Endocrine

Question 1

What is phenylketonuria (PKU)?

Answer 1

Liver enzyme deficiency –> can’t process phenylalanine (protein) properly –> brain damage r/t to ↑ phenylalanine

Question 2

How is PKU diagnosed?

Answer 2

Newborn screening

Question 3

What CAN’T a pt w/PKU eat?

Answer 3

AVOID proteins, milk, meat, eggs, beans, nuts, and aspartame

Question 4

What SHOULD a pt w/PKU eat?

Answer 4

Low phenylalanine diet – fruits, veggies, & low protein bread, cereals, & pastas

Question 5

High blood sugar S/S =

Answer 5

** hot & dry, blood sugar high **

AMS, fatigue/weak, dry, flushed, blurry vision, fruity breath, thirsty, hungry, and ↑ UOP

Question 6

Low blood sugar S/S =

Answer 6

** cool & clammy, give em’ candy **

Irritable, sweaty, tremors, palpitations, tachycardia

Question 7

Rapid Insulins =

Answer 7

Aspart, Lispro, & Glulisine

Onset: 15 min
Peak: 30-90 min
Duration: 3-5 hours

Question 8

Short (regular) Insulin =

Answer 8

Regular (R’s)

Onset: 30-60 min
Peak: 2-4 hours
Duration: 5-8 hours

Question 9

Intermediate Insulin =

Answer 9

NPH

Onset: 1-3 hours
Peak: 2-4 hours
Duration: 10-16 hours

Question 10

Long-Acting Insulin =

Answer 10

Glargine (lantus) & Detemir

Onset: 1-2 hours
Peak: NONE
Duration: 6-24 hours

Question 11

What is Type 1 Diabetes?

Answer 11

Autoimmune (genetic) prob –> pancreas damage & NO insulin production

Question 12

S/S of Type 1 Diabetes =

Answer 12

Weight loss
Polydipsia (thirsty)
Polyphagia (hungry)
Polyuria (lots of pee)
Blurry vision

Question 13

How is Type 1 Diabetes diagnosed?

Answer 13

A1c testing

Question 14

How would you treat HYPOglycemia?

Answer 14

Eat or drink 15-20g of carbohydrates!!

Question 15

How would you treat HYPERglycemia?

Answer 15

Fluid & electrolyte replacement

Insulin admin

Question 16

What is Diabetes Insipidus (DI)?

Answer 16

Posterior pituitary gland prob –> not enough ADH (vasopressin)

Body can’t balance fluid levels properly

Question 17

What can cause DI?

Answer 17

Surgery 
Head trauma
Gene mutation
Granulomatous dz (immune deficit)
Infx encephalitis/meningitis
Leukemia
Phenytoin reaction

Question 18

S/S of DI =

Answer 18

Dehydration (thirsty, dry mm, no tears, bad turgor)
Weight loss
↑ UOP
Tachycardia
Tachypnea

Question 19

Patho of DI =

Answer 19

Not enough ADH –> pt can’t hold on to/concentrate urine –> pee until they’re dehydrated –> drink excessively to make up for loss

Question 20

Treatment for DI =

Answer 20

Replace ADH w/DDAVP (desmopressin) - synthetic ADH

Keep in fridge, clear nostril, repeat if child sneezes, monitor S.G. (1.005-1.030), monitor for OD (SIADH), and for weight gain

Question 21

What would you call an ADH overload?

Answer 21

SIADH

Question 22

What is NORMAL specific gravity (S.G.)?

Answer 22

1.005 - 1.030

Question 23

What is SIADH?

Answer 23

Excessive secretion of ADH r/t CNS changes

Water is reabsorbed & UOP ↓ –> ↓ Na+ r/t hemodilution

Question 24

Is sodium increased or decreased w/SIADH & why?

Answer 24

Sodium is ↓ b/c of hemodilution

Blood is being diluted by reabsorbed water

Question 25

S/S of SIADH =

Answer 25

``` Water intoxication HYPONa+ JVD ↑ BP Weight gain Fluid in lungs Edema ```

Question 26

Treatment for SIADH =

Answer 26

Fluid monitoring/restriction Monitor electrolytes Admin DEMECLOCYCLINE (↓ reabsorption of water)

Question 27

What medication is given to ↓ water reabsorption and treat SIADH?

Answer 27

DEMECLOCYCLINE

Question 28

DI v.s. SIADH = | S/S

Answer 28

``` DI = ↑ UOP & dry HYPERNa+ Osmolality > 300 (↓) S.G. < 1.005 (↓) & not concentrated Dehydration/thirsty ``` ``` SIADH = ↓ UOP & wet HYPONa+ Osmolality < 280 (↑) S.G. > 1.030 (↑) & concentrated Fluid retention/weight gain ```