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Types of Hormonal and Metabolic Dysfunction - Coggle Diagram
Types of Hormonal and Metabolic Dysfunction
result of impairment of the hypothalamic-pituitary axis?
result of hormone deficits or excess?
5. Cushing syndrome
clinical manifestations include:
Moon Face
Buffalo
Osteoporosis
Renal calculi
Muscle weakness
treatment modalities
Surgery or radiation to remove tumors that cause excess ACTH or Cortisol
Diagnostic criteria
based on a 24-hour urine collection during which elevations in cortisol are noted
Imaging to find tumors
6. Addison Disease
clinical manifestations include:
Deficiency in Mineralocorticoids
Dehydration, hyponatremia, hyperkalemia, hypotension, weakness, fatigue, shock
Deficiency in Glucocorticoids
Hypoglycemia, weakness, poor stress response, fatigue, anorexia, nausea, vomiting, weight loss, personality changes
Deficiency in Androgens
Sparse axillary and pubic hair in women
Elevated ACTH levels
hyperpigmentation
treatment modalities
for acute illness, Isotonic IV fluid replacement with either hydrocortisone sodium succinate or phosphate.
for gradual illness, oral replacement of glucocorticoid and mineralcorticoid hormones
Increased salt intake during hot weather
Diagnostic criteria
lab analysis of electrolyte levels that show hyponatremia and hyperkalemia
Serum corticosteroid levels are measured after admin of ACTH
result of ectopic hormone production?
1. Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Excess ADH secretion
clinical manifestations include:
Hypotonic hyponatremia
Decreased Urine output
anorexia, nausea, vomiting, headache, irritability
psychosis, gait disturbances, seizures, or coma.
Diagnostic criteria
(Hyponatremia) Serum sodium less than 135 mEq/L
(Hypotonicity) plasma osmolality less than 280 mOsm/kg
Highly concentrated urine with a high sodium content
Absence of renal, adrenal, or thyroid abnormalities
treatment modalities
Focus on removing the cause of SIADH
Hypertonic intravenous solutions for severe hyponatremia.
Water restriction for mild hyponatremia
result of impaired hormone inactivation and elimination?
2. Diabetes Insipidus
Deficient ADH secretion
clinical manifestations include:
Polyuria (large volume urine output)
excessive thirst
Inappropriately dilute urine
Diagnostic criteria
Made through patient history and physical exam
Recent surgery to remove brain tumor
Past head trauma
Signs of dehydration and enlargement of bladder
Urine specific gravity: 1.005 or less
Urine osmolality less than 200 m Osm/kg
treatment modalities
Hydration is the most important form of DI treatment.
IV hypotonic solution for those with inadequate thrist
Desmopressin
result of impairment of the endocrine gland?
3. Hyperthyroidism (Graves Disease)
Diagnostic criteria
Made through patient history and physical exam
"family history of"
Autoimmune disease
Thyroid Disease
Emigration from an iodine-deficient location
Suppressed TSH levels
Elevated serum T3 and T4 levels
clinical manifestations include:
Goiter (enlargement of the thyroid gland)
Exophthalmos (a protrusion of the eyeballs)
treatment modalities
Medications that block thyroid hormone production
Or surgical removal of thyroid gland; partial or full
or gland destruction
4. Hypothyroidism
treatment modalities
Lifelong thyroid hormone replacement
Levothyroxine (Synthroid, Levoxyl).
clinical manifestations include:
fatigue
cold intolerance
weakness
weight gain
dry skin
coarse hair
impaired reproduction
Myxedema is unique to finding hypothyroidism
Diagnostic criteria
Serum thyroid hormones may be decreased
TSH is elevated
result of impaired negative feedback loop?