| What are the early signs of hypothyroidism? | Weight gain, difficulty concentrating, constipation, fluid/weight gain |
| Mood swings, depression, infertility, and acute fatigue syndrome are late signs of ______ | Hypothyroidism |
| What would assessment of the hair and skin of a patient with hypothyroidism reveal? | Hair that is thin and falling out
Thickened skin |
| Hormone replacement therapy using dissected animal thyroid, T4, and levothyroxine therapy are used to treat _________ | Hypothyroidism |
| What kind of agents are preferred over biologic agents to treat hypothyroidism? | Synthetic agents |
| What time of the day are drugs used to treat hypothyroidism administered? | In the morning |
| How should levothyroxine be taken? | On an empty stomach |
| What temperature should the room be set to for a patient with hypothyroidism? | 70-74 F |
| A patient with hypothyroidism needs an adequate intake of iodine found in foods such as: | Salt water fish
Eggs
Milk |
| A simple goiter develops when the thyroid gland enlarges in response to: | Low iodine levels in the bloodstream |
| In a patient with a simple goiter, what accumulates in the thyroid follicles, causing them to enlarge? | Thyroglobulin (colloid) |
| How is a simple goiter diagnosed? | By physical appearance |
| ______ solution is an antihyperthyroid agent, used in conjunction with other medications to decrease or shrink the thyroid gland | Lugol's solution |
| What is the medical treatment of a simple goiter? | Oral administration of potassium iodine and foods high in iodine |
| How many people in the US are affected by cancer of the thyroid each year? | 25 per 1 million |
| What is the principal clinical manifestation of thyroid cancer? | Firm, fixed, small, rounded, painless mass |
| What is suspected when a thyroid scan shows a "cold" nodule? | Papillary thyroid cancer |
| When a patient has thyroid cancer, thyroid function tests usually yield ______ results | Normal |
| What is the treatment of thyroid cancer? | Total thyroidectomy with lifelong hormone replacement |
| Hyperparathyroidism usually occurs in adults between which ages? | 30 - 70 |
| What is the primary clinical manifestation of hyperparathyroidism? | Hypercalcemia |
| Hypercalcemia occurs as calcium _____ the bones, and accumulates in the _______ | Leaves the bones and accumulates in the bloodstream |
| A fractured bone, unrelated to trauma may be the first presentation of which illness? | Hyperparathyroidism |
| Which blood levels are increased in a patient with hyperparathyroidism? | PTH
Alkaline phosphate |
| What will a radiographic examination reveal in a person with hyperparathyroidism? | Skeletal decalcification |
| In hyperparathyroidism, serum ______ levels are elevated whereas _______ levels are decreased. | Calcium levels are elevated, serum phosphorus levels are decreased |
| What is the diuretic of choice in treating a patient with hyperparathyroidism? | Furosemide |
| Why are thiazide diuretics contraindicated in a patient with hyperparathyroidism? | They decrease renal excretion of calcium- increased hypercalcemic state |
| Some diuretics, and lithium can _____ the serum calcium level. | Elevate |
| Hypoparathyroidism occurs when there is decreased _____, resulting in decreased levels of serum calcium | PTH |
| Decreased PTH in the bloodstream causes increased _______, and decreased ________ | Increased serum phosphorus, decreased calcium |
| A patient with hypoparathyroidism will have signs and symptoms of ________, do to lack of serum calcium | Hypocalcemia |
| Why should calcium gluconate and calcium chloride be given slowly? | These drugs irritate the vessel wall |
| At what rate should calcium gluconate be given? | 1mL/min |
| Which drug interferes with normal parathyroid functioning? | Cimetidine (Tagamet) |
| What is the preferred vitamin D supplement prescribed for a patient with hypoparathyroidism experiencing chronic and resistant hypocalcemia? | Calcitroil (Rocaltrol) |
| How much calcium should a patient with hypoparathyroidism consume daily? | 1200mg/day |
| A patient with hypoparathyroidism should consume a diet low in ________ | Phosphorus |
| Cushing's syndrome is caused by excess _______ | Corticosteroids; particularly glucocorticoids |
| Moon face and buffalo hump are signs and symptoms associated with which syndrome? | Cushing's syndrome |
| What is the most common feature of Cushing's syndrome? | Weight gain |
| Hypokalemia is usually present in a patient with _____________. | Cushing's syndrome |
| Why does hyperglycemia occur in a patient with Cushing's syndrome? | Glucose intolerance and increased glucose release by the liver |
| If the patient cannot undergo surgery, what kind of therapy may be used to treat Cushing's syndrome? | Mitotane (Lysodren) therapy |
| Tuberculosis causes _______ worldwide. | Addison's disease |
| What is the most common cause of Addison's disease? | Autoimmune response |
| Adrenal hypofunction is also called _______. | Addison's disease |
| Adrenal insufficiency occurs most often in which ages? | Younger than 60 |
| Clinical manifestations of Addison's disease are not evident until __% of the adrenal cortex is destroyed | 90% |
| A life-threatening emergency caused by insufficient adrenocortical hormones is called ______ | Addisonian crisis |
| Decreased serum sodium, increased serum potassium, and decreased serum glucose are lab values associated with ____________. | Addison's disease |
| What is the most common form of hormone replacement therapy for a patient with Addison's disease? | Hydrocortisone |
| Management of an addisonian crisis includes hydrocortisone therapy, and 0.9% _____ and 5% _____. | 0.9% saline, 5% Dextrose |
| What occurs when the adrenal glands do not secrete adequate amounts of glucocorticoids, mineralocorticoids, and androgens? | Adrenocortical insufficiency- Addison's disease |
| The patient with Addison's disease should carry an emergency kit with ___mg of _______. | 100 mg of hydrocortisone |
| A rare tumor of the adrenal medulla that causes excessive secretion of catecholamine is called a _________. | Pheochromocytoma |
| Secretion of excessive catecholamine results in severe __________. | Hypertension |
| During hypertensive crisis. the blood pressure may fluctuate as high as _____. | 300/175 mm Hg |
| What is the simplest and most reliable test for pheochromocytoma? | 24 hour urine collection |
| Which drug is used for patients with pheochromocytoma to help inhibit catecholamine production and must be continued if the tumor is inoperable? | Metyrosine (Demser) |
| If pheochromocytoma is left untreated, it may lead to which 3 conditions? | Diabetes mellitus
Cardiomyopathy
Death |
| Insulin is a _____ that allows the body's cells to absorb glucose from the bloodstream | Protein |
| What is the average about of insulin secreted in an adult? | 40 to 50 unites every 24 hrs |
| What is the value for a normal blood glucose level? | Between 70 and 100 mg/dl |
| Within ____ years of the diagnosis of Type 1 Diabetes, all of the beta cells have been destroyed and no insulin is produced | 5 years |
| What is the main problem in Type 2 diabetes? | Abnormal resistance to insulin action |
| What are the two reasons a patient with diabetes (elevated blood glucose) is at risk for infection? | 1. Increased amount of glucose is a food source for pathogens
2. Circulatory and nervous system complications |
| Signs and symptoms of type 1 diabetes often occur under the age of ___ | 30 |
| What are the three poly's of type 1 diabetes? | Polydipsia
Polyuria
Polyphagia |
| What causes the patient with type 1 diabetes to lose weight? | The body burns fat and protein instead of glucose for energy |
| During exercise, the muscles use glucose even if _______ is not available | Insulin |
| Glucose is stored in the form of glycogen in the _____ | Liver |
| Abnormal amounts of glucose are excreted in the ______ | Urine |
| HbA1C can determine the patient's average blood glucose levels over the past _____ days | 120 (3 months) |
| When should a diabetic patient test their blood glucose levels if receiving two or more injections of insulin per day? | Before meals and at bedtime |
| A diabetic patient should maintain near normal blood glucose levels of: | 60 - 99 mg/dl |
| HbA1C levels should be ______ | 4% - 6% |
| Exercise _____ the absorption rate of glucose | Increases |
| What is necessary before exercise if the patients blood glucose level is less than 100 mg/dl? | Carbohydrate snack |
| When should a type 2 diabetes patient discontinue oral antidiabetic medication before surgery? | 48 hours before surgery |
| When is Glargine (Lantus) taken? | Once a day at bedtime |
| What kind of insulin is "peakless" and works around the clock for 24 hours? | Glargine (Lantus) |
| What is the only kind of insulin that can be administered intravenously? | Regular insulin |
| What kind of insulin is Lispro (Humalog)? | Rapid-acting |
| When do rapid-acting insulins peak? | 10-30 min |
| 100 U syringes are marked in ____ increments | 2-unit increments |
| Insulin needles are very fine, ___ to ___ gauge | 25 - 32 gauge |
| Insulin should be administered at what temperature? | Room temperature |
| List the best sites for insulin injection in order, starting with the most preferred site: | Abdomen, arms, thighs, buttocks |
| What is the closest substitute to a healthy, working pancreas? | Insulin pump |
| What does glucagon do? | Stimulates the liver to change stored glycogen into glucose |
| What is the usual adult dose of glucagon? | 0.5mg -1mg |
| Which drug acts adjunct to insulin therapy, and decreases gastric emptying, glucagon secretion, and glucose output? | Pramlintide (Symlin) |
| Some patients with type 1 diabetes have the option of a pancreas transplant. When is a pancreas transplant usually performed? | If the patient has end stage renal disease, and has already had a kidney transplant or will need one |
| What are the chronic complications of diabetes mellitus? List three. | 1. Blindness
2. Cardiovascular problems
3. Renal failure |
| What is the principal mineralocorticoid? | Aldosterone |
| Aldosterone regulates sodium and potassium, causing _______ to increase and _______ to decrease? | Sodium increases, potassium decreases |
| Epinephrine and norepinephrine are released by the _____ ______. | Renal medulla |
| Mineralocorticoids are involved primarily in ______ and _______ balance; indirectly manages blood pressure. | Water and electrolyte balance |
| Glucocorticoids exhibit _______ properties. | Anti inflammatory properties |
