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Hormone Excesses and Deficiencies - Coggle Diagram
Hormone Excesses and Deficiencies
Mineralocorticoids (aldosterone)
Excess
Hyperaldosteronism
Adrenal glands secrete excess aldosterone
Cause
Adrenal gland tumor
Clinical manifestations
Hypertension
Hypokalemia
Hypernatremia
Polydipsia
Polyuria
Metabolic alkalosis
Diagnosis
Blood levels
Aldosterone
Renin
Treatment
Surgical removal of adrenal tumor
Supportive care
Management of electrolyte imbalances
Deficit
Hypoaldosteronism
Aldosterone deficiency
Causes
Diabetes
Lead poisoning
Kidney disease
Primary adrenal insufficiency
Diagnosis
Physical examination
Blood tests
Serum aldosterone
Plasma renin activity
Serum cortisol
Clinical manifestations
Hyponatremia
Hyperkalemia
Dehydration
Hypotension
Treatment
Electrolyte imbalance management
Low potassium diet
Adequate salt intake
Loop or thiazide diuretics
Antidiuretic hormone
Deficit
Diabetes insipidus
Inability to retain water (Insufficient ADH)
Major causes
Insufficient ADH production
Ingestion of large amount of fluids with decreased ADH
Inadequate kidney response to ADH (nephrogenic DI)
Clinical manifestations
Polyuria
Polydipsia
Dilute urine with low specific gravity
Serum hyperosmolality
Severe dehydration
Diagnosis
Physical examination and history
Signs of dehydration
Enlarged bladder
Urine specific gravity of 1.005 or <
Urine osmolality < 200
Treatment
Hydration
Hypotonic IV solution therapy
Desmopressin (DDAVP)
Excess
Syndrome of inappropriate antidiuretic hormone (SIADH)
ADH promotes water retention
Causes excess water within cells
Increase in total body water composition
Sodium dilution in extracellular space
Tumor secreting ectopic ADH
Clinical manifestations
Decreased urine output
Hypotonic hyponatremia
Serum sodium < 115-120
Headache
Irritability
Muscle cramps and weakness
Diagnosis
Sodium level < 135
Plasma osmolality < 280
Highly concentrated urine
Decreased urine volume
Treatment
Removing the cause
Water restriction
Isotonic or hypertonic IV solution therapy
Glucocorticoids (cortisol)
Excess
Cushing syndrome
Prolonged exposure to glucocorticoids
Causes
Pituitary gland tumors stimulating excess ACTH production
Ectopic production of ACTH or CRH
Overstimulation of the adrenal cortex
Excess cortisol production
Adrenal hyperplasia
Adrenal gland tumors that stimulate excess cortisol production
Long-term use of corticosteroid medications
Suppression of inflammatory and immune responses
Suppression of cortisol production
Clinical manifestations
Excessive circulation glucose
Glucose intolerance
Impaired stress response
Face/posterior neck obesity
Extremity weakness and muscle wasting
Behavioral changes
Osteoporosis
Thinning of hair
Diagnosis
24 hour urine collection
Imaging studies to locate tumors
Treatment
Removing the cause
Corticosteroid medications
Surgery or radiation for tumors
Deficit
Addison disease
ACTH deficiency
Destruction of pituitary gland
Hemorrhage
Trauma
Tumors
Radiation
Surgical removal
Autoimmune destruction
Most common cause
Inability of adrenal gland to produce
Androgens
Mineralocorticoids
Glucocorticoids
Clinical manifestations
Signs of deficient steroids hormones
Hyperpigmentation of skin and mucous membranes
Diagnosis
Physical examination
Electrolyte level analysis
Hyperkalemia
Hyponatremia
Serum corticosteroid levels
Treatment
Isotonic IV fluid replacement
Hydrocortisone sodium succinate or phosphate
Oral glucocorticoid/mineralocorticoid
Increased salt intake in hot weather
Parathyroid hormone
Excess
Hyperparathyroidism
Causes
Hyperplasia of 2 or more parathyroid glands
Adenoma on a gland
Excess PTH secretion
Clinical manifestations
Renal calculi formation
Pathologic fractures
Hypercalcemia
Diagnosis
Blood tests measuring
Calcium
PTH levels
24 hour urine collection
Treatment
Surgical removal (parathyroidectomy)
Bone health medications and vitamins
Deficit
Hypoparathyroidism
Deficit PTH levels
Causes
Injury to parathyroid gland
Autoimmune attack
Clinical manifestations
Muscle spasms
Hypocalcemia
Seizures
Bone deformities
Diagnosis
Blood tests
Low PTH
Low calcium
Elevated phosphorous
Treatment
PTH repalcement
Oral calcium replacement
Thyroid hormone
Excess
Hyperthyroidism
Graves disease
Autoimmune condition
IgG antibodies bind to
TSH receptor on thyrocytes
Stimulation of excessive TSH
Thyrotoxicosis
Clinical manifestations
Weight loss
Agitation
Heat intolerance
Tachycardia
Fine hair
Oily skin
Goiter development
Exophthalmos
Diagnosis
Family history
Physical exam
Measuring TSH level
Treatment
Reducing thyroid hormone levels
Medications
Surgical removal of thyroid
Radioactive iodine
Deficit
Hypothyroidism
Congenital
During fetal development
Lack of thyroid gland development
Lack of thyroid hormone synthesis
Problem with TSH secretion
Acquired
Causes
Impaired TSH or TRH secretion
Thyroid gland destruction
Deficient thyroid hormone synthesis
Affects women 10 times more frequently than men
Clinical manifestations
Fatigue
Cold intolerance
Weight gain
Dry skin
Coarse hair
Constipation
Impaired memory
Myxedema
Diagnosis
Patient history
Physical examination
Lab testes
Sensitive TSH assay
Free T4, total T4, T3 uptake
Thyroid autoantibodies
Antithyroglobulin
Treatment
Replacement of deficient hormone
Alleviation of clinical symptoms
Levothyroxine (Synthroid)
Growth hormone
Excess
Before puberty
Giantism
After puberty
Acromegaly
Most common cause
Tumor on pituitary gland
Producing excess growth hormone
Clinical manifestations
Excessive skeletal growth
Overactive sebaceous glands
Enlarged tongue
Hypertension
Left sided heart failure
Diagnosis
Blood tests
Growth hormone suppression test
Treatment
Restore pituitary gland function
Removal of tumor
Radiation therapy
Injection of growth hormone blocking medications
Deficit
Dwarfism
Growth hormone deficiency
Clinical manifestations
Short stature
Immature facial features
Delayed puberty
Obesity
Insulin resistance
Diagnosis
Physical examination
Growth hormone stimulation test
Treatment
Reducing complications
Synthetic growth hormone
Causes
Genetics
Unknown