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theoretical 2 exam 4 > endocrine > Flashcards

endocrine Flashcards

1
Q

functions of endocrine system:

enables body to ______ energy

A

metabolize

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2
Q

functions of the endocrine system:

_____, _____, and develop

A
  • reproduce

- grow

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3
Q

endocrine system maintains ______

A

homeostasis

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4
Q

endocrine system responds to _____ and ____

A

stress and injury

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5
Q

2 major classes of hormones

A
  • steroids

- thyronines

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6
Q

age related changes have a _______ response

A

compensatory

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7
Q

effects of aging:

thyroid gland ____ and activity decreases

A

atrophies

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8
Q

____ metabolic rate with aging

A

lower

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9
Q

reduced ____ _____ uptake with aging

A

radioactive iodine

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10
Q

less secretion and release of ______ w aging

A

thyrotropin

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11
Q

diminished ____ function with aging

A

adrenal

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12
Q

_______ secretion decreases

A

ACTH

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13
Q

decreased secretion of ACTH further reduces ____, ____, ______, _______ and _____

A
  • estrogen
  • progesterone
  • androgen
  • 17-ketosteroids
  • glucocortiocoids
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14
Q

volume of _____ gland decreases

A

pituitary

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15
Q

decreased volume of pituitary gland causes _____ _____ hormone level reduction

A

somatotropic growth

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16
Q

seventh leading cause of death in older adults

A

type 2 diabetes

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17
Q

glucose intolerance due to increased amounts of ____ ___ in obese older adults

A

fat tissue

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18
Q

___% of older adults have diabetes

A

20

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19
Q

symptoms of type 2 diabetes

A
  • hypotension
  • periodontal disease
  • stroke
  • gastric hypotony
  • impotence
  • neuropathy
  • confusion
  • glaucoma
  • Dupuytens contracture
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20
Q

fasting blood sugar recommended every ___ years for persons over ___ years

A
  • 3 years

- 45

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21
Q

most effective test for diabetes

A

glucose tolerance test

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22
Q

ADA recommends ____g of carbs ingested several days before blood work

A

150g

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23
Q

test should be performed more than once to avoid

A

false positive results

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24
Q

criteria for diagnosis of type 2 diabetes:

symptoms and random blood glucose concentration greater than or equal to _____ mg/dL

A

200

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25
Q

criteria for diagnosis of type 2 diabetes:

fasting blood glucose concentration greater than or equal to ____mg/dL

A

126

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26
Q

criteria for diagnosis of type 2 diabetes:

blood glucose concentrations 2 hours after oral glucose intake greater than or equal to ____mg/dL

A

200

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27
Q

criteria for diagnosis of type 2 diabetes:

glycosylated hemoglobin (HbA1C) greater than or equal to ___%

A

6.5%

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28
Q

meds that decrease glucose tolerance (5)

A
  • furosemide
  • diuretics
  • estrogen
  • ethacrynic acid
  • nicotinic acid
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29
Q

meds that lower blood sugar levels (3)

A
  • MAIOs
  • propanolol
  • high dosage of salicylates
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30
Q

hypoglycemia:

blood glucose less than ____mg/dL

A

70

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31
Q

hyperglycemia s/s (6)

A
  • increase in urination
  • increase in appetite, followed by lack of appetite
  • weakness, fatigue
  • blurred vision
  • headache
  • glycosuria
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32
Q

hypoglycemia s/s (5)

A
  • cold, clammy skin
  • numbness of fingers, toes, mouth
  • tachycardia
  • nervousness, tremors
  • faintness, dizziness
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33
Q

diabetes management:

choose foods low in _____ fat and ___ fat

A
  • saturated

- trans

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34
Q

_______ respirations are the body’s attempt to reverse metabolic acidosis through the exhalation of CO2

A

Kussmaul

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35
Q

teach pt about prevention, recognition, and management of hypoglycemia if pt is taking _____ or ______

A
  • sulfonylureas

- metformin

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36
Q

diabetic ketoacidosis most likely to occur in pts with type ___

A

1

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37
Q

s/s of diabetic ketoacidosis (4)

A
  • hyperglycemia
  • ketosis
  • acidosis
  • dehydration
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38
Q

what is it called when ketone bodies are excreted in the urine?

A

ketonuria

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39
Q

during ketonuria, _____ that are cations are excreted with the anionic ketones to try to maintain _____ _______

A
  • electrolytes

- electrical neutrality

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40
Q

insulin deficiency stimulates the production of glucose from _____ _____ in the liver furthering hyperglycemia

A

-amino acids

41
Q

s/s of dehydration in DKA (3)

A
  • dry mucous membranes
  • tachycardia
  • orthostatic hypotension
42
Q

acetone is noted on breath as a sweet, fruity odor in what condition?

A

diabetic ketoacidosis

43
Q

common causes of hyperosmolar hyperglycemia syndrome (5)

A
  • UTIs
  • pneumonia
  • sepsis
  • acute illness
  • newly diagnosed type 2 diabetes
44
Q

what is it called when a pt w diabetes is able to make enough insulin to prevent diabetic ketoacidosis but not enough prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion?

A

hyperosmolar hyperglycemia syndrome

45
Q

HHS causes severe ______

A

hyperglycemia

46
Q

HHS causes ______ ______ depletion

A

extracellular fluid

47
Q

HHS causes ____ ______

A

osmotic diuresis

48
Q

HHS often related to impaired ______ ______

A

thirst sensation

49
Q

HHS related to functional inability to replace _____

A

fluids

50
Q

the main difference between HHS and DKA is that the pt with HHS usually has enough circulating ______ so that ketoacidosis does not occur

A

insulin

51
Q

lab values for HHS:

blood glucose greater than ____mg/dL

A

600

52
Q

lab values for HHS:

marked increase in serum _____

A

osmolality

53
Q

HHS treatment:

when blood glucose falls to about ____mg/dL IV fluids containing ______ are given to prevent hypoglycemia

A
  • 250

- dextrose

54
Q

first goal of therapy for DKA is to begin _____ and ______ replacement

A

fluid and electrolyte

55
Q

obtain serum _____ level before starting insulin in pt with DKA

A

-potassium

56
Q

3 major types of glucose lowering agents

A
  • insulin
  • oral agents (OAs)
  • noninsulin injectable agents
57
Q

_____ (injected) insulin is needed when a pt has inadequate insulin to meet specific metabolic needs

A

exogenous

58
Q

type ___ diabetes is a progressive illness

A

2

59
Q

rapid acting insulin:

-peak: ___min- __ hours

A

30 min-3 hours

60
Q

rapid acting insulin examples (3)

A
  • Humalog
  • Novolog
  • Apidra
61
Q

rapid acting insulin duration: __-___ hours

A

3-5 hours

62
Q

short acting insulin examples (2)

A
  • Humulin R

- Novolin R

63
Q

short acting insulin duration:

__-___ hours

A

5-8 hours

64
Q

intermediate acting insulin examples (2)

A

-NPH– Humulin N, Novolin N

65
Q

intermediate acting insulin duration:

___-___ hours

A

12-18 hours

66
Q

long acting insulin examples (3)

A
  • Lantus
  • Levemir
  • Tresiba
67
Q

long acting insulin duration:

__-___ hours

A

16-24 hours

68
Q

inhaled insulin example (1)

A

afrezza

69
Q

inhaled insulin duration:

___1/2-___ hours

A

2 1/2-3 hours

70
Q

fastest subcutaneous absorption is from the ______

A

abdomen

71
Q

what is it called when a high dose of insulin causes a decline in blood glucose levels during the night causing counterregulatory hormones to be released?

A

Somogyi effect

72
Q

what counter regulatory hormones are release during somogyi effect (4)

A
  • glucagon
  • ephinephrine
  • growth hormone
  • cortisol
73
Q

if the pt has morning hyperglycemia, checking blood glucose levels between
___ and ____a.m. for hypoglycemia to determine if the cause is the Somogyi effect

A

2-4am

74
Q

_______ and _____ are excreted in increased amounts in the morning may be the cause of _____ ______

A
  • growth hormone and cortisol

- dawn phenomenon

75
Q

dawn phenomenon tends to be most severe during ______ and _____ adulthood bc _______ ______ is at its peak

A
  • adolescents and young adulthood

- growth hormone

76
Q

treatment for somogyi effect:

reducing ________ of _____

bedtime _____

A
  • dosage of insulin

- snack

77
Q

treatment for dawn phenomenon:

increase in ____

adjustment of ___________time

A
  • insulin

- administration

78
Q

most widely used oral agent

A

metformin

79
Q

_____ is the most effective first line treatment for type 2 diabetes

A

metformin

80
Q

primary action of ______ is to reduce glucose production to the liver

A

metformin

81
Q

the primary action of metformin is to reduce ____ production by the _____

A
  • glucose

- liver

82
Q

_____ is a major side effect of sulfonylreas

A

hypoglycemia

83
Q

primary action of ______ is to increase insulin production by the pancreas

A

-sulfonylureas

84
Q

______ are more rapidly absorbed and eliminated by pancreas than sulfonylreas so they are less likely to cause hypoglycemia

A

meglitinides

85
Q

______ ______ inhibitors work by slowing down carb absorption in the small intestine

A

alpha glucosidase inhibitors

86
Q

alpha glucosidase inhibitors slow down the absorption of ______ in the _____ intestine

A
  • carbohydrates

- small

87
Q

if alpha glucosidase inhibitors are taken with the first bite of each main meal, they are most effective in lowering ______ blood glucose

A

postprandial

88
Q

_______ most effective for pts with insulin resistance

A

thiazolidinediones

89
Q

Avandia (thiazolidinediones) is associated with adverse ______ events

A

cardiovascular

90
Q

Pioglitazone (Actos) can worsen ____ ____ and is associated with increased risk of ______ cancer

A
  • heart failure

- bladder

91
Q

sulfonylreas carries risk for _____due to delayed clearance in older adults

A

hypoglycemia

92
Q

administer metformin _____ meals

A

after

93
Q

take sulfonylureas ____ hour before meals

A

half hour

94
Q

The recommendation for pts who use multiple insulin injections a day or insulin pumps is to monitor their blood glucose ___-___ times a day

A

4-8

95
Q

_____ _______ agent is _____(short/long) acting with less adverse effects on older adults

A
  • insulinotropic anti diabetic agent

- short

96
Q

med class with the lowest risk of hypoglycemia

A

thiazolidinediones

97
Q

hemoglobin A1C used to monitor effectiveness of disease control over a
__-__ week period of time

A

6-12

98
Q

triglyceride levels below ____mg/dL is ideal

A

150

theoretical 2 exam 4 (3 decks)

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