Assessment & Management of Patients with Endocrine Disorders

Assessment & Management of Patients
with Endocrine Disorders
What is diabetes insipidus?
a disorder caused by inadequate amounts of ADH which causes excessive water loss


Clinical Manifestations diabetes insipidus
• urine output of 250mL/hour (polyuria)
• nocturia
• Intense thirst (polydipsia)
• hypovolemia/dehydration

Urine chemistry of diabetes insipidus (diagnostic)
decreased urine specific gravity
decreased osmolality
decreased pH
decreased sodium
decreased potassium


Serum chemistry of diabetes insipidus (diagnostic)
increased serum osmolality
increased sodium
increased potassium


Medical management diabetes insipidus
dDavp (desmopressin)
thiazide diuretics & NSAIDS can decrease urine output


What is Syndrome of Inappropriate Diuretic Hormone?
Excess amount of ADH (anti-diuretic hormone)


Syndrome of Inappropriate Diuretic Hormone manifestations
concentrated urine
decreased urine output
fluid retention
dilutional hyponatremia


Medical management Syndrome of Inappropriate Diuretic Hormone
hypertonic NaCl (3%) IV

, loop diuretics
vasopressin antagonists
tetracycline derivative


What is hypothyroidism?
too little thyroid hormone being produced


Hypothyroidism manifestations
fatigue/ expressionless
hair loss, dry skin
numbness/tingling
intolerance to cold
weight gain


Hypothyroidism diagnostics
TSH normal to high
T3, T4 levels- low
cholesterol levels- high
T3 resin uptake- increased
radioactive iodine uptake- decreased


Hypothyroidism SEVERE complications
Myxedema
-severe deficiency in thyroid hormone
-life-threatening
-hypo everything


Hypothyroidism medical management
Synthetic levothyroxine
glucocorticoids


What is hyperthyroidism?
Too much thyroid hormone being produced.


Hyperthyroidism manifestations
anxious/ fine tremor
heat intolerance
weight loss w/ increased appetite
diarrhea
exophthalmos