The Basics
True/False: Most hormone regulation is regulated through positive feedback.
FALSE. It is regulated through NEGATIVE feedback.
Lab values for an individual newly dx with hypothyroidism will show:
A. low TSH and high T4
B. high TSH and high T4
C. low TSH and high T4
D. high TSH and low T4
D. high TSH and low T4
What are the two most distinct signs of hyperthyroidism? (SATA)
A. exopthalamos
B. irritability
C. insomnia
D. goiter
A. exopthalamos
D. goiter
Addison's disease is a ________ (deficiency/surplus) of:
A. Mineral-cortical hormones
B. Androgenic hormones
C. Hypothalamic-cortical hormones
D. Adreno-cortical hormones
D. Deficiency of Adrenocortical hormones
Cushing's disease is cause by a(n) _________ (insufficiency/surplus) of corticosteroid hormones.
S/s include the following: (SATA- 4 correct)
A. Bruises & Petechiae
B. Hypoglycemia
C. Moon Face
D. Fat deposits on face & back of shoulders
E. Thin extremities
surplus
A. Bruises & Petechiae
C. Moon Face
D. Fat deposits on face & back of shoulders
E. Thin extremities
A. zinc
B. iodine
C. chloride
D. magnesium
B. iodine
S/s of hypothyroidism include: (SATA- 3 correct)
A. Cold Intolerance
B. Exopthalamos
C. Constipation
D. Apathy
A. Cold Intolerance
C. Constipation
D. Apathy
Hyperthyroidism is known also known as GRAVES' disease. What are the main symptoms? (SATA)
A. Hypertension
B. weight loss
C. generalized edema
D. irritability
E. bradycardia
A. Hypertension
B. weight loss
D. irritability
S/s of Addison's disease include all of the following except:
A. Depression
B. Hyperglycemia
C. Postural Hypotension
D. Fatigue
B. Hyperglycemia
-will have hypoglycemia
All of these are true about Cushing's syndrome except:
A. The incidence is much higher in women than men and in ages 25-40 yrs old.
B. It is most commonly caused my long term oral corticosteroid use.
C. treatment involves removing the source or identifying cause of excess corticosteroid and lowering the dose to decrease serum levels
D. this syndrome has a low mortality rate and a good prognosis
D. this syndrome has a loss mortality rate and a good prognosis
A negative feedback loop: (SATA)
A. happens when your system needs to slow down or completely stop a process that is happening.
B. happens when there is a low level of hormone in the blood that is inhibiting enough stimulation of endocrine tissues.
C. In the case of the endocrine system, the sensors recognize the hormonal rise and the action it causes to achieve homeostasis; once homeostasis is achieved, the sensor signals the endocrine tissue to stop secreting the hormone.
D. happens when there is a high level of the hormone in the blood that may inhibit further secretion of that hormone.
A. happens when your system needs to slow down or completely stop a process that is happening.
C. In the case of the endocrine system, the sensors recognize the hormonal rise and the action it causes to achieve homeostasis; once homeostasis is achieved, the sensor signals the endocrine tissue to stop secreting the hormone.
D. happens when there is a high level of the hormone in the blood that may inhibit further secretion of that hormone.
The life-threatening complication that can occur in end stage hypothyroidism is a(n) ____________ (thyroid storm/ myxedema coma).
S/s of this condition are: (SATA 2 correct)
A. Seizures
B. Hypothermia
C. Hyperthermia
D. Hypoventilation
Myxedema coma
B. Hypothermia
D. Hypoventilation
The medical emergency associated with untreated hyperthyroidism is known as a(n) __________ (thyroid storm/myxedema coma).
S/s of this include:
A. Hyperthermia
B. tachycardia and/or atrial fibrillation
C. coma
D. tremors
A. Hyperthermia
B. tachycardia and/or atrial fibrillation
D. tremors
A patient presents to the ED with N/V, confusion, acute abdominal pain, hypotension and fever. When reviewing her medication list you see she takes hydrocortisone (Cortef). Given her symptoms, what is the appropriate course of action?
A. Get STAT labs to check her CRF & ACTH levels. Give PO hydrocortisone.
B. Administer IV hydrocortisone & monitor for shock.
C. CTM. If she develops a high fever or seizures give IV hydrocortisone.
D. Give PO hydrocortisone Q1 hr, while monitoring her labs and until there is a moderate reduction is symptoms then reduce to Q4 hrs.
B. Administer IV hydrocortisone & monitor for shock.
-pt is in an adrenal crisis, indicating that she most likely abruptly withdrew from her medication and is exhibiting signs of adrenocortical insufficiency.
Osteoporosis is characterized by which of the following:
A. lack of calcium and Vit. D
B. improper nutrition, genetic factors and lifestyle choices
C. metabolic bone demineralization, decreased bone density & subsequent fractures
D. being at least 50 years old and sustaining 2 or more fractures in a years with low levels of calcium of vit. D
C. metabolic bone demineralization, decreased bone density & subsequent fractures
___ (T3/T4) is the most circulating of the thyroid hormones. ___ (T3/T4) must be converted to the ___ (T3/T4) form
T4
T4 must be converted to T3
The nurse knows the patient needs more teaching about levothyroxine when she makes which statements: (SATA 2 correct)
A. "I will take it once per day in the morning after my breakfast."
B. "I will avoid strawberries, peaches, pears, brussel sprouts and peas."
C. "I will feel an improvement in my symptoms within 1-3 days."
D. "I will call my HCP if I experience excessive nervousness, insomnia, chest discomfort or intolerance to heat."
A. "I will take it once per day in the morning after my breakfast."
C. "I will feel an improvement in my symptoms within 1-3 days."
What are the two methods of treatment of hyperthyroidism?
A. cortisol
B. levothyroxine (synthroid)
C. surgery
D. PTU
CD
Which measures if taken will be most effective in preventing the adverse effects of corticosteroid therapy? (SATA)
A. administer it locally when possible
B. alternate-day dosing to minimize adrenal atrophy
C. use the lowest dose possible
D. administer it systemically when possible
ABC
What is the primary reason women at increased risk for osteoporosis especially later in life?
A. they are usually more inactive then men
B. decreased estrogen levels
C. they are more susceptible to vitamin D deficiencies than men
B. estrogen levels decrease after women go through menopause
Therapeutic response depends on:
A. amount of hormones, metabolism, & sensitivity
B. sensitivity, amount of hormones & age
C. amount of hormones, sensitivity & number of receptors
D. genetic predisposition, sensitivity & number of receptors
C. amount of hormones, sensitivity & number of receptors
The most common cause of hypothyroidism:
A. Congenital cretinism
B. Hashimoto's thyroiditis
C. Graves' Disease
D. Addison's Disease
B. Hashimoto's thyroiditis
A. Report pulse >100 bpm or <60 bpm
B. monitor for bleeding & ecchymosis
C. take this medication at your convenience throughout the day, a specific time isn't needed
D. immediately report severe skin rash or swollen lymph nodes, sore throat, fever, diarrhea, vomiting, irritability, or weakness
Should teach pt to take the medication at the same time every day, at evenly spaced intervals around the clock.
Long term adverse effects of corticosteroid therapy include: (SATA)
A. hypoglycemia
B. bone fractures
C. peptic ulcers
D. delayed wound healing
B. bone fractures --> caused by osteoporosis
C. peptic ulcers
D. delayed wound healing --> remember, steroids suppress your immune response!
True/False: Osteoporosis is a normal part of aging.
False!