Altered Hormonal and Metabolic Functions

Damage to HPA

Damage to Feedback Mechanisms

Damage to Endocrine Glands #

Damage to Cell Receptors

hyperpituitariarism

hypopituitariarism

Addison Disease

Hypothyroidism

Diabetes Insipidus (DI)

Cushing Syndrome

Hyperthyroidism

SIADH

SIADH

Addison Disease

severe dehydration

excessive thirst

polyuria

anorexia, NV

pyschosis, gait disturbances (Na <110meq/L)

decreased/concentrated urine

Diagnostics

hypotonicity

hyponatremia

Tx

IV hypertonic solution

fluid restriction

Diagnostics

bladder enlargement

urine osmolality <200, urine-specific gravity of 1.005 or less

recent cranial surgery/head trauma

Tx

Desmopressin (DDAVP)

hypotonic IVF

Hypothyroidism #**

Hyperthyroidism #

fatigue, cold intolerance, wt gain

tumor common cause

goiter, myxedema

cretinism

Diagnostics

free T4, total T4, T3 uptake

thyroid antibodies

↑ TSH, serum thyroid decreased

Levothyroxine

wt loss, agitation, sweating

thyrotoxic crisis, thyrotoxicosis

Graves Dx

Diagnostics

↓ TSH

family hx

eye protrusion

enlarged/firm thyroid

Tx

radioactive iodine

beta-blockers

full thyroid ablation

Cushing Syndrome #

hirsutism

thin/atrophic skin

trunk obesity, moon face, buffalo hump

↑ BG

Diagnostics

imaging

24-hr urine w/↑ cortisol

Tx

corticosteriods

surgery/radistion

hyperpigmentation skin

↓ gluoco/mineral corticoids, androgens

hypoglycemia, vomiting

sparse public/axillary hair women

dehydration, hyonatremia

Tx

high Na diet

lifetime steroids

isotonic IVF w/hydrocortisone

tumors that may be producing ↑ ACTH/cortisol

Damage to Metabolism & Elimination