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ECOS2 Exam 1 > Approach To Endocrine Complaints1: Metabolic Syndrome, Obesity, Diabetes > Flashcards

Approach To Endocrine Complaints1: Metabolic Syndrome, Obesity, Diabetes Flashcards

1
Q

Reason fro excess H

A

Neoplasm
Autoimmune
Excess H administration

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2
Q

Reason for H Deficiency

A

Autoimmune destructions, surgery, infection, inflammation, hemorrhage

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3
Q

How to treat H resistance

A

Decrease H. Levels

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4
Q

How many Americans have BMI over 25

A

70% (overweight)

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5
Q

Metabolic Syndrome
(Insulin Resistance Syndrome)
Sx to Dx this

A

33% USA (any 3 of the following)

  1. Central Obesity (waist is >40in M or >35in W)
  2. High TAGs, or HDL low
  3. BP : > 130/85mmHg
  4. Fasting Glucose : >100mg/dL
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6
Q

How to Manage MS

A
  1. Diet : Mediterranean + DASH (stop HTN)
  2. Exercise (150min/week)
    * reduce weight
  3. Metformin : treat high fasting glucose
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7
Q

Diabetes Type 2

What is happening

A
  1. Insulin Resistance (high glucose levels in BVs)
  2. Impaired insulin secretion
  3. Increased Hepatic Glucose production
    =hyperglycemia + organ damage
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8
Q

Diabetes Mellitus

Reason many are undiagnosed

A

Long asymptotic period of up to 10years(25% of people with diabetes dont know)
9.4% of USA has this

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9
Q

How to Dx DM

A

elevated hemoglobin A1C (see average Blood level the past 3 months)

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10
Q

Common side Sx of DM

A
  1. Blurred vision
  2. Focus problems
  3. High thirst + urination (polydypsia + polyuria)
  4. Slow sore healing
  5. Neuropathy
  6. Polyphagia (eat more)
  7. Weight loss
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11
Q

DM common things on PE

A
  1. Acanthosis Nigricans
  2. Foot Ulcer
  3. Retinopathy, hemorrhage or aneurysm, cotton wool spots
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12
Q

Dx DM you need 4 things

A
  1. A1C > 6.5%
  2. Fasting Glucose > 126
  3. 2hr glucose > 200 (oral)
  4. Random Glucose > 200 (+ hyperglycemia sx)
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13
Q

How to do PE for DM

A

Inspect, Palpate
Pedal pulse, capillaries refill, temperature
10g monofilament Test
128g tuning fork Test

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14
Q

DM management

A
  1. nutrition therapy
  2. Self-management
  3. Metformin
  4. Insulin (if high end of diabetes)
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15
Q

Organs that DM most Targets

A
  1. Kidneys
  2. Eyes
  3. NS
  4. CVS
  5. Skin
  6. Teeth
  7. Genitourinary System
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16
Q

In the next 5 years how many is world will have DM

A

43%

17
Q

First step of DM

A

Insulin resistance

Insulin rises

18
Q

Second step of DM

A

Glucose rise also

19
Q

3rd step of DM

A

Glucose increases more
Insulin cant be made anymore
Still high insulin resistance

20
Q

What genetic factor is involved in T1D

A

A type of HLA allele (common in Scandinavia)

Immune response is triggered by an environmental tigger ——> destroys B-cells

21
Q

Sx of T1D

A
  1. Weigh loss more then weight gain
  2. DKA (25% only have this)
  3. Fatigue
  4. Polyuria, Polydipsia,
  5. NORMAL insulin sensitivity
22
Q

What 3 autoimmune disease can cause T1D

A
  1. Autoimmune Thyroiditis
  2. Celiac Disease
  3. Addison’s Disease : adrenal gland destroyed
23
Q

Hyperglycemia in T2D and T1D

A

Higher in T1D

24
Q

DKA

A

Insulin deficiency + increase glucagon released (even more glucose)
= ketone bodies form in liver -> highly acidemic +dehydration
*seen in T1D

25
Q

HHS (Hyperglycemic Hyperosmolar State

A

Insulin deficiency + low fluid intake,
= sever dehydration + electrolyte loss (urine a lot also)
* for T2D

26
Q

What should DKA and HHS patients do

A

Go to hospital
IV Fluids
IV insulin
K replacement

27
Q

Hypoglycemia in DM

A

Usually due to medication
70% of pts
6-10% die from this in T1D
*PEARL = confusion, altered mental state, seizure, low consciousness = check BLOOD GLUCOSE (usually when blood is below 70 or can be in higher ranges)

28
Q

Reason for hypoglycemia Sx when brain is trying to get enough glucose energy

A
  1. ACH SYMPATHETIC: sweating ,higher, paresthesia
  2. Adrenal Gland EPI + NORE + CORTISOL : palpitations, tremor, anxiety
    * can be very serious and lead to hypoglycemic unawareness —-> unconscious immediately
29
Q

Where is acanthosis Nigricans is found in

A

T2D

30
Q

Poor skin turgor is

A

In t1d

31
Q

Hallmark t1d

A

Dehydrated and poor skin turgor, and ketogenic, weight loss

Poor skin turgor happens from dehydration

ECOS2 Exam 1 (15 decks)

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