Reference LIst Lab Values For 241 Test 1

This is a reference list for what hormone levels and lab values change with what disorder. It also includes what lab tests are done to diagnose what disorders. I'm making this because between all the adrenal disorders and eferything they affect I'm having trouble keeping straight what causes what.

Disorders
Diabetes Insipidus - Decrease in ADH in both primary and secondary DI.

SAIDH - Inrease in ADH regardless of the cause.

Hypothyroidism - Primary has a reduction of T3 and T4 with an elevation of TSH. Secondary has a reduction in TSH, T3 and T4. Tertiary has a reduction in TRH, TSH, T3 and T4.

Hyperthyroidism - Graves disease is most common and results in an increase in T3 and T4 with a decrease in TSH. Hashimoto's can have an increase in T3 and T4 during the acute phase and a decrease during the chronic phase. Since the pituitary is unaffected by Hashimoto's TSH will decline during the acute phase and increase during the chronic phase. Goiter (enlargement) is caused by an increase in TSH in response to a decrease in T3 and T4.

Hyperparathyroidism - Increase in PTH from the parathyroid gland which results in an increase in serum calcium levels. Normally this is done in response to low calcium but in primary hyperparathyroidism this is not the case. Secondary is when phosphorus is not excreted by the kidneys which causes an increase in PTH. Phosphorus levels will not be high unless it's secondary.

Hypoparathyroidsm - Decrease in PTH not in response to calcium levels. Usually due to removal of PT.

Pheochromocytoma - Adrenal Medulla secretes more epi and norepi in sesponse to neoplasm. Urinary VMA (metabolites of epi and norepi) to diagnose. Also use a catecholimine serum test to check concentrations of epi and norepi. Supine for 30 minutes, saline lock 30 minutes before blood draw. Will also have hyperglycemia.

Aldosteronism - Increase in aldosterone from the adrenal cortex leads to hypernatremia, hypokalemia. and alkalosis.

Cushing's (Hypercortisolism) - Primary has an increase in cortisol, a glucocorticoid, as well as mineralcorticoids and androgens. The cause is an adrenal neoplasm so ACTH is low in response to elevated SSS hormones. Secondary and ectopic both have elevated ACTH levels, in addition to elevated cortisol levels, either from a pituitary problem or ectopic tumor. Hyperglycemia, hypernatremia, hypokalemia and lowered eosinophils.

Adrenalcortical Insuffeciency (jAddison's) - Primary has an ideopathic decrease in adrenal cortex function so a decrease in cortisol and aldosterone with an increase in ACTH to try and compensate. Secondary is due to pituitary malfunction so ACTH, cortisol, aldosterone and androgens are all decreased. Both have hypokalemia, hyponatremia, hypoglycemia and lowered esoeosinophils.

Diabetic Ketoacidosis -  Elevated glucose, ketones, acidosis lowered sodium and potassium.

HHNK - No ketosis or acidosis. Hyperglycemia, hyponatremia and hypokalemia.