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Types of Hormonal and Metabolic Dysfunction, TSH, Regulatory influences…
Types of Hormonal and Metabolic Dysfunction
Syndrome of Inappropriate Antidiuretic Hormone Secretion
ADH secreted by hypothalamus
Clinical Manifestations:
Anorexia, Nausea, Vomiting, Heachache
Diagnostic Criteria:
Decreased urine volume, Hyponatremia (serum NA <134 mEq/L), concentrated urine with high sodium content
Treatment:
Water restriction, intravenous saline administration, Medication to block effects of ADh or increase urine output
Diabetes Insipidus
Condition of insufficient ADH result in body's inability to retain water
Clinical Manifestations:
Polyuria, excessive thirst, severe dehydration, shock, death
Diagnostic Criteria:
Patient history of recent surgery, signs of dehydration, ADH levels, Urine specific gravity of 1.005 or less
Treatment:
Drink proper fluids, IV hydration, Desmopressin
Hyperthyroidism
Excessive thyroid hormone due to excessive stimulation of thyroid gland
Clinical Manifestations:
Enlarged thyroid gland, Weight loss, agitation, sweating, diarrhea, tachycardia
Diagnostic Criteria:
Enlarged/slightly firm thyroid gland, Eye protrusions, TSH level, thyroxine level,increased uptake of radioactive iodine by thyroid gland.
Treatment:
Gland destruction via radioactive iodine, Medications to block thyroid hormones production, ablation of thyroid gland
Hypothyroidism
Deficient thyroid hormone
Clinical Manifestations:
Fatigue, cold intolerance, weakness, weight gain, dry skin, coarse hair, constipation, goiter
Diagnostic Criteria:
TSH elevated, Serum thyroid hormones decreased
Treatment:
Replace deficient thyroid hormones, hormone replacement therapy, Levothyroxine (synthetic t4)
Cushing Syndrome
prolonged exposure to elevated levels of either endogenous or exogenous glucocorticoids
Clinical Manifestations:
Excessive circulating glucose, behavioral changes, obesity, extremity weakness, osteoporosis,hirsutism
Diagnostic criteria:
Increase cortisol excretions, Imaging studies to find tumors that secrete excess ACTH/cortisol
Treatments:
Surgery or radiation to remove tumors, Corticosteroid medication for preventing adrenal crisis
Addison Disease
Rare, acute ACTH deficiency from lack of CRH or ACTH or secretions of hormones from adrenal cortex
Clinical Manifestations:
Hyperpigmentations of skin and mucous membranes, hypoglycemia, weakness, hypotension, fatigue, shock
Diagnostic Criteria:
Electrolyte levels for hyponatremia and hyperkalemia, low corticosteroid levels
Treatment:
isotonic IV fluid replacement, IV infusion of hydrocortisone, increase in salt intake, oral replacement of glucocorticoid
TSH
Regulatory influences are exerted on the anterior, posterior pituitary glands and hypothalamus