control of homeostatic dysfunction Flashcards

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1
Q

what are the characteristics of diabetes type 1?

A
  • caused by a hormonal problem causing a destruction to homeostasis.
  • have high blood glucose levels (hyperglycaemia)
  • does not produce enough insulin/their cells have a resistance (the main role of insulin is to stimulate the cells to take in glucose from the blood)
  • insulin also stimulates conversion of glucose to glycogen in liver and muscles
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2
Q

treatments of type 1 diabetes?

A
  • regular injections of insulin
  • use of programmable pump that provides a continuous supply of insulin beneath the skin
  • artificial pancreas= Consists of three devices; a continuous glucose monitoring system, an insulin infusion pump and a blood glucose device (to calibrate the cgm)
  • the device links a continuous glucose monitor which checks blood sugar levels every five minutes, to an insulin pump.
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3
Q

benefits of treatments of type 1 diabetes?

A
  • by having a programmable pump, patients don’t have to go to the pain and effort of having to measure their own dosages and inject themselves daily.
  • Reduces large fluctuations in blood glucose levels
  • with the artificial pancreas- patients don’t have to prick for blood glucose levels
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4
Q

risks of the treatments for type 1 diabetes?

A
  • even with the treatments, the patient runs a risk of having kidney failure, heart attack, stroke, amputations, blindness or nerve damage
  • if a person is responsible for their own dosages instead of a programmable pump, there’s a risk of an overdose or under dose of insulin.
  • weight gain as cells absorb glucose
  • Fat necrosis may also develop in patients who regularly inject insulin. Which is a painful lump which grows in the tissue just below the skins surface
  • for the artificial pancreas = may include hypoglycaemia, hyperglycaemia, skin irritation or redness around the device’s infusion patch. Not safe for children aged 6 or under and patients who required fewer than 8 units of insulin per day.
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5
Q

ethical concerns related to treatment of type 1 diabetes?

A
  • for young children suffering the disorder, it can be deemed unethical the amount of needles and drips they receive.
  • the insulin used for medication used to be extracted from the pancreases of cows and pigs
  • in 1980s genetically engineered human insulin was produced. This was done by the gene for human insulin being inserted into bacterial DNA, where the bacteria was then cultured to make human DNA.
  • yeast is now used in a similar way to make insulin.
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6
Q

characteristics of type 2 diabetes?

A
  • known as non-insulin dependent or adult-onset diabetes
  • type 2 sufferers are able to produce insulin but their cells don’t respond to it
  • it’s a lifestyle disease (more common in people who are not physically active or obese)
  • develops gradually, its estimated that half the population who have type 2 diabetes haven’t been diagnosed yet.
  • because cells do not respond to insulin they do not take glucose from the blood.
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7
Q

what causes type 2 diabetes?

A

-caused by lack of physical activity, being overweight, a diet that is high in fat, sugar and salt, yet low in fibre, high blood pressure, high blood cholesterol and smoking

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8
Q

treatments of type 2 diabetes?

A
  • management programs that aim to keep blood glucose levels within the normal range
  • careful diet, regular physical activity, maintaining a healthy weight, monitoring blood glucose
  • occasionally medication if blood glucose can’t be controlled by other measures. (metformin)
  • insulin therapy (requires needles)
  • sulfonylureas= help your body secrete more insulin from the beta cells of the pancreas by acutely lowering the plasma glucose
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9
Q

benefits of the treatments of type 2 diabetes?

A

-doesn’t always require administering needles
-promotes healthy lifestyle choices
-Metformin: can play a role in preventing cancer compared to not taking metformin and also reduces risk of open angle glaucoma by 21%, is affordable and has no weight gain
-insulin injections: Very quickly brings down your blood glucose level to a healthier range
feature thin needles that are high tech, multi-beveled and coated with lubricants to enter the skin smoothly

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10
Q

risks of the treatment of type 2 diabetes?

A
  • sometimes healthy lifestyle changes aren’t enough to maintain blood glucose levels
  • metformin can cause nausea and diarrhoea
  • Sulfonylureas causes hypoglycaemia and weight gain and sensitivity to sun
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11
Q

characteristics of hyperthyroidism?

A
  • commonly known as Graves’ disease (an enlargement of the thyroid caused by immune system reaction)
  • cells are overstimulated so symptoms include; rapid heartbeat, weight loss, increased appetite, fatigue, sweating, anxiety and protruding eyeballs.
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12
Q

causes of hyperthyroidism?

A

-is a result of too much thyroxine

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13
Q

treatments of hyperthyroidism?

A
  • drugs that block the thyroid glands use of iodine (methimazole)
  • surgery to remove some or all of the gland
  • give the patient a drink containing radioactive iodine (the radioactive iodine molecules are taken up by thyroid cells, which are then killed by the radioactivity, this is safe as other cells in the body don’t absorb iodine therefor are unaffected. The radioactive iodine is eventually excreted in the urine.)
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14
Q

risks of treatments of hyperthyroidism?

A

RADIO ACTIVE IODINE
-risk of developing radioiodine-induced hypothyroidism
-radio iodine cannot be used for all patients, eg kids and pregnant women should avoid it and often kills an excessive amount of thyroid cells.
METHIMAZOLE
-Can take several weeks to take full effect
-The major risk of these medications is occasional suppression of production of white blood cells by the bone marrow
-Side effects include: nausea, vomiting, mild rash or itching, joint/muscle pain, numb/tingling skin, shortness of breath, coughing up blood, signs of liver problems (yellow eyes/skin, dark urine, severe stomach pain) or signs of kidney problems (change in urination amount, bloody urine)

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15
Q

characteristics of hypothyroidism?

A

-more common than hyperthyroidism
-occurs due to problems with the thyroid gland or problems with the pituitary/hypothalamus
-symptoms include slow heart rate, unexplained weight gain, fatigue, lack of energy, intolerance to the cold, swelling of the face and goitre
-caused by lack of iodine
-a thyroxine molecule contains 4 iodine atoms (T4). A triiodothyronine molecule contains 3 iodine atoms (T3).
Enlargement of the thyroid is known as goitre.

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16
Q

what causes hypothyroidism?

A
  • due to too little thyroxine

- occurs due to problems with the thyroid gland or problems with the pituitary/hypothalamus

17
Q

treatments of hypothyroidism?

A

-Consuming more iodine. An example of this is the Australian governments compulsory addition of iodine in most breads in October 2009.
-Iodised table salt is also available.
-daily use of a synthetic thyroid hormone- levothyroxine (oral medication), Restores adequate hormone levels, reversing the signs and symptoms of hypothyroidism
-Alternatively, animal extracts that contain the thyroid hormone are available (come from the glands of pigs and contains both T4 and T3)
-Desiccated thyroid extract is thyroid gland that has been dried and powdered for medical use and is taken orally
(Usually made from pigs, sheep or cows)

18
Q

benefits of hypothyroidism treatments?

A

-reverses any weight gain
-lowers cholesterol levels
LEVOTHYROXINE
-levothyroxine can be used during pregnancy
ANIMAL EXTRACTS
-Some patients prefer this treatment as a more ‘natural’ thyroid hormone
-Some patients have recorded improvement after switching from levothyroxine to the animal extracts
-Can be used during pregnancy and breast feeding

19
Q

risks involved with treatment of hypothyroidism?

A

-Its a lifelong medication
-increases appetite
-insomnia
-heart palpitations
-shakiness
-sweating
-insensitivity to heat
-thin skin and brittle hair
LEVOTHYROXINE:
-increased appetite, weight loss, heat sensitivity, excessive sweating, headache, hyperactivity, nervousness, anxiety
-If a patient suddenly stops taking levothyroxine they can into withdrawal and experience symptoms like panic attacks and fatigue

20
Q

ethical concerns related to treatment of hyperthyroidism?

A
  • health care providers should discuss benefits of sharing info with relatives about genetic conditions
  • provided obligation to respect patients autonomy but obliged to protect patients with limited decision making abilities.
  • screening for newborns for hyper has to be approved by parents.
  • it may be deemed unethical by some people to ingest radioactive material, regardless of it not being prescribed to the pregnant or young.
21
Q

ethics of hypothyroidism?

A

-Used to be treated with tablets made from the dried and powdered thyroid glands of animals, mainly pigs.
-Levothyroxine:
Synthetic therefore made in a lab, so fears of it not being ‘natural’ may exist due to not knowing what else may be inside the medication
-Animal extracts:
You can purchase glandular extracts in occasional health food stores which are not regulated by the FDA and therefore there legitimacy and purity aren’t guaranteed and therefore could be false advertising putting the patient at risk

22
Q

what causes diabetes 1?

A
  • Occurs due to a fault in the patients immune system which causes the destruction of beta cells in the islets of Langerhans of the pancreas
  • beta cells produce insulin
23
Q

benefits of the treatments of hyperthyroidism?

A
  • Methimazole: Easy to use as all is required is an oral tablet, Is amongst one of the cheapest treatment methods
  • Radioactive iodine:
  • This treatment is a permanent and more reliable cure for hyperthyroidism
  • It can destroy all or part of the thyroid gland, depending on what is required
  • Extremely small excess risk of cancer