Alterations Of Endocrine Functon Flashcards

1
Q

What is the cause of type 1 diabetes mellitus?

A

An autoimmune response that targets the beta cells in the pancreas

Type 1 diabetes mellitus is caused by autoimmune destruction of pancreatic beta cells leads to insulin deficiency. The possible causes are genetics and environmental factors including viral infection and possibly diet.

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2
Q

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

A

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

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3
Q

An acute insulin deficiency causes potassium to shift into cells resulting in hypokalemia.

A

False

The presence of insulin stimulates glucose uptake into cells. During the process of glucose uptake, potassium in transported into the cell. An acute insulin deficiency results in a decrease in glucose uptake resulting in hyperglycemia, and a decrease in potassium uptake resulting in hyperkalemia.

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4
Q

Why do individuals with type I diabetes mellitus sometimes produce excess ketones?

A

Insulin deficiency leads to the uncontrolled breakdown of fat/lipids in adipose tissue.

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5
Q

Bobby Davies, a 12-year-old male, is newly diagnosed with type 1 diabetes mellitus (DM). His blood glucose level is 280 mg/dL (normal - 70-110 mg/dL). The signs and symptoms of DM you would expect Bobby to exhibit include:

A

polydipsia and polyuria.

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6
Q

What is a risk factor for hypoglycemia among type 1 diabetics?

A

Taking insulin and not eating

Insulin decreases plasma glucose levels and therefore can potentially cause hypoglycemia.

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7
Q

Type 1 diabetics who experience repeated episodes of hypoglycemia often miss the early warning signs of hypoglycemia because:

A

the early autonomic warning signs are not activated.

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8
Q

Nineteen-year-old Susan Lee has type 1 diabetes mellitus. She is admitted to the hospital with the following lab values: plasma glucose 500 mg/dl (high); urine glucose 4+ (high); arterial pH 7.20 (low). Her parents state that she has been sick with the “flu” for a week. Which of the following statements best explains her circumstances?

A

The stress of her viral illness has caused ketoacidosis.

Elevated plasma glucose, glycosuria, and low blood pH is characteristic of diabetic ketoacidosis. This complication occurs in type 1 diabetics and can occur in response to severe stress, illness, omission of insulin, or taking medications that raise blood glucose levels.

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9
Q

Type 1 diabetes is mainly a result of genetics, whereas the causes of type 2 diabetes are strictly environmental.

A

False

Type 2 diabetes mellitus actually has a stronger genetic link that type 1 diabetes. Type 1 diabetes is understood to be caused by a combination of genetic and environmental factors.

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10
Q

The pathophysiology of type 2 diabetes mellitus (DM) involves:

A

down regulation of insulin receptors.

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11
Q

In addition to hyperglycemia, what other condition often develops in type 2 diabetics?

A

Dyslipidemia

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12
Q

Which pathophysiological feature is present in hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)?

A

Profound dehydration

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13
Q

Management of diabetes mellitus involves measuring glycosylated hemoglobin (hemoglobin A1c) levels. The purpose of this test is to:

A

monitor long-term glucose control.

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14
Q

Chronic complications of type 1 and type 2 diabetes mellitus (DM) such as retinopathy and nephropathy are primarily related to:

A

chronic, uncontrolled hyperglycemia.

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15
Q

What are the 3 main consequences of insulin deficiency?

A

Decreased glucose uptake into cells (cell starvation in the land of plenty, Hyperglycemia)
Decreased potassium uptake into cells (K+ isn’t transported into the cell with glucose)
Fat breakdown in adipose tissue (decreased inhibition of lipolysis, it occurs unchecked)

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16
Q

In patients with type 1 diabetes, what clinical manifestations do patients report? And which are observed in clinic?

A

Patients report:
Polyuria
Polydipsia
Polyphagia
Weight loss

In clinic observe:
Glycosuria
Hypergycemia

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17
Q

What is diabetic ketoacidosis?

A

Is caused by a severe insulin deficiency leading to severe hyperglycemia and uncontrolled lipolysis.

18
Q

What are the main causes of diabetic ketoacidosis?

A

Undiagnosed type 1 diabetes mellitus
Omission of insulin
Physiological stress
Taking medications that antagonize insulin

19
Q

What is hypoglycemia?

A

Blood glucose level < 50-60 mg/dL
Results from getting too much insulin for the body’s current needs

20
Q

What are hypoglycemia clinical manifestations?

A

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

See tachycardia, palpitations, diaphoresis

21
Q

What are late clinical manifestations of hypoglycemia?

A

Due to decreased CNS function (brain is largely dependent on glucose)

See confusion, headache, irritability, weakness, double vision, and later seizures and loss of consciousness

22
Q

What are type 2 diabetes mellitus risk factors?

A

Genetics
Obesity
Age > 40 years
Ethnicity
Polycystic ovarian syndrome
Hyperinsulinemia

23
Q

What conditions often develops in type 2 diabetes?

A

Downregulation of Insulin Receptors
Decreased glucose uptake into cells
Development of dyslipidemia
Beta cell destruction
Metabolic Syndrome

24
Q

What are the clinical manifestations of type 2 diabetes?

A

Same as in Type 1, without the weight loss
Polyuria (increased urine output)
Polydipsia (thirst)
Glycosuria (glucose in the urine)
Hyperglycemia (high glucose in blood)

25
Q

An acute insulin deficiency causes potassium to shift into cells resulting in hypokalemia.

A

False

26
Q

What causes Diabetic ketoacidosis (DKA)?

A

Undiagnosed type 1 diabetes mellitus
Omission of insulin
Physiological stress
Taking medications that antagonize insulin

27
Q

What causes Hypoglycemia?

A

Overdose of insulin (or antihyperglycemic agents)
Delayed or omitted meals after taking insulin
Increased exercise (especially without extra food)
Alcohol

28
Q

What are the risk factors of Type 2 Diabetes Mellitus?

A

Genetics
Obesity
Age >40 years
Ethnicity
Polycystic ovarian syndrome

29
Q

If insulin levels are chronically high, the individual is said to have

A

hyperinsulinemia.

30
Q

What is Type 2 diabetes in a nutshell:

A

Downregulation of Insulin Receptors
Decreased glucose uptake into cells
Development of dyslipidemia
Beta cell destruction
Metabolic Syndrome

31
Q

What is retinopathy?

A

Damaged capillaries in the retina leads to visual disturbances and blindness

32
Q

What is Nephropathy?

A

Damaged capillaries in the kidneys leads to loss of protein in the urine and eventually chronic renal failure

33
Q

What causes neuropathy?

A

Hyperglycemia leads to compromised perfusion of peripheral neurons.

34
Q

What most directly causes the chronic microvascular and macrovascular complications of both Type 1 and Type 2 DM?

A

Hyperglycemia

35
Q

What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?

A

When the kidneys are exposed to excessive amounts of antidiuretic hormone (ADH).

36
Q

What causes SIADH?

A

Post-surgery: see increased ADH secretion for 5 to 7 days following general anesthesia
Ectopic production by cancers (especially pulmonary)
Pulmonary infections: tuberculosis, other bacterial pneumonias
CNS disorders (head trauma, infections, stroke)

37
Q

Syndrome of inappropriate ADH (SIADH) results in:

A

hyponatremia
reduced plasma osmolarity
Increased blood volume/ blood pressure

38
Q

What is diabetes insipidus?

A

When the pituitary produces insufficient amounts of ADH (or the kidneys fail to respond to the ADH).

39
Q

What is neurogenic Diabetes insipidus?

A

(a.k.a. Central)
Insufficient amounts of ADH secreted due to lesions of hypothalamus or posterior pituitary.

40
Q

What causes neurogenic diabetes insipidus?

A

brain tumors, stroke, infections, head trauma.

41
Q

What is nephrogenic diabetes insipidus?

A

Inadequate response to ADH due to renal tubule damage

42
Q

What causes Nephrogenic diabetes insipidous?

A

Caused by several renal diseases and drug toxicity (e.g., lithium)