Alterations of Endocrine Function II

Question 1

What is insulin?

Answer 1

• Produced by Beta cells in the endocrine pancreas

- half-life is short (in 15mins you only have half of what was started with)

Question 2

General physiological effects of insulin:

Answer 2

• control of postprandial plasma glucose levels
• promotes glucose storage as glycogen
• lipid and protein synthesis

Question 3

What is diabetes Mellitus?

Answer 3

A group of disorders associated with alterations in insulin activity.

Question 4

Type 1 diabetes Mellitus (DM)

What is it and possible causes?

Answer 4

Autoimmune disease: autoantibodies and cytotoxic T cells target beta cells and insulin

Possible causes: genetics and environmental factors

Question 5

Patho of Diabetes Mellitus?

Answer 5

Autoimmune destruction of pancreatic beta cells leads to insulin deficiency

Question 6

Decreased potassium uptake into cells leads to…

Answer 6

Hyperkalemia

Question 7

Clinical manifestations of Diabetes Mellitus (DM)

Answer 7

Uncontrolled or undiagnosed type 1 DM

• UA (urinalysis)
• polyuria (increased urine output)
• usually hungry

Question 8

Acute complications of type 1 diabetes

Answer 8

Hypoglycemia

Blood glucose level <50-60mg/dL

Question 9

Causes in Diabetics

Answer 9

• overdose of insulin
• delayed or omitted meals
• increased exercise
• alcohol and drugs

Question 10

Early manifestations of Type 1:

Answer 10

SNS (sympathetic nervous system) response to low blood glucose levels triggers the adrenal medulla to produce epinephrine

Question 11

Later manifestations type 1:

Answer 11

Due to decreased CNS function

• brain is not getting enough glucose
• seizures
• always give sugar than insulin

Question 12

Hypoglycemia unawareness

Answer 12

Typically occurs in long-term type 1 diabetes

-normal autonomic warning signs are not perceived

Question 13

Diabetic Ketoacidosis (DKA)

Answer 13

Acute, life threatening hyperglycemia complication of type 1 DM

Question 14

Causes of DKA

Answer 14

• Omission of insulin in a type 1 diabetic

- Undiagnosed type 1 diabetes Mellitus (high sugars)

Question 15

Clinical consequences of DKA

Answer 15

• severe hyperglycemia
• hypotension and shock
• fluid and electrolyte imbalance

Question 16

What is Type 2 DM?

Answer 16

Known as non-insulin-dependent diabetes or adult onset diabetes

Question 17

Risk factors:

-ethnicity

Answer 17

• Polycystic ovarian syndrome

- Native America, Hispanic, Pacific Islander, African American

Question 18

Patho Type 2 DM?

Answer 18

• Leads to Hyperinsulinemia
• insulin resistance
• decreased glucose uptake leads to hyperglycemia

Question 19

Clinical Manifestations of Type 2 DM

Answer 19

• polyuria (increased urine output)
• polydipsia (thirst)
• other changes

Question 20

Acute complication of Type 2 DM

Answer 20

Hyperosmolar Hyperglycemic Nonketonic Syndrome (HHNKS)

-no keytones being produced

Question 21

Causes of Type 2 DM

Answer 21

> 60

• Failure to take meds
• taking Beta blockers

Question 22

Chronic complications of DM

Answer 22

Related to hyperglycemia regardless of the type

Question 23

Neuropathies

Answer 23

Peripheral neuron dysfunction

Question 24

Increased risk of infection in DM

Answer 24

If a diabetic has a wound, it’ll take time to heal

Question 25

The symptom of glycosuria in diabetes Mellitus is best explained by which of the following mechanisms?

Answer 25

The transport maximum for glucose reabsorption is reached which stimulates the process of osmotic diuresis

Question 26

T or F: an acute insulin deficiency causes potassium to shift into cells resulting in hypokalemia ?

Answer 26

FALSE

Question 27

Type 1 DM signs and symptoms:

Answer 27

Polydipsia and polyuria

Question 28

T or F: Type 1 diabetes is mainly a result of genetics, whereas the causes of type 2 diabetes are mainly environmental?

Answer 28

FALSE

Question 29

Patho of Type 2 DM involves:

Answer 29

Down regulation of insulin receptor

Question 30

Which of the following Patho features is present in HHNKS?

Answer 30

Profound Dehydration

Question 31

Management of diabetes Mellitus involves measuring glycosylated hemoglobin levels. The purpose of this test is:

Answer 31

Monitor long-term glucose control

Question 32

Patho of DKA?

Answer 32

Flow chart on on page 6 of notes