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Patho: GI > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Cause of Type 1a, 1b DM

A

Type 1 DM, autoimmune beta cell destruction results in minimal or no insulin production
1b, not autoimmune; no INSULIN

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2
Q

DM type 2 cause

A

Not immune mediated, Defects in insulin receptors and postreceptor signaling

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3
Q

what is the most common chronic childhood dz

A

DM 1

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4
Q

What 3 important features of DM 2

A

Minimal insulin production, liver releases more glucose and cells avoid using glucos, glucose stays in the blood stream

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5
Q

Contributing factors to DM 2

A

Genetic (insulin resistance), obesity, sedentary lifestyle

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6
Q

What factor is inherited in the cause of DM 2

A

insulin resistance

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7
Q

What is metabolic syndrome

A

Characteristics that lead to DM 2

Insulin resistance, HTN, dyslipidemia, procoagulant state trombus), obesity

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8
Q

Dx for DM 2 levels include fasting level, random plasma glucose level, and 2 hr plasma level of

A

fasting- more than 130, 200

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9
Q

Side effect of bioguanides and what is less common in these type of oral antiglucemics

A

lactic acidosis

Less common risk of hypoglucemia

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10
Q

Meds increase risk of hypoglucemia

A

Oral antiglucemics, ACE inhibitors, Beta blockers, MOA, alcohol alcohol competes with liver for metabolism)

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11
Q

DKA is seen in which type of DM

A

1

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12
Q

DKA tx

A

Fluids, insulin, electrolyte imbalance

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13
Q

Electrolyte imbalaces of DKA

A

Hypokalemia, hyponatremia and low bicarbonate

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14
Q

Hyperglycemic hyperosmolar syndrome is seen in

A

TYPE 2 DM, older pts

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15
Q

Tx of hyperglycemic hyperosmolar syndrome

A

fluids, insulin, correction of electrolytes same as DKA

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16
Q

WHen should oral hypoglucemics be stopped ***

A

24-48 hrs before surgery

17
Q

DM management, maintain blood glucose in which levels

A

100-180

18
Q

What is insulinoma, are the malignant or benign, where are they located and what do they secrete

A

Rare, benign, insulin releasing tumor located in pancreatic islet cells

19
Q

What is MEN

A

MEN syndrome: insulinoma, hyperparathyroidism, and pituitary tumor

20
Q

Tx for Insulinoma

A

diazodide, inhibits insulin release

Other veramapil, phenytoin, propanolol, glucocorticosteroids, somastatin, octreotide, and lancreotide

21
Q

Whipples triad

A

Hypoglucemia fasting, blood glucose at 50, resolves iwth glucose

22
Q

Meds used in hyperthyroidism management

A

May use: opioids, VA, N2O, thipental (decreases conversion of T4 to T3)
Avoid: indirect acting vasopressors, drugs that stimulate sympathetic NS.
NMB: small Nondep, due to coexisting MG

23
Q

What complications can be caused with removal of thyroid gland

A

Hypothyrodism, hemorrhage with tracheal compression, unilateral or bilateral RLN damage, motor nerve of SLN damage and removal of hypothyrodism

24
Q

Thyroid storm may be precipitated by

A

Trauma, infection, SURGERY and stress

25
Q

Thyroid storm pahtophysiology

A

Inhibition of thyroid hormone binding to proteina and more free thyroid hormone

26
Q

Meds used in anesthesia management of hypothyroidism

A

Avoid: opioids
Use: direct acting vasopressors, pancuronium

27
Q

Management for thyroid storm

A

glucose solution, antithyroid meds, Bblockers, decadrone, for afib-bblockers and digilatis, cooling

28
Q

What period will thyroid storm be seen?

A

Postop after emergency surgery if inadequaltely treated

29
Q

In subclinical hypothyrodism, what levels of TSH is associted with a CAD risk

A

More than 10 mu/l

30
Q

What levels of TSH are associated with euthyroid and hypothryroid

A

euthyroid: 10, hypothyroid 5

31
Q

Is Regional anesthesia safe for hyperthyrodism

A

YES, it is preffered

32
Q

Pt with angina and hypothyrodism should get a______ before hormone replacement

A

Angiography

33
Q

Medication used for hypothyrodism

For emergency before surgery

A

I-Thyroxine

Triiodothironine

34
Q

For Goiter Thyroid tumors what type of anesthesia

A

VA, N2O and NO NMB

35
Q

Preop corticosteroids are given to patients

A

who have been receiving more than 20 mg daily of prednisone or glucocorticosteroids are considered with Adrenal inhibition

36
Q

What is the most common cause of AI

A

Administration of exogenous steroids

Patho: GI (3 decks)

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