Chapter 18 Part II: Endocrine System Flashcards
Pathology
- Pancreas: Diabetes Mellitus (DM I & II)
“The American Diabetes Association (ADA) released new research on March 22, 2018 estimating the total costs of diagnosed diabetes have risen to $327 billion in 2017 from $245 billion in 2012, when the cost was last examined. This figure represents a 26% increase over a five-year period.”
- Hypophysis: Adenohypophysis
• Growth Hormone (GH): Hyper/hyposecretion
Lab Tests
Fasting Blood Sugar (FBS) & Urine
Pathology: Pancreas: Hypersecretion
• Hyperinsulinism
Hypoglycemia, convulsions, fainting
Pathology: Pancreas: Hyposecretion
• Diabetes mellitus
Lack of insulin secretion or resistance of insulin in promoting sugar, starch, and fat metabolism in cells.
Type 1: childhood onset, typically; can occur in adulthood.
Type 2 : adult onset, typically.
Type 1 Diabetes
Clinical features:
- Usually occurs before age 30.
- Abrupt, rapid onset of symptoms.
- Little or no insulin production.
- Thin or normal body weight at onset.
- Ketoacidosis often occurs.
Symptoms:
- Polyuria (glycosuria promotes loss of water).
- Polydipsia (dehydration causes thirst).
- Polyphagia (tissue breakdown causes hunger).
Treatment:
- Insulin
Type 2 Diabetes
Clinical features:
- Usually occurs after age 30.
- Gradual onset; asymptomatic.
- Insulin usually present.
- 85% are obese.
- Ketoacidosis seldom occurs.
Symptoms:
- Polyuria sometimes seen.
- Polydipsia sometimes seen.
- Polyphagia sometimes seen.
Treatment:
- Diet; oral hypoglycemics or insulin.
Pathology of the Pancreas
• Pancreas produces insulin and glucagon.
• Hypersecretion: excess secretion of insulin causes hypoglycemia, possibly due to a tumor??
- Fainting spells, convulsions and loss of consciousness due to low sugar.
• Hyposecretion: diabetes mellitus.
- Lack of insulin secretion or resistance of insulin in promoting sugar, starch and fat metabolism in cells.
Diabetes Mellitus: Type I: insulin deficiency
- Childhood onset (before 30 yo), destruction of beta islet cells of pancreas (little or no insulin production).
- S/S: thin patients, polyuria, polydipsia, polyphagia, ketoacidosis from burning fat leading to ketone and acid accumulation.
- Tx: monitor sugar level throughout the day and give insulin injections.
Diabetes Mellitus: Type II: insulin resistance
- Adult onset (after 30 yo).
- S/S: obese patients (central abdominal obesity), hyper/triglycerid/emia, insulin resistance, high BP.
- Tx: diet, weight reduction, exercise, lifestyle modification, insulin (oral hypoglycemic agents) if necessary.
- Can lead to many complications if left uncontrolled for a long time: diabetic retinopathy (leads to blindness), nephropathy, neuropathy, atherosclerosis (leading to heart attacks), perivascular ischemia with gangrene (diabetic foot).
- Gestational diabetes in women with a predisposition to diabetes in later life.
Pathology of the Pituitary Gland: Anterior Lobe
Hypersecretion
- Acromegaly
- Gigantism
Hyposecretion
- Dwarfism
- Panhypopituitarism
Laboratory Tests: Fasting plasma glucose (FPG)
Measures circulating glucose in a patient who has fasted at least 8 hours.
Laboratory Tests: Serum and urine tests
Measures hormones, electrolytes, glucose, etc., in blood and urine as indicators of endocrine function.
Laboratory Tests: Thyroid function tests
Measures T3, T4, and TSH in the bloodstream.
Laboratory Tests: Fasting blood sugar (FBS) or fasting plasma glucose (FPG)
Measures circulating glucose level in a patient who has fasted at least 8 hours.
- Can diagnose diabetes and pre-diabetes (blood glucose is higher than normal but not high enough).
- Normally 99 mg/dL or lower
- Pre-diabetes: 100 - 125
- Diabetes: above 126
A1C
Blood test that measures glycosylated hemoglobin (HbA1C) to access glucose control.
