MDT 15.6 Endocrine (study all s/s and op and clinical tx)

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Hyperthyroidism affects what precentage of women at what age range?: 2% ages 30-40
Hyperthyroidism affects what percentage of men: .2%
How many causes of Hyperthyroidism are there?: 11
In Hyperthyroidism 80-90% of all cases result in which autoimmune disease?: Graves Disease
What is another term for Graves Disease?: Thyrotoxicosis
In TX of graves Disease what is the SIG for Propanolol?: 10mg po increase until threaputic effect is achieved typical dose is 80mg
What is the max dose for Propanolol?: 120mg QD
What is required to DX Hyperthyroidism?: Lab confirmation
What is TX for thyroid storm?: Control fluid and electrolytes
Propanolol 30mg po QID
Tylenol 325mg x 2 po Q4
*COOL PT.*
O2
Medevac ASAP
Thyroid storm has a mortality rate of what?: 20%
Hypothyroidism risk does what with age?: Increases
Hypothyroidism affects what percentage of women?: 1.5-2.0%
Hypothyroidism affects what percentage of men?: .2%
In hypothyroidism prevalence increases at age 60 to what in both sexes?: 6% in women
2.5% in men
How many types of Hypothyroidism?: 3
What are the 3 types of Hypothyroidism?: Primary
Secondary
Tertiary
What is an autoimmune gland dysfunction causing decreased levels of thyroid hormone: Hashimoto's Thyroiditis
Which Hypothyroidism accounts for greater than 90%?: Primary
What are significant general findings in Hypothyroidism?: Loss of outer 1/3 of eyebrow
Cold intolerance
What is another name for Hyperaldosterone?: Conn's syndrome
What is another name for Hypercortisolism?: Cushing syndrome
What is Adrenogenital syndrome?: A hypersecretion of sex steroid
Where is aldosterone secreted from in the Adrenal gland?: Outside
Where is glucocorticoid secreted from in the Adrenal gland?: Middle
Where is the sex steroid secreted from in the adrenal gland?: Inside
What is the cause of 90% of all Hyperadrenalism?: Pituitary Adenomas (Cushing syndrome)
What is the RX for Hyperadrenalism?: Ketoconozole 200mg po Q6 while monitoring liver enzymes.
What is the number one cause of Hypoadrenalism in USN/USMC personnel?: The abrupt cessation of glucocorticoid therapy.
Chronic hypoadrenalism is the leading cause of destruction of what?: The adrenal gland
Chronic hypoadrenalism accounts for what percent of all cases?: 80%
In chronic hypoadrenalism it usually appears by age what?: 15
In chronic hypoadrenalism it can cause what type of hemorrhage?: Bilateral adrenal hemorrhage.
When doing a CBC for hypoadrenalism what would be expected findings in acute?: Eosinophila
What are the two causes of Diabetes Insipidus?: Neurogenic and Nephrogenic
Neurogenic Diabetes Insipidus is the body falling to produce what?: ADH
Nephrogenic Diabetes Insipidus is caused by what?: Renal tube failing
What is a clinical TX for Diabetes Insipidus?: Daily weight checks.
What is a chronic disorder of carb metabolism, hyperglycemia and glycosuria, from inadequate production or use of insulin?: Diabetes Mellitus (DM)
What is the cause of Type 1 DM?: No production of insulin

Destruction of Pancreas B cells
What is the cause of Type 2 DM?: No reaction to insulin.

tissue insensitive to insulin as a result of obesity.
What percentage of Pt.s have idiopathic Type 1 DM?: 10%
90% of all DM cases are a result from which type?: Type 2
Diabetes accounts for what percent of legal blindness?: 8%
What is the leading cause of end stage renal disease?: Diabetes Mellitus
Pt.s with which disease process are twice as likely to develop cardiovascular disease?: Diabetes Mellitus
DM insulin therapy is to maintain blood glucose levels at or above what?: 250
In operational TX of DM Type 1 what is the standard dose of insulin?: .3-.5un/kg/qd sc divided dose

NPO
In operational TX of DM Type 2 what is the standard dose of insulin?: 1-1.5un/kg/qd sc divided dose
What must be done prior to initiating insulin therapy?: MO consult
What is a life threatening condition resulting from DM from severe insulin deficiency?: Diabetic Ketoacidosis
What is the predominant demographic for DKA: 1-25y/o
In hyperthyroidism you would expect a decrease in (what), but an increase in (what)?: Decrease in TSH, an increase T4 and free T3.
In hypothyroidism you would expect an increase in (what), but a decrease in (what)?: Increased TSH, an a decrease free T4.
In the clinical tx of hypothyroidism what is the indicated medication?: Synthroid 25-100 mcg/day
What is Synthroid?: Synthetic T4
Central obesity, Plethoric (moon face), muscle wasting extremities, hypertension, skin fragility, buffalo hump, and menstrual irregularities are physical findings of what disease?: Cushing Syndrom (Hypercortisolism)
Inadequate secretion of corticosteroids due to partial or complete destruction of the adrenal glands is defined as what?: Hypoadrenalism
Which type of DM has excessive polyuria, PROFOUND weakness and fatigue, polyphagia w/ weight loss, blurred vision, and usually under 30 years old?: Type I
Which type of DM has weakness and fatigue, recurrent excessive blurred vision, excessive vulvovaginitis and pruritus, and excessive peripheral neuropathy?: Type II
What are the expected lab findings in DM?: Fasting blood glucose >126, random blood glucose >200.
In cases of hypoglycemia, what is the indicated operational tx?: Diet, get blood glucose over 80 mg/dl.

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