DM/MetS/Reproductive Flashcards
What causes PCOS
-Genetics
-Hormonal imbalances(insulin resistance, ⬆️androgen)
-obesity
environmental (exposure to chemicals)
What are the comorbidities associated with PCOS
Endometrial cancer
DM2
Liver disease
Cardiac disease
Anxiety and depression
PCOS is leading cause of…
Infertility in women
What causes primary amenorrhea
-Genetic/autoimmune abnormalities
- hormonal abnormalities
-PCOS
-severe stress
- extreme wt loss or gain
What causes secondary amenorrhea
Hormonal imbalance: PCOS, thyroid disorders, gonadotropin deficiency
Medications
Stress
Extreme wt loss or gain
Criteria for primary amenorrhea
Menses has not occurred by the age of 16
Criteria for secondary amenorrhea
Absence of menses >3mo in woman w/ regular cycle or -absence>6 mo in women w/ irregular cycle
Labs in metabolic syndrome
⬆️ LDL and ⬇️ HDL
⬆️Triglycerides
⬆️ fasting glucose
Complications of metabolic syndrome
Heart attack/ Heart disease
Kidney dysfunction
Stroke
What is the role of insulin in metabolic syndrome
- increased insulin resistance
- causes pancreas to secrete more insulin, which in turn can lead to DM2
Type 1 Diabetes
- autoimmune destruction of beta cells in pancreas
-Childhood/adolescent onset - insulin dependent
-DKA
Type 2 Diabetes
- insulin resistance/ eventual beta cell dysfunction
- adult onset
- not always insulin dependent
-HHNK
Patho of insulin
-Hormone secreted by islet cells in pancreas
- released when serum glucose levels⬆️
- stimulate cellular uptake of glucose
- promotes storage of carbs, fats, and proteins
DKA…
- associated with DM1
-BG <800mg/dL- lower levels, than HHNK d/t higher renal excretion of glucose
-ketones= the > the insulin deficiency, the > ketones are needed; fatty acids breakdown for fuel since body can’t get sugar into cells from lack of insulin
- lower levels, than HHNK d/t higher renal excretion of glucose
HHNK
- BG >1000mg/dL
- higher mortality rate than DKA
- severe hyperglycemia= fatty acid breakdown–> delivered to liver for gluconeogenesis; insulin suppresses glucagon= contributes to ⬆️ BG; other hormones released to oppose insulin or stimulate gluconeogenesis= positive feedback loop
What hormones play a role in DM1
1) Insulin
2) Glucagon- stimulates liver to release stored glucose; uninhibited w/ DM1
3) Amylin- co secreted with insulin to help regulate blood sugar; deficient
4) Somatastatin- regulates release of insulin and glucagon; deficient
What hormones play a role in DM2
1) Glucagon- abnormality high
2) Cortisol- can worsen insulin resistance
3)Growth Hormone
4) GLP-1
