Endocrine Flashcards
What is hyperparathyroidism?
Excess PTH leads to elevated calcium and decreased serum phosphate which c aides demineralization of bone
What are 12 symptoms asssiciated with hyperparathyroidism?
Proximal weakness Fatigue Glove/stocking sensory loss (peripheral neuropathy) Osteopenia/fx Confusion Gout Pancreatitis Osteititis fibrosis cystica (bone lesions called brown tumors)
What is hypoparathyroidism?
Decreases or absent PTH causing low calcium
What are 8 symptoms of hypoparathyroidism?
Neck stiffness Muscle cramps Seizures Irritability Depression Skeletal muscle twitching parasthesias Chvosteks sign (tap facial nerve in front of ear)
What fasting glucose level indicates diabetes? Casual glucose level?
Fasting glucose > 126
Casual glucose > 200
What is normal fasting glucose?
60-110
What are red flag glucose levels where exercise is unsafe? What level puts you at risk for diabetic ketoacidosis?
Glucose < 70 or >250 at the start of exercising
> 350 at risk for ketoacidosis
Optimal A1C should be below what %? What % requires immediate insulin therapy?
Below 7%
10% requires immediate insulin therapy
When is insulin at its peak in the blood? Should you exercise during this time frame?
2-4 hours after taking insulin it’s at its peak, do not exercise
How much should insulin be decreased by before anticipated exercise how much should post exercise insulin be decreased by?
30-35%
Post exercise decrease by 30%
Where should insulin be injected before exercise? How long should you wait to exercise an injected limb?
Inject insulin into non exercising body part.
Do not exercise body part where insulin is injected for at least 1 hour
When is the best time to exercise someone with diabetes after a meal?
1 hour after
What should a diabetic do in terms of complex carb in take 24 hours before and after exercise?
Increase it
If prior to exercise a patient blood glucose is 70 what should you do?
Give a carbohydrate snack and re check in 15 mins
What are 3 aspects of a foot care program?
- Wash do not soak feet daily in warm water followed by application of petroleum jelly or lotion
- Toenails cut straight across by podiatrist
- Clean, white socks should be worn with minimal wrinkles and wide jogging or walking shoes. Use different shoes or alternate shoes each day
What are the signs of postural hypotension?
Dizziness with standing
Increased HR by > 10bpm
Drop in systolic bp of 20mm/Hg
What are symptoms of increased intracerebral pressure ? What is this associated with?
Slow pulse
Increase in SBP > 10
Decrease in diastolic > 10
Associated with fluid excess
What should be recommended for patients with nocturnal reflux?
Sleep lying on their left side to reduce regurgitation and aspiration
What is Murphy’s percussion test? What does it indicate and what should be done if positive?
Perform percussion to costovertebral angle (area that forms angle shape between vertebrae and lower ribs)
If positive can indicate kidney infection, refer to a physician.
What is stress incontinence? What muscle should you strengthen?
Loss of urine due to increase in intrabdominal pressure.
Pubococcygeus
What is urge incontinence? What is it usually due to?
Involuntary loss of urine associated with an abrupt and strong desire to void.
Detrusor muscle overactivity
What is overflow incontinence? What is usually the cause?
Overdistention of bladder without complete emptying
Weak detrusor muscle
What is functional incontinence?
Incontinence due to functional deficits. Bladder functions normally
What are GU red flags?
Blood in urine (refer to Md)
C/s pain and incontinence occurring at same time (possible c/s disc protrusion)
Saddle anesthesia due to caude equine lesion
Back or shoulder pain with changes in color, odor, flow/amount of urine
Murphy’s percussion test
What position increases pressure on the inferior vena cava in pregnant women?
Supine
What position reduces vena cava syndrome?
Left side lying
How do you test for diastasis recti?
Have patient in hook-lying position and raise head and shoulders off of the floor. Palpate lobes Alba.
How do you measure size of diastasis?
Finger width. Each finger is a cm wide. If > 2cm head lifts, head lift and pelvic tilts, and kegels are contraindicated.
When can the diastasis patient perform leg lifts, quadruped position curl ups, etc?
When diastasis has fully resolved
What 3 modalities are contraindicated during pregnancy?
Deep heating agents, electrical stimulation, traction
What does a post c section exercise program include? (4) progress to what?
Diaphragmatic and upper chest breathing, pelvic floor exercises and pelvic mobility exercises
More vigorous abdominal exercises
7 contraindications for exercise in maternity
Incompetent cervix Vaginal bleeding of any kind Placenta previa Loss of amniotic fluid before labor Premature labor Maternal heart disease Maternal diabetes
For bariatrix patients what intensity should aerobic training start at?
What duration? What frequency?
50% max HR
20 minute session can break down to 10 minute intervals
4-6 days per week
For resistance training in bariatrix patients what intensity should you start at? Set/reps? Time? Frequency.
30-40% 1rm
1-2 sets 15-20 reps
30 mins
4 days per week Non consecutive
Circuit training good to incorporate for aerobic benefit as well
