Endocrine Flashcards
A syndrome with disordered metabolism and inappropriate hyperglycemia due to either an absolute deficiency in insulin secretion or a reduction in its biological effectiveness
Diabetes Mellitus
Type 1 diabetes has an _____ onset and is caused by destruction of pancreatic ____ cells. _______ can be found in the blood and urine.
Acute onset
Islet cells
Ketones found in the blood and urine
Classic s/sx of type 1 diabetes
3 P’s: polyuria, polydipsia, and polyphagia
Children with type 1 diabetes have weight _____ but ______ hunger.
loss
increased
In advanced type 1 diabetes, an ophthalmic exam may reveal microaneurysms, or ______ _____ ______.
cotton wool spots
Deep tendon reflexes are _______ in advanced disease of type 1 diabetes.
diminished
Diagnostic criteria for type 1 diabetes requires a serum fasting BG of greater than ____ on 2 separate occasions.
126 mg/dl
If BG is greater than ___ mg/dl AND there is polydipsia, polyuria, and weight loss are present, then the diagnosis must be confirmed by ______ studies.
200
Fasting
Hemoglobin A1c is elevated. The normal HgA1c is _ to _%
4-6%
Management includes obtaining baseline fasting _______, _____, ______ studies and EKG
triglycerides
cholesterol
renal studies
What should the total carbohydrate intake be for a type 1 diabetic?
50 to 60% of total caloric intake
Total fats should make up what percent of total caloric intake?
25-30%
Total fiber should have ____ grams/1000 calories.
25
Protein should make up what percent of total caloric intake?
10 to 20%
What does of insulin should a patient presenting with ketones be started on?
0.5 units/kg/day
This results when nocturnal hypoglycemia stimulates a surge of counter regulatory hormones that raise blood sugar. This patient is HYPOGLYCEMIC at 3 am and rebounds with an elevated blood sugar at 7 am.
The Somogyi effect
This results when tissue becomes desensitized to insulin nocturnally. Blood sugar gets progressively highter throughout the night and is elevated at 7 am. This desensitization is due to presence of growth hormone, which spikes at night.
Dawn Phenomenon
What is the treatment for the Somogyi effect?
reduce or eliminate night dose of insulin
What is the treatment for the Dawn Phenomenon
Add or increase the dose of night time insulin
Type 2 diabetes has an _____ onset
insidious
Type 2 diabetes s/sx include darkened neck skin called ______ _____.
Acanthosis nigricans
What is typically the first symptom in women with type 2 diabetes?
recurrent vaginitis
Name four signs that are associated with insulin resistance:
Acanthosis Nigricans
Hypertension
Dyslipidemia
Polycystic ovarian disease
Screening for DM2 should be completed if there is a _____ history of DM2, race (AA, NA, Hisp, A/PI), or signs are present consistent with DM2.
family
What age should screening for DM2 begin? Age ___ or onset of _____, then every __ years.
Age 10 or onset of puberty then every 2 years
What drug is approved by the FDA for treatment of DM2 in children?
metformin (glucophage)
How does metformin work?
It reduces gluconeogenesis
A series of clinical disorders associated with increased circulating levels of free thyroxine or triiodothyronine.
Hyperthyroidism
Most common in children and is associated with diffuse enlargement of thyroid, hyperactivity of the gland, presence of antibodies against different fractions of the thyroid gland.
Grave’s disease
Hyperthyroidism is more common in ____ , with a ratio of 8:1
females
Onset of hyperthyroidism is between ages __ and __
12 and 14
Deep tendon reflexes are _________ in hyperthyroidism.
Hyperactive
In hyperthyroidism, TSH is ______ and T3/T4 are _______
TSH is decreased
T3 and T4 are increased
What can be given as a treatment that can reduce the vascularity of the thyroid gland?
Lugol’s solution
What medication is helpful for symptomatic relief in hyperthyroidism?
Propranolol 10-80 mg QID
A condition resulting in lack of circulating thyroid hormone
Hypothyroidism
Hypothyroidism is most often due to __________ ________.
Autoimmune thyroiditis
______ ________ is a cause of juvenile thyroiditis.
Hashimoto’s thyroiditis
In neonates, there may be no obvious signs in the first month of life. Then you begin seeing poor _____, _____ and ______.
Poor feeding
Bradycardia
Hypotonia
For hypothryoidism, think of the old lady….the brake pedal is stuck so you have….
constipation, weight gain, weakness, delayed bone age/growth, dry skin thinning hair and brittle nails
In hypothyroidism, TSH is ______ while T3/T4 are _____
TSH = elevated T3/T4 = decreased
What drug is helpful in the treatment of hypothyroidism?
Synthroid (which is better than levothyroxine–the generic)
A child is considered to have short stature if the height falls more than ___ standard deviations below the mean
Two
Failure to grow more than ___ cm/year also is present in short stature children
4 cm/yr
If a patient is considered short stature, the primary provide should always assess for ______.
Neglect
