Endocrinology: Notes

Question 1

Type I Diabetes Mellitus

Answer 1

Usually caused by no insulin production and has a very early onset.

Question 2

Type II Diabetes Mellitus

Answer 2

Caused by decreased production of insulin/ often that combined with poor responsiveness to insulin produced.
Obesity plays large role

Question 3

Graves’ Disease

Answer 3

Strongly Hereditary
Six times more common in women than men
Autoantibodies are generated that stimulate the thyroid gland to produce excessive amounts of thyroid hormones.
Signs and Symptoms:
Agitation
Emotional Changeability
Insomnia
Poor heat tolerance
Weight Loss despite increased appetite
Weakness
Dyspnea
Tachycardia
A-fib in older pts
Treatment
B-adrenergic blockers for cardiac stress if present
Glucocorticoid therapy (dexamethasone) reducing the level of T4.

Question 4

Thyroid Storm

Answer 4

Signs and Symptoms:
Fever of 106 F
Irritability
Delirium
Com
Tachycardia
Hypotension
Vomiting
Diarrhea
Less serious signs- slight fever and marked lethargy
Treatment:
O2
Fluid Resuscitation if needed
Cardiac monitoring
Glucocorticoid and B-adrenergic blockers

Question 5

Myxedema

Answer 5

Thickening of connective tissue in the skin and other tissues, including the heart. Long term exposure to inadequate levels of thyroid hormones.
Signs and symptoms:
Fatigue
Slowed mental function
Lethargy
Cold Intolerance
Constipation
Decreased appetite with increased weight 
Puffy face
Thinned hair
Enlarged tongue
Pale, cool skin
Hypothermia
Low amplitude bradycardia
CO2 retention.
Treatment: 
Focus on ABC's
Cardiac and Pulmonary Monitoring
Intubation is often necessary
IV Access- but limit fluids

Question 6

Cushing’s Syndrome (Hyperadrenalism)

Answer 6

Disorder of Adrenal Glands- excess cortisol
Hypertension
Hypokalemia
Weight Gain- Especially in trunk of body, face, and neck
Fat accumulation on upper back
Skin- thinning, almost transparent
Facial Hair among women
Mood swings
Impaired memory or concentration

Question 7

Addison’s Disease

Answer 7

Form of shock associated with adrenocortical insufficiency and characterized by profound hypotension and electrolyte imbalances
Sighs and Symptoms:
Weakness
Fatigue
Decreased Appetite and weight loss
Hyperpigmentation of skin and mucous membrane
Treatment:
Monitor cardiac and resp. function
If hypoglycemic give D50W