Endocrine Flashcards
What is phenylketonuria (PKU)?
Liver enzyme deficiency –> can’t process phenylalanine (protein) properly –> brain damage r/t to ↑ phenylalanine
How is PKU diagnosed?
Newborn screening
What CAN’T a pt w/PKU eat?
AVOID proteins, milk, meat, eggs, beans, nuts, and aspartame
What SHOULD a pt w/PKU eat?
Low phenylalanine diet – fruits, veggies, & low protein bread, cereals, & pastas
High blood sugar S/S =
** hot & dry, blood sugar high **
AMS, fatigue/weak, dry, flushed, blurry vision, fruity breath, thirsty, hungry, and ↑ UOP
Low blood sugar S/S =
** cool & clammy, give em’ candy **
Irritable, sweaty, tremors, palpitations, tachycardia
Rapid Insulins =
Aspart, Lispro, & Glulisine
Onset: 15 min
Peak: 30-90 min
Duration: 3-5 hours
Short (regular) Insulin =
Regular (R’s)
Onset: 30-60 min
Peak: 2-4 hours
Duration: 5-8 hours
Intermediate Insulin =
NPH
Onset: 1-3 hours
Peak: 2-4 hours
Duration: 10-16 hours
Long-Acting Insulin =
Glargine (lantus) & Detemir
Onset: 1-2 hours
Peak: NONE
Duration: 6-24 hours
What is Type 1 Diabetes?
Autoimmune (genetic) prob –> pancreas damage & NO insulin production
S/S of Type 1 Diabetes =
Weight loss Polydipsia (thirsty) Polyphagia (hungry) Polyuria (lots of pee) Blurry vision
How is Type 1 Diabetes diagnosed?
A1c testing
How would you treat HYPOglycemia?
Eat or drink 15-20g of carbohydrates!!
How would you treat HYPERglycemia?
Fluid & electrolyte replacement
Insulin admin
What is Diabetes Insipidus (DI)?
Posterior pituitary gland prob –> not enough ADH (vasopressin)
Body can’t balance fluid levels properly
What can cause DI?
Surgery Head trauma Gene mutation Granulomatous dz (immune deficit) Infx encephalitis/meningitis Leukemia Phenytoin reaction
S/S of DI =
Dehydration (thirsty, dry mm, no tears, bad turgor) Weight loss ↑ UOP Tachycardia Tachypnea
Patho of DI =
Not enough ADH –> pt can’t hold on to/concentrate urine –> pee until they’re dehydrated –> drink excessively to make up for loss
Treatment for DI =
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
What would you call an ADH overload?
SIADH
What is NORMAL specific gravity (S.G.)?
1.005 - 1.030
What is SIADH?
Excessive secretion of ADH r/t CNS changes
Water is reabsorbed & UOP ↓ –> ↓ Na+ r/t hemodilution
Is sodium increased or decreased w/SIADH & why?
Sodium is ↓ b/c of hemodilution
Blood is being diluted by reabsorbed water
S/S of SIADH =
Water intoxication HYPONa+ JVD ↑ BP Weight gain Fluid in lungs Edema
Treatment for SIADH =
Fluid monitoring/restriction
Monitor electrolytes
Admin DEMECLOCYCLINE (↓ reabsorption of water)
What medication is given to ↓ water reabsorption and treat SIADH?
DEMECLOCYCLINE
DI v.s. SIADH =
S/S
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