| A | B |
|---|
| Decreased circulating hormone levels result in | Up regulation (increase in receptor sites) |
| What happens when the thyroid hormone in the body is too low? | 1) Hypothalamus releases TRH; 2) Pituitary releases TSH; 3) Thyroid releases T3 and T4; 4) Once levels increased the TRH and TSH are inhibited |
| What word is used to describe a deficiency in all pituitary hormones? | Panhypopituitarism |
| Increased hormone levels can cause | Down regulation (decrease in receptor sites) |
| In a patient with hypopituitarism, which hormone deficient is the most serious? | ACTH (the one that triggers the adrenal hormones) |
| Are most hormone levels regulated by positive or negative feedback? | Negative feedback |
| Growth hormone increases after puberty cause? | Acromegaly If it happens before puberty it can result in gigantism |
| What does the growth hormone do? | Increases protein synthesis; increases glucose levels; and increases fatty acid mobilization |
| Too much ADH result in? | SIADH (Syndrome of Inappropriate Antidiuretic Hormone (retention of water) |
| A hyposecretion of ADH results in? | Diabetes Insipidus (excessive loss of water and sodium) |
| If a patient loses too much water or too much blood what serious complication could result? | Hypovolemic Shock |
| Name the actions of the Thyroid Hormone | Increases metabolism; Increases protein synthesis; Increases reflexes; Increases GI motility |
| Why would a healthcare provider check for Thyroid Antibodies? | To access for autoimmune thyroid disease |
| Grave's disease is? | An autoimmune hyperthyroid disease |
| Hashimoto's Thyroiditis is? | Autoimmune hypothyroidism |
| If a patient has a low thyroid level what is the first thing that occurs? | The hypothalamus will release TRH |
| What is necessary for the synthesis of thyroid hormone? | Iodine |
| Does a goiter occur with hypothyroidism? Hyperthyroidism? or Both? | Both |
| Cretinism refers to? | Congenital hypothyroidism complications |
| What are the manifestations of hypothyroidism | Bradycardia, cold intolerance, weight gain, mental dullness, myxedema |
| What happens in Myxedematous Coma? | Decreased blood glucose; hypoventilation; hypothermia; lactic acidosis; cardiovascular collapse; coma |
| What are the manifestations of hyperthyroidism? | Tachycardia, heat intolerance, increased metabolism, weight loss |
| What is exophalamus? | Abnormal protrusion of the eyeball, sometimes seen in hyperthyroidism |
| Causes of Thyroid Storm | Infection, stress, trauma, manipulation of the thyroid gland |
| What are the manifestations of Thyroid Storm | Agitation, angina, delirium, increased temperature, heart failure, tachycardia, restlessness |
| Causes of Cushing's Syndrome | Pituitary tumor, long term steroid use, small cell oat cancer, adrenal cortex tumor, too much ACTH, too much glucocorticoids |
| In Cushing's Syndrome the blood glucose will be ___________ and the salt will be _____________ | Both will be increased |
| What causes a buffalo hump in Cushing's Syndrome? | Redistribution of fat |
| Why does a patient with Cushing's Syndrome have hypertension? | Sodium and water retention due to increased aldosterone (mineralocorticoid) |
| In Addison's Disease will the patient have to take medication for the rest of their life? | Yes, all adrenal cortex hormones will need replacement |
| Why does a patient with Addison's Disease have bronze color skin? | Due to the increased ACTH levels |
| What are some manifestations of Addison's Disease? | Fluid loss, hypotension, hyponatremia and hyperkalemia are all due to the lack of mineralocorticoid (aldosterone). Low blood glucose, poor tolerance to stress, weight loss, fatigue are all due to low glucocorticoid (cortisol) levels |
| Too much mineralocorticoid results in? | Increase sodium and water retention and hypokalemia |
| What is a Hemoglobin A1C? | A test that assesses for glucose control over a period of three months; it's represented as a % |
| Polyuria results from? | Osmotic diuresis |
| Polydipsia occurs when? | A patient is dehydrated |
| Why does a person in DKA have fruity breath? | Ketone production |
| What is glycosuria? | Glucose in the urine |
| Kussmaul respirations occur when? | They occur as a compensatory mechanism if the patient is in metabolic acidosis. |
| In DKA the blood glucose will be > _________. In HHNS/ HHNK the blood glucose will be > _____________. | DKA > 250 mg/ dL; HHNS/ HHNK > 600 mg/ dL |
| What usually precipitates DKA and HHNS/ HHNK? | Illness/ infection |
| Hot and dry ___________. Cold and clammy _____________. | Hot and dry sugar high (hyperglycemia). Cold and clammy give some candy (hypoglycemia) |
| What is release to decrease blood glucose levels? | Insulin from the beta cells of the pancreas |
| What is released to increased blood glucose levels, like in hypoglycemia? | Glucagon from alpha cells |
| A diabetic did not eat a snack before bedtime what could occur? | Somogyi Effect - blood glucose dropped in the middle of the night and glucagon was released; resulting in an elevated blood glucose in the am |
| Acute complications of DM | DKA, HHNK/HHNS, Somogyi Effect, Dawn Phenomenon |
| Chronic complications of DM | Neuropathy, Nephropathy, Diabetic Retinopathy, Ischemic brain attack, PAD, CAD, foot ulcers, infections |
