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Altered Hormonal and Metabolic Function - Coggle Diagram
Altered Hormonal and Metabolic Function
Syndrome of inappropriate antidiuretic hormone
Alterations
The body makes too much antidiuretic hormone and secretes too much water
Damage to the hypothalamic pituitary axis
Cause
A tumor that is secreting ectopic ADH
Clinical manifestations
Decreased an concentrated urine output
Hypotonic hyponatremia
Serum sodium < 120 mEq/L
Anorexia, nausea/vomiting, disorientation
Serum sodium < 110 mEq/L
psychosis, seizures, coma
Diagnostic Criteria
based on laboratory findings such as hyponatremia, hypotonicity, decreased urine volume, highly concentrated urine
Treatment
IV isotonic or hypertonic solutions
Water restriction
Lasix
demeclocycline
Diabetes insipidus
Cause
trauma or surgery near the hypothalamus, renal insufficiency, Lithium toxicity
Clinical Manifestations
serum hyperosmolarity
shock/death
polyuria
excessive thirst
Diagnostic Criteria
patient history, physical examination, tests of ADH, serum solute concentration, and urine specific gravity
Treatment
Increase fluids
IV hydration
Desmopressin
Alterations
inadequate kidney response to the presence of ADH
insufficient production of ADH by the hypothalamus
ineffective secretion by the posterior pituitary
impairment of hypothalamic osmoreceptors
Hyperthyroidism
Causes
pituitary adenoma
large amounts of iodine
thyroid disease
Graves disease
Clinical Manifestations
weight loss
exophthalmos
Excessive metabolic rate
goiter
fine hair
Diagnostic Criteria
Tests of TSH, free thyroxine, T3, T4
patient history and physical exam
Treatment
medications
surgical removal of thyroid
gland destruction
Alteration
Excessive thyroid hormone
Hypothyroidism
Causes
Lack of thyroid gland development
Autoimmunity
iodine deficiency
radiation
medications
Alterations
Deficienct thyroid synthesis
Destruction of the thyroid
Impaired TSH or TRH secretion
Clinical manifestations
Cretinism
fatigue
weight gain
coarse hair
myxederma
Diagnostic criteria
patient history and physical examination
Tests of TSH assay, free T4, total T4, and T3 uptake, thyroid autoantibodies, antithyroglobulin
Treatment
Hormone replacement therapy
Levothyroxine
Cushing syndrome
Alteration
prolonged exposure to elevated levels of endogenous or exogenous glucocorticoids
Cause
long term administration of corticosteroids
tumors of the pituitary
tumors of the adrenal gland
Clinical manifestations
Excessive circulating glucose
Immune and inflammatory suppression
Impaired stress response
ectopic production of ACTH or CRH from a distant tumor
Diagnostic criteria
collection of 24 hour urine
imaging studies to locate tumors
Treatment
Surgical removal of tumors
Reducing corticosteroid use
Medications
Addison disease
Alteration
High level of ACTH production from the pituitary
deficiency in glucocorticoids, mineralocorticoids, androgens
Cause
Destruction of the pituitary
Lack of hormones secreted
Autoimmune destruction
Clinical manifestation
hyperpigmentation of the skin and mucous membranes
hyponatremia
hyperkalemia
personality changes
shock
Diagnostic Criteria
serum corticosteroid level tests
Treatment
Isotonic IV fluid replacement
Hydrocortisone sodium succinate or phosphate