Term
|
Definition
- Overactive thyroid
- Graves or goiter
- Chronic Graves can breakdown thyroid to the point of becoming hypothyroid
- Multiple causes
- Utilizes the negative feedback loop for TSH vs. T3 and T4 (increased T3 and T4 means decreased TSH)
- Manifestations: high blood pressure and pulse, increased appetite with weight loss, diarrhea, extreme warmth, exophthalmos (bulging eyes)
- Collaborative care: medications (antithyroid medications, iodine, beta blockers), radioactive iodine treatment, surgery, surgical removal of gland, nutritional therapy
|
|
|
Term
| Thyrotoxicosis (Thyroid Storm) |
|
Definition
- Complication of hyperthyroidism
- Caused by untreated or undertreated hyperthyroid
- Stressors can lead to it
- Automatic ICU admission
- Treatment: bring hormones down (antithyroid medications, iodine), beta blockers
- Can lead to death if not treated
|
|
|
Term
|
Definition
- Primary: thyroid destruction or injury
- Secondary: pituitary problem
- Manifestations: fatigue, cold intolerance, anemia, slow heart rate, low blood pressure
- Collaborative care: hormone restoration
|
|
|
Term
|
Definition
- Extreme underproduction of thyroid hormone
- Can lead to collapse of the cardiac system
- Hypothermia, hypoventilation, bradycardia
- Treatment: restore thyroid hormone
|
|
|
Term
|
Definition
- Risks: childhood cancer (due to radiation doses), family history, increased age
- Types: follicular, medullary, anaplastic (worst)
- Manifestations: painless nodule on thyroid, hemoptysis or airway obstruction, tumors grow in response to TSH
- Treatment: surgery, chemo, radiation
- Similar care to hypothyroidism
|
|
|
Term
|
Definition
- Increase in cortisol secretion
- Cushing's syndrome: occurs from prolonged steroid use or any excess of cortisol in the body
- Cushing's disease: occurs from a pituitary tumor that increase ACTH secretion, leads to increased cortisol secretion
- Manifestations: weight gain (moon face, trunk, back), thin/fragile skin, excess bruising, all blood values are elevated except potassium due to excess aldosterone, insomnia, sweating, fatigue, extreme stress state
- Diagnostics: increased plasma cortisol, 24 hour urine cortisol, possible saliva test (administered late at night), plasma ACTH levels, CT scan of pituitary to detect tumor
- Collaborative care: lower cortisol (priority), decrease steroid doses, remove adenoma on pituitary, remove ACTH producing tumor elsewhere in body (lung or pancreas), high fluid imbalance risk
|
|
|
Term
|
Definition
- Low cortisol levels in body
- Primary: all 3 hormones reduced
- Secondary: pituitary disease
- Most commonly autoimmune
- Not manifested until at least 90% of adrenal cortex is destroyed
- Manifestations: everything is low except potassium due to low aldosterone, headache, nausea and vomiting, hyperpigmentation
- Treatment: increase blood pressure, increase electrolytes, increase blood sugar, correct underlying cause, hormone therapy, fluid balance
- Diagnosis: plasma cortisol levels, antibodies, electrolytes, CT and MRI for tumors, ACTH stimulation test
|
|
|
Term
|
Definition
- Sudden decrease in hormone levels
- Extreme fluid loss
- Extremely high potassium
- Extremely low sodium
- Shock management is key
- High risk patients: recent adrenal surgery, high stress, trauma
|
|
|
