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Hormonal and Metabolic Dysfunctions - Coggle Diagram

- - - - Decreased and concentrated urine output, anorexia, nausea, vomiting, headache, irritability, disorientation, muscle cramps, weakness, psychosis, gait disturbances, and seizures or coma
    - - Treatment focuses on removing the cause of SIADH, if possible. For example, water restriction and saline administered via IV for mild or severe hyponatremia, respectfully.
    - - Hyponatremia: Serum Na < 135 mEq/L; Hypotonicity: Plasma Osmolality < 280 mOsm/kg; decreased urine volume, highly concentrated urine with a high sodium content; and absence of renal, adrenal, or thyroid abnormalities
- - - - Lab tests to determine TSH levels, patient history (family history of autoimmune disease), and physical exam (weight loss).
    - - Enlargement of the thyroid gland (goiter), excessive metabolic rate of the body, weight loss, agitation, restlessness, sweating, heat intolerance, diarrhea, tachycardia, palpitations, tremors, fine hair, oily skin, irregular menstrual cycle in women, and weakness.
        
        Graves Disease: Exophthalmos-bilateral protrusion of the eyeballs
    - - Treatment is based on reducing thyroid hormone levels often through gland destruction via radioactive iodine, medications that block thyroid hormone production, or surgical removal of all or part of the gland
- - - - Lab tests to determine TSH, Free T4, total, T4 and T3 uptake, thyroid autoantibodies, and antithyroglobulin tests
    - - Fatigue, goiter, cold intolerance, weakness, weight gain, dry skin, coarse hair, constipation, lethargy, impaired reproduction, and impaired memory. Myxedema-boggy non-pitting, edematous tissues on the face, mucous membranes, hand and feet
    - - Treatment focuses on replacing deficient hormone with the goals of normalization of THS, T4, and T3 levels along with alleviations of clinical signs and symptoms via the use of lifelong thyroid hormone replacement therapy
- - - - Based on a 24-hour urine collection during which elevations of cortisol excretion are noted. Imaging studies to locate possible tumors that may be secreting excess ACTH or cortisol
    - - Excess glucose circulation, suppression of inflammatory and immune responses, behavioral changes, and impaired stress response. Obesity of trunk, face and upper back: moon face and buffalo hump. Striae (stretch marks), weakness, muscle wasting, atrophic and thin skin. Hirsutism- development of excessive body and facial hair, or changes in patterns of pubic and axillary hair growth (primarily in women)
    - - Treatment is focused on removing the cause of excess hormone production. Ex: surgery or radiation. Corticosteroid medications needed to avert an adrenal crisis
- - - - Isotonic IV fluid replacement; improvement of blood pressure; and salt intake needs to be monitored
    - - Insufficient Glucocorticoids- weakness, poor stress response, hypoglycemia, fatigue, nausea. Insufficient Mineralocorticoids- dehydration, hyponatremia, hyperkalemia, weakness, fatigue, and shock. Insufficient Androgens- sparse axillary and pubic hair in women.
    - - Based on clinical presentation and lab analysis of electrolyte levels, depressed serum corticosteroids levels after ACTH administration
- - - - Patient history of surgery to remove brain tumor, or head trauma. Signs of dehydration and possible bladder enlargement. Lab tests to determine ADH levels, Specific Gravity of 1.005 or less, and urine osmolality <200 mOsm/kg
    - - IV hydration with hypotonic solution, desmopressin (synthetic vasopressin analog that acts like an antidiuretic)
    - - Polyuria (large volume of urine output), excessive thirst, shock, and death.