Endocrine Flashcards
normal serum osmolality
275-295
serum osmo > 295 typically indicates pt is
serum osmo < 275 typically indicates pt is
dry
dilute blood
what is serum osmolality?
how concentrated the blood is
list the isotonic fluids
What is the purpose?
NaCl
LR
PlasmaLyte
Purpose: to rehydrate patient and stay in vasculature since serum osmo is similar
list the hypertonic fluids
What is the purpose?
What type of line do you need to admin through?
D5 0.2 NS
D5 1/2 NS
D5LR
D10W
- 3% NS: USED TO CORRECT CEREBRAL EDEMA OR TO CORRECT HYPONATREMIA
5% NS
23.4% NS
Purpose: to pull fluid from cell into vasculature
Admin through a central line
list the hypotonic fluids
what is their purpose?
0.45% NaCL (half NS)
0.2% NaCl
Purpose: cellular hydration
PURPOSE OF 3% NORMAL SALINE
REVERSE CEREBRAL EDEMA
CORRECT HYPONATREMIA
what is T1DM?
autoimmune issue where beta cells of pancreas have been destroyed resulting in insulin deficiency
T2DM
pancreas not making enough insulin and/or organs have insulin resistance, resulting in relative insulin deficiency
what do the alpha cells of the pancreas do?
cell that produces glucagon
what do the beta cells of the pancreas do?
cells that produces insulin
what does insulin do?
transports glucose from vasculature into the cells
what do delta cells of the pancreas do?
cells that produce somatostatin (which inhibits the release of glucagon and insulin)
Normal HbA1C
Purpose of HbA1C
4.0 - 5.6%
Purpose of HbA1C: evaluated effectiveness of DM therapy
average glucose range of HbA1C 6-7%
100- 150 mg/dL
> 7% HbA1C =
poorly controlled glucose levels
List the 4 pieces of Metabolic syndrome and the ranges for each
- HTN
> 130/85 - Diabetes
FBGL > 100 or diagnosed T2DM - Dyslipidemia
high triglycerides >150
high LDL
Low HDL <40 males, <50 females
-Abdominal obesity
Waistline > 40in men
Waistline > 35 in women
What does insulin do?
Hormone that drives glucose, water, and potassium into cells
IV insulin onset of action
IV is 5-10 mins
Rapid Acting Insulin (SQ)
Onset of Action:
Peak:
Duration:
OOA: 5-15 mins
Peak: 1-3 hours
DOA: 4-6 hours`
Regular Insulin (SQ)
Onset of Action:
Peak:
Duration:
OOA: 30mins
Peak: 1-3 hours
DOA: 6-8 hours
List the Cardiovascular sx of hypoglycemia. good fucking luck
What causes this?
palpitations
tachycardia
diaphoresis
pallor
cool skin
piloerection
irritability
Caused by activation of SNS
List the Neuro sx of hypoglycemia
blurred vision
slurred speech
headache
difficulty concentrating
confusion
fatigue, weakness
diplopia
anxiety/tremors
staggering gait
seizure, coma
What level do we consider to be hypoglycemic?
< 70
causes of hypoglycemia
too much insulin
N/V
*interrupted TF
inc. metabolic needs
excessive etoh
adrenal insuff
cirrhosis (glycogen converted to glucagon in liver)
pregnancy
How to treat hypoglycemia if ALOC and NO IV access?
0.5-1mg IM Glucagon
