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Acute Care 5460 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

increases the glucose

A

glucagon

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2
Q

what is the 4 parts of counter regulatory mechanism (GGGE)

A
  • glucagon alpha cells in pancreas release liver stores of glucose
  • epi stress reaction
  • glucocorticoids from adrenals
  • growth hormone - pitutary
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3
Q

insulin dependent/ totally disabled beta cells

A

diabetes type 1

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4
Q

tirad of diabetes management

A

diet
exercise
meds

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5
Q

AIC diagnostic criteria (3)

A

5.7-6.4 PRE
>= 6.5 DIABETES
>= 7 Uncontrolled

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6
Q

when do you get tested for DM

A

healthy/ no risks 35 years Q3 years
GD every 3. years for life
BMI >25 or 1 risk factor now & Q3 years

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7
Q

when to screen for pre diabetics & med options

A

yearly

metformin

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8
Q

BMI should be less than what

A

25

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9
Q

first line meds for HTN & DM

A

ACE/ARBS

BB/CCB/thiazides on some circumstances

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10
Q

when to refer to a nephrologist

A

GFR <30

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11
Q

diabetic eye care

A

DM1 dx dilated eyes within 5 years then Q1 year
DM2 dx dilated eyes Q year
avoid vigorous exercise with retinopathy

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12
Q

acute care glucose range recommendation

A

140-180

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13
Q

low TSH indicates

A

hyperactive thyroid

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14
Q

high TSH indicates

A

hypoactive thyroid

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15
Q

hashimotos is a form of

A

hypothyroidism

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16
Q

graves disease is a form of

A

hyperthyroidism

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17
Q

When should TSH be measured in a hospitalized patient

A

only when clinical symptoms lead to suspicion

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18
Q

total or free T3 is not tested in

A

hypothyroidism

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19
Q

what 2 labs should be tested in response to hypothyroid meds

A

TSH and Free T4

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20
Q

amiodarone therapy can cause

A

hyperthyroidism

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21
Q

hot, sweaty, weight loss, fatigue, tachycardia/AF, anxiety, bug eyed

A

hyperthyroidism

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22
Q

T3 may elevate first in

A

hyperthyroidism

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23
Q

Methimazole
propylthiouracil (PTU)
iopanoid acid

A

hyperthyroid meds

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24
Q

goiters and marked bug eyes are s/s of

A

graves disease (hyperthyroidism)

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25
Q

hypermetabolic state, extremely ill/rare

A

hyperthyroidism storm

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26
Q

In thryoid cancer, what do “cold” and “hot” nodules mean

A

“cold” do not absorb iodine so likely CANCER

“hot” do absorb iodine so less likely cancer

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27
Q

Synthroid, levothroid

A

thyroid medications

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28
Q

confused and delirium patient consider testing TSH for

A

myxedema coma/severe untreated hypothyroidism

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29
Q

goiters and autoimmune with hypothyroidism is

A

hashiomotos

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30
Q

a reaction that occurs when patient holds onto fluids (endocrine)

A

SIADH

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31
Q

medication that can cause abnormal ADH secretion

A

morphine

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32
Q

Intake > Output
weight increase
edema
vomitting/abd cramps

A

SIADH

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33
Q

LOW serum osmolarity HIGH urine osmolarity

LOW serum sodium HIGH urine sodium

A

SIADH

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34
Q

TX for SIADH

A

restrict free water
force diuresis with NS & Lasix
hypertonic (3%) NS

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35
Q

Vaptans are sued for

A

SIADH by antagonizing vasopressin receptors

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36
Q

recommended Na correction recommendation

A

1-2mEq/hr

10 mEq/day

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37
Q

polyuric syndrome that results from deficient/insensitive ADH; causing volume depletion

A

diabetes inSIPidus

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38
Q

medications that induce renal deficiency leading to DI

A

litium

methicillin

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39
Q 
LOC changes
thirst
hypotension
tachycardia
poor skin turgor
elevated temp 
increaes UO
A

Diabetes Insipidus

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40
Q

HIGH serum osmolarity. LOW urine osmolarity

A

Diabetes Insipidus

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41
Q

Decrease urine specific gravity

A

Diabetes Insipidus

42
Q

DI usually has what electrolyte disturbances (3)

A

HYPER Natremia
HYPER Calcemia
HYPO kalemia

43
Q

Desmopressin acetate test is WHAT in diabetes insipidus

A

POSITIVE - you would see a decrease in symptoms

44
Q

Treatment options for DI

A

NS or 1/2 NS

HCTZ with K replacement

45
Q

imbalance of h20 intake and concentrated urine

A

DI

46
Q

dehydration despite lots of h20

A

DI

47
Q

DDAVP is drug specific to THIS

A

DI

48
Q 
serum bicarb <18
anion gap high  (8-16 normal)
pH <7.3 
POC glucose >250
faster onset
A

DKA

49
Q

anion gap calculation

A

NA - {Cl + HCO3} = AG

50
Q

glucose >600
serum osmolarity high >280
slow development

A

HHS

51
Q

stress counter regulatory hormones

A

glucagon
epinephrine
gluccocortoicoids
growth hormone

52
Q

Corrected Na

A

2 mEq/L for every 100 mg above normal glucose

53
Q

what to do if K is < 3.3 in DKA/HHS

A

correct/replace BEFORE INSULIN

54
Q

5 P;s of pheochromocytoma

A 
Perspiration
Palpitations
Pallor
Pain
Pressure (HTN)
55
Q

pheochromocytomas typically arise on

A

ADRENAL GLAND

56
Q

type of body response for a pheochromocytoma

A

fight or flight

57
Q

what do paragangliomas typically produce

A

CATECHOLAMINE producing tumors…

remember lots of epi, levo etc = HTN, palpitations, pain headaches etc.

58
Q

what to remember for a PHEO tumor test

A

LOTS of meds can affect results

59
Q

best dx for pheochromocytoma

A

MRI with contrast

then CT

60
Q

N/V with kidney failure

A

Haldol 1/2 dose (2.5 or 5)

61
Q

N/V with liver failure

A

reglan 60mg/24 hours

62
Q

N/V meds to be caution with in CHF

A

reglan and zofran

63
Q

N/V med caution with HIV

A

reglan for risk EPS

64
Q
A
65
Q

subQ pain or deep muscle pain

A

somatic

66
Q

pain when receptors in pevlis/abd/ chest/ intestines activated

A

visceral

67
Q

babies wtih this often hospitalized

A

whooping cough/ pertussis

68
Q

5 shot series starting at 2 months

A

pertussis, DTAP

69
Q

TDAP is ____

and who should get ______

A

a pertussis booster, anyone over 11 or around a baby should get a booster

70
Q

biguanides

A

metformin

71
Q

side effects of metformin (biguanides)

A

diarrhea, neuropathy, lactic acidosis

72
Q

caution with metformin (biguanides)

A

renal disease acute liver injury/hepatic renal failure

73
Q

SGLT-2 meds

A

-GLIFLOZIN

74
Q

yeast infections are more common with what DM medication class

A

-GLIFLOZIN

75
Q

DPP-4 drugs

A

-GLIPTIN

76
Q

this DM drug class you need to be careful with hx of pancreatitis

A

DPP-4 (-GLIPTIN)

77
Q

AGI drugs (2)

A

Acarbose

Miglitol

78
Q

TZDS diabetic drugs

A

Pioglitazone

79
Q

Sulfonylurea side effects

A

weight gain and hypoglycemia

80
Q

Sulfonylurea drugs

A

glipizide
glyburide
-IDES

81
Q

this drug class is good for non compliance or refusal of insulin; NOT for new DM

A

Sulfonylureas (-IDES)

82
Q

Meglitinides; also lower LDL

A

-GLINIDE

83
Q

What LDL drug also lower blood sugar

A

Colesevelam

84
Q

Monotherapy is indicated for what A1C

A

<7.5

85
Q

Dual therapy is indicated for an A1C of

A

> 7.5

86
Q

triple therapy is indicated when

A

AIC >9

87
Q

drop in sugar around 0200 r/t counter regulating hormines kicking in

A

somoygi effect

88
Q

growth hormone secreted at night which leads to decreased insuin sensitivity; hyperglycemic at 0200 and in AM

A

dawn phenomenon (sun rising, glucose rising)

89
Q

Basal inuslin, QD

A

glargine (lantus)

levimir

90
Q

pre-prandial insulin

A

lisprp, aspart, glulisine, inhaled insulin

91
Q

pre-prandial insulin tips

A

test 10-15m before a meal

cover largest meal with it

92
Q

cheaper insulin and used more if on it for a long time

A

NPH 70/30

divide 2/3 in am 1/3 in pm

93
Q

rapid acting insulin

A

humalog
novolog
glulisine

94
Q

short acting insulin

A

regular/novolin

95
Q

intermediate insulin

A

NPH

96
Q

long acting insulin

A

lantus

levemir

97
Q

Morality is relative to the norms of one’s culture

No absolute truths in ethics—what is morally right and
wrong varies from person to person and society to society

A

Ethical Relativism

98
Q

Examination of the context of a situation in order to come
to moral conclusion.

how does action affect person, family, and those
depending upon one another

A

feminist Theory

99
Q

Morality of action judged based on the action’s adherence
to rules. Dependent on intention of the action

Act in a way that you would be okay with everyone acting
that way

A

Deontology

100
Q

What is best for most people

Value of act determined by the act’s usefulness—with
emphasis on outcome

A

Utilitarianism

Acute Care 5460 (3 decks)

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