Endocrine Study Guide
📌 1. Endocrine System Overview
● Functions: Regulates metabolism, growth, development, tissue function, sexual function,
reproduction, sleep, and mood.
● Endocrine glands release hormones directly into the bloodstream.
● Disorders are caused by either an underproduction or overproduction of hormones
📌 2. Pituitary Gland – “Master Gland”
● Hormones: Anterior: TSH, ACTH, GH, LH, FSH, Prolactin Posterior: ADH and
Oxytocin
● Disorders:
○ Cushing's Syndrome (Excess secretion of ACTH) ↑ circulating cortisol: Moon
face, buffalo hump, weight gain, thin skin, striae. - May have body image issues
○ Diabetes Insipidus (↓ADH): Polyuria, polydipsia, low urine specific gravity
(dilute urine) and excessive thirst .
○ Acromegaly: Overproduction of GH (Somatotropin) after puberty – enlarged
hands, feet, jaw.
○ Dwarfism: underproduction of GH (Somatotropin) - short stature
📌 3. Thyroid Gland
● Hormones: T3, T4, Calcitonin
● Diagnostic Tests: TSH, Free T4, Radioactive iodine uptake, thyroid scan.
○ Assess medications (especially with iodine) taken 24 hours prior to any imaging
● Hypothyroidism: (Hashimoto’s disease)
○ Decreased T3 T4 - Increased TSH
○ Causes: Autoimmune & lack iodine in diet
○ S/S: Cold intolerance, fatigue, weight gain, dry skin, hair loss, goiter.
○ Myxedema coma: Life-threatening; caused by levothyroxine non-compliance.
● Treatment: Levothyroxine for life - dosing may change based on lab results
● Hyperthyroidism (Graves’ Disease):
○ S/S: Heat intolerance, weight loss, tachycardia, goiter, bulging eyes
(exophthalmos).
○ Thyroid Storm: Hyperthermia, tachycardia, nausea, restlessness.
○ Treatment: Methimazole, PTU, radioactive iodine, thyroidectomy, beta blockers
help tachycardia and anxiety (end in LOL).
○ Thyroidectomy Complications: Airway obstruction (from swelling), tetany
(monitor for Chvostek’s and Trousseau’s signs), nerve damage, bleeding.
📌 4. Parathyroid Glands
● Regulates calcium and phosphate.
● Hyperparathyroidism: ↑ calcium (risk for kidney stones, bone pain). Provide adequate
hydration and nutrition, may lower calcium in diet (not eliminate it)
● Hypoparathyroidism: ↓ calcium → tetany, seizures, positive Chvostek’s (cheek) &
Trousseau’s (hand flexing inward).
● Treat with calcium gluconate, vitamin D.
📌 5. Adrenal Glands
● Hormones: (Cortex) Cortisol, aldosterone, (Medulla) epinephrine, norepinephrine.
● Secretion of epinephrine help regulate blood pressure
● Cushing’s Disease (↑ cortisol & ACTH): See above.
● Addison’s Disease (↓ cortisol/aldosterone): Weakness, hyperpigmentation,
hypotension.
● Adrenal crisis: Life-threatening, treat with IV steroids.
📌 6. Ovaries & Testes
● Ovaries: Produce estrogen & progesterone.
● Testes: LH stimulates testosterone production.
● Polycystic Ovarian Syndrome (PCOS):
○ S/S: Irregular menses, excessive hair growth, infertility.
○ Risks: Type 2 diabetes, obesity, sleep apnea.
○ Tx: Metformin, lifestyle change, hormonal regulation.
📌 7. Pancreas & Diabetes
● Endocrine function: Insulin, glucagon.
● Types of Diabetes:
○ Type 1: Autoimmune destruction of beta cells – insulin dependent.
○ Type 2: Insulin resistance – lifestyle-related.
○ Gestational Diabetes
○ Pre-diabetes: A1C 5.7–6.4% ○
■ Educate the patient to increase activity to help lower glucose levels for 24
hours post-exercise
■ Dietary changes ; lose weight; overall lifestyle changes
○
● A1C Goal: < 7% Helps determine effectiveness of treatment for blood sugar control
● DKA (Type 1):
○ S/S: Fruity breath, Kussmaul respirations, dehydration, 3 P’s.
○ Tx: IV - give fluids (Normal Saline 0.9%), insulin, monitor potassium.
● Diabetes Education:
○ Foot care, examine for sores, monitor for hypo/hyperglycemia.
○ Medication: Insulin types, Metformin, GLP-1s (Ozempic), SGLT2 inhibitors.
○ Nutrition: Carb counting (45-60 gms daily), low glycemic diet.
📌 8. Labs & Diagnostics to Know
Test/Result Interpretation
TSH ↑ Hypothyroidism
TSH ↓ Hyperthyroidism
Serum Calcium ↑ Hyperparathyroidism, risk of kidney stones
Serum Calcium ↓ Hypoparathyroidism, risk of tetany
A1C > 6.5% Diabetes Diagnosis
GCS < 9 + Glucose < 40 Emergency – give D50
📌 Extra things
● Methimazole Teaching: (Hyperthyroidism) Don’t stop abruptly, take at same time daily!
It takes time to work.
● Radioactive Iodine: Avoid contact, flush twice, avoid children and pregnant women 5
days, etc, see slide.
● Thyroidectomy Positioning: High Fowler's to prevent respiratory distress. Think about
swelling around the airway.
● Calcium Gluconate: For tetany post-thyroidectomy.
● Shellfish Allergy: Contraindication for iodine-based scans.
● Sulkowitch Urine: Helps to diagnose Hyperparathyroidism - measures secreted Ca+
● Insulin Glargine (Lantus) - no peak effect - long acting
● Regular Insulin - peak effect 30 minutes
● PTU - blocks T3 and T4 and inhibits production of new thyroid hormone
● Betablockers - decrease anxiety and heart rate in hyperthyroidism
● Methimazole - treats excessive thyroid hormone
● I-131- Radioactive Iodine used to destroy thyroid gland and decrease amount of
thyroxine - if too much destruction will lead to hypothyroidism nand will need
Levothyroxine
● Normal Calcium Levels - 8.8-10.4
● TSH - 0.4-4.0 (will be opposite of T3 and T4)
● Phosphorous 2.7-4.5
● Magnesium 1.8-2.6
**This is not all inclusive but a great guide to help you study key points for
the exam - make flashcards and memorize please!