Endocrine Flashcards
1
Q
increases the glucose
A
glucagon
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
3
Q
insulin dependent/ totally disabled beta cells
A
diabetes type 1
4
Q
tirad of diabetes management
A
diet
exercise
meds
5
Q
AIC diagnostic criteria (3)
A
5.7-6.4 PRE
>= 6.5 DIABETES
>= 7 Uncontrolled
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
7
Q
when to screen for pre diabetics & med options
A
yearly
metformin
8
Q
BMI should be less than what
A
25
9
Q
first line meds for HTN & DM
A
ACE/ARBS
BB/CCB/thiazides on some circumstances
10
Q
when to refer to a nephrologist
A
GFR <30
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
12
Q
acute care glucose range recommendation
A
140-180
13
Q
low TSH indicates
A
hyperactive thyroid
14
Q
high TSH indicates
A
hypoactive thyroid
15
Q
hashimotos is a form of
A
hypothyroidism
16
Q
graves disease is a form of
A
hyperthyroidism
17
Q
When should TSH be measured in a hospitalized patient
A
only when clinical symptoms lead to suspicion
18
Q
total or free T3 is not tested in
A
hypothyroidism
19
Q
what 2 labs should be tested in response to hypothyroid meds
A
TSH and Free T4
20
Q
amiodarone therapy can cause
A
hyperthyroidism
21
Q
hot, sweaty, weight loss, fatigue, tachycardia/AF, anxiety, bug eyed
A
hyperthyroidism
22
Q
T3 may elevate first in
A
hyperthyroidism
23
Q
Methimazole
propylthiouracil (PTU)
iopanoid acid
A
hyperthyroid meds
24
Q
goiters and marked bug eyes are s/s of
A
graves disease (hyperthyroidism)
25
hypermetabolic state, extremely ill/rare
hyperthyroidism storm
26
In thryoid cancer, what do "cold" and "hot" nodules mean
"cold" do not absorb iodine so likely CANCER
"hot" do absorb iodine so less likely cancer
27
Synthroid, levothroid
thyroid medications
28
confused and delirium patient consider testing TSH for
myxedema coma/severe untreated hypothyroidism
29
goiters and autoimmune with hypothyroidism is
hashiomotos
30
a reaction that occurs when patient holds onto fluids (endocrine)
SIADH
31
medication that can cause abnormal ADH secretion
morphine
32
Intake > Output
weight increase
edema
vomitting/abd cramps
SIADH
33
LOW serum osmolarity HIGH urine osmolarity
| LOW serum sodium HIGH urine sodium
SIADH
34
TX for SIADH
restrict free water
force diuresis with NS & Lasix
hypertonic (3%) NS
35
Vaptans are sued for
SIADH by antagonizing vasopressin receptors
36
recommended Na correction recommendation
1-2mEq/hr
| 10 mEq/day
37
polyuric syndrome that results from deficient/insensitive ADH; causing volume depletion
diabetes inSIPidus
38
medications that induce renal deficiency leading to DI
litium
| methicillin
39
```
LOC changes
thirst
hypotension
tachycardia
poor skin turgor
elevated temp
increaes UO
```
Diabetes Insipidus
40
HIGH serum osmolarity. LOW urine osmolarity
Diabetes Insipidus
41
Decrease urine specific gravity
Diabetes Insipidus
42
DI usually has what electrolyte disturbances (3)
HYPER Natremia
HYPER Calcemia
HYPO kalemia
43
Desmopressin acetate test is WHAT in diabetes insipidus
POSITIVE - you would see a decrease in symptoms
44
Treatment options for DI
NS or 1/2 NS
| HCTZ with K replacement
45
imbalance of h20 intake and concentrated urine
DI
46
dehydration despite lots of h20
DI
47
DDAVP is drug specific to THIS
DI
48
```
serum bicarb <18
anion gap high (8-16 normal)
pH <7.3
POC glucose >250
faster onset
```
DKA
49
anion gap calculation
NA - {Cl + HCO3} = AG
50
glucose >600
serum osmolarity high >280
slow development
HHS
51
stress counter regulatory hormones
glucagon
epinephrine
gluccocortoicoids
growth hormone
52
Corrected Na
2 mEq/L for every 100 mg above normal glucose
53
what to do if K is < 3.3 in DKA/HHS
correct/replace BEFORE INSULIN
54
5 P;s of pheochromocytoma
```
Perspiration
Palpitations
Pallor
Pain
Pressure (HTN)
```
55
pheochromocytomas typically arise on
ADRENAL GLAND
56
type of body response for a pheochromocytoma
fight or flight
57
what do paragangliomas typically produce
CATECHOLAMINE producing tumors...
remember lots of epi, levo etc = HTN, palpitations, pain headaches etc.
58
what to remember for a PHEO tumor test
LOTS of meds can affect results
59
best dx for pheochromocytoma
MRI with contrast
| then CT
60
N/V with kidney failure
Haldol 1/2 dose (2.5 or 5)
61
N/V with liver failure
reglan 60mg/24 hours
62
N/V meds to be caution with in CHF
reglan and zofran
63
N/V med caution with HIV
reglan for risk EPS
64
65
subQ pain or deep muscle pain
somatic
66
pain when receptors in pevlis/abd/ chest/ intestines activated
visceral
67
babies wtih this often hospitalized
whooping cough/ pertussis
68
5 shot series starting at 2 months
pertussis, DTAP
69
TDAP is ____
| and who should get ______
a pertussis booster, anyone over 11 or around a baby should get a booster
70
biguanides
metformin
71
side effects of metformin (biguanides)
diarrhea, neuropathy, lactic acidosis
72
caution with metformin (biguanides)
renal disease acute liver injury/hepatic renal failure
73
SGLT-2 meds
-GLIFLOZIN
74
yeast infections are more common with what DM medication class
-GLIFLOZIN
75
DPP-4 drugs
-GLIPTIN
76
this DM drug class you need to be careful with hx of pancreatitis
DPP-4 (-GLIPTIN)
77
AGI drugs (2)
Acarbose
| Miglitol
78
TZDS diabetic drugs
Pioglitazone
79
Sulfonylurea side effects
weight gain and hypoglycemia
80
Sulfonylurea drugs
glipizide
glyburide
-IDES
81
this drug class is good for non compliance or refusal of insulin; NOT for new DM
Sulfonylureas (-IDES)
82
Meglitinides; also lower LDL
-GLINIDE
83
What LDL drug also lower blood sugar
Colesevelam
84
Monotherapy is indicated for what A1C
<7.5
85
Dual therapy is indicated for an A1C of
>7.5
86
triple therapy is indicated when
AIC >9
87
drop in sugar around 0200 r/t counter regulating hormines kicking in
somoygi effect
88
growth hormone secreted at night which leads to decreased insuin sensitivity; hyperglycemic at 0200 and in AM
dawn phenomenon (sun rising, glucose rising)
89
Basal inuslin, QD
glargine (lantus)
| levimir
90
pre-prandial insulin
lisprp, aspart, glulisine, inhaled insulin
91
pre-prandial insulin tips
test 10-15m before a meal
| cover largest meal with it
92
cheaper insulin and used more if on it for a long time
NPH 70/30
| divide 2/3 in am 1/3 in pm
93
rapid acting insulin
humalog
novolog
glulisine
94
short acting insulin
regular/novolin
95
intermediate insulin
NPH
96
long acting insulin
lantus
| levemir
97
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
Ethical Relativism
98
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
feminist Theory
99
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
Deontology
100
What is best for most people
Value of act determined by the act’s usefulness—with
emphasis on outcome
Utilitarianism
