Ch 38 and 39 by Melissa Robertson

Growth Hormone Disorders

mrobertson082 — 2024-02-15 22:29:07 UTC

Acromegaly - gigantism (in childhood), nose, jaw, bone enlargement, happens over time/progressive, intolerance to carbs so increase glucose diagnostics - GH response to oral glucose tx -Hypophysectomy, meds to block GH

Short stature - grow to 3 or 4 feet; diagnostics - GH response to induced hypoglycemia; tx - synthetic GH

Hormones

mrobertson082 — 2024-02-15 22:29:10 UTC

ADH - Antidiuretic hormone; retains more water

TSH - produced in the anterior pituitary; thyroid stimulating hormone

Parathyroid hormone - regulates Ca+; in parathyroid glands on the back of the thyroid

T3, T4 - thyroid hormones; 3 and 4 indicate the number of iodine atoms

Calcitonin - In thyroid; targets bone tissue, for growth of bones

Glucagon - Pancreas; conversion from glycogen to glucose in the liver; made by alpha cells

Insulin - transport glucose to the cell to be used for fuel; made in pancreas by Beta cells

DI vs SIADH

mrobertson082 — 2024-02-15 22:29:12 UTC

DI - too little ADH; increased UOP - 3 to 15 L per day; DEHYDRATION - poor skin turgor, extreme thirst (polydipsia), diagnostic - water deprivation test; labs affected - urine specific gravity, SODIUM (high - above 145); Tx - hypotonic solutions IV, vasopressin (synthetic ADH)

SIADH - too much ADH; water retention; hyponatremia (below 135); weight gain, muscle cramps, seizures. Tx - fluid restriction, hypertonic IV solutions, surgical removal of tumor, lasix

Hypophysectomy

mrobertson082 — 2024-02-15 22:29:14 UTC

Removal of pituitary gland

Pre op - Baseline neuro assessment; Teach after care (related to pressure in nose) and dressing

Post op - clear and watery drainage on dressing not ok, call MD. Want bloody, mucous drainage. Semi fowlers positions, No nose blowing, coughing, sneezing, straining of any kind. Monitor for frequent urination and thirst

Hypo vs hyper thyroid

mrobertson082 — 2024-02-15 22:29:16 UTC

Hypothyroid - fatigue, bradycardia, weight gain; tx - synthroid; myxedema coma

Hyperthyroid - weight loss, diarrhea, tachyardia; thyroid storm; tx - tapozole, thyroidectomy, radioactive iodine, beta blockers

Goiters - enlarged thyroid gland

Graves disease - exopthalmos

Addisons vs Cushings

mrobertson082 — 2024-02-15 22:29:18 UTC

Addisons - low cortisol, hypotension, bronze skin, weakness and fatique; dx - ACTH stimulation test; tx - glucocorticoids and minerocorticoids lifelong; addisons crisis triple or double doses during stress to avoid crisus

Cushings - high cortisol, weight gain with obesity in trunk but thin extremities, moon face and buffalo hump; dx - dexamethasone suppression test; tx - Meds, low sodium high potassium diet