Patho Exam 3 Ch 22

Which of the following is a symptom of a prolactinoma? Galactorrhea Loss of body hair Excessive menses Pregnancy

Galactorrhea, amenorrhea (absence of menses), hirsutism (excessive body hair), and osteopenia can be caused by a prolactinoma

Hypersecretion of thyroid hormone (TH) causes?

Graves disease Graves disease is caused by the hypersecretion of TH

Which of the following is a symptom of Graves disease? Lethargy Goiter Cool moist skin Decreased sympathetic response

Graves disease is an autoimmune disease. Its symptoms include hyperthyroidism, goiter (diffuse thyroid enlargement), ophthalmopathy, and dermopathy.

A person develops severe dehydration and hyperglycemia. An absence of ketosis has occurred. What condition does this person have? Hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) DKA Hypoglycemia Somogyi effec

HHNKS is different from DKA in the degree of insulin deficiency and fluid deficiency. It is also characterized by a lack of ketosis. Somogyi effect occurs when hypoglycemia stimulates glucose counter regulation of hormones, which causes a rebound hyperglycemia.

SIADH

Hyponatremia Water intoxication Posterior pituitary Fluid volume excess >BP < urine output < Sodium (hyponatremia) Excess antidiuretic hormone (ADH) Cuased by trauma, tumors, infection, meds Fluid restriction Diuretic Treat the underlying cause

Hyposecretion of thyroid hormone (TH)

Myxedema

Which of the following are associated with myxedema coma? (Select all that apply.) Decreased level of consciousness Hyperglycemia Lactic acidosis Hypertension

Myxedema coma is a diminished level of consciousness, which is an emergency associated with severe hypothyroidism. Signs and symptoms include hypothermia, hypoventilation, hypotension, hypoglycemia, and lactic acidosis.

Hypersecretion of adrenal medulla hormones

Pheochromocytoma A rare, catecholamine-secreting tumor that may precipitate life-threatening hypertension

ACTH

Secreted by anterior pituitary Linked to hypothalamus by hypophyseal portal system Hypthalamus secrets a releasing hormone CRH (corticotropic releasing hormone) to the anterior pituitary to release ACTH ACTH targets adrenal cortex -> cortisol ACTH targets adrenal cortex -> aldosterone Cortisol - converts fats and proteins into glucose Antiinflamitory aldosterone Facilitates Na reabsorption and K secretion in kidneys

Anterior Pituitary Hormones

TSH - thyroid - TH ACTH - adrenal cortex - cortisol & aldosterone FSH - gonads - sperm production FSH - gonads (ovaries) - egg development PRL (prolactin) - mammary glands - milk produciton LH (leutinizing) - gonads (ovaries) - ovulation - LH (leutinizing) - gonads (ovaries) estrogen and progesteron in prep for pregnancy LH (leutinizing) - gonads - Testosterone GH (growth hormone) - Liver - cells (food processing, growth and reproduction)

Which statement best describes the Somogyi effect? Hyperglycemia, followed by hypoglycemia Hypoglycemia, followed by rebound hyperglycemia Early morning rise in blood glucose with no hypoglycemia Early morning hypoglycemia without rebound hyperglycemia

The Somogyi effect is a unique combination of hypoglycemia, followed by rebound hyperglycemia.

Which condition is associated with the absence of hypothalamic releasing or inhibiting hormones? Hypotension Incorrect Cessation of menses Increased spermatogenesis Excessive height

The absence of hypothalamic releasing or inhibiting hormones causes the cessation of menses, impaired spermatogenesis, failure to thrive, and short stature in children.

Which of the following is a symptom of syndrome of inappropriate antidiuretic hormone (SIADH)? Hyponatremia Hypernatremia Hyperosmolality (serum) Hypo-osmolality (urine)

The cardinal features of SIADH are symptoms of water intoxication, which includes hyponatremia (low serum sodium), serum hypo-osmolality, and inappropriately concentrated (hyperosmolar) urine with respect to serum osmolality.

Graves ocular manifestations

There are two categories of ocular manifestations: (1) functional abnormalities resulting from hyperactivity of the sympathetic division of the autonomic nervous system (lag of the globe on upward gaze or a lag of the upper lid on downward gaze) and (2) infiltrative changes involving the orbital contents with enlargement of the ocular muscles. The infiltrative changes result from TSH receptor autoantibodies reacting with receptors on orbital fibroblasts. Increased secretion of hyaluronic acid, orbital fat accumulation, inflammation, and edema of the orbital contents result in exophthalmos (protrusion of the eyeball). Periorbital edema and extraocular muscle weakness lead to diplopia (double vision).

Which statement is true concerning a diagnosis of thyroid carcinoma? Thyroid carcinoma is the most common endocrine malignancy. Correct Individuals with thyroid carcinoma have elevated T3 and T4 levels. Incorrect Heredity appears to be the most common risk factor for thyroid carcinoma. Most tumors are undifferentiated.

Thyroid carcinoma is relatively rare but is the most common type of endocrine malignancy. Most individuals with thyroid carcinoma have normal T3 and T4 levels and are therefore euthyroid. The most common risk factor is exposure to ionizing radiation. Most tumors are differentiated.

An individual experiences visual changes that begin in one eye but now involve the second eye. Which condition does this person most likely have? Pituitary infarction ACTH insufficiency Growth hormone (GH) insufficiency Pituitary adenoma

With a pituitary adenoma, pressure on the optic chiasm can increase, which can cause visual changes that can progress from one eye to the other.

When an individual experiences nausea, vomiting, loss of body hair, fatigue, weakness, and hypoglycemia, which hormone deficiency is the most likely cause? Thyroid-stimulating hormone (TSH) Incorrect Adrenocorticotropic hormone (ACTH) Correct Follicle-stimulating hormone (FSH) Luteinizing hormone (LH)

Within 2 weeks of the complete absence of ACTH, symptoms of nausea, vomiting, anorexia, fatigue, and weakness develop. With the absence of TSH, cold intolerance, dry skin, mild myxedema, lethargy, and decreased metabolic rate are exhibited. FSH and LH deficiencies are associated with amenorrhea; atrophic changes in the vagina, uterus, and breasts; decrease in body hair; and diminished libido.

Graves disease

results from a form of type II hypersensitivity in which there is stimulation of the thyroid by autoantibodies directed against the TSH receptors stimulation of TSH receptors in the gland results in hyperplasia of the gland (goiter) and increased synthesis of TH, especially of triiodothyronine (T3). Increased levels of TH affect every physiologic system and result in the classic signs and symptoms of hyperthyroidism. TSH production by the pituitary is inhibited through the usual negative feedback loop.

The common cause of elevated levels of antidiuretic hormone (ADH) secretion is: A. Ectopically produced ADH B. Inflammation of the hypothalamus C. Posterior pituitary tumor D. Inflammation of the nephrons

A A common cause of elevated levels of ADH secretion is ectopically produced ADH

Hypoglycemia, followed by rebound hyperglycemia, is observed in those with: A. The Somogyi effect B. The dawn phenomenon C. Diabetic ketoacidosis D. Hyperosmolar hyperglycemic nonketotic syndrome

A Hypoglycemia, followed by rebound hyperglycemia, is observed only in the Somogyi effect.

Which condition may result from pressure exerted by a pituitary tumor? A. Hypothyroidism B. Hypercortisolism C. Diabetes insipidus D. Insulin hyposecretion

A If the tumor exerts sufficient pressure, then thyroid and adrenal hypofunction may occur because of lack of thyroid-stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH). These result in the symptoms of hypothyroidism and hypocortisolism. The remaining options are not associated with the pressure exerted by a pituitary tumor.

Which form of diabetes insipidus (DI) is treatable with exogenous antidiuretic hormone (ADH)? A. Neurogenic B. Psychogenic C. Nephrogenic D. Ischemic

A Neurogenic DI is treated with ADH replacement therapy

Diabetes insipidus is a result of: A. Antidiuretic hormone hyposecretion B. Antidiuretic hormone hypersecretion C. Insulin hyposecretion D. Insulin hypersecretion

A Of the available options, diabetes insipidus is a result of insufficient antidiuretic hormone.

Type 2 diabetes mellitus is best described as a(an): A. Resistance to insulin by insulin-sensitive tissues B. Need for lispro instead of regular insulin C. Increase of glucagon secretion from α cells of the pancreas D. Presence of insulin autoantibodies that destroy ß cells in the pancreas

A One of the basic pathophysiologic characteristics of type 2 diabetes is the development of insulin-resistant tissue cells. None of the remaining options appropriately describes type 2 diabetes

Which classification of oral hypoglycemic drugs decreases hepatic glucose production and increases insulin sensitivity and peripheral glucose uptake? A. Biguanide (metformin) B. Sulfonylureas (glyburide) C. Meglitinides (glinides) D. α-Glycosidase inhibitor (miglitol)

A Only biguanides decrease hepatic glucose production and increase insulin sensitivity and peripheral glucose uptake.

The term used to describe a person who experiences a lack of all hormones associated with the anterior pituitary is: A. Panhypopituitarism B. Adrenocorticotropic hormone deficiency C. Hypopituitarism D. Anterior pituitary failure

A Panhypopituitarism is the only available term that is correctly associated with the lack of all anterior pituitary hormones

Which laboratory value is consistently low in a patient with diabetes insipidus (DI)? A. Urine-specific gravity B. Serum sodium C. Urine protein D. Serum total protein

A The basic criteria for diagnosing DI include a low urine-specific gravity while sodium levels are high. Protein levels are not considered

Pathologic changes associated with Graves disease include: A. High levels of circulating thyroid-stimulating immunoglobulins B. Diminished levels of thyrotropin-releasing hormone C. High levels of thyroid-stimulating hormone D. Diminished levels of thyroid-binding globulin

A The only option that correctly describes the changes associated with Graves disease identifies high levels of circulating thyroid-stimulating immunoglobulins that are found in more than 95% of individuals diagnosed with the disease.

A patient who is diagnosed with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, no change in his polyuria level has occurred. These symptoms support a diagnosis of: A. Neurogenic diabetes insipidus B. Syndrome of inappropriate antidiuretic hormone C. Psychogenic polydipsia D. Osmotically induced diuresis

A The stated symptoms are reflective of neurogenic diabetes insipidus and not of the remaining options

Which serum glucose level would indicate hypoglycemia in a newborn? A. 28 mg/dl B. 40 mg/dl C. 60 mg/dl D. 80 mg/dlA

A Serum glucose <30 mg/dl in newborn (first 2 to 3 days) and <55 to 60 mg/dl in adults is associated with hypoglycemia.

A person may experience which complications as a result of a reduction in parathyroid hormone (PTH)? (Select all that apply.) A. Muscle spasms B. Tonic-clonic seizures C. Laryngeal spasms D. Hyporeflexia E. Asphyxiation

A, B, C, E Symptoms associated with hypoparathyroidism are related to hypocalcemia. Hypocalcemia causes a lowering of the threshold for nerve and muscle excitation so that a slight stimulus anywhere along the length of a nerve or muscle fiber may initiate a nerve impulse. This creates tetany manifested as muscle spasms, hyperreflexia, tonic-clonic convulsions, laryngeal spasms, and, in severe cases, death from asphyxiation.

A chronic complication of diabetes mellitus is likely to result in microvascular complications in which areas? (Select all that apply.) A. Eyes B. Coronary arteries C. Renal system D. Peripheral vascular system E. Nerves

A, C, E Of the options provided, the areas most often affected are the retina, kidneys, and nervesHypersecretion of thyroid hormone (TH)

Hypersecretion of growth hormone (GH)

Acromegaly

Which statement is true regarding acromegaly? Occurs as a result of excessive levels of ACTH. Is commonly caused by GH-secreting pituitary adenoma. Occurs more frequently in men than in women. Is a relatively common condition.

Acromegaly occurs as a result of GH hormone excess and is most commonly caused by a GH-secreting pituitary adenoma. It occurs more commonly in women and is a relatively uncommon condition occurring in approximately 70 in 1 million persons.

Hyposecretion of adrenal cortex hormone

Addison disease Autoimmune disease accounts for 70% of Addison's disease. This occurs when the body's immune system mistakenly attacks the adrenal glands. This autoimmune assault destroys the outer layer of the glands. Long-lasting infections -- such as tuberculosis, HIV, and some fungal infections -- can harm the adrenal glands

Which result may be used as a diagnosis for diabetes mellitus? Fasting glucose value greater than 126 mg/dl Plasma glucose value of 200 mg/dl or greater 30 minutes after ingesting glucose Random glucose level greater than 126 mg/dl Symptoms of polyphagia with a normal random glucose level

An accurate diagnosis occurs with more than one fasting glucose value greater than 126 mg/dl, a plasma glucose value in the 2-hour sample of 200 mg/dl or greater, or a random glucose level greater than 200 mg/dl with symptoms of polydipsia, polyphagia, and polyuria.

Which disorder is caused by hypersecretion of the growth hormone (GH) in adults? A. Cushing syndrome B. Acromegaly C. Giantism D. Myxedema

B Acromegaly is a term for adults who have been exposed to continuously high levels of GH, whereas the term giantism is reserved for children and adolescents. The other options do not apply to hypersecretion of GH.

Renal failure is the most common cause of which type of hyperparathyroidism? A. Primary B. Secondary C. Exogenous D. Inflammatory

B Chronic renal failure is the most common cause of secondary hyperparathyroidism because of the resulting hyperphosphatemia that stimulates parathyroid hormone secretion. Although the other options may occur, they are not the most common types of the disorder.

A patient diagnosed with diabetic ketoacidosis (DKA) has the following laboratory values: arterial pH 7.20; serum glucose 500 mg/dl; positive urine glucose and ketones; serum potassium (K+) 2 mEq/L; serum sodium (Na+) 130 mEq/L. The patient reports that he has been sick with the "flu" for 1 week. What relationship do these values have to his insulin deficiency? A. Increased glucose use causes the shift of fluid from the intravascular to the intracellular space. B. Decreased glucose use causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis. C. Increased glucose and fatty acids stimulate renal diuresis, electrolyte loss, and metabolic alkalosis. D. Decreased glucose use results in protein catabolism, tissue wasting, respiratory acidosis, and electrolyte loss.

B Decreased glucose causes fatty acid use, ketogenesis, metabolic acidosis, and osmotic diuresis, which have resulted in the symptoms listed in the question. The relationship between the stated assessment values and insulin deficiency is not effectively described by any of the other options

Giantism occurs only in children and adolescents because their: A. Growth hormones are still diminished. B. Epiphyseal plates have not yet closed. C. Skeletal muscles are not yet fully developed. D. Metabolic rates are higher than in adulthood.

B Giantism is related to the effects of growth hormones on the growth of long bones at their epiphyseal plates.

Which form of diabetic insipidus (DI) will result if the target cells for antidiuretic hormone (ADH) in the renal collecting tubules demonstrate insensitivity? A. Neurogenic B. Nephrogenic C. Psychogenic D. Ischemic

B Only nephrogenic DI is associated with an insensitivity of the renal collecting tubules to AD

Which disorder is considered a co-morbid condition of acromegaly? A. Hypotension B. Diabetes C. Brain cancer D. Thyroid cancer

B Symptoms of type 2 diabetes mellitus, such as polyuria and polydipsia, may occur. Acromegaly-associated hypertension is usually asymptomatic until symptoms of heart failure develop. Neither thyroid nor brain cancer has been associated with acromegaly.

The level of thyroid-stimulating hormone (TSH) in individuals with Graves disease is usually: A. High B. Low C. Normal D. In constant flux

B The hyperfunction of the thyroid gland leads to suppression of TSH because of the normal negative feedback mechanism, thus eliminating the other options as being correct. Graves disease is an autoimmune disorder that leads to an overactive thyroid gland (hyperthyroidism). An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks healthy tissue.

A deficiency of which chemical may result in hypothyroidism? A. Iron B. Iodine C. Zinc D. Magnesium

B The only cause of hypothyroidism from among the provided options is a deficiency of endemic iodine.

Which laboratory value would the nurse expect to find if a person is experiencing syndrome of inappropriate antidiuretic hormone (SIADH)? A. Hypernatremia and urine hypoosmolality B. Serum potassium (K+) level of 5 mEq/L and urine hyperosmolality C. Serum sodium (Na+) level of 120 mEq/L and serum hypoosmolality D. Hypokalemia and serum hyperosmolality

C A diagnosis of SIADH requires a serum sodium level of less than 135 mEq/L, serum hypoosmolality less than 280 mOsm/kg, and urine hyperosmolarity. Potassium levels are not considered a factor.

Polyuria occurs with diabetes mellitus because of the: A. Formation of ketones B. Chronic insulin resistance C. Elevation in serum glucose D. Increase in antidiuretic hormone

C Glucose accumulates in the blood and appears in the urine as the renal threshold for glucose is exceeded, producing an osmotic diuresis and the symptoms of polyuria and thirst.

The first laboratory test that indicates type 1 diabetes is causing the development of diabetic nephropathy is: A. Dipstick test for urine ketones B. Increase in serum creatinine and blood urea nitrogen C. Protein on urinalysis D. Cloudy urine on the urinalysis

C Microalbuminuria is the first manifestation of this form of renal failure. Although the other options may develop, they occur after protein is found in the urine.

What causes the microvascular complications in patients with diabetes mellitus? A. The capillaries contain plaques of lipids that obstruct blood flow. B. Pressure in capillaries increase as a result of the elevated glucose attracting water. C. The capillary basement membranes thicken, and cell hyperplasia develops. D. Fibrous plaques form from the proliferation of subendothelial smooth muscle of arteries.

C Microvascular complications are a result of capillary basement membranes thickening and endothelial cell hyperplasia. None of the remaining options appropriately describes the cause of microvascular complications in patients with diabetes mellitus

The cause of neurogenic diabetes insipidus (DI) is related to an organic lesion of the: A. Anterior pituitary B. Thalamus C. Posterior pituitary D. Renal tubules

C Neurogenic DI is a result of dysfunctional antidiuretic hormone synthesis, caused by a lesion of the posterior pituitary, hypothalamus, or pituitary stalk.

Visual disturbances are a result of a pituitary adenoma because of the: A. Liberation of anterior pituitary hormones into the optic chiasm B. Pituitary hormones clouding the lens of the eyes C. Pressure of the tumor on the optic chiasm D. Pressure of the tumor on the optic and oculomotor cranial nerves

C Of the available options, pressure on the optic chiasm is the only cause for visual disturbances resulting from a pituitary adenoma.

Amenorrhea, galactorrhea, hirsutism, and osteoporosis are each caused by a: A. Posterior pituitary adenoma B. Thymoma C. Prolactinoma D. Growth hormone adenoma

C Of the options available, the hallmark of a prolactinoma is the sustained elevation of serum prolactin that is responsible for the symptoms listed in the question. Prolactinoma is a condition in which a noncancerous tumor (adenoma) of the pituitary gland in your brain overproduces the hormone prolactin. The major effect is decreased levels of some sex hormones — estrogen in women and testosterone in men

The most common cause of hypoparathyroidism is: A. Pituitary hyposecretion B. Parathyroid adenoma C. Parathyroid gland damage D. Autoimmune parathyroid disease

C The most common cause of hypoparathyroidism is damage caused during thyroid surgery

The most probable cause of low serum calcium after a thyroidectomy is: A. Hyperparathyroidism, secondary to Graves disease B. Myxedema, secondary to surgery C. Hypoparathyroidism caused by surgical injury D. Hypothyroidism caused by the lack of thyroid replacement

C The most common cause of hypoparathyroidism is damage caused during thyroid surgery, resulting in a lack of circulating PTH and causing a depressed level of serum calcium.

A person diagnosed with type 1 diabetes experiences hunger, lightheadedness, tachycardia, pallor, headache, and confusion. The most probable cause of these symptoms is: A. Hyperglycemia caused by incorrect insulin administration B. Dawn phenomenon from eating a snack before bedtime C. Hypoglycemia caused by increased exercise D. Somogyi effect from insulin sensitivity

C The most likely cause of these symptoms is hypoglycemia, which is often caused by a lack of systemic glucose as a result of muscular activity. None of the remaining options appropriately describes why a person diagnosed with type 1 diabetes experiences the described symptoms.

Graves disease develops from a(n): A. Viral infection of the thyroid gland that causes overproduction of thyroid hormone B. Autoimmune process during which lymphocytes and fibrous tissue replace thyroid tissue C. Thyroid-stimulating immunoglobulin that causes overproduction of thyroid hormones D. Ingestion of goitrogens that inhibits the synthesis of the thyroid hormones, causing a goiter

C The pathologic features of Graves disease indicates that normal regulatory mechanisms are overridden by abnormal immunologic mechanisms that result in the stimulation of excessive TH.

The effects of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion include solute: A. Retention and water retention B. Retention and water loss C. Dilution and water retention D. Dilution and water loss

C The symptoms of SIADH secretion are a result of dilutional hyponatremia and water retention.

The signs of thyrotoxic crisis include: A. Constipation with gastric distention B. Bradycardia and bradypnea C. Hyperthermia and tachycardia D. Constipation and lethargy

C The systemic symptoms of thyrotoxic crisis include hyperthermia and tachycardia.

Posterior Pituitary

Contain neurons, which originate in the hypothalamus ADH (antidiuretic hormone) - kidney - electrolyte balance, BP, BV OT (Oxytocin) - prepare uterus for pregnancy (after pregnancy - milk in mammary glands) Release directly into system

Cortisol

Converts fats and proteins into glucose Antiinflamitory

Hypersecretion of adrenocorticotropic hormone (ACTH)

Cushing disease Cushing disease is caused by the hypersecretion of ACTH.

Diagnosing a thyroid carcinoma is best performed with: A. Measurement of serum thyroid levels B. Radioisotope scanning C. Ultrasonography D. Fine-needle aspiration biopsy

D Fine-needle aspiration of a thyroid nodule is generally performed to diagnose this condition; this method is best for early detection, thus eliminating the other options.

When comparing the clinical manifestations of both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS), which condition is associated with only DKA? A. Fluid loss B. Weight loss C. Increased serum glucose D. Kussmaul respirations

D Kussmaul respirations are only observed in those with DKA.

Retinopathy develops in patients with diabetes mellitus because: A. Plaques of lipids develop in the retinal vessels. B. Pressure in the retinal vessels increase as a result of increased osmotic pressure. C. Ketones cause microaneurysms in the retinal vessels. D. Retinal ischemia and red blood cell aggregation occur.

D Retinopathy appears to be a response to retinal ischemia and red blood cell aggregation. None of the remaining options appropriately describes the relationship between retinopathy and diabetes mellitus

What are clinical manifestations of hypothyroidism? A. Intolerance to heat, tachycardia, and weight loss B. Oligomenorrhea, fatigue, and warm skin C. Restlessness, increased appetite, and metrorrhagia D. Constipation, decreased heat rate, and lethargy

D The lower levels of thyroid hormone result in decreased energy metabolism, resulting in constipation, bradycardia, and lethargy, thus eliminating the remaining options

Palpation of the neck of a person diagnosed with Graves disease would detect a thyroid that is: A. Left of midline B. Small with discrete nodules C. Normal in size D. Diffusely enlarged

D The only option that characterizes Graves disease is a diffused enlargement of the thyroid gland.

A person has acne, easy bruising, thin extremities, and truncal obesity. These clinical manifestations are indicative of which endocrine disorder? A. Hyperthyroidism B. Hypoaldosteronism C. Diabetes insipidus D. Cushing disease

D These symptoms are characteristic of Cushing disease and are caused by excessive ACTH secretion.

Diabetes insipidus, diabetes mellitus, and syndrome of inappropriate antidiuretic hormone all exhibit which symptom? A. Polyuria B. Edema C. Vomiting D. Thirst

D Thirst is the only symptom common to all these conditions.

Which statement is true regarding diabetic ketoacidosis (DKA)? An increase in insulin is observed. Assessment shows a decrease in catecholamines. Condition peaks in the older adult. Accelerated gluconeogenesis and ketogenesis are present

DKA develops when an absolute or relative deficiency of insulin or an increase in insulin counter regulatory hormones is present. This increase includes catecholamines, cortisol, glucagon, and growth hormone. Emotional factors and stress, especially in children, can contribute to the development of DKA. Profound insulin deficiency results in decreased glucose uptake, increased fat mobilization with the release of fatty acids, and accelerated gluconeogenesis and ketogenesis. In addition, glucose production increases, peripheral glucose use decreases, and fat mobilization increases.

DI

Decrease in antidiuretic hormone (ADH) < fluid vol deficit > urine output (up to 3 L) dry/degtdrated (sunken eyes) Thirsty <BP > sodium concentration due to water loss (Hypernatremia) Treat underlying cause Increase fluid replacement (keep hydrated) Synthetic ADH (DDAVP)

Aldosterone

Facilitates Na reabsorption and K secretion in kidneys