Diabetes Flashcards
1
Q
Gland
A
Tissue that secretes something
2
Q
Ducted gland that covers body surface or cavity
A
Exocrine gland
3
Q
Ductless gland that secretes into surrounding tissue or the bloodstream
A
Endocrine gland
4
Q
Exocrine gland examples
A
Oil, salivary and sweat glands. Pancreas
5
Q
Endocrine examples
A
Pancreas, pituitary, thyroid, parathyroid
6
Q
Glands secrete chemical messengers called ____
A
Hormones
7
Q
What is a hormone?
A
Chemical messenger that triggers other chemical events in the body. Keeps body in homeostasis
8
Q
Protein hormone:
A
Made out of amino acids chains called peptides. Cannot dissolve through the cell membrane easily. Makes proteins ideal for binding with cell surfaces
9
Q
Hormone proteins target ____
A
Cell surface
10
Q
Hormone proteins are the “____”
A
First messenger
11
Q
First messenger
A
Binds to cell membranes that triggers another chemical reaction in the cell membrane. The chemical in the cell membrane is the second messenger.
12
Q
Second messenger
A
The chemical in the cell membrane triggered by the first messenger when it comes to protein hormones.
13
Q
Effects of protein hormones
A
Rapid acting
Cell activity
Water soluble
14
Q
Peptide
A
Strings of amino acids arranged in a special way (i.e. insulin)
15
Q
Hormones can be ___ or ____
A
Proteins and lipids
16
Q
Lipids
A
Fat
17
Q
Lipids are intercellular, meaning __________
A
They dissolve through the cell membrane
18
Q
Why are lipids intercellar (able to dissolve through the cell membrane)?
A
The cell membrane is a lipid cell membrane
19
Q
Amino acids combine to form ____
A
Proteins
20
Q
Lipid hormones can be ____ or ____
A
Cholesterol, fatty acids
21
Q
Effects of lipid hormones
A
Slower acting
Stimulates genetic machinary for synthesis
Fat soluble
22
Q
Insulin is a type of ____ hormone
A
Protein
23
Q
Types of protein/amino acid hormones
A
Epi, nor epi, thyroid
24
Q
Type of lipid/cholestrol hormone
Type of lipid/fatty acid hormone
A
Steroids
Prostaglandins
25
The hypothalmus stimulates/inhibits the ___ gland
Pituitary
26
"Master Gland"
Pituitary gland
27
Pituitary gland produces what three hormones?
Thyroid stimulating hormone
Follicle stimulating hormone
Luteinizing hormone
28
Thyroid does what?
Metabolism
| Produces T4, T3 and calcitonin (deposits serum calcium into bone)
29
Hormone that reduces circulatory serum calcium by making deposits into bone?
Calcitonin (produced by the thyroid)
30
Parathyroid does what?
Produces parathyroid hormone which increases serum calcium in the blood. Will pull the calcium out of the bone
31
What hormone increases the serum calcium in the blood by pulling calcium out of the bone?
Paraythroid hormone
32
Osteoprosis is because:
In post menopause, for women replacement in calcitonin is difficult. Can make withdrawels from bone but not deposits.
33
Adrenal cortex
Kidney function
Fluid/electrolytes
Inflammatory response
34
Adrenal medulla
Stress response
35
Thymus
Immune function
| As make way through childhood, shrinks when finished with adolescense, will be gone
36
Pancreas is an ___ and ____ gland. Produces ____ and ____.
Exocrine and endocrine
| Insulin and glucagon
37
Ovaries
Produce estrogen and progesterone. Produced in follicles of ovaries. Depends on where you are in your menstral cycle and whether or not you are pregnant
38
Testes
Testosterone
39
Hypothalmic control is controlled via a ____
Negative feedback loop
40
Negative feedback loop for hypothalmic control
Hypothalmus produces thyroid releasing hormone (TRH) which triggers the pituitary gland to produce thyroid stimulating hormone (TSH) which triggers to the tyroid to produce T3 and T4 which go to cells and do metabolism. The amount of T3 and T4 then results in a negative feedback loop, which tells the hypothalmus to stop producing TRH and the pituitary to stop producing TSH
41
Where is the pancreas located?
Left upper quadrant
Oriented posteriorly toward the right
Retroperitoneal space
42
The pancreas is a solid or hollow organ?
Solid
43
Pancreas endocrine glands are located where?
Ductless cells located in the Islets of Langorhauns
44
____ make up 70% of the Islets
Beta cells
45
What cells produce isulin?
Beta cells
46
____ cellsm make up 20% of the Islets
Alpha cells
47
What cells produce glucagon?
Alpha cells
48
What two hormones help regulate sugar?
Insulin and glucagon
49
Pancreas exocrine glands are ducted ___.
Acinar cells
50
What do acinar cells do?
Produce and secrete digestive enzymes
51
Most of the pancrease is an exocrine or endocrine gland?
Exocrine
52
Acinar cells secrete digestive enzymes into the ____
Duodenum
53
Insulin
Proteinaeous hormone
| First messenger that triggers a second messenger to open up the cell to glucose
54
Where is insulin required?
For all cells except the brain and central nervous system because glucose passes freely through the blood brain barrier
55
Normal sugar metabolism (increase in glucose)
Increase in glucose->stimulates parasympathetic nervous system->stimulates beta cells->increase in insulin->can take sugar (glucose) into cells
56
Normal sugar metabolism (decrease in glucose)
Decrease in glucose->stimulates sympathetic nervous system->stimulates alpha cells->increase in glucagon-> mobilize sugar stores
57
Ingested carbohydrates
Carbon, hydrogen, Oxygen
58
Rapidly absorbed from gut into circulatory system
Carbohydrates
59
Fatty acid stored as an adipose tissue
Triglyceride
60
Short term storage in liver and muscle tissue
Glycogen
61
Glycogen stored in muscle is used for what?
The muscle in which it is stored
62
Glycogen stored in the liver is used for what?
Systemic use
63
Long term storage in liver and adipose tissue
Fat
64
With carbohydrates, for long term storage, take glucose and turn it into ____
Fatty acid
65
Proteins are made up of
Carbon, hydrogen, oxygen, nitrogen
66
C, H, O and N are components of ____
Amino acids
67
Why are proteins a more sustainable source of energy:
More complex, so take longer to break down
68
Breaking down proteins
Protein->->broken down into glucose (energy) and amino acids (protein synthesis)->glucose and amino acids absorbed into the bloodstreem
69
Fat breaks down into_____
Fatty acids and glycerol
70
Fats are ___ uptake and ____ conversion
Slow, slow
71
When blood glucose level decreases:
Glucagon triggers mobilization of your stores
72
Breaking of glucose
Glycogemolysis
73
When burn through glycogen, have to access ___
Fats
74
Fats->->->->glucose=
Gluconeogenesis
75
Gluconeogenesis
The creation of new glucose
76
Why do we burn through glycogen before fats?
Because gluconeogenesis is a clunky process. It is a more complicated pathway
77
Normal blood sugar
80-140 mg/dL
78
Fasting blood sugar
| Post meal blood sugar
70-100
| 90-140
79
Decreased insulin production
Diabetes
80
Type I diabetes
No insulin production so patients are insulin dependent
Reuslt of autoimmune process??
Usually happens in childhood-"juvenile onset"-genetic component
81
Type II diabetes
Insulin produced but insufficient quality and quantity
Start off on orgal agents to stimulate pancreas
Patients are non-insulin dependent but may end up becoming partially dependent on insulin
Adult onset diabetes-usually due to lifestyle (diet, obesity, alcohal), but there may be a genetic component
82
In type 1 diabetes, there is no insulin, so what is happening to blood sugar?
Blood sugar is increasing and glucose is accumulating in the circulatory system
83
Oncotic pressure and type 1 diabetics
Patient is hyperglycemic (blood sugar >200)=glucose in your urine (sweet urine)->oncotic pressure draws water from cells into vessels. The cells are dehydrated. On a vascular level, there is lots of pressure. The kidneys are overwhelmed.
84
Signs of type I diabetes
Polyuria
Polydipsia (thirst)
Polyphagia (hunger)
85
Why are type 1 diabetics experiencing polyphagia?
Cells are not producing enough energy (because no insulin to bind to cell to trigger second messenger to let glucose in) so always hungry
86
What happens when cannot let glucose into the cells?
The body starts breaking down proteins and fats. Proteins have amino acids and uric acid and fats have fatty acids and ketones
87
Rapid, deep sighing respirations
Kussmaul respirations
88
Juicy fruit breath
Acetine breath
89
Poisoning that results from all the chemicals (amino acids+uric acid+fatty acid+ketones) that shouldn't be there
Diabetic keto acidosis
90
```
Type 1 diabetics:
Skin
HR
RR
BP?
```
Warm and dry
Tachycardic
Increased RR because blowing off acid (remember diabetic keto acidosis)
BP? Not super hypertensive????
91
Type 2 diabetics have what kind of metabolism?
Hybrid metabolism because have some insulin, but not enough
92
Type 2 diabetes has:
Hyperglycemia Hyperasmolar non ketatic syndrome
93
Type 2 diabetics have what symptoms:
Polyuria
Polydipsia (thirst)
Polyphagia (hunger)
94
Do you need to be diabetic to have hypoglycemia?
No
95
Onset of hypoglycemia
Rapid
96
S/S of hypoglycemia
Hungry, irrittable, headache, dizzy, weak, syncope, combative, may eventually seize
Pale, cool, diapheretic
Increased heart rate
nausa
97
The ____ nervous system is activated when an individual is hypoglycemic
sympathetic
98
When hypoglygemic, go to ___ cells to stimulate then to relese glucagon
alpha
99
Go to alpha cells to release glucagon
Adrenergic stimulation
100
Reasons for hypoglycemia
Too much insulin
Too little food
Too much exercise
101
When do you give glucose?
Blood sugar <20
102
Medications that affect blood sugar
Diuretics, steroid, benzodiazponienes, sometimes beta blockers
103
Other things can can affect blood sugar?
Pregnancy, illness, alcohal
104
Complications with diabetes -coronary artery disease
Episodes of acidosis->can lead to vascular damage->if damange inside of lumen=plaque build up->hypertension->coronary artery disease
105
Complications with diabetes-nerve damage
Screws with sodium/potassium pumps across cell membranes=nerves->results in nerve damanger->can have diabetic "nerve pain", neuropathy, retinopathy,
106
Vascular damage and nerve damage=set the stage for ____
Necrotic wounds=>healing issues=>amputations
107
Diabetes are prone to ___, ___ and ____
Renal failure, CVA and silent MI
