Emily Shared "Endocrine Block" - 53 Picmonics

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Endocrine Block

Cushing's Syndrome Characteristics
More Common in Women
Exogenous Etiologies
Glucocorticoids
Endogenous Etiologies
Decreased ACTH
Primary Adrenal Disease
Increased ACTH
Pituitary Adenoma (Cushing's Disease)
Paraneoplastic: Small Cell Carcinoma
CRF-releasing Tumors
2 mins
Pheochromocytoma
Cause/Mechanism
Adrenal Medulla Tumor
Increased Catecholamines
Assessment
Episodic Hypertension
Diaphoresis
Abdominal or Chest Pain
Interventions
Surgery
Antihypertensives
Phenoxybenzamine
Metyrosine (Demser)
Considerations
Do Not Palpate Abdomen
3 mins
Cushing's Syndrome Symptoms And Diagnosis
Symptoms/Findings
Osteoporosis
Amenorrhea
Truncal Obesity
Skin changes
Buffalo Hump
Immune Suppression
Moon Facies
Hypertension
Decreased insulin sensitivity
Diagnosis
24-hour urine free Cortisol
Dexamethasone Suppression Test
2 mins
Steroid Hormones
Characteristics
Nuclear Membrane
Long-Lived and Slow-Acting
Cholesterol-Derived
Intracellular Receptors
DNA Transcription
Examples
Testosterone
Aldosterone
Estrogen
Cortisol
2 mins
Peptide Hormones
Characteristics
Fast-Acting and Short-Lived
Bind To Cell Membrane Receptors
Stimulate Secondary Messengers
Amino Acid-Derived
Examples
Insulin
Parathyroid Hormone (PTH)
Vasopressin
Oxytocin
2 mins
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
2 mins
Addison's Disease
Mechanism
Chronic 1° Adrenal Insufficiency
Atrophy
Destruction
Symptoms
Deficiency In Cortisol And Aldosterone
Skin Hyperpigmentation
Increased POMC
Hypotension
Hyperkalemia
Acidosis
Addisonian Crisis
Diagnosis
ACTH (Cosyntropin) Stimulation Test
Treatment
Exogenous Cortisol
2 mins
17 Alpha Hydroxylase Deficiency
Decreased Cortisol
Decreased Sex Hormones
Increased Mineralocorticoids (DOC)
Hypertension
Hypokalemia
XY Externally Phenotypic Female
No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
XX Externally Phenotypic Female
Sexual Infantilism
2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
Hypothalamus
Characteristics
Anterior Pituitary Stimulated Through the Hypophyseal Portal
GHRH
GnRH
TRH
PIF
CRF Released During Stress
Posterior Pituitary Stimulated Through Neural Control
3 mins
Anterior Pituitary
Characteristics
Hypothalamic Control
FLAT PeG Mnemonic
Tropic Hormones
Follicle-Stimulating Hormone (FSH)
Lutenizing Hormone (LH)
Adrenocorticotropic Hormone (ACTH)
Thyroid-Stimulating Hormone (TSH)
Direct Hormones
Prolactin (PRL)
Growth Hormone (GH)
2 mins
Posterior Pituitary
Characteristics
Neuroendocrine Reflex Stimulation (By Hypothalamus)
Direct Hormones
Vasopressin
Increased Water Retention (In Kidneys)
Oxytocin
Increased Uterine Contraction
Mammary Glands Contraction
2 mins
Levothyroxine
Indications
Hypothyroidism
Myxedema Coma
Mechanism of Action
Isomer of thyroid hormone (T4)
T3 has higher potency
Side Effects
Hyperthyroid symptoms
56 secs
Thyroid Gland
Characteristics
TSH Stimulates T3 and T4 Release
Metabolism Regulation
Blood Calcium Sensor
Calcitonin Release
Blood Calcium Decreases
Bone Building
2 mins
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
2 mins
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
1 min
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Mechanisms
2nd Generation Sulfonylureas
Blocks Potassium Channels in Beta Cells
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Considerations
More Potent
Beta Blockers Reduce Effects
Avoid Alcohol
Avoid Breastfeeding
2 mins
Metformin
Indications
Diabetes Mellitus Type 2
Polycystic Ovary Syndrome (PCOS)
Mechanism of Action
Decreased Gluconeogenesis
Increased Insulin Sensitivity
Side Effects
Lactic Acidosis
GI Distress
Weight Loss
B12 Deficiency
Contraindication
GFR < 30 ml/min
2 mins
Diabetes Assessment
Assessment Type 1
Juvenile Onset
Absent Insulin Production
Ketosis Prone
Assessment Type 2
Adult Onset
Insulin Resistance
Obesity
Gestational Diabetes
Onset During Pregnancy
Glucose Intolerance
Complications
Retinopathy
Peripheral Vascular Disease
Nephropathy
Neuropathy
2 mins
Oral Glucose Tolerance Test (OGTT)
Used for Diabetes Screening
Fasting State
Samples Drawn
Baseline
Normal < 100 mg/dL
30 and 60 Minutes
Normal < 200 mg/dL
120 Minutes
Normal < 140 mg/dL
2 mins

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