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ACP Term 2 Study > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What is the endocrine system involved in?

A

-growth, metabolism, and adaptation.

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2
Q

What can Hormones be categorized as?

A
  • amines/Amino acids
  • Peptides, polypeptides, glycoproteins and proteins
  • Steroids
  • Fatty acid derivatives
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3
Q

What are the main endocrine organs in the body?

A
  • pineal
  • Pituitary (A+P)
  • Thyroid/parathyroids
  • Adrenal (cortex/medulla)
  • Stomach
  • Pancreas
  • Duodenum
  • Ovary/testes
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4
Q

What is the HPA axis?

A

Hypothalamic-pituitary-Adrenal

The bodies hormone response to extrernalities such as stress, pain, infection, hypoglycaemia, trauma, hemorrhage, sleep resulting in cortisol reaching target organs.

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5
Q

Where is Glucagon secreted

A

The islets of Langerhans within the pancreas

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6
Q

Describe Adrenal Insufficiency

A
  • decreased adrenal cortex function

- Decreased aldosterone and cortisol function

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7
Q

s/s of adrenal insufficiency

A

Weakness, dehydration, inability to respond to stress.

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8
Q

Describe Addisons disease

A
  • primary adrenal insufficiency

- Adrenal cortical hormones, and elevated ACTH levels

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9
Q

S/S of Addisons Disease

A
  • Bronze pigmentation
  • Body hair distribution changes
  • GI upset
  • Weakness
  • Hypoglycaemia
  • hyperkalemia
  • Hypotension
  • Weight loss
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10
Q

What is primary Adrenal Insufficiency?

A
  • mineralocorticoid deficiency

- Glucocorticoid deficiency

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11
Q

What is Secondary Adrenal Insufficiency?

A

More common

  • Lack of ACTH secretion from the pituitary leading to a reduced production of cortisol
  • Commonly found in patients who abruptly stop glucocorticoid therapy
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12
Q

Describe Cushings syndrome (Three forms hypersecretion)

A

Manifestation of hypercortisolism of any cause.

3 forms:

  • pituitary form
  • Adrenal Form
  • Ectopic Cushings

May also result from long term glucocorticoids

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13
Q

Physical exam findings in the cushings patient

A 
Moon face
Buffalo hump
Skin ulcers
Osteoporosis
Cardiac Hypertrophy
Obesity

and more!

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14
Q

Other causes of Hypercortisolism

A
  • pregnancy
  • Malnutrition
  • Alcoholism
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15
Q

Describe Congenital Hypothyroidism

A
  • congenital malformation of thyroid gland

- Poor TH synthesis or TH synthesis

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16
Q

S/S of congenital hypothyroid

A

-large tongue
-weight gain
-Poor feeding
-Excessive sleep
-Constipation
Jaundice
-Poor muscle tone
-Umbilical hernia

17
Q

Describe Hypothyroidism

A
  • Hypo-metabolic state

- Myxedematous involvement of tissues

18
Q

Describe a myxoedema coma

A
  • Profound Hypothyroid
  • Life threatening
  • Most common in elderly women with Hx of hypothyroidism
19
Q

Describe Hyperthyroidism

A
  • Hyper-metabolic state
  • Excessive delivery of T3 & T4 to peripheral tissues
  • Most common in graves disease.
20
Q

What is a thyroid storm

A
  • Life-Threatening Thyrotoxicosis

- Precipitated by infection, DKA, trauma

21
Q

What are three actions of insulin

A
  • Promotes glucose uptake by target cells & provides for glucose storage as glycogen
  • Prevents fat and glycogen breakdown and inhibits gluconeogenesis
  • Increases protein synthesis
22
Q

Describe T1DM

A

destruction of pancreatic beta cells

23
Q

Describe T2DM

A

Results from increased insulin resistance

24
Q

What are the three “polys” in diabetes

A

Polyuria
Polydipsia
Polyphagia

25
Q

How is diabetes diagnosed?

A

Fasting BGL
-2 episodes over 7mmol/L

Random BGL
-1 episode over 11.1mmol/L with symptoms

26
Q

What are the four principle types of exogenous insulin?

A
  • Rapid acting
  • Short acting
  • Intermediate acting
  • long acting
27
Q

Describe DKA

A

When ketone production exceeds cellular use and renal excretion.

28
Q

S/S of DKA

A
  • Polyuria & Polydipsia over 2 days is common
  • Kussmauls respirations
  • Hypotension and tachycardia
29
Q

Parts of definitive DKA diagnosis

A
  • Hyperglycemia >14mmol/L
  • Low bicarbonate <15mEq
  • Low pH <7.35
  • Excess ketone bodies

May aslo see

  • HyperK
  • Pseudohyponatremia
  • Metabolic Acidosis
30
Q

ACP Tx for DKA

A
  • ABC’s
  • fluid!
  • If ECG changes suggesting hyper K present consider Calcium (1G), salbutamol (20mg)
31
Q

When can Hyperglycemic hyperosmolar non-ketotic syndrome occur

A
  • T2DM
  • Acute Pancreatitis
  • Severe Infection
32
Q

How does HHNK present

A
  • Dehydration
  • Neuro compromise
    a. seizures, hemiparesis, aphasia, nystagmus, hallucinations
  • Excessive thirst
  • Generally progressive over days and may be mistaken for a stroke.
33
Q

HHNK Diagnosis

A
  • Hyperglycemia (>33mmol/L)
  • Hyperosmolarity (<310)
  • Dehydration
  • Absence of ketoacidosis
  • Depression of sensorium
34
Q

HHNK management

A

Correct hypo perfusion

ACP Term 2 Study (15 decks)

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