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

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
Thyroid storm pahtophysiology
Inhibition of thyroid hormone binding to proteina and more free thyroid hormone
26
Meds used in anesthesia management of hypothyroidism
Avoid: opioids Use: direct acting vasopressors, pancuronium
27
Management for thyroid storm
glucose solution, antithyroid meds, Bblockers, decadrone, for afib-bblockers and digilatis, cooling
28
What period will thyroid storm be seen?
Postop after emergency surgery if inadequaltely treated
29
In subclinical hypothyrodism, what levels of TSH is associted with a CAD risk
More than 10 mu/l
30
What levels of TSH are associated with euthyroid and hypothryroid
euthyroid: 10, hypothyroid 5
31
Is Regional anesthesia safe for hyperthyrodism
YES, it is preffered
32
Pt with angina and hypothyrodism should get a______ before hormone replacement
Angiography
33
Medication used for hypothyrodism | For emergency before surgery
I-Thyroxine | Triiodothironine
34
For Goiter Thyroid tumors what type of anesthesia
VA, N2O and NO NMB
35
Preop corticosteroids are given to patients
who have been receiving more than 20 mg daily of prednisone or glucocorticosteroids are considered with Adrenal inhibition
36
What is the most common cause of AI
Administration of exogenous steroids