Module 10: Endocrine Disorders
Module Authors
Miguel Medina, PA-C
Assistant Professor, Physician Assistant Education Department
Western University of Health Sciences Pomona, CA
Debbie Santivaņez-Williams, MSc, FNP
Instructor, Master of Science in Nursing/Family Nurse Practitioner Program
Western University of Health Sciences, Pomona, CA
Tina M. Meyer, PA-C
Clinical Consultant and Adjunct Professor
Western University of Health Sciences, Pomona, CA
Review Concepts
Review Concept 1: Hypoglycemia
By the end of this Review Concept you should be able to:
- Define hypoglycemia and differentiate postprandial hypoglycemia, fasting hypoglycemia, and iatrogenic or exogenous hypoglycemia
- Differentiate the clinical presentations of postprandial hypoglycemia and fasting hypoglycemia
- Describe the diagnostic workup of postprandial hypoglycemia and fasting hypoglycemia
- List differential diagnosis of postprandial hypoglycemia and fasting hypoglycemia
- Describe acute and long-term management of hypoglycemia
Review Concept 2: Diabetes Mellitus
By the end of this Review Concept you should be able to:
- Define diabetes mellitus (DM) and describe the incidence of DM in the general population
- Differentiate Type 1 (insulin-dependent) and Type 2 (non-insulin dependent) DM in terms of incidence and prevalence
- Describe normal glucose metabolism in terms of the normal fed state and normal fasting state
- Describe the pathogenesis, etiology, and clinical presentation of Type 1 DM
- Describe the pathogenesis, etiology, and clinical presentation of Type 2 DM
- List macrovascular and microvascular complications of Type 2 DM
- Outline procedures and protocols for screening, diagnostic workup, and clinical management of patients with DM
- List nonpharmacological interventions used in the treatment of DM
- List pharmacological agents used alone or in combination for the treatment of DM
- List agents, mechanism of action, indications/ contraindications, adverse reactions and drug-drug interactions for the following agents antihyperglycemic agents:
- Sulfonylureas
- Metformin
- Acarbose
- Troglitazone
- Describe the use of insulin in the treatment of DM and the complications of insulin therapy
Review Concept 3: Dyslipidemias
By the end of this Review Concept you should be able to:
- Describe the epidemiology of dyslipidemia
- Differentiate primary and secondary causes of dyslipidemia
- Summarize National Cholesterol Education Program (NCEP) guidelines for cholesterol screening and interpretation of test results
- Describe the diagnostic workup and clinical management of patients with dyslipidemia based on:
- Total cholesterol levels
- Low-density lipoprotein levels
- High-density lipoprotein levels
- Triglyceride levels
- Describe the pharmacological management of dyslipidemia, including principal agents, administration, indications, and side effects
Review Concept 4: Goiters
By the end of this Review Concept you should be able to:
- Describe the epidemiology of goiters
- Differentiate the etiology and clinical presentation of diffuse goiters and multinodular goiters
- Outline procedures and protocols in the diagnostic workup of patients with goiters
- Differentiate procedures and protocols in the clinical management of patients with diffuse and multinodular goiters
- Describe the epidemiology, clinical presentation, and clinical management of subacute thyroiditis
Review Concept 5: Hypothyroidism
By the end of this Review Concept you should be able to:
- Describe the epidemiology and types of hypothyroidism
- Differentiate the etiology of hypothyroidism with and without thyroid gland enlargement
- Differentiate the clinical presentation of subclinical and clinical hypothyroidism
- List signs and symptoms of hypothyroidism in adults and infants
- Outline procedures and common findings in the diagnostic workup of the patient with hypothyroidism
- List differential diagnoses of hypothyroidism
- Outline procedures and protocols in the clinical management of the patient with hypothyroidism
- Describe dosing and administration recommended for levothyroxine replacement therapy
Review Concept 6: Hyperthyroidism
By the end of this Review Concept you should be able to:
- Describe the epidemiology of hyperthyroidism
- Differentiate the epidemiology and clinical characteristics of hyperthyroidism associated with:
- Graves' disease
- Toxic goiters and adenomas
- Thyroiditis
- Exogenous iodine and thyroid hormone
- Describe the clinical presentation and complications of advanced hyperthyroidism:
- Clinical presentation
- Pathogenesis and etiology
- Diagnostic workup
- Clinical management
- List tests and common findings in the diagnostic workup of the patient with hyperthyroidism
- Outline the procedures and protocols in the clinical management of the patient with Graves' disease
- Describe dosing, indications, and adverse reactions associated with the following agents used in the pharmacological treatment of Graves' disease:
- Radioactive iodide
- Thioamides
- Inorganic iodides
- Beta blockers
- Outline the procedures and protocols in the management of toxic multinodular goiters, adenomas, and thyroiditis
- Describe the epidemiology, clinical presentation, complications and management protocols associated with thyroid storm.
Review Concept 7: Disorders of the Adrenal Gland
By the end of this Review Concept you should be able to:
- Differentiate between the two primary disorders of the adrenal glands: Cushing's syndrome and Addison's disease
- Describe the epidemiology and clinical presentation of Addison's disease
- Outline procedures and findings in diagnostic workup of patients with Addison's disease
- Describe clinical management of patients with Addison's disease
- Describe incidence and onset of four different types of Cushing's syndrome
- Compare and contrast clinical presentation of Cushing's syndrome in young adults and older adults
- Outline procedures and findings in diagnostic workup of patients with Cushing's syndrome
- Describe clinical management of patients with Cushing's syndrome
Review Concept 8: Electrolyte Disorders
By the end of this Review Concept you should be able to:
- List common electrolyte disorders
- Define the following disorders:
- Hypokalemia
- Hyperkalemia
- Hyponatremia
- Hypernatremia
- Describe the epidemiology, clinical presentation of the electrolyte disorders listed above
- Outline procedures, findings for diagnostic workup of patient with any of the electrolyte disorders listed above
- Outline procedures clinical management of patient with any of the electrolyte disorders listed above
Review Concept 9: Acid-Base Disturbances
By the end of this Review Concept you should be able to:
- Define the following conditions in terms of their effect on the body's acid-base balance:
- Metabolic alkalosis
- Metabolic acidosis
- Lactic acidosis
- Respiratory alkalosis
- Respiratory acidosis
- Differentiate the above conditions in terms of their etiology, clinical presentation and treatment.
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