Endocrine Flashcards

1
Q

What is diabetic neuropathies? What contributes to it?

A

Most common cause of neuropathy

Diabetic neuropathy is nerve damage that is caused by diabetes

Chronic hyperglycemia and demyelination contribute to neural changes and delayed conduction

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2
Q

S+S of T1DM?

A

Fluctuating blood glucose levels when assessed

-Generally are tired and lost weight

Gradual destruction of beta cells leading to insulin deficiency and hyperglycemia

As Glucose accumulates in blood it dumps into urine as renal threshold is exceeded, causing osmotic diuresis which manifests in polyuria and thirst, which are the first 2 symptoms of Type 1

Affects metabolism of fat, protein, and carbohydrates – body is prevented from storing energy for future use = tired

Fat and protein breakdown due to lack of insulin = weight loss

Increased metabolism of fats and proteins = high levels of ketones = potential ketoacidosis

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3
Q

T1 DM will go into? While T2DM will go into

A

T1: Diabetic ketoacidosis

T2: Hyperosmolar hyperglycemic syndrome)

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4
Q

Risk factors for T2DM?

A

Age
Obesity
Glucose intolerance
Hypertension
High cholesterol levels
Family history
Sedentary behaviour
Prior history of gestational diabetes
Native American, Hispanic, African descent

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5
Q

What do Delta cells do in the pancreas?

A

Exocrine function - digestive properties

Somatostatin (growth hormone inhibitor) – regulates alpha-cell and beta-cell function – inhibits secretion of insulin & glucagon – coming into the delta celss

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6
Q

What is diabetic ketoacidosis?

A

Insulin levels are too low, glucose can’t go into cells,– breakdown of fat which produces ketones occurs too quickly
Normally our body uses ketones in muscles and heart – too much causes the blood to become acidotic

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7
Q

What is goitre? What does it cause?

A

Goitre - Swelling from enlarged thyroid gland (thymus) – major cause is iodine deficiency – swelling to increase thyroid production = can cause hyperthyroidism – causing the hypothyroidism

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8
Q

What is diabetic retinopathy? What kind of onset does it have? What else will develop along side diabetic retinopathy?

A

Leading cause of blindness worldwide

More likely in type 2 due to potential for longstanding

hyperglycemia before diagnoses – gradual onset

Most people with diabetes will develop retinopathy as well as cataracts and glaucoma

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9
Q

What is damaged in diabetic nephropathy? What is it caused by?

A

Glomeruli are injured by hyperglycemia & intraglomerular hypertension

Progressive glomerulosclerosis and decreased glomerular blood flow

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10
Q

Positive Vs negative feedback loops?

A

Positive feedback increases the secretion vs negative feedback decreases the secretion

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11
Q

S+S of hypoglycemia

A

pallor, palpitations, diaphoresis (excessive sweating), dizziness, irritability, fatigue, poor judgement, confusion, visual disturbances, seizures, & coma

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12
Q

S+S of thyroid storm?

A
  • hyperthermia, tachycardia, agitation, delirium, nausea & vomiting
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13
Q

Causes of hypofunctining endocrine disorders?

A

Could be born with a problem

Destroyed through cancer or trauma

Aging – risk factors

Atrophy – what can the medication be doing/causing

Receptor defects – what is going wrong with it

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14
Q

Hypothyroidism S+S?

A

-Cold intolerance
-Decresed sweating
-Weight gain
-Constipation
Depression and irritability
-Slow HR
-Irregular heavy periods
-Brittle nails
-Puffy face
-Muscle or joint pain
-Loss of hair
-Brady cardia

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15
Q

What is Myxedema? S+S?

A

severely advanced hypothyroidism

Weight gain, mental dullness, sensitivity to cold
Can lead to myxedema coma

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16
Q

Polydispcia Vs polyuria?

A

Polydispcia- Wants to eat everything
Polyurlia: urinating everything out – fluid electrolyte imbalnence

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17
Q

What is Hashimoto’s disease?

A

Hashimoto’s disease most common cause of hypothyeoridsm – autoimmune thyroiditis
Gradual inflammatory destruction of thyroid tissue
Genetic risk factors
Linked to autoimmune conditions

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18
Q

What is happening with glucagon and Amylin in T1DM? what does it cause/result in?

A

Glucagon (increased)– hormone produced by alpha cells of the islets acts in liver to increase blood glucose levels

Amylin (decreased) – beta cell hormone – normally suppresses glucagon release from alpha cells

Lack of insulin and excess of glucagon causes hyperglycemia in type 1 diabetes

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19
Q

S+S of Diabetes Insipidus?

*Hypofunction disorder - low levels of ADH

A

-High urinary output
-Low levels of ADH
-Hypernaterima
-Dehydration
-Loss/lose to much fluid -Excessive thirst

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20
Q

What is going high but not extremely high in diabetic ketoacidosis?

A

Sugar is going to high (not extreme)

21
Q

What kind of onset does diabetic ketoacidosis have?

A

Rapid onset

22
Q

What does increased levels of thyroxine hormone result in? (hyperthyroidism)

A

Increased metabolic rate with heat intolerance

Increased tissue sensitivity to stimulation

23
Q

What do Beta, insulin, and amylin cells secrete in the pancreas? what do each of these hormones do?

A

Beta – big target problem is when these cells are being destroyed

Insulin –promotes cellular glucose uptake

Amylin – co-secreted with insulin – regulates glucose concentration – delay gastric emptying & suppressing glucagon secretion after meals – helping to slow down digestion and with our blood sugar control

24
Q

what kind of endocrine disorder is diabetes insidious?

A

Hypofunction disorder

25
How does obesity lead to insulin resistance in T2DM?
Obesity leads to insulin resistance, or a suboptimal response of insulin in our sensitive tissues (liver, muscle, adipose tissue)
26
S+S of HHS (Hyperosmolar hyperglycemic syndrome)
High serum glucose Normal bicarbonate & pH – no acidosis Dehydration elevates glucose levels due to volume depletion Increased thirst and urination (at the beginning of the syndrome) Feeling weak. Nausea. Weight loss. Dry mouth, dry tongue. Fever. Seizures. Confusion.
27
S+S of graves disease?
Ophthalmopathy – upper eyelid retraction, lid lag, swelling, redness, bulging eyes (exopthalmos) Dermopathy – red shiny round lesion of thin skin pretibial – can be asymptomatic or itching – localized myxedema
28
3 stages/steps to diabetic retinopathy?
1 – Increase in retinal capillary permeability, vein dilation, microaneurysm formation 2 – progressive retinal ischemia with areas of poor perfusion causes infarcts 3 – angiogenesis & fibrous tissue formation in the optic disc – traction of new vessels can cause retinal detachment or hemorrhage No correction – clotting off areas causing a loss of vision
29
What is temporarily reset in Antidiuretic Hormone Secretion (SIADH)? What will this cause?
Osmolality threshold is temporarily reset in SIADH so patients still feel thirsty – internal meter got set wrong and they are retaining to much fluid
30
S+S of Diabetes Insipidus? *Hypofunction disorder - low levels of ADH
-High urinary output -Low levels of ADH -Hypernaterima -Dehydration -Loss/lose to much fluid -Excessive thirst
31
How is T1DM idiopathic?
Idiopathic – strong genetic link, more common in Asian or African descent – but still rare
32
What S+S do hyper and hypo thyroisim share?
-Fatigue -Insomnia -Weight loss
33
What can diabetic neuropathies lead to/cause?
Can lead to wrist drop or foot drop, muscle atrophy, weakness, & pain in muscles, hip, thighs, or buttocks Loss of pain, temperature, or vibration sensations Neuropathy causes charcot arthropathy, which is progressive deterioration of weight bearing joints
34
What is going on with the pancreas in T2DM when it releases insulin but there is a residence?
The pancreas is releasing insulin, but the body’s cells resist insulin – this triggers the pancreas to release more insulin – eventually there is a decrease in beta-cell mass and reduction in function = essentially the pancreas is exhausted of its insulin
35
What is a thyroid storm? What triggers it?
Acute exacerbation of hyperthyroidism Medical emergency – death can occur within 24 hours – they have a disease and when they are put under a huge amount of stress it gets to be to much for them Partially treated or undiagnosed Grave’s disease + increase stress
36
What are the Exocrine and Endocrine functions of the pancreas?
Exocrine – releases digestive enzymes – releases things into the GI tract Endocrine – release of hormones is the focus of our study of the pancreas – produces insulin
37
S+S of T2DM?
Slower onset May be asymptomatic Polyuria – sweet smelling urine Excessive thirst Fatigue Dry skin Sores that won’t heal More infections than normal Unexplained weight loss Sudden vision changes
38
Hyperthyroidism S+S?
Weight loss or gain -Short and light periods -Increased sweating -Nail thinking and flaking -Puffy or bulging eyes -Heat intolerance -Nervousness and anxiety -Muscle weakness -Diarrhea Peripheral edema Tacycardia -Exophthalmos
39
What is type 2 diabetes?
Slowly progressive autoimmune disease that destroys beta cells of the pancreas
40
S+S of diabetic ketoacidosis?
Dry mouth, strong thirst Polyuria *Deep respirations in metabolic acidosis = respiratory system trying to compensate for acidosis, but blowing off CO2 – kusmall breathing Fruity breath – due to ketones Nausea, vomiting Confusion, loss of consciousness
41
What is a hypofunctioning endocrine disorder?
Decreased secretion of hormones
42
What does insulin resistance lead to?
Insulin resistance leads to Beta cells secrete more insulin but then can no longer keep up – overuse of beta cells
43
Who do we see diabetic ketoacidosis in?
newly diagnosed diabetics Individuals not taking enough insulin or not taking any insulin Stomach illness with excessive vomiting People who are not diabetics – going to see this here where they are struggling to manage with their diabetes
44
What does hyperfunction refer to?
Increased stimulation of an endocrine gland -Excessive secretion of hormones -Ectopic tumor elsewhere
45
What do Alpha cells secrete and do in the pancreas?
Glucagon – acts primarily in the liver, it is stimulated by low glucose levels increases blood glucose concentration by stimulating glycogenolysis & gluconeogenesis high glucose levels = insulin promotes glucose conversion to glycogen for storage
46
S+S of syndrome of Antidiuretic Hormone Secretion (SIADH) – high levels of ADH? *Hyperfunction disorder
-Low urinary output -High levels if ADH -Hyponatermia -Over hydrated -Retain too much fluid -Excessive thirst
47
What does a decrease in thyroid hormone levels in Hashimoto's disease cause/do?
Decrease in thyroid hormone levels: Lowers energy metabolism & lowers heat production Low basal metabolic rate (number of calories required to keep your body functioning at rest) cold intolerance, lethargy
48
What is diabetic nephropathy?
Most common cause of chronic kidney disease & end stage kidney disease Hyperglycemia, advanced glycation end products, inflammation all contribute to kidney disease