2 disease states

Question 1

diabetic ketoacidosis is…

Answer 1

life threatening complication of severe insulin deficiency

Question 2

diabetic ketoacidosis symptoms

Answer 2

• hyperglycemia
• water loss
• hypokalemia
• altered fat metabolism (production of ketones)

Question 3

hypoglycemia is…

Answer 3

complication of insulin therapy

- blood glucose < 50 mg/dl

Question 4

initial hypoglycemia symptoms

Answer 4

• tachycardia
• palpitations
• sweating
• nervousness

P.N.T.S.

Question 5

untreated hypoglycemia symptoms

Answer 5

• headache
• confusion
• drowsiness
• fatigue

Question 6

severe hypoglycemia symptoms

Answer 6

• seizure
• coma
• death

Question 7

hypoglycemia treatment

Answer 7

TEST GAG REFLEX (so patient doesn’t aspirate)

• administer 10-20g of carbs
• severe: IV dextrose, IM glucagon

Question 8

type 1 diabetes

Answer 8

(formerly juvenile onset)

• destruction of pancreas beta cell (responsible for insulin synthesis)

SIGNIFICANT HYPERGLYCEMIA at presentation

Question 9

type 2 diabetes

Answer 9

non-insulin dependent, adult onset

• insulin resistance and/or impaired insulin secretion
• lifestyle modifications!!!!!!!!!!!!!!!!
• primarily treatment: oral agents
• insulin may be prescribed if not responsive to lifestyle modifications and oral meds

SIGNIFICANT HYPERGLYCEMIA at presentation

Question 10

lipodystrophy

Answer 10

tissue atrophy or hypertrophy

can interfere with insulin absorption

Question 11

gigantism

Answer 11

excessive growth during childhood

GH!

Question 12

acromegaly

Answer 12

excessive growth after puberty

GH!

Question 13

hyperthyroidism treatments (x3)

Answer 13

• treat the cause!
• tapazole (methimazole)
• PTU (propylthiouracil)
• Iodine-131

Question 14

hypothyroidism looks like…

Answer 14

• cretinism
• myxedema
• primary, secondary
• s/s resulting from hyperthyroidism tx

Question 15

hyperthyroidism looks like…

Answer 15

• grave’s disease
• plummer’s disease (toxic nodular goiter)
• • thyroid carcinoma
• thyrotoxic crisis (thyroid storm)
• pituitary adenoma
• overtreatment of hypothyroidism

Question 16

grave’s disease

Answer 16

thyrotoxicosis, excess T4 and T3

Question 17

hypothyroidism primary cause

Answer 17

thyroid gland disorder

Question 18

hypothyroidism secondary cause

Answer 18

decrease in TSH secretion

Question 19

addison’s disease

Answer 19

adrenal insufficiency (hyposecretion)

Question 20

cushing’s syndrome

Answer 20

hyperaldosteronism

Question 21

grave’s disease looks like

Answer 21

• exopthalmos
• tachycardia), palpitations
• excessive perspiration, heat intolerance
• nervousness, irritability
• weight loss

Question 22

cretinism

Answer 22

hypothyroidism

Question 23

myxedema

Answer 23

hypothyroidism

Question 24

plummer’s disease

Answer 24

toxic nodular goiter, hyperthyroidism

• caused by thyroid adenoma
• NO exopthalmos

Question 25

thyrotoxic crisis

Answer 25

• severe thyrotoxicosis

- excessive levels of thyroid hormones

Question 26

myxedema

Answer 26

• severe thyroid deficiency
• exaggerated presentation of hypothyroidism
• coma –> death

Question 27

cretinism

Answer 27

• hypothyroidism in infants
• stunted growth
• dwarfism
• puffy face
• potbelly
• macroglossia
• mental deficiency
• hearing impairment

Question 28

ADH deficiency

Answer 28

treat with vasopressin analog

Question 29

excess free water

Answer 29

treat with AVP antagonist – ONLY WORKS IN KIDNEYS

Question 30

excess free water looks like

Answer 30

CHF
cirrhosis (osmolality, osmotic pressure messed up)
SIADH (syndrome of inappropriate ADH)