Ch 14 - Hormones/diabetes Flashcards
2 major thyroid hormones
T3 (triiodothyronine) and T4 (thyroxine)
Cellular consequence of thyroid hormones
Mitochondria get bigger and increase in number
2 types of disease with thyroid gland
Hyperthyroidism or hypothyroidism
S/S of hyperthyroidism
High state of excitability
Intolerance to heat
Increased sweating
Mild to extreme weight loss
Muscle weakness
Nervousness
Extreme fatigue
Inability to sleep
Tremor of hands
S/S Hypothyroidism
Fatigue
Extreme somnolence
Extreme muscular sluggishness
Slow heart rate
Decreased blood volume and cardiac output
Increased weight
Mental sluggishness
Depressed growth of hair
Causes of hyper or hypothryroidism (4)
Autoimmunity
Cancer (tumor)
Diet (lack of iodine)
Genetics (lacking enzymes)
What is a goiter
Large protrusions on the neck due to enlarged thyroid gland
Are goiters for hypo or hyper
BOTH, but seen more often in hypothyroidism
What happens when hypo causes a goiter?
Hypo patients have low thyroid hormones so the body over-produces thyroid stimulating so it tells the thyroid gland to grow bigger and bigger
Treatment for hypothyroidism
T3 and T4 drugs exist
Adverse effects of T3 and T4 drugs
Similar to hyperthyroidism
Nervoussness
Heart palpitations
Tachycardia
Intolerance to heat
Unexpected weight loss
Treatments for hyperthyroidism
Thyroidectomy
Radioactive iodine
Inhibit thyroid hormone synthesis
Goal of birth control hormonal contraceptives
Inhibit ovulation and fertilization
2 types of oral birth control
Combined oral contraceptive pill
Regular preventative measure
Major side effects of estrogen and progestogen
breast fullness
depression
fluid retention
headache
nausea
vomiting
What are SERMs?
Selective estrogen-receptor modulators and they can be agonist or antagonist
What is the name of the medication used to treat estrogen-dependent breast cancers?
Tamoxifen
What are androgens?
Anabolic steroids that have masculinizing effects
Is insulin released on high or low blood glucose?
High levels of glucose in the blood
2 major types of diabetes Mellitus
Type 1 and Type 2
uncommon type of diabetes
gestational diabetes in pregnant women
Pathophysiology of type 1 diabetes (autoimmune)
The beta islet cells of the pancreas get damaged and destroyed by autoimmune disease. Now insulin can not be produced at sufficient levels
Which type of diabetes is insulin-dependent?
Type 1
Most frequent type of diabetes
Type 2
Pathophysiology of type 2 diabetes
Genetic factors or bad lifestyle or over weight, the insulin receptors stop working so the pancreas makes extra insulin even though the tissues are insulin resistant.
Symptoms of uncontrolled diabetes type 1 and typ e2
polyuria (inc. urine output)
polyphagia (inc. app)
polydipsia (inc. thirst)
unexplained weight loss
fatigue
blurred vision
irritable
neuropathy
ketosis
Name the 4 test used for diagnosis of diabetes
- glycosylated hemoglobin
- fasting plasma glucose levels
- glucose tolerance test
- symptoms of hyperglycemia
Difference between type 1 and type 2 during glucose tolerance test
Type 1 will have low insulin to start with and the level will not really change after the test because the pancreas is not working well
Type 2 will have insulin increase a lot during the test, because the pancreas is still working well.
Primary methods for non-drug control of type 2 diabetes
Diet and exercise
Drug treatments for type 1 diabetes
- rapid acting/short acting
- intermediate acting/extended long acting
which drug is injected before a meal?
rapid acting/short acting
Which drug is called the “basal injection” - a sort of maintenance dose?
Intermediate acting/extended long acting
If hypoglycemia occurs after the insulin injection, what to do?
immediate source of sugar
if unconscious = hospital for glucagon injection or parenteral glucose
complications of insulin:
weight gain
allergy to medecine
lipohypertrophy (lump at site of injection)
drug treatments for type 2 diabetes
- insulin secretagogues
- biguanides
- insulin sensitizers
- alpha-glucosidase inhibitors
- insulin
consequence of insulin secretatogues
cause pancreas to secrete more insulin
consequence of biguanides
reduces release of glucose from the liver
consequence of insulin sensitizers
make tissue more able to use glucose
Goal for treating type 2 diabetes (AIC levels)
Lower you AIC to 7% within 6-12 months
goal for blood glucose values before meals =
4 to 7 mmol/L
goal for blood glucose values 2h after a meal =
5 to 10 mmol/L
