Adult Endo 2 Flashcards
What are some of the long term complications of DM?
Which is the major cause of mortality?
Cardiovascular Disease (major Cause) CAD
1) What HbA1C value indicates good control?
2) What happens if HbA1C is too low?
1) 6.5 or less
2) Hypoglycemia and syncope
1) What is a form of autonomic neuropathy?
2) What happens in it?
3) Why is this important?
1) Diabetic Gastropathy
2) Variable stomach emptying
3) Insulin requirements are variable
1) How can nephropathy for proteinuria be screened?
2) What is normal Urine Protein level?
3) As Kidney Function Declines, what happens to Insulin Requirement?
1) Random Urine Sample
2) <300 mg/24 hour
3) Also declines
(As Kidney fails, Increased amount of insulin in body, and thus less insulin is needed)
1) What is the earliest measurable sign of proteinuria and diabetic nephropathy?
2) What is the amount?
1) Microalbumin
2) 30 mg-300 mg
1) When is a 24hr urine collection used in diabetic nephropathy?
2) What is being used for?
1) Only in advanced Kidney Disease (NOT routinely)
2) Protein and Creatine Clearance
What should be ordered quarterly on diabetic patients?
1) SGM log (Self Glucose Monitoring)
2) HbA1C
3) Foot inspection
SHF
What should be done annually for diabetic monitoring?
1) Monofilament Testing
2) Urine Protein Screening
3) Dilated Eye Exam
MUD
What are some general foot care recommendations?
1) Daily Inspection
2) Moisturize (Avoid under/between toes)
3) Prescription Shoes
4) No Barefoot
DMP N
What is the most important Lifestyle Modification in diabetes
Physical Activity
What behavior is the single most additive risk for vascular disease?
Smoking
What are the characteristic of T1DM?
- Hormones
- Volume?
- Mental?
- Cause?
1) Absolute Insulin Deficiency
1) Absolute Glucagon Excess
2) Volume Depletion
3) Mental Status Changes
4) Autoimmune
What are the characteristic of T2DM?
1) Hormones?
2) Volume?
3) Mental?
1) Relative Insulin Deficiency and Glucagon Excess
2) Volume Depletion
3) Mental Status Changes
What are the signs and sx of Hyperthyroidism
1) Cardio Issues?
2) Fat?
3) GI?
4) Other?
1) Tachycardia and Bruits
2) Weight loss and Gynecomastia
3) Diarrhea
4) Tremor
TSH, Free T4 Levels
1) Primary Hypothyroid
2) Primary Hyperthyroidism
3) TSH Producing Tumor
4) Central Hypothyroidism
1) Increased TSH, Decreased FT4
2) Decreased TSH, Increased FT4
3) Increased TSH, Increased FT4
4) Decreased TSH, Decreased FT4
Euthyroid Sick
1) What do they look like?
2) What is the issue with labs?
3) What should be cautioned in this?
1) Critically Ill patient
2) Does not fit with primary, secondary, or tertiary dysfunction
3) Interpreting thyroid testing and treatment
Thyroid Surgery
1) What nerve can be damaged?
2) What other endocrine structure can be damaged?
1) Recurrent Laryngeal Nerve
2) Parathyroids
How does PTH increase intestinal absorption of calcium?
Stimulates Renal 1,25(OH)2D
1) If Ca and PO4 are moving in opposite directions, what is the issue?
2) If Ca and Po4 are moving in the same direction, what is the issue?
1) PTH Imbalance
2) Vitamin D issue
What are five causes of hypercalcemia?
1) Parathyroid
2) Malignancy
3) Vitamin D
4) High Bone Turnover
5) Renal Failure
PMV HR
What is the treatment for hypercalcemia of malignancy if patient has altered mental status or EKG changes (qt shortening)
Aggressive Volume expansion with isotonic Saline
How do you test for Osteoporosis and Excessive Bone Turn-over?
DEXA scan