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Altered Hormone Function (Cushing Syndrome (Results from (tumors of the…
Altered Hormone Function
Syndrome of Inappropriate Antidiuretic Hormone Secretion
excessive production and release of ADH despite changes in serum osmolality and blood volume
caused by
tumor, which releases the ectopic ADH
excessive ADH leads to
excess fluid intracellularly which increases total water concentration
dilutes sodium concentration in the extracellular space
Clinical Manifestations
prolong hyponatremia :
coma
disturbances
seizures
onset of hyponatremia
headache
anorexia
nausea/vomiting
treatment
water restriction(mild hyponatremia)
hypertonic IV(severe hyponatremia)
medication blocking ADH
No impairment of hypothalamus, pituitary or endocrine gland
Diabetes Insipidus
insufficient ADH production
can be caused by
inadequate kidney response to the presence of ADH(nephrogenic DI)
from renal disease, lithium toxicity, hyper/hypokalemia
ingestion of extremely large volumes of fluids, decreasing ADH levels
insufficient production of ADH by the hypothalamus or ineffective secretion by the posterior pituitary
most common cause of DI and comes from impairment of hypothalamic osmoreceptors from surgery
Clinical Manifestations
polyuria
excessive thirst
severe dehydration
shock
Treatment
hydration
IV hydration with a hypotonic solution
antidiuretic medication
Hyperthyroidism(Graves disease)
excessive thyroid hormone
caused from
autoimmune condition where IgG antibodies bind to TSH receptor on thyrocytes and stimulate excessive thyroid hormone secretion
results in
thyrotoxicosis
hyperplasia of thyroid gland due to excessive stimulation
Clinical Manifestations
goiter(enlargement of thyroid gland)
exophthalmos(protrusion of eyeballs)
caused from interaction of TSH and fibroblasts antigens found in extraocular muscles/tissues
weight loss
heat intolerance
tachycardia
Treatment
gland destruction via radioactive iodine
medications that block thyroid production
full ablation of thyroid hormone
Hypothyroidism
can be acquired
acquired
deficient thyroid synthesis
destruction of thyroid gland
impaired TSH or TRH secretion
caused from
autoimmunity(Hashimoto thyroiditis)
may attack the thyroid gland or block TSH or its receptor
iodine deficiency
removal of thyroid gland
congenital
occurs during fetal development and results in a lack of thyroid gland development
lack of appropriate synthesis of thyroid hormone
problems with TSH secretion
Clinical Manifestation
fatigue
cold intolerance
weight gain
impaired memory
goiter( from thyroid gland enlarging to increase function)
Treatment
replacing the hormone(Levothyorixne-T4 synthetic)
medication allievating symptoms
Cushing Syndrome
prolonged exposure to elevated levels of
endogenous( from adrenal cortex or cortisol producing tumors)
exogenous corticosteroids
suppress the inflammatory/immune response
Results from
tumors of the pituitary gland that stimulate excess ACTH production
tumors of the adrenal gland that stimulate excess cortisol
long-term administration of corticosteroid medications
ectopic production of ACTH or CRH from a tumor at a distant site
Clinical Manifestations
protein degradation(muscle weakness/muscle wasting)
moon face( from mobilization of fats and changes in fat metabolism)
ulcer formation
Physiological Changes
excessive circulating glucose
glucose intolerance
impaired stress response
excess production of aldosterone and androgen hormones occurs as well
Treatment
surgery
radiation therapy
Addison's disease
ACTH deficiency
lead to
death
sevre hypotension
shock
result from
lack of ACTH or CRH
impaired ACTH production from the pituitary gland
lack of secretion of hormones from the adrenal cortex
autoimmune destruction of the adrenal cortex is the most common cause
Clinical Manifestations
hypoglycemia
weight loss
dehydration
Treatment
isotonic IV fluid replacement infused with hydrocortisone sodium succinate or phosphate
salt intake increased in hot weather