Endocrine Flashcards
DM Type 2
Insulin resistance leading to ineffective transport of glucose out of blood vessels
Risk Factors for DM Type 2
Age>45, BMI>25, sedentary lifestyle, gestation diabetes, hypertension, HbA1c>5.7, fasting glucose>100
Clinical presentation of DM Type 2
Polyuria, polydypsia, polyphagia, increased hunger, weight gain, dehydration, impaired healing, recurrent UTIs, acanthosis nigricans, retinopathy
ADA Diagnosis criteria
HbA1c>6.5, fasting glucose>126, 2-hr glucose>200 on oral glucose tolerance, random glucose >200
Diabetic foot exams
look for callus, breaks in skin, pulses, sensation, dryness
What is the ominous octet of type 2 diabetes?
NT dysfunction, increased lipolysis, increased glucose reabsorption, decreased glucose uptake, decrease incretin effect, increased hepatic glucose production, increased glucagon secretion, impaired insulin secretion
Describe DKA
look sick, mental changes, nausea, vomiting, abdominal pain, signs of dehydration, Kussmaul resp., fruity breath
What are some associated conditions with type 1 diabetes?
autoimmune thyroiditis, celiac disease, addison’s disease
What is metabolic syndrome?
group of metabolic abnormalities that confer increased risk of CVD and diabetes mellitus
How do we diagnose Metabolic syndrome?
abdominal obesity, triglycerides>150, HDL<40 in men and <50 in women, BP>130/85, Fasting glucose>100
What is a primary disease?
inhibits action of downstream glands, gland itself
What is a secondary disease?
pituitary gland problem
What is a tertiary disease?
dysfunction of hypothalamus and its ability to release hypothalamus
What are some causes of endocrine dysfunction?
hormone excess, hormone deficiency, resistance
How do we measure hormone levels?
immunoassays, plasma and urinary samples, correct interpretation in clinical context
What is dynamic endocrine testing?
suppression or stimulation test
What are the two maintain types of treatment for endocrine diseases?
replacing the deficient hormone, suppressing excess hormone production
What are the key functions of the thyroid?
metabolism, secrete T3, T4, and TSH
What are some common clinical manifestations of hyperthyroidism
weight loss, anxiety, diaphoresis, heat intolerance
What are some potential causes for hyperthyroidism?
Graves’, goiter, toxic adenoma, amiodarone-induced thyroiditis
What are some common clinical manifestations of hypothyroidism?
fatigue, weight gain, anorexia, dry, coarse skin, cold intolerance, weakness, impaired memory
What are some potential causes for hypothyroidism?
Hashimoto’s thyroiditis, iodine deficiency, subacute thyroiditis, sever illness, amiodarone and other drugs
What is a classic presentation of Graves’?
proptosis and exophthalmos
What is the function of PT glands?
Calcium regulation in the body
What are some symptoms of hypocalcemia?
spastic reflexes, chvostek’s sign, Trousseau’s sign
What are some symptoms of hypercalcemia?
bone disease, nephrolithiasis, increased calcitriol, renal tubular acidosis, hypertension, bradycardia, decreased QT interval
What is primary hyperparathyroidism?
prolonged PTH excess, presents as anorexia, nausea, constipation, polydipsia, and polyuria
What is hypoparathyroidism?
most common cause of hypocalcemia, decreased PTH levels
What is Cushing’s syndrome?
overproduction of ACTH by pituitary or ingestion of exogenous corticosteroids
What are some common presentations of cushing’s?
HTN, central obesity, depression, hirsutism, moon facies, buffalo hump, easy bruising, striae
How do you examine the thyroid?
have patient flex neck, place index fingers just below cricoid, have patient swallow, displace trachea to right and left to feel size and texture
What might the thyroid feel like if the patient had Graves disease?
soft
What might the thyroid feel like if the patient had a malignancy or hashimoto’s?
firm
What might the thyroid feel like if the patient had thyroiditis?
tender
What are the steps of a diabetic foot exam?
- examine for lesions (claw toes, ulcers, amputations, toenails)
- monofilament testing
- vibratory testing using 128 Hz
- superficial pain
- bilateral DTRs of ankle
- bilateral pulses
