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ENDOCRINE SYSTEM > CLINICAL CARE OF THE ENDOCRINE SYSTEM > Flashcards

CLINICAL CARE OF THE ENDOCRINE SYSTEM Flashcards

1
Q

WHAT IS THE TRIAD THAT HELPS DIAGNOSE A PATIENT WITH HYPOGLYCEMIA?

A
  • BLOOD GLUCOSE <70
  • S/SX OF HYPOGLYCEMIA (NEURO AND EMOTIONAL)
  • RESOLUTION OF S/SX WITH GLUCOSE.

WHIPPLES TRIAD

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2
Q

IMPAIRMENT OF BRAIN FUNCTION WOULD SHOW SERUM BLOOD GLUCOSE LEVELS AT WHAT VALUE?

A

APPROXIMATELY 50

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3
Q

S/SX OF HYPOGLYCEMIA BEGIN IN PLASMA LEVELS AT WHAT RANGE??

A

60

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4
Q

SPONTANEOUS HYPOGLYCEMIA IN ADULTS ARE CLASSIFIED INTO THESE TWO TYPES

A

FASTING

POST PRANDIAL

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5
Q

SUBACUTE OR CHRONIC MANIFESTATION OF HYPOGLYCEMIA,

A

FASTING

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6
Q

THIS TYPE OF SPONTANEOUS HYPOGLYCEMIA IN ADULTS IS RELATIVELY ACUTE WITH FIGHT OR FLIGHT SYMPTOMS

A

POST PRANDIAL

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7
Q

WHAT ARE THE 2 BROADENED CATEGORIES OF HYPOGLYCEMIA

A

NEUROGLYCOPENIC

SYMPATHOMIMETIC

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8
Q

BESIDES A FINGER STICK TO TEST BLOOD GLUCOSE, WHAT ARE SOME OTHER LABS YOU CAN GET TO CHECK

A

C-PEPTIDE, SERIAL GLUCOSE , SULFONYLUREA

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9
Q

WHAT IS THE IMMEDIATE TREATMENT FOR HYPOGLYCEMIA?

A

PROVISION OF GLUCOSE

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10
Q

PO INTERVENTIONS SHOULD ONLY BE ATTEMPTED ON WHO?

A

CONSIOUS PATIENTS WITH NO ALTERED MENTAL STATUS

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11
Q

A PATIENT WITH RECURRING DROPS IN GLUCOSE LEVELS WITH NO ALTERATIONS TO EVERY DAY LIFE IS ABLE TO BE RETAINED OR SHOULD BE MEDEVAC’D?

A

MEDEVAC (GET MO ONBOARD)

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12
Q

PRE DIABETES WILL SHOW AN IMPAIRED FASTING GLUCOSE OF HOW MUC

A

100-125MG/DL

LACK OF INSULIN BREAKING DOWN SUGARS

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13
Q

IN PREDIABETES A PATIENT MAY HAVE AN HGB-A1C ELEVATION OF WHAT PERCENT RANGE?

A

5.7-6.4%

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14
Q

IN PRE DIABETES A PATIENT MAY HAVE THIS LEVEL OF BLOOD GLUCOSE 2 HOURS FOLLOWING A MEAL (POSTPRANDIAL)

A

140-199MG/DL

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15
Q

THIS TYPE DIABETES IS ASSOCIATED WITH THE TERM PANCREATIC BURNOUT…..

A

TYPE 2 DIABETES

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16
Q

WHAT ARE THE RISK FACTORS FOR TYPE 2 DIABETES?

A
  • FAMILY HX OF DIABETES
  • OBESITY
  • DIET
  • PHYSICAL INACTIVITY
  • RACE
  • POST CHILDBIRTH
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17
Q

PRE DIABETES IS PRETTY BENIGN AND ASYMPTOMATIC AND WILL ONLY ASSOCIATE WITH THIS NEUROLOGICAL SYMPTOM?

A

SUBTLE LOWER EXTREMITY PARATHESIA

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18
Q

A PATIENT WHO IS OBESE CAN TAKE THIS MEDICATION TO HELP LOWER THEIR RISK OF DIABETES

A

METFORMIN 850MG

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19
Q

IN OBESE PATIENTS WHO DO NOT NEED MEDS. WHAT IS THE BEST TREATMENT FOR PREDIABETES

A

LIFESTYLE MODIFICATIONS SUCH AS WEIGHT LOSS FROM AN EXERCISE ROUTINE

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20
Q

METABOLIC DISORDER OR DISEASE THAT IS BROUGHT ABOUT FROM INSUFFICIENT PRODUCTION OF INSULIN OR INADEQUATE ACTIVITY OF INSULIN RECEPTORS.

A

DIABETES MELLITUS

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21
Q

WHAT ARE THE 3 CATEGORIES OF DIABETES MELLITUS

A

TYPE 1
TYPE 2
GESTATIONAL DIABETES

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22
Q

WHICH CATEGORY OF DIABETES MELLITIS IS AUTO-IMMUNE IN NATURE,

-CAN HAVE PARTIAL OR ABSOLUTE DEFICIENCY OF ENDOGENOUS INSULIN PRODUCTION

REQUIRE EXOGENOUS INSULIN FOR SURVIVAL

A

TYPE 1

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23
Q

TYPE 1 DIABETES IS CHARACTERIZED WITH THESE SIGNS OR SYMPTOMS

A
  • POLYURIA
  • WEIGHT LOSS
  • PLASMA GLUCOSE IS HIGH WITH FASTING
  • KETONES IN BLOOD OR URINE
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24
Q

WHAT TEST IS USED IN HELPING DIAGNOSE A PATIENT WITH SUSPICION OF TYPE 1 DIABETES WHEN THEIR BGL IS <126MG/DL

A

GLUCOSE TOLERANCE TEST

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25
Q

WHAT IS THE BENEFIT OF USING GLYCOSYLATED HEMOGLOBIN (HBA1C)?

A
  • NO NEED FOR FASTING

- GREAT WAY TO DOCUMENT TRENDS OVER TIME OF MONTHS (2-3)

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26
Q

WHAT ARE THE DIAGNOSABLE VALUES FOR THE FOLLOWING LABS :

HBA1C
FASTING PLASMA GLUCOSE

A

HBA1C >126MG/DL

HbA1C OF 6.5%

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27
Q

WHAT IS THE MEDICATION OF CHOICE AND STANDARD FOR ALL PATIENTS DIAGNOSED WITH TYPE 1 DIABETES?

A

INSULIN

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28
Q

BEFORE GIVING INSULIN WHAT SHOULD THE IDC DO?

A

CALL PHYSICIAN SUPERVISOR

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29
Q

WHAT IS THE IMMEDIATE SHORT TERM GOAL YOU WANT TO ACHIEVE WITH A PATIENT WHO IS DIAGNOSED WITH TYPE 1 DIABETES?

A
  • CONTROL HYPERGLYCEMIA

- MAINTAIN SERUM ELECTROLYTES AND HYDRATION

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30
Q

SOMEONE WHO IS DIAGNOSED WITH TYPE 1 DIABETES IS NOW RESPONSIBLE FOR MONITORING THESE ASPECTS OF THEIR LIFE MUCH MORE CLOSELY

A

FOOD
EXERCISE
ILLNESS
STRESS

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31
Q

WHAT IS THE BP MED OF CHOICE FOR SOMEONE WHO IS DIABETIC?

A

ACE INHIBITORS

32
Q

TYPE 1 DIABETES IS WORLD WIDE DEPLOYABLE? WHY OR WHY NOT?

A

MEMBER IS USUALLY NOT WWD DUE TO ILLNESS.

REQUIRES MEDBOARD

33
Q

PATIENTS WHO ARE NEWLY DIAGNOSED AS DIABETIC AND TYPE 1 SHOULD BE REFERRED TO THESE AREAS OF CARE

A

ENDOCRINE AND INTERNAL MED

34
Q

HOW DO YOU TREAT A PATIENT IN INSULIN OVERDOSE?

A

CHECK BGL

  • HAVE PT DRINK SODA
  • RECHECK BGL EVERY 15-20 MINUTES FOLLOWING
35
Q

A PATIENT WHO WAS INSULIN OVERDOSE HAS STARTED TO NORMALIZE IN VITALS AFTER YOU GAVE ORAL GLUCOSE. WHAT SHOULD THE PATIENT DO NOW?

A

EAT A WELL BALANCED MEAL

36
Q

THIS COMPLICATION FOUND IN OLDER PATIENTS WITH TYPE 2 DIABETES WILL SAY THEY FEEL LIKE A STOCKING GLOVE EFFECT ON THEIR LEGS

A

NEUROPATHY

37
Q

DIABETIC PATIENTS ARE HOW MUCH MORE LIKELY TO HAVE AN M.I?

A

3-5 TIMES MORE LIKELY OR COMMON

38
Q

AFTER 10-15 YEARS, 25-50% OF TYPE 1 DIABETES PATIENTS WILL SHOW SIGNS OF……..

INCREASES TO 75-95% AFTER 15, 100% AFTER 30 YEARS.

A

DIABETIC RETINOPATHY

39
Q

THIS DISORDER OF THE EYES OCCURS IN ABOUT 6% OF PATIENTS WITH DIABETES

A

GLAUCOMA

40
Q

DIABETES THAT IS CHARACTERIZED AS INSULIN RESISTANCE DUE TO INADEQUATE ACTIVITY OF INSULIN RECEPTORS.

A

DIABETES TYPE 2

41
Q

THE MOST PREVELENT AGE FOR DIABETES TYPE 2

A

40, BUT BECOMING PREVELENT IN KIDS.

42
Q

OF TYPE 1 AND 2 DIABETES, WHICH ONE ACCOUNTS FOR ABOUT 90% OF INDIVIDUALS WITH THIS ILLNESS?

A

TYPE 2

43
Q

VASCULAR DISEASE IS THE CAUSE OF DEATH IN WHAT PERCENT OF DIABETES TYPE 2 PATIENTS?

A

70%

44
Q

SOMEONE IN STAGE 1 OF DIABETES TYPE 2 USUALLY STARTS WITH WHAT TREATMENT?

A

DIET
WEIGHT REDUCTION
EXERCISE

45
Q

STAGE 2 OF DIABETES TYPE 2 TREATMENT USUALLY ENTAILS WHAT IN TREATMENT

A

ANTIDIABETIC MEDS

46
Q

STAGE 3 OF DIABETES TYPE 2 TREATMENT USUALLY ENTAILS WHAT ?

A

LACK ON INSULIN CONTROL AND NEED FOR POSSIBLE INSULIN THERAPY

47
Q

A PATIENT WHO YOU MAY NOT MANAGE FOR DIABETES WILL STILL REQURE THIS COMPREHENSIVE EXAM ANNUALLY

A

FOOT EXAM

48
Q

DIABETES THAT IS BROUGHT ON BY PREGNANCY

A

GESTATIONAL DIABETES

49
Q

MOTHERS WITH GESTATIONAL DIABETES ARE AT RISK OF THIS COMPLICATION WITH PREGNANCY

A

MACROSOMIA WHICH IS BIRTHING A HEAVY BABY

RISK DEVELOPING TYPE 2

50
Q

A PATIENT WITH THE FOLLOWING SYMPTOMS

BGL >250MG/DL
ACIDOSIS OF BLOOD
BICARB <15MEQ
POSITIVE FOR KETONES

A

DKA

51
Q

THIS EMERGENT CONDITION IS USUALLY INITIAL MANIFESTATION OF DIABETES TYPE 1 AND 2

A

DKA

52
Q

CLINICAL FINDINGS OF DKA?

A

POLYURIA/POLYDYPSIA/ FATIGUE, N/V AND MENTAL STUPOR

RAPID DEEP BREATHING WITH ACETONE BREATH

ABD TENDERNESS WITH NO UNDERLYING CAUSE

53
Q

WHAT IS THE INITIAL MANAGEMENT PRIORITY FOR A PATIENT WITH DKA?

A

VOLUME REPLETION

54
Q

WHEN BLOOD GLUCOSE FALLS BELOW 250MG/DL OR LESS, WHAT IS THE RANGE YOU WANT TO MAINTAIN BLOOD GLUCOSE ?

A

200-300 MG/DL

55
Q

WHEN TREATING HYPERGLYCEMIA OR DKA.

WHEN WOULD YOU BE ABLE TO REDUCE OR D/C I.V. FLUIDS

A

ONCE IMPROVED VITALS AND BLOOD GLUCOSE IS LESS THAN 250MG/DL

56
Q

HOW MUCH FLUID REPLACEMENT CAN CAUSE ACUTE RESPIRATORY DISTRESS OR CEREBRAL EDEMA

A

5 LITERS IN 8 HOURS

57
Q

WHAT IS THE LOADING DOSE OF INSULIN FOR HYPERGLYCEMIA / DKA?

A

.15 UNITS/ KG AS IV BOLUS, FOLLOWED BY .1 UNIT/KG/H CONTINUOUSLY INFUSED OR GIVEN EVERY HOUR VIA IM.

58
Q

WHAT ARE SOME COMPLICATIONS OF DKA?

A

AMI
RENAL FAILURE
CEREBRAL EDEMA

59
Q

ABNORMAL GROWTH OF THE GLAND

A

GOITER

60
Q

GOITERS ARE COMMON IN REGIONS WITH THIS DEFICIENCY IN THEIR DIETS

A

LOW IODINE

61
Q

WHAT ARE THE 3 COMMON TYPES OF GOITERS FOUND IN ENDEMIC AREAS

A

EUTHROID
HYPERTHYROID
HYPOTHYROID

62
Q

AN ESTIMATED # OF POEPLE WITH LOW IODINE INTAKE

A

1.9 BILLION

63
Q

HOW MANY COUNTRIES SHOWN TO HAVE IODINE DEFICIENCY

A

30 COUNTRIES

64
Q

A THYROID GOITER CAN CAUSE WHAT TO HAPPEN IN REGARDS TO THE UPPER AIRWAY.

A

CAN CAUSE TRACHEAL COMPRESSION, RESPIRATORY DISTRESS/FAILURE AND DYSPHAGIA IF LARGE ENOUGH.

65
Q

LAB FINDINGS FOR SERUM T4 AND TSH ARE USUALLY SHOW AT WHAT VALUE

A

NORMAL

66
Q

LAB FINDINGS FOR THYROID REACTIVE IODINE ARE SHOWN AT WHAT VALUES

A

ELEVATED

67
Q

SOMEONE WHO HAS A HX OF BEING FROM ENDEMIC AREA WHERE THEY DON’T GET ENOUGH IODINE USUALLY BENEFIT FROM THIS TREATMENT IN REGARDS TO A THYROID GOITER.

A

INTRODUCTION OF IODINE VIA TABLE SALT

68
Q

ADULTS WITH LARGE GOITERS MAY REQUIRE THIS DIFINITIVE PROCEDURE FOR COSMETIC REASONS , COMPRESSIVE SYMPTOMS OR THYROTOXICOSIS

A

THYROIDECTOMY

69
Q

YOU HAVE A 32 Y.O SAILOR REPORT TO MEDICAL WITH THE FOLLOWING SYMPTOMS.

  • WEAKNESS
  • COLD INTOLERANCE
  • CONSTIPATION
  • DEPRESSION
  • MENORRHAGIA
  • HOARSENESS
  • DRY SKIN
  • BRADYCARDIA
A

HYPOTHYROIDISM

70
Q

A PATIENT WITH HYPOTHYROIDISM WILL SHOW WHAT LEVEL OF REACTION WITH DEEP TENDON REFLEXES

A

LESS OR DELAYED

71
Q

HYPOTHYROIDISM WILL SHOW T4 AS…….

A

LOW

72
Q

THIS HORMONE WILL SHOW AS ELEVATED WITH HYPOTHYROIDISM

A

THYROID STIMULATING HORMONE

73
Q

WHAT ARE THE 3 LEVELS OF HYPOTHYROIDISM?

A

PRIMARY

SECONDARY

MATERNAL

74
Q

THIS FORM OF HYPOTHYROIDISM IS DUE TO THYROID GLAND DISEASE

A

PRIMARY

75
Q

THIS TYPE OF HYPOTHYROIDISM IS DUE TO LAC OF PITUITARY TSH

A

SECONDARY HYPOTHYROIDISM

76
Q

AN EXPECTANT MOTHER WHO IS FOUND TO HAVE MATERNAL HYPOTHYROIDISM WILL NEED TO INCREASE THEIR HORMONE DOSAGE BY HOW MUCH?

A

30%

ENDOCRINE SYSTEM (2 decks)

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