Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine LAB - Professor Sample > Endo #2 > Flashcards

Endo #2 Flashcards

1
Q

Thyroid Scanning (Thyroid Scintiscan) what is it ?

A

Radioactive substance is given to patient and the thyroid uptakes the isotope

Camera is passed over the neck and thyroid can be visualized

**the T uptakes the isotope and it makes it glow when u take images and you are looking for thyroid nodules **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thyroid Scanning (Thyroid Scintiscan) when is it used ?

A

Evaluate for thyroid nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thyroid Scan Classifies the nodule or mass: nonfunctioning ?

A

Cold

  • *nonfucniton or inactive - cold
  • *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Thyroid Scan Classifies the nodule or mass functioning ?

A

Hot

** active - hot

functioning like T NL functions - HOT

not function NL like T then it will not pick up the Isotope

HOT - lighting up even after the rest of the T is done with the isotope **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Thyroid Scan: Hot result ?

A

Graves disease
Ig attacking TSH receptors making the area more active

Toxic goiter
is it functioning or not, G enlarged cause T was over active = toxic, or is it there from inflammation or destruction - differenacite between the two

Functional adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thyroid Scan: Cold result ?

A

Thyroiditis

Non-toxic Goiter

Carcinoma - not normal functioning tha T normally does

Cyst

Nonfunctional Adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thyroid Scan own notes ?

A

Iodine deficiency - non toxic - over worked over time

US = FNA - feel a mass do this test to see if it is H or C and, a US to see if it is a cysts or not and put a needle in the area and get a bx sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Glucose Testing own notes ?

A

L - gametogenesis

H blood glucose levels makes insulin releases from the P which drive G into the cell and it makes the L take G out of the blood and store it as glycogen

L blood glucose it acts on the P to cause glycogen release and release G into the blood

frequency I use and no eating - hypo

Dm is actually a high blood sugar problem

to high G they can go into ketoacidosis and electrolyte distrunabces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Glucose Testing types ?

A

Random Blood Glucose

2 hour post-prandial glucose

Fasting Blood Glucose

Hemoglobin A1C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Who should get tested: Testing for TII Diabetes and Prediabetes in asxs. adults ?

A

TII Diabetes testing should be done in all adults who are overweight or obese

BMI > equal to 25 or 23 in sia americans, who have > or equal to 1 diabetes risk factor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diabetes risk factors ?

A

Physical inactivity

first degree relative with D

high risk ethnicity

Women who delivered a baby > 9 lbs or dx with GDM

HDL-C <35 +- TG >250

HTN (>140/90)

A1C > or equal to 5.7%, IGT or IFG

condition associated with insulin resistance: obesity, acanthuses nigerians, PCOS

CVD hx.

**impaired glucose tolerance - IGT

PCOS - polycystic ovarian syncrome **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who should get tested? Age ?

A

Testing should begin at age 45, especially if individual is overweight or obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who should get tested? If NL results ?

A

repeat testing in > or equal to 3 yr intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hgb A1C what is it ?

A

About 7% of Hgb A can combine with glucose in a process called glycosylation (not easily reversed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hgb A1C when is it used ?

A

Diagnose and/or monitor diabetes

Takes 3 weeks to rise and 4 weeks to decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hgb A1C what does it mean ?

A

Gives a percentage (glucolyciyaed in the serum) that corresponds to an average blood glucose range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Average daily blood sugar - 135 = what A1C level ?

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Average daily blood sugar - 170 = what A1C level ?

A

7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Average daily blood sugar - 205 = what A1C level ?

A

8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Average daily blood sugar - 240 = what A1C level ?

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Average daily blood sugar - 275 = what A1C level ?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Average daily blood sugar - 310 = what A1C level ?

A

11%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Average daily blood sugar - 345 = what A1C level ?

A

12%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hgb A1C own notes ?

A

typically it is quarterly - every three months

great patients and young and health - 6 months

lover than 7 for non preg.

anything about 6.5% is Diabete and we want to keep out D around 7% ( more stringent = <6.5%)

5.7-6.4% pre DM - they are become insulin resistance - body is need more I to do the job it used to do

Need I to open the door for G to get into the cell

No Insulin then TI DM
TII - rusty dorr hinges - I used to be able to open door , now there need two big men to open door cause the door is resistant ( adipose, fat cell - reduce insulin = obese patients, diet - attack P with high glucose over and over build resistance)

drugs to increase I from the P or used the I they have in a more effective way

Impaired fasting glucose - pre DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

2 hr post-prandial glucose (PPG) what is it ?

A

Measurement of the amount of glucose in the blood 2 hrs after a meal is ingested.

Meal acts as a glucose challenge.

Usually glucose levels return to “pre-meal” range after 2 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

2 hr post-prandial glucose (PPG) when is it used ?

A

Evaluate for diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

2 hr post-prandial glucose (PPG) NL ?

A

≤ 140 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

2 hr post-prandial glucose (PPG) Diabetes value ?

A

≥ 200 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

2 hr post-prandial glucose (PPG): Values between ___-___ should be rechecked with another test ( this is the impariened fasting glucose level )

A

140-200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

2 hr post-prandial glucose (PPG) own notes ?

A

2 hours after a meal is ingested

used they will retrun to pr meal levels around 2 hours - NL = less then 140 in 2 hours normally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Oral Glucose Tolerance Test (OGTT) ?

A

Similar to the post-prandial glucose although in this test a glucose “load” is administered.

Usually 75 g of anhydrous glucose given PO

Same values as 2 hr PPG

**75 G is the 2 hours test - after 2 hours it should be less then 140 - over 200 is DM **

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

OGTT
 Gestational DM Testing own notes ?

A

for pregos we give 50 g load for 1 hour ( need to be 8 hours fasting)

if failed then need to come back in another day with a 100 g test ( test at 1 hr, 2 hr, and 3 hr)

stick with the NDDG #’s ( anything over the numbers is DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

OGTT
 Gestational DM Testing: fasting NDDG # ?

A

105

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

OGTT
 Gestational DM Testing: 1 hour NDDG # ?

A

190

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

OGTT
 Gestational DM Testing: 2 hour NDDG # ?

A

165

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

OGTT
 Gestational DM Testing: 3 hour NDDG # ?

A

145

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Fasting Plasma Glucose (FPG) NL ?

A

70-100(99) mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Fasting Plasma Glucose (FPG) pre-diabetic ?

A

100-126

39
Q

Fasting Plasma Glucose (FPG) diabetes ?

A

> or equal to 126

** THIS IS FASTING!!!**

have them come in i the morning w/o eating or drinking anything

40
Q

Fasting is defined as ?

A

no caloric intake for more than or equal to 8 hours

41
Q

Random Plasma Glucose (RPG) diabetes number ?

A

Any value ≥200 mg/dL = diabetes

42
Q

DM Autoantibody Panel what is it ?

A

Panel used to discover autoantibodies

Useful in diagnosing Type I DM

43
Q

DM Autoantibody Panel when is it used ?

A

Diagnosing juvenile diabetes or Late onset Autoimmune Diabetes of the Adult

Correlate with progression to Type I DM

Increased risk of developing DM in 1st degree relatives in TI DM

44
Q

Insulin Autoantibody (IAA) ?

A

Antibodies to insulin

45
Q

Islet Cell Antibody (ICA) ?

A

Antibodies attacking islet cells

46
Q

Glutamic Acid Decarboxylase Antibody (GAD Ab) presence ?

A

Type I DM

Gestational DM may need insulin for life.
( highly likely )

**TII DM have lower Neg. titers

get all three with the panel

47
Q

Insulin what is it ?

A

Measures serum levels of insulin

48
Q

Insulin when is it used ?

A

Used to diagnose insulinoma

Used to evaluate patients with fasting hypoglycemia

**more insulin then it should ( opposite prob then DM) and they are constant dropping BS, hypoglycemia when fasting always **

49
Q

Insulin increased ?

A

Insulinoma

Cushing syndrome:
-Overproduction of cortisol

Obesity:
-Insulin resistance causes persistent highs

Acromegaly:

  • Overproduction of growth hormons
  • somatmetings
50
Q

Insulin decreased ?

A

IDDM
-insulin dependent DM

Hypopituitarism:
-Reduced thyroid and adrenal functions

51
Q

C-Peptide what is it ?

A

Cleaved off of proinsulin molecule to create insulin

Measurement of endogenous insulin production

**measure meant out endogenous Insulin - insulin being made in the body

CP is discarded remnant with I is made and it is cleave off when making I - good indicator of how much I is being produced **

52
Q

C-peptide increased ?

A

Insulinoma

Pancreas transplant

Renal failure

Oral hypoglycemic agents

53
Q

C-peptide decreased ?

A

Factitious hypoglycemia

IDDM

Pancreatectomy

54
Q

Adrenal Hormones: Zona glomerulosa , examples?

A

Mineralcorticoids (regulate mineral balance)

Aldosterone

55
Q

Adrenal Hormones: Zona fasciculata, examples?

A

Glucocorticoids (regulate glucose metabolism)

Cortisol, Corticosterone, Cortisone

**C - stress, increase glucose , decrease inflammation , **

56
Q

Adrenal Hormones: Zona reticularis , examples?

A

Androgens (stimulate masculinization)

Dehydroepiandrosterone

57
Q

Adrenal Hormones: Adrenal medulla , examples?

A

Stress hormones (stimulate sympathetic ANS)

Epinephrine, Norepinephrine

58
Q

Cortisol is a ?

A

Potent glucocorticoid

**excess cortison - cushing

decrease - addisons **

59
Q

↑ Cortisol from what ?

A

prolonged stress

Surgery
Trauma
Chronic infection or disease
Hypo- or hyperthermia
Restraint
60
Q

↑ Cortisol effects on the body ?

A

↑ Plasma glucose

↑ Plasma fatty acids

↑ Plasma amino acids

↓ Inflammatory response

61
Q

↑ Cortisol own notes ?

A

body is trying to cope with increase Inflamma response in the body

prolong period of stress = inflammation - body thinks it is under attack and raise G levels and give u things to fight stress off by lower inflammation levels and battle the stress off

62
Q

Cortisol Testing ?

A

Serum cortisol

Saliva for cortisol

24 Urine free cortisol

Dexamethasone suppression test

ACTH stimulation test

**8am = highest ( peak)

lowest at 4 pm ( tough) **

63
Q

Primary adrenal insufficiency ?

A

due to impairment of the adrenal glands

Addisons Disease q

64
Q

Secondary adrenal insufficiency ?

A

Is caused by impairment of the pituitary gland or hypothalamus

  • *secondary - pituitary level
  • *
65
Q

Tertiary adrenal insufficiency ?

A

is due to hypothalamic disease and decrease run corticotropin releasing factor (CRF)

66
Q

Laboratory Testing for Adrenal Insufficiency

initial testing ?

A

Measure early morning serum cortisol

  • *initial tets is morning C level at 8 am - if higher then 5 then it is less likes for Adrenal insufficiency
  • *
67
Q

Measure early morning serum cortisol: __________ µg/dL makes primary adrenal insufficiency less likely

A

Cortisol ≥5

If serious consideration is given to this diagnosis, perform stimulation testing

68
Q

Follow abnormal cortisol results with ?

A

adrenocorticotropic hormone (ACTH) testing

69
Q

If ACTH _____ pg/dL – adrenal failure likely

A

> 300

Pituitary is making it but Adrenal Gland is not working ( adrenal failure primary)

70
Q

If ACTH ____ pg/dL – pituitary failure likely.

A

<10

**- ACTH is not being produce - prob. a pituitary problem **

71
Q

If ACTH _____ pg/dL – administer ACTH (cosyntropin) stimulation test

A

<300

72
Q

Testing based on ACTH result ?

A

ACTH stimulation test (cosyntropin)

73
Q

ACTH stimulation test (cosyntropin) measures ?

A

Measures cortisol response to cosyntropin (250 µg using serial cortisol measures )

74
Q

ACTH stimulation test (cosyntropin): _______ µg/dL ( with synthetic ACTH) – primary severe adrenal failure

A

Cortisol <5

75
Q

ACTH stimulation test (cosyntropin):_______ µg/dL – normal; primary adrenal insufficiency unlikely ( cause it is responding to ACTH being put into the system)

A

Cortisol >20

76
Q

Abnormal cortisol testing ?

A

abnormal Cortisol results and think adrenal INsufficencit, then follow initiall test with ACH level = is it pituitary fault or hypothalamus fault

77
Q

ACTH Stimulation Test:

ACTH = decreased (negative feedback)

Cortisol = increased

condition ?

A

NL response

78
Q

ACTH Stimulation Test:

ACTH = decreased (negative feedback)

Cortisol = decreased

condition ?

A

Primary Adrenal insufficiency

79
Q

ACTH = ↑

Cortisone = ↓

Aldosterone = ↓

Basal secretion ?

A

Primary

the adrenal gland is the problem

80
Q

ACTH = ↓

Cortisone = ↓

Aldosterone = NL

Basal secretion ?

A

Secondary

pituitary problem , it is not making it

81
Q

ACTH = ↓

Cortisone = ↓

Aldosterone = NL

Basal secretion ?

A

Tertiary

Hypothalamus problem ,

82
Q

24 hour urine for free cortisol ?

A

Collect 24-hour urine specimen

Measure cortisol excreted in the urine

If high, suggests Cushings

83
Q

24 hour urine for free cortisol ? dont to dx ?

A

cushings

84
Q


Evaluating for Cushings

Serum Cortisol and ACTH: Endogenous examples ?

A

Pituitary adenoma

Tumors producing ACTH (carcinoid)

Adrenal tumors

85
Q


Evaluating for Cushings

Serum Cortisol and ACTH: Exogenous examples?

A

Exogenous steroids

prednisone, glucocrticoids

86
Q


Evaluating for Cushings

: endogenous ACTH ?

A

↑ elevated

↑ elevated

↓ decreased ( ACTH trying to shut off)

87
Q


Evaluating for Cushings

: endogenous basal cortisol ?

A

8am: elevated
4pm: elevated

88
Q


Evaluating for Cushings

: exogenous ACTH ?

A

↓ decreased

because no fluctuation, constant High C levels cause we are giving it to them

89
Q


Evaluating for Cushings

: exogenous basal cortisol ?

A

Loss of diurnal variation

90
Q

Evaluating for Cushings: Dexamethasone Suppression Test ?

A

Synthetic steroid similar to cortisol

Suppresses ACTH secretion

Results in drop of 50% or more of plasma cortisol

**give them a steroid and see what C levels do , it should suppress ACTh and drop plasma cortisol levels **

91
Q

ACTH = decreased

Cortisol = decreased

condition ?

A

Normal Response

92
Q

ACTH = elevated

Cortisol = elevated

condition ?

A

Pituitary Tumor ( no response to Dx)

93
Q

ACTH = decreased

Cortisol = elevated

condition ?

A

Adrenal Tumor

94
Q

ACTH = decreased

Cortisol = increase

condition ?

A

Steroid treatment

Clinical Medicine LAB - Professor Sample (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions