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Type of Hormonal and Metabolic Dysfunction - Coggle Diagram
Type of Hormonal and Metabolic Dysfunction
Diabetes Insipidus (DI)
condition of insufficient ADH that results in the inability of the body to concentrate or retain water
Three major causes of DI
insufficient production of ADH by the hypothalamus or ineffective secretion by the posterior pituitary
inadequate kidney response to the presence of ADH also called nephrogenic DI
ingestion of extremely large volumes of fluids and decreasing ADH levels; water intoxication can sometimes be attributed to a psychiatric disturbance
Clinical manifestations
polyuria
excessive thirst
highly diluted urine
shock
death
Diagnostic test
ADH level measurement
urine-specific gravity measurement
serum solute concentration measurement
Treatment
aimed at regaining fluid
Treatment types
hydration (drinking or IV)
desmopressin (DDAVP)
Hyperthyroidism
state of excessive thyroid hormone
can result from
excessive stimulation to the thyroid hormone
diseases of the thyroid gland
excess production of TSH by a pituitary adenoma
Clinical manifestations
weight loss
sweating
restlessness
heat intolerance
agitation
tachycardia
diarrhea
tremors
palpitations
irregular mensuration
weakness
Diagnostic test
physical examination
protrusion of the eyes
enlarged and slightly firm thyroid gland
serum TSH level screening
most common cause is Graves disease
Treatment
based on reducing thyroid hormone levels
Treatment types
radioactive iodine
medications that block thyroid hormone production
surgical removal of all or part of the gland
Syndrome of Inappropriate Antidiuretic Hormone (ADH) Secretion
condition of excessive production and release of ADH despite changes in serum osmolality and blood volume
most common cause is a tumor which is secreting ectopic ADH
Clinical Manifestations
are related to hyponatremia
decreased urine output
concentrated urine output
anorexia
vomiting
headache
nausea
irritability
muscle cramps
weakness
psychosis
seizures
coma
Diagnostic tests and findings
hyponatremia
highly concentrated urine with high sodium
hypotonicity
decreased urine volume
absence of renal, adrenal or thyroid abnormalities
Treatment
focuses on removing the cause if possible
Treatment types
Severe hyponatremia
isotonic or hypertonic saline IV
medications to block the effects of ADH or to increase urine output
Mild hyponatremia
water restriction
ADH Alteration
Hypothyroidism
state of deficient thyroid hormone
can be
congenital
acquired
Clinical manifestations
cold intolerance
weakness
fatigue
dry skin
weight gain
lethargy
constipation
coarse hair
impaired reproduction
impaired memory
Diagnostic test
sensitive TSH assay
study of free T4, total T4, and T3 uptake
thyroid antibodies measurement
antithyroglobulin tests
Treatment
focuses on replacing the deficient hormone with the goals of normalization of TSH, T4 and T3 levels along with alleviation of signs and symptoms
Treatment types
thyroid replacement therapy
levothyroxine
Thyroid hormone alteration
Addison Disease
Acute ACTH deficiency
considered one of the most serious endocrine disorders
can result from lack of
ACTH
CRH
most common cause is the autoimmune destruction of the layers of the adrenal cortex
Clinical manifestations
hypoglycemia
weakness
hyperpigmentation
fatigue
nausea/vomiting
dehydration
hyponatremia
hyperkalemia
sparse axillary and pubic hair in women
Diagnostic test
serum corticosteroid level measurement
laboratory analysis of electrolyte levels
Treatment
aimed at improving symptoms and ACTH levels
Treatment types
isotonic fluid replacement infused with hydrocortisone sodium succinate or phosphate
oral replacement of glucocorticoids
mineralocorticoid hormones
in some cases antibiotics for infection
Adrenal gland dysfunction
Cushing Syndrome
condition of prolonged exposure to elevated levels of either endogenous or exogenous glucocorticoids
Four major processes that can lead to this syndrome
tumors of the pituitary gland that stimulate excess ACTH production
Tumors of the adrenal gland that stimulate excess cortisol production
long term administration of corticosteroid medication
Ectopic production of ACTH or CRH from a tumor at a distant site such as small cell carcinoma of the lung
Clinical manifestations
extremity weakness
obesity of trunk, face and upper back
muscle wasting
increased infections
skin ulcerations
poor wound healing
euphoria
psychosis
hirsutism
Diagnostic test
24 hour urine collection
imaging studies
Treatment
focused on removing the cause of the excess hormone production
Treatment types
surgery
corticosteroid medication
radiation