Quizsxzc

• Hyperparathyroidism:

  • Overproduction of parathyroid hormone leads to hypercalcemia
  • Characterized by bone decalcification and development of renal calculi containing calcium
  • Primary HyperPTH is due to hyperplasia or tumor
  • Secondary HyperPTH is associated with chronic renal failure
• Manifestations of Hyperparathyroidism:

  • Bone decalcification
  • Polyuria
  • Renal calculi
  • Nausea, vomiting, anorexia
• Medical Management of Hyperparathyroidism:

  • Combination of calcitonin (Calcimar) and corticosteroids
  • Surgical management: Parathroidectomy
• Hypoparathyroidism:

  • Decrease in PTH causes decrease in bone resorption
  • Hypocalcemia results in decreased serum calcium level
• Manifestations of Hypoparathyroidism:

  • Chvostek's & Trousseau's signs
• Medical Management of Hypoparathyroidism:

  • Calcium gluconate
  • Vitamin D
• Pheochromocytoma (Chromaffinoma):

  • Tumor usually benign, originates from chromaffin cells of adrenal medulla or ectopic sites
  • Excess secretion of catecholamines
• Manifestations of Pheochromocytoma:

  • Hypertension
  • Headache
  • Hyperglycemia
• Diagnostic tests for Pheochromocytoma:

  • 24hr urine collection
  • Plasma catecholamine
  • CT scan, UTZ, MRI
  • Metaiodobenzylguanidine MIBG
• Medical Management of Pheochromocytoma:

  • Phentolamine
  • Phenoxybenzamine
  • Propranolol
  • Surgical Management: Adrenalectomy
• Addison's Disease:

  • Adrenal cortex function is inadequate
• Manifestation of Addison's Disease:

  • Hypotension
• Complication of Addison's Disease:

  • Addisonian crisis
• Diagnostic tests for Addison's Disease:

  • Blood glucose
  • Serum potassium
  • WBC
• Medical Management of Addison's Disease:

  • Hydrocortisone (Solu-Cortef)
  • Vasopressor amines
• Cushing's Syndrome:

  • Excessive adrenocortical activity
• Manifestations of Cushing's Syndrome:

  • Excessive mineralocorticoids
  • Excessive glucocorticoids
  • Excessive androgen
• Diagnostic tests for Cushing's Syndrome:

  • Overnight dexamethasone test
  • CT scan / MRI
• Nursing Management of Cushing's Syndrome:

  • Removal of pituitary or adrenal gland
  • Low sodium diet
  • Monitor I&O
• Diabetes Mellitus (DM):

  • Types: Type 1, Type 2, GDM, Secondary Diabetes
• Diagnostic tests for DM:

  • FBS
  • RBS
  • HbA1C
  • CBG
• Overview of treatment for DM:

  • Oral and Injectable drugs in 4 steps
• Insulin Therapy:

  • Indication: Used to treat all patients with type 1 diabetes
  • Type 1 diabetes requires lifelong administration
  • Type 2 diabetes requires long-term basis for glucose control
• Acute complications of DM:

  • Hypoglycemia: caused by too much exercise and omission of meals
• Management of Hypoglycemia:

  • 10-15 grams of simple sugar
  • IV-D 50/50
• Diabetes Ketoacidosis (DKA):

  • Life-threatening condition with severe insulin deficiency
  • More common in type 1 diabetes
• Manifestations of DKA:

  • Hyperglycemia
  • Dehydration/electrolyte loss
• Management of DKA:

  • Rapid reversal of dehydration
  • Rapid reversal of hyperglycemia
  • Correct electrolyte imbalance, especially hyperkalemia
• Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNK):

  • Extreme hyperglycemia without ketosis and acidosis
  • Most common in type 2 diabetes
• Manifestations of HHNK:

  • Hypotension
  • Dehydration
  • Tachycardia
• Chronic Complications of DM:

  • Macroangiopathy: CVA, MI, PVD
  • Microangiopathy: nephropathy, retinopathy, neuropathy