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USU: MSN 570 WEEK 5
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
2 mins
Adrenal Gland (Basic)
Characteristics
Adrenal Cortex
RAAS Stimulates Aldosterone
CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
2 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
Hypothalamus
Characteristics
Anterior Pituitary Stimulated Through the Hypophyseal Portal
GHRH
GnRH
TRH
PIF
CRF Released During Stress
Posterior Pituitary Stimulated Through Neural Control
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
Pathophysiology
Hypersecretion of ADH
Increased Sensitivity to ADH
Signs & Symptoms
Serum Hypoosmolality
Coma and Seizure
Dilutional Hyponatremia
Cramps and Tremors
Euvolemia
Change in LOC
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
Monitor Serum and Urine Osmolality
IandOs with Daily Weights
Restrict Fluid Intake
Monitor Cardiovascular and Neurological Status
Seizure Precautions
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
Diuretics
Hypertonic IV Fluids
Demeclocycline
Tolvaptan and Conivaptan
1 min
Testes
Characteristics
FSH Stimulates Sertoli Cells
Inhibin B Release
LH Stimulates Leydig Cells
Leydig Cells Secrete Testosterone
Testosterone Causes Male Development
2 mins
Thyroid Function Screening Tests
If TSH High
Free T4 (FT4)
If TSH Low
Free T4 (FT4) and T3 (Triiodothyronine)
Consider Serum Total T4 (Thyroxine)
Considerations
Only Total T4 Increases in Pregnancy
T4 is Converted to T3
Avoid for Inpatient Screening
2 mins
Thyroid Gland
Characteristics
TSH Stimulates T3 and T4 Release
Metabolism Regulation
Blood Calcium Sensor
Calcitonin Release
Blood Calcium Decreases
Bone Building
2 mins
Thyroid Nodule Assessment
Initial Tests
Thyroid-Stimulating Hormone (TSH)
Ultrasound
Normal / Elevated TSH
Fine Needle Aspiration
Most Accurate Test
Decreased TSH
Radioactive Iodine Uptake (RAIU)
Hot Nodules Rarely Malignant
Free T3 and T4
Considerations
Repeat Ultrasound 6 -18 Months
2 mins
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