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altered hormonal and metabolic function - Coggle Diagram
altered hormonal and metabolic function
SIADH
excess production and release of ADH
caused by tumor somewhere in body
hormone secreted ectopically
negative feedback mechanism does not respond
manifestations
Sodium <110mEq leads to psychosis, gait disturbances, seizures, coma
Na+ 115-120mEq leads to anorexia, N/V, headache, irritability, disorientation, muscle cramps, weakness
diagnostic criteria
absence of renal, adrenal, thyroid abnormalities
hypotonicity
decreased urine output and concentrated with high sodium content
hyponatremia
treatment
fluid restriction
remove tumor/cause
hypertonic saline infusion
Hypothyroidism
manifestations
goiter
fatigue, cold intolerant, weak, weight gain, dry skin, constipation, impaired reproduction and memory
myxedema
caused by
congenital
Hashimoto thyroiditis (autoimmune)
antibodies attack gland cells
deficient thyroid hormone synthesis
destruction of gland
impaired TSH or TRH secretion
diagnostic criteria
serum thyroid levels low and TSH elevated
labs used: thyroid autoantibodies, antithyroglobulin
deficient thyroid hormone
treatment
levothyroxine
Addison disease
diagnostic criteria
electrolyte abnormalities on labs
low corticosteroids after administration of ACTH
manifestations
hypoglycemia, weakness, fatigue, anorexia, N/V, weight loss (cortisol)
dehydration, hyponatremia, hyperkalemia, hypotension, fatigue, shock (aldosterone)
treatment
hydrocortisone infusion with tapering
followed by oral glucocorticoids and mineralocorticoids
caused by
autoimmune destruction of adrenal cortex layers
insufficient cortisol and aldosterone production
leads to high ACTH
Cushing Syndrome
caused by
pituitary tumor stimulating ACTH production
excess cortisol production
adrenal tumor stimulate cortisol production
long term use of corticosteroids
manifestations
glucose intolerance
suppression of inflammatory and immune responses
impaired stress response
moon face and buffalo hump
extremity weakness and muscle wasting
excess glucocorticoids
diagnostic criteria
24-hour urine collection for presence of cortisol
imaging studies to locate tumors
treatment
surgery or radiation of tumor
taper off corticosteroid medications
DI
manifestations
polyuria
polydipsia
dilute urine with low specific gravity
dehydration
shock and death if untreated
caused by
hypothalamic osmoreceptor impairment
impairment in hypothalamic-pituitary axis
inadequate kidney response to ADH
water intoxication
ineffective secretion by posterior pituitary
treatment
hydration oral or hypotonic IV solution
desmopressin
insufficient ADH
diagnostic criteria
labs: ADH level, serum solute concentration, urine specific gravity
history of recent head trauma or surgery
signs of dehydration
Hyperthyroidism
treatment
gland destruction or surgical removal
anti-hormone medications
excessive thyroid hormone
diagnostic criteria
family history of thyroid or autoimmune disease
low serum TSH and high free thyroxine levels
increased uptake of radioactive iodine
manifestations
goiter
exophthalmos
excessive metabolic rate
weight loss, agitation, sweating, heat intolerant, diarrhea, palpitations, tremors, fine hair, irregular menstrual cycle
caused by
Graves disease (autoimmune)
excessive thyroid gland stimulation
IgG antibodies bind to TSH receptors on thyrocytes
hyperplasia of gland
impairment of thyroid gland
excess production of TSH by pituitary adenoma