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Starred Summer 2015 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Endocrine pancreas - alpha cells secrete what?

A

Glucagon

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2
Q

Endocrine pancreas - beta cells secrete what?

A

Insulin

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3
Q

Endocrine pancreas - delta cells secrete what?

A

Somatostatin (decreases GI motility and HCl)

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4
Q

Exocrine pancreas secretes what?

A

digestive enzymes & NaHCO3

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5
Q

How much insulin is secreted by beta cells per day?

A

50 units - if someone is on more insulin than that, know the pancreas is not functioning much if at all

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6
Q

Glycogenolysis

A

Breakdown of glycogen

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7
Q

Gluconeogensis

A

Generation of glucose from non-CHO metabolism (of lactate, pyruvate, etc)

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8
Q

Ketogenesis

A

Formation of ketones by breakdown of fatty acids

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9
Q

Lipolysis

A

Breakdown of lipids into free fatty acids

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10
Q

Protein catabolism

A

breakdown of proteins into amino acids

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11
Q

What mediates the activity of insulin receptors

A

tyrosine kinase- the rate limiting step

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12
Q

Anesthesia goal of blood glucose

A

140-200

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13
Q

Hypoglycemia level

A
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14
Q

HgA1C target before surgery

A

> 6,

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15
Q

1st manifestation of nephropathy in diabetic patients

A

proteinuria/microalbuminuria “prediabetic” - microalbuminuria is earlier sign - start on ACE-I’s now

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16
Q

Nephropathic patient with DM has higher risk of what

A

Ischemic heart disease

17
Q

Autonomic Nervous System Neuropathy & DM

A

Hypoglycemic unawareness, thermoregulatory problems, increased resting HR, orthostatic, vagal denervation, decreased response to atropine & propanolo, short QT, decreased sensation to angina

18
Q

Sudden death syndrome

A

Sudden profound decreased HR & BP only responsive to epi - high incidence of cardiorespiratory arrest - high suspicion if preop orthostatic

19
Q

Prayer sign

A

glycosylation of tissue proteins - likely atlanto-occipital joint involvement

20
Q

Do you hold or not hold noninsulin injectables before surgery

A

Hold, they are like oral antidiabetics

21
Q

Differentiation of diabetic ketoacidosis

A

Will have urine/plasma ketones with or without lactic acidosis, increased lipolysis causes more ketone bodies which creates high anion-gap metabolic acidosis

22
Q

DKA treatment

A

Fluid, insulin to decrease glucose by 10% by hour, correct K+ deficit

23
Q

Hyperosmolar Hyperglycemic Nonketotic differentiation

A

No ketones, increased glucose causes hyperosmolar diuresis causing dehydration/hyponatremia = renal failure, lactic acidosis & thromboses

24
Q

HHNK treatment

A

NaCl, K supplement, minimal insulin

25
Q

Counterregulatory failure of diabetes

A

At about 10 years body is unable to secrete glucagon, epinephrine, cortisol & growth hormone

26
Q

Insulin to take day of surgery?

A

Usual long-acting, 50% of NPH & continue basal rate

27
Q

Protamine & diabetic patient considerations

A

If patient on NPH may have anaphylactic shock when given protamine- give 1-5 mg test dose over 5-10 minutes

28
Q

Hyperthyroid diagnosis

A

Decrease TSH, increased T4 & Total T3/T4

29
Q

Thyroid storm manifestations

A

Increased temp, HR, decreased BP, K. NO muscle rigidity, increase in CK, or acidosis (that’s MH!)

30
Q

Thyroid storm tx

A

100% oxygen, fluid, esmolol or propanolol, propylthiouracil, hydrocortisone, cooling, correction of cause

31
Q

Is MAC changed with thyroid disease?

A

NO, hypothyroid with decreased CO may increase speed of inhalation onset

32
Q

Accidental parathyroid removal results in what symptoms?

A

Tingling fingertips & lips, tetany, seizures, laryngospasm from hypocalcemia

33
Q

Hypothyroid diagnosis

A

Increased TSH, decreased T3/T4

34
Q

When should myxedema coma NOT go to surgery (even emergent)

A

T4

Starred Summer 2015 (12 decks)

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