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Hyperthyroidism & Graves disease.
- Thyroid gland is excreting too much T4
- Since elevated T4, anterior pituitary will not release TSH
- Slightly elevated Ca+
- Skinny "hyper" disease; rapid speech, movement, body temp, insomnia, tremors, diarrhea, decreased muscle strength
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Hypothyroidism & Hashimoto's disease.
- Thyroid gland not excreting enough T3 or T4
- Since low T3 & T4, anterior pituitary will release more TSH
- Ca+ levels normal
- Fat "hypo" lethargic disease; slow mentation, apathy, decreased HR, cold, weakness, arthralgia, paresthesias, constipation, distention, anorexia, N/V, dry, thick skin, puffy face and eyes
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Addison's disease.
- Adrenal gland not excreting enough glucocorticoids, mineralocorticoids
- Since decreased glucocorticoids, anterior pituitary releases more ACTH (adrenocorticotrophic hormone)
- High Ca+, K+
- Low Na+, Cl-
- Lethargy, fatigue, muscle weakness, GI disturbance, weight loss, menstrual changes, impotence
- Hypoglycemia, postural hypotension
- Skin hyperpigmentation "tan" r/t high ACTH levels
- John F. Kennedy had Addison's
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Cushing's disease.
- Adrenal gland excreting too much glucocorticoids, mineralocorticoids
- Anterior pituitary producing too much ACTH, causing increased adrenal gland production
- Low K+, low/normal Ca+
- High Na+, Cl-
- Generalized muscle wasting, weakness
- Moon face, buffalo hump, truncal obesity, skinny arms/legs, hirsutism (masculine looking females)
- Hyperglycemia, hypertension
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Hyperparathyroid.
- Pituitary gland excreting too much PTH (parathyroid hormone)
- High Ca+, Cl- (think hyper parathyroid = hyper calcium)
- Low phosphorous
- Weakness, anorexia, constipation, emotional disorders, decreased attention span
- Osteoporosis, fractures, stones, pancreatitis, renal failure, cardiac changes, psychosis, coma
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Hypoparathyroid.
- Pituitary gland not excreting enough PTH (parathyroid hormone)
- Low Ca+ (think hypo parathyroid = hypo calcium)
- Sometimes elevated Cl-
- High phosphorous
- Tingling in fingers, hands, feet, lips, tetanus, muscle cramps, difficulty walking, throat constriction, laryngospasm, dyspnea, GI cramping, incontinence, behavioral changes, psychosis, brittle hair/nails, seizure, hyperreflexive deep tendons
- Chvostek's (cheek tap) & Trousseau's (BP cuff, forearm/hand flexion) signs
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Symptoms of Inappropriate Antidiuretic Hormone Hypersecretion (SIADH).
- Posterior pituitary excreting too much ADH (antidiuretic hormone)
- Low Na+, Cl-, serum osmolality (think too much water, too dilute)
- High urine concentration (not enough water leaving body)
- Commonly found in small cell carcinoma (lungs), pneumonia, brain tumors, head trauma, stroke, meningitis, encephalitis
- Low (Na+) and wet (water retention)
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Diabetes Insipidus.
- Posterior pituitary not excreting enough ADH (antidiuretic hormone) -or- renal insensitivity to ADH
- High Na+, serum osmolality (think water leaving too quickly, dehydration)
- Low urine concentration (water in urine, not body)
- Polyuria, polydyspia
- High (Na+) and dry (dehydrated)
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