Emergency Care in Addison's Disease and Cancer

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Questions and Answers

What is one of the primary causes of a life-threatening emergency for a patient with Addison's disease?

  • Low levels of catecholamines
  • Normal stress levels
  • Excessive hydration
  • Not treated properly (correct)

Which symptom indicates an imminent crisis in a patient experiencing insufficient adrenal function?

  • Extreme blood pressure fluctuation (correct)
  • Slight weight gain
  • Increased appetite
  • Mild headaches

What immediate intervention is crucial for treating a patient with acute adrenal insufficiency?

  • Cooling the patient down
  • Oral potassium supplements
  • Increasing physical activity
  • IV Solu-Cortef/IV fluids (D5NS) **STAT!** (correct)

What condition may result from untreated Addison's disease complications?

<p>Kidney failure; shock (C)</p> Signup and view all the answers

What is the primary function of the adrenal medulla under stress conditions?

<p>Produce excessive amounts of catecholamines (D)</p> Signup and view all the answers

What is the primary goal of hematopoietic stem cell transplantation (HSCT)?

<p>To eradicate diseased tumor cells and facilitate the engraftment of healthy stem cells (B)</p> Signup and view all the answers

Which of the following therapies uses high-energy beams to impact tissue?

<p>Radiation therapy (A)</p> Signup and view all the answers

What is a common complication associated with cancer cachexia?

<p>Fat and muscle depletion (C)</p> Signup and view all the answers

Which therapy is known for acting on specific targets related to cancer and causing less damage to healthy cells?

<p>Targeted therapy (B)</p> Signup and view all the answers

What type of therapy directly implants radioactive material into a tumor?

<p>Brachytherapy (B)</p> Signup and view all the answers

Which of the following treatments can help manage obstructive oncologic emergencies?

<p>Surgical intervention to remove the tumor (C)</p> Signup and view all the answers

Why is malnutrition a significant concern in cancer patients?

<p>It leads to immune dysfunction and tissue wasting (A)</p> Signup and view all the answers

At what point does initiation of cancer occur?

<p>When exposure to carcinogens causes a mutation in DNA (C)</p> Signup and view all the answers

Which of the following treatments is primarily used to block hormone effects that promote cancer growth?

<p>Hormone therapy (C)</p> Signup and view all the answers

Which type of cancer is primarily associated with the skin and internal organs?

<p>Carcinomas (A)</p> Signup and view all the answers

What is a common characteristic of cancer cells compared to normal cells?

<p>They proliferate indiscriminately (A)</p> Signup and view all the answers

What contributes to about one-third of all cancer-related deaths in the U.S.?

<p>Tobacco use and unhealthy lifestyle choices (A)</p> Signup and view all the answers

What condition may result from accidental removal of parathyroid tissue during thyroid surgery?

<p>Hypocalcemia (B), Hyperphosphatemia (D)</p> Signup and view all the answers

Which of the following is a recommended strategy for cancer prevention?

<p>Limit exposure to carcinogens such as smoking (B)</p> Signup and view all the answers

Which medication should be monitored due to a risk of toxicity when taken with Digoxin?

<p>Oral calcium (A)</p> Signup and view all the answers

What is a common characteristic of normal cells in contrast to cancer cells?

<p>They respect cell boundaries and exhibit contact inhibition (B)</p> Signup and view all the answers

What is the primary function of Vasoactive Intestinal Peptide (VIP)?

<p>Controls H2O secretion/absorption from intestines (C)</p> Signup and view all the answers

Which type of carcinogen is highlighted as a specific example in the context of chemical carcinogens?

<p>Arsenic (A)</p> Signup and view all the answers

What autoimmune disorder is characterized by the production of Thyroid Stimulating Immunoglobulin (TSI)?

<p>Graves Disease (D)</p> Signup and view all the answers

What is a common sign of hypoparathyroidism?

<p>Severe tetany (D)</p> Signup and view all the answers

What stage follows the initiation phase in cancer development?

<p>Promotion (A)</p> Signup and view all the answers

What is a potential consequence of hypomagnesemia often linked to chronic alcoholism?

<p>Laryngospasm (B), Parathesia (D)</p> Signup and view all the answers

Which hormone is NOT primarily secreted by the thyroid gland?

<p>Insulin (D)</p> Signup and view all the answers

Which symptom is specifically associated with Graves Disease in addition to hyperthyroidism symptoms?

<p>Protruding eyeballs (C)</p> Signup and view all the answers

Which food type should be avoided to manage calcium and phosphate levels?

<p>Soft drinks (B)</p> Signup and view all the answers

What role does calcitonin play in the body?

<p>Incorporates calcium into bone (B)</p> Signup and view all the answers

What intervention is necessary when treating hypoparathyroidism?

<p>Monitor calcium and phosphate levels (B)</p> Signup and view all the answers

What is a consequence of pseudo-hypoparathyroidism?

<p>Impaired response to PTH (C)</p> Signup and view all the answers

What condition is described as a life-threatening emergency related to the thyroid?

<p>Thyroid Storm (A)</p> Signup and view all the answers

Which part of the adrenal glands is responsible for producing adrenaline?

<p>Medulla (C)</p> Signup and view all the answers

Thyroid hormones regulate all of the following EXCEPT:

<p>Red blood cell production (A)</p> Signup and view all the answers

Which treatment option is specifically mentioned for managing eye symptoms in Graves Disease?

<p>Eye drops (C)</p> Signup and view all the answers

Which medication is most commonly used for managing hyperthyroidism?

<p>Methimazole (B)</p> Signup and view all the answers

What is the main reason patients may require hormone replacement therapy (HRT) after a thyroidectomy?

<p>Removal of thyroid gland (C)</p> Signup and view all the answers

What should patients avoid when managing hypothyroidism?

<p>Iodine-rich foods (C)</p> Signup and view all the answers

Which of the following is a primary cause of hypothyroidism?

<p>Hashimoto's thyroiditis (D)</p> Signup and view all the answers

What is a critical sign of myxedema coma that requires immediate intervention?

<p>Severe hypotension (B)</p> Signup and view all the answers

What is a common symptom of hypothyroidism that patients may experience?

<p>Eyelids drooping (A)</p> Signup and view all the answers

Which intervention is recommended for a patient who has undergone a thyroidectomy?

<p>Monitor calcium levels (B)</p> Signup and view all the answers

What should be done if a patient experiences symptoms of thyroid storm?

<p>Monitoring EKG and BP (B)</p> Signup and view all the answers

What is a potential risk of taking sedatives or narcotics in a patient with hypothyroidism?

<p>Myxedema coma (B)</p> Signup and view all the answers

What lifestyle change is vital for patients taking antithyroid medications?

<p>Avoiding iodine-rich foods (C)</p> Signup and view all the answers

Flashcards

Cancer Cachexia

A wasting syndrome characterized by unintentional weight loss, muscle atrophy, and immune dysfunction.

Radiation Therapy

A type of cancer treatment that uses high-energy beams to break chemical bonds in DNA, damaging cancerous cells.

Immunotherapy

A type of cancer treatment that utilizes the body's immune system to fight cancer. This includes using cytokines, vaccines, and monoclonal antibodies.

Targeted Therapy

A type of cancer treatment that targets specific molecules or pathways involved in cancer growth, minimizing damage to normal cells.

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Hematopoietic Stem Cell Transplantation (HSCT)

A treatment that aims to replace diseased bone marrow with healthy stem cells, often used for patients with chemotherapy-resistant tumors.

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Obstructive Oncologic Emergency

A life-threatening complication of cancer that involves tumor obstruction of an organ or blood vessel.

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Hormone Therapy

A form of cancer treatment that blocks the effects of hormones involved in cancer growth. Examples include corticosteroid blockers and estrogen receptor blockers.

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Chemotherapy

A type of cancer treatment that uses drugs to kill rapidly dividing cancer cells.

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Defective Cell Proliferation in Cancer

Cancer cells grow uncontrollably and ignore boundaries between cells. They invade and spread to other tissues, forming tumors.

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Defective Cell Differentiation in Cancer

Normal cells mature and perform a specific function. Cancer cells lack this specialization, taking on multiple functions, making them unpredictable.

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Initiation Stage of Cancer

A mutation in DNA that causes a cell to become cancerous. This can be caused by exposure to carcinogens.

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What are Carcinogens?

Carcinogens are substances that can cause cancer. They can be chemical, radiation or viral.

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Promotion Stage of Cancer

The stage where altered cells begin to rapidly multiply due to exposure to promoters. These accelerators can be hormones, alcohol, or certain dietary components.

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Leukemias and Lymphomas

Cancers of the blood and blood-forming tissues, like bone marrow.

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Carcinomas

Cancers that arise from cells lining organs and cavities, such as the skin, lungs, and digestive tract.

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Sarcomas

Cancers that develop from connective tissues, such as muscle, bone, and blood vessels.

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Hypothyroidism

This disorder occurs when the thyroid gland doesn't make enough thyroid hormones.

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Hashimoto's Thyroiditis

The most common cause of hypothyroidism. This is an autoimmune disorder where the body's immune system attacks the thyroid.

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Enlarged Thyroid (Goiter)

A sign of hypothyroidism that can be seen in most cases. It can occur with Hashimotos Thyroiditis.

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Hypothyroidism Symptoms

Classic symptoms of hypothyroidism, remember SLOW. It includes fatigue, weight gain, constipation, dry skin, hair loss, and intolerance to cold.

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Myxedema Coma

A serious complication of hypothyroidism that can be life-threatening. It occurs when the thyroid hormone levels are extremely low, resulting in a coma like state.

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Synthroid

A medication used to treat hypothyroidism. It's a synthetic form of thyroid hormone.

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Myxedema Coma

It's a medical emergency, requiring immediate action.

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Sedatives and Narcotics

Medications that should be avoided with hypothyroidism. These meds can put patients at risk for myxedema coma.

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Consistent Dosing

When taking thyroid hormone replacement medication, this principle is very important. Always take your meds at the same time each day.

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Hypothyroidism-related Brain Changes

A condition linked to hypothyroidism where the brain is affected. Can manifest as memory issues, confusion, and dementia.

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Vasoactive Intestinal Peptide (VIP)

A peptide hormone that controls the secretion and absorption of water from the intestines.

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What is the location and function of the thyroid gland?

The thyroid gland is a butterfly-shaped organ located in the neck, just below the Adam's apple. Its primary function is to regulate the body's metabolism.

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How does the thyroid produce its hormones?

The thyroid gland uses iodine from our diet to produce its primary hormones, T3 (triiodothyronine) and T4 (thyroxine). T4 is converted to T3, which is the more active form.

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What are the functions of T3 and T4?

T3 and T4, produced by the thyroid, are crucial for regulating metabolism. They affect heart rate, the sympathetic nervous system, growth, body temperature, fertility, digestion, muscle contractions, and the burning of calories.

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What is the function of Calcitonin?

Calcitonin, a hormone produced by the thyroid gland, plays a role in calcium metabolism, helping incorporate calcium into bones.

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What is Graves disease?

Graves disease is an autoimmune disorder in which the body produces antibodies (TSI) that stimulate the thyroid to overproduce thyroid hormones, leading to hyperthyroidism. This is often a hereditary condition.

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What are the signs and symptoms of Graves disease?

Graves disease, a hyperthyroid condition, can lead to protruding eyeballs, double vision, sensitivity to light, and a skin condition called pretibial myxedema, causing redness and swelling on the lower legs and feet.

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What is thyroid storm?

Thyroid storm is a medical emergency caused by severe hyperthyroidism. It can lead to high fever, rapid heartbeat, confusion, and even coma requiring immediate medical care.

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Hypocalcemia

A condition where the blood calcium levels are too low.

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Hyperphosphatemia

A condition where the blood phosphate levels are too high.

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Hypoparathyroidism

A condition that occurs when the parathyroid glands are not working properly, leading to low calcium levels in the blood.

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Trousseau's Sign

A sign of hypocalcemia where the hand and fingers spasm when the blood pressure cuff is inflated.

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Chvostek's Sign

A sign of hypocalcemia where tapping lightly on the face causes twitching of the facial muscles.

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Adrenal Glands

Small, yellowish-brown glands located on top of the kidneys.

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Adrenal Medulla

The inner portion of the adrenal glands, which produces hormones like adrenaline.

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Adrenal Cortex

The outer portion of the adrenal glands, which produces hormones like cortisol.

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Adrenal Crisis

A life-threatening medical emergency that occurs when the adrenal glands are unable to produce sufficient cortisol. This can be caused by Addison's disease, adrenalectomy, or pituitary gland dysfunction.

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Pheochromocytoma

A rare tumor in the adrenal medulla that produces excessive amounts of catecholamines, such as epinephrine and norepinephrine.

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Cortisol

The primary hormone secreted by the adrenal cortex in response to stress. Cortisol plays a crucial role in regulating blood sugar, blood pressure, and immune response.

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Adrenal Crisis Symptoms

A serious condition characterized by severe pain in the abdomen, back, and legs, often accompanied by weakness, dehydration, and potentially loss of consciousness.

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Adrenal Crisis Treatment

Immediate treatment for adrenal crisis includes intravenous administration of Solu-Cortef (hydrocortisone) and fluids (D5NS) to restore hormone balance and hydration.

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Study Notes

Med-Surg Study Guide

  • Burns: Covers types (thermal, chemical, electrical, cold, radiation, friction), burn severity (depth and extent), location-related issues. Includes the Rule of Nines for burn assessment. Includes the Parkland formula for calculating fluid therapy needs. Includes risk factors for burn patients.

  • Cancer: Details the pathophysiology, types of cancer (leukemia/lymphoma, carcinoma, sarcoma), and stages of cancer development (initiation, promotion, progression). Information on prevention (limit exposure to carcinogens, healthy lifestyle) and types of treatment.

  • Cardiac Basics: Includes cardiac terms such as preload/afterload, stroke volume, cardiac output, ejection fraction. Details about the flow of blood through the heart, heart sounds and cardiac biomarkers.

  • Heart Failure: Describes left-sided and right-sided heart failure, including causes (CAD, MI, HTN, damaged valves). Includes risk factors, signs/symptoms, and diagnosis using BNP levels. Discusses interventions and diet recommendations.

  • Coronary Artery Disease (CAD): Explains the buildup of fatty plaques, types of CAD, risk factors (modifiable & not). Covers signs/symptoms and diagnostic methods, as well as interventions and medications to manage CAD.

  • Angina Pectoris: Details the cause (reduced blood flow), types (stable, unstable, variant), signs/symptoms, risk factors, and includes the treatment and diagnostic methods.

  • Myocardial Infarction (MI): Describes the decreased blood flow, causes, early signs, and heart changes post-MI. Includes risk factors, signs/symptoms in both men and women, and the time-related changes after an MI. Discusses possible interventions.

  • Electrolyte Imbalances: Covers sodium (Na+), potassium (K+), calcium (Ca++), Magnesium (Mg++), chloride (Cl-) and phosphorus (P04) imbalances, with normal ranges and causes (high and low). Includes symptoms and management strategies. Includes a section on relationships between electrolytes.

  • Endocrine System: Details the major endocrine glands (hypothalamus, pituitary, pineal, parathyroid, thyroid, thymus, adrenal, pancreas, ovaries, testes) and their functions. Includes the pathophysiology and causes/symptoms for related disorders like hyperthyroidism, hypothyroidism and Cushing's Syndrome, and Addison's Disease.

  • Gastrointestinal: Includes the digestive system, functions, and accessory organs, detailing their role in digestion. Describes issues like gastroesophageal reflux disease (GERD), peptic ulcer disease, and inflammatory bowel disease (IBD). Includes relevant types (i.e. Crohn's, Ulcerative Colitis), causes/symptoms, and treatment.

  • Musculoskeletal: Defines bone cells, joints, muscles, tendons, bursae, fascia and covers issues such as sprains/strains, repetitive strain injury, rotator cuff injury, cartilage injury and fractures, including descriptions, causes, and treatments.

  • Respiratory: Covers lung anatomy and physiology, including gas exchange. Includes conditions such as pneumonia, COPD, and asthma. Discusses relevant signs and symptoms, causes and treatment.

  • Neurology: Covers brain anatomy, including lobes (frontal, parietal, temporal, occipital), cerebellum and brainstem. Details the role of Cranial nerves. Includes diseases like increased intracranial pressure, stroke, multiple sclerosis, Parkinson's disease, myasthenia gravis.

  • Urinary Tract Infections: Describes the causes and symptoms of various urinary tract infections (UTIs). Includes Urethritis, Pyelonephritis, Cystitis and details on diagnosis and treatment.

  • Renal: Covers the kidney's anatomy (renal capsule, cortex, medulla, renal artery/vein), along with nephron functions. Details the RAAS system as well as kidney-related diseases such as Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), and Renal Calculi (Kidney Stones), detailing their respective causes, symptoms and treatments.

  • Other: Includes less specific but important topics, like the possible complications of the mentioned conditions where the page breaks out the information into different categories for clarity and ease of learning.

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