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Altered Hormonal & Metabolic Function - Coggle Diagram
Altered Hormonal & Metabolic Function
Syndrome of Inappropriate ADH Secretion
Treatments: water restriction, hypertonic IV solutions, medications to block effects of ADH or increase urine output
Clinical Manifestations: decreased and concentrated urine output, anorexia, nausea, headache, vomiting, muscle cramps, seizures, coma or psychosis
Diagnostic Criteria: hyponatremia, hypotonicity, decreased urine volume, highly concentrated urine w/ a high sodium content, absence of renal, adrenal or thyroid abnormalities
Diabetes Insipidus
Treatments: drinking more water to replace urine losses, IV hydration, synthetic vasopressin analog
Diagnostic Criteria: physical examination, normally this occurs after surgery or head trauma, enlargement of the bladder, lab measures of ADH levels and urine specific gravity of 1.005 or less
Clinical Manifestations: polyuria, excessive thirst, highly diluted urine w/ low specific gravity, dehydration, and serum hyperosmolality
Cushing Syndrome
Treatments: surgery/radiation to remove tumors causing excessive ACTH or cortisol
Clinical Manifestations: thinning of scalp hair, moon face, osteoporosis, increased facial hair, muscle weakness, buffalo hump, protruding abdomen w/ stretch marks
Diagnostic Criteria: 24 hour urine collection - elevation in cortisol is found
Imaging studies needed to locate tumors
Hyperthyroidism
Clinical Manifestations: muscle wasting, tremor, fine hair, goiter, sweating, exophthalmos, tachycardia, weight loss
Treatments: reducing hormone levels thru gland destruction using radioactive iodine, medications that block hormone production or surgery to remove part of gland
Diagnostic Criteria: physical exam can reveal large, firm thyroid gland & protrusion of eyes, measuring serum TSH levels and serum-free thyroxine
Hypothyroidism
Treatments: levothyroxine (synthetic T4) drug used to replace deficient hormone
Diagnostic Criteria: lab studies looking at levels of TSH, free T4, T3 uptake, and antithyroglobulin test
Clinical Manifestations: gradual and include coarse hair, loss of lateral eyebrows, large tongue, pallor, myxedema, constipation, periorbital edema, gastric atrophy
Addison Disease
Diagnostic Criteria: Lab analysis of electrolyte levels showing hyponatremia & hyperkalemia and analysis of serum corticosteroid levels
Treatments: IV fluids infusion w/ hydrocortisone sodium succinate. Salt intake may need to be increased in hot weather
Clinical Manifestations: insufficient levels of glucocorticoids, mineralocorticoids, and androgens causing sparse pubic hair, dehydration, hypoglycemia, weakness, and shock