would be low
Serum free T3 and T4 would be elevated.
Remember the knocking on the door analogy:
the pituitary gland recognizes that the t3 and t4 are elevated, so it will not send anyone
to knock on the thyroids door to increase it (aka will not send out any more TSH)
Hypothyroidism (hashimotos's) labs
TSH level would be __
T3/T4 would be ___ - ANSWER- TSH level is high
T3& T4 are low.
This is because the TSH is trying to get the thyroid to produce more T3 and T4, but the
thyroid cant. Hence the patient will need synthetic T4. (synthroid)
Pituitary abnormality labs
TSH would be
and T3/T4 would be - ANSWER- TSH would be elevated
T3/T4 would also be elevated
This is how you know its the pituitary because the negative feedback system is failing.
Treatment of hyperthyroidism - ANSWER- TREATMENT: Hyperthyroidism
First treat patients symptoms (potentially beta blockers)
Then:
●Anti-Thyroid Medications: Importance for timely dosing and Side effect of drowsiness
● Methimazole
