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pathophysiology > Endocrine and Gastrointestinal (GI) diseases > Flashcards

Endocrine and Gastrointestinal (GI) diseases Flashcards

1
Q

What things can diabetes cause (major cause factor for?)

A

blindness, kidney failure, heart attacks, stroke, lower limb amputation

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2
Q

What is the role of insulin? and where is it secreted and goes to?

A

to lower blood sugar when hyperglycaemic
it is secreted by beta cells, in the islets of langerhans, (in the pancreas) it promotes the uptake within cells for ATP production and storage in the liver.
it binds to the cell wall, does not enter cells.

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3
Q

What is the role of glucagon? where is it secreted and where does it go to?

A

to raise blood sugar when hypoglycaemic
its produced by alpha cells (in pancreas) travels to liver to induce hepatic breakdown of glycogen into glucose.

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4
Q

What is T1 diabetes?

A

INSUFFICIENT INSULIN PRODUCTIONS (pancreas doesnt produce enough)
is treated with insulin injections
most common in childhood, young adult, puberty, but can be any age
(T1 diabetics are much more unstable and can develop issues much quicker)

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5
Q

What is T2 diabetes?

A

INSULIN RESISTANCE
increase in blood glucose levels

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6
Q

Signs and symptoms of diabetes?

A

4Ts - TOILET, THIRSTY, TIRED, THINNER
- polyuria (excess urination, common with hyperglycaemic)
- polydipsia (excessive thirst, common with hyperglycaemic)
- polyphagia (excessive hunger)
- weight loss
record a BM

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7
Q

What can polyuria cause?

A

dehydration, very quickly, HR increase, similar to hypovolemia as body is trying to push what little fluid body has around. (can happen when T1 has a stomach bug)

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8
Q

What can a BM of less than 1 cause?

A

Seizures - hypoglycemic

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9
Q

What is a normal BM range?

A

4-8

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10
Q

What is a normal body pH? and which pH is incompatible with life

A

7.35-7.45
any lower then 6.8 is considered incompatible with life (DKA)

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11
Q

What do you do to manage hypoglycemia ?

A

least invasive: try get them to eat carbs and orange juice/milk. glucogrel (glucose in a tube) (pt needs enough conciousness to swallow) and also is quick acting they will need to eat something else too more long acting
more invasive: IV glucose (have to mix with water, they come in 500ml you give 100ml at a time)
glucagon can mean the person wakes up feeling a bit hungover

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12
Q

What is DKA?

A

Diabetic ketoneacidosis
where there is a severe lack of insulin in the body, so the body can’t break down sugars for energy. Instead it starts to use fats, breaking down these fats release ketones, which decrease pH, making body acidotic.
(the patient may smell like peardrops)

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13
Q

What does the body do to try and reverse acidosis?

A
  • get rid of ketones through urination, polyuria
  • blow of CO2 (which is also acidic) through kussmaul breathing (rapid deep breathes, that seem like exagerrated sighing )
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14
Q

Is DKA more common in T1 or T2 diabetics?

A

T1 however can still happen in T2

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15
Q

What sort of things can set diabetics off and cause DKA?

A

increased anxiety/stress (produces more adrenaline)
exam stress/ new jobs
DKA is more prominent in children too as parents learn to manage and as they are harder to manage as they are also constantly growing so treatment changes

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16
Q

How quickly does DKA develop?

A

Over 1-2 days

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17
Q

What is HSS?

A

Hyperosmolar hyperglycaemic syndrome
severe relative insulin deficiency
there is profound hyperosmolarity (from urinary water losses)
(has a higher mortality rate compared to DKA)

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18
Q

Is HSS more common in T1 or T2 diabetes?

A

Its typically present in T2 (who don’t have well controlled diabetes) or previously undiagnosed T1

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19
Q

How long does it take for HSS to develop?

A

develops over days -> weeks

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20
Q

Both DKA and HSS are due to a dangerous rise in glucose levels, only one is a rise in ketones, which is it?

A

DKA

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21
Q

Where are your adrenal glands?

A

They sit onto of your kidneys, they are part of the endocrine system
they make steroid hormones

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22
Q

What is adrenal insufficiency or crisis, and what can cause it?

A

It happens when the adrenal glands do not produce enough cortisol hormone to support the body’s metabolism
this can be because of an autoimmune disorder such as Addisons disease or sudden withdrawal from steroids, or there are other conditions which can lead to the damage or under stimulation of the adrenal gland

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23
Q

What is Addisons disease?

A

An autoimmune disease where the body attacks the adrenal glands.
the glands consist of 3 layers
(outside)
- zona glomerulosa
- zona fasiciulata
- zona reticularis
Addisons disease destroys these layers

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24
Q

What are non modifiable factors for Addisons disease?

A
  • other autoimmune disorders such as thyroid disease, T1D, pernicious anaemia
  • trauma leading to the haemorrhage of the adrenal gland
  • tumors on the adrenal gland
  • use of anticoagulants
  • TB (inflames adrenal glands),HIV, or fungal infections
  • Female
  • Age 30-50
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25
Q

What can cause Steroid induced adrenal crisis?

A
  • prolonged use of corticoids (non-anabolic steroids, prednisone, or hydrocortisone for asthma or psoriasis
  • polypharmacy - multiple or excessive prescribed drugs
  • removal of steroid therapy without guidance, such as prednisone or hydrocortisone
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26
Q

What are primary and secondary cancers? and how can this impact the adrenal gland?

A

primary cancer -the initial one e.g. starts in the lung
secondary cancer/metastatic - it has moved to other areas, e.g. the adrenal gland, symptoms are dependant on how much of the layers are damaged, the body is quite good at compensating so sometimes won’t know until a large amount of the adrenal cortex has been lost

27
Q

When the Zona Glomerulosa is damaged, hormone loss occurs of aldosterone? what are the symptoms?

A

Hyperkalemia (high K and low Na Hyponatermia)
Hypovolemia
Salt craving
Nausea
Stomach pain, non-specific, very generalised

28
Q

When the Zona Fasciculata is damaged, hormone loss occurs of Cortisol? what are the symptoms?

A

Muscle weakness, lethargy, unable to maintain activity, hyperpigmentation of skin around the mouth and insides of the mouth, low BM

29
Q

When the Zona recticularis is damaged, hormone loss occurs of testosterone? what are the symptoms?

A

In females: loss of underarm and public hair, loss of sex drive.
In men: this doesn’t affect them as much as their testes also produce testosterone.

30
Q

Signs and symptoms of Addisons disease?

A

Steadily worsening fatigue, abdominal pain, nausea and vomiting, diarrhoea, loss of appetite and unintentional weight loss, muscle pain and spasms, dehydration, low BP, low BM, craving salty food

31
Q

What management is given for Addisons disease?

A

hydrocortisone is given to replace cortisol
fludrocortisone is given to replace aldosterone

32
Q

What is graves disease?

A

An autoimmune disease where your immune system attacks the thyroid, is the most common reason for hyperthyroidism where the thyroid produces too much thyroid hormone.

33
Q

Where is your thyroid gland located?

A

It is butterfly shaped and is at the front of your neck

34
Q

What is the job of the thyroid?

A

to regulate the metabolism, metabolic rate

35
Q

Factors that mean you are more likely to develop graves disease ?

A

female at birth
between 30-50 (but can effect older and younger people)
history of thyroid disease
smoke
if you have another autoimmune disorder such as (rheumatoid arthritis, lupus, T1D, celiac, vitiligo)

36
Q

What body parts and how does graves disease affect them?

A

heart, skeletal muscle, eyes, skin, bones, liver,
can cause tachycardia which can lead to further heart conditions, and osteoporosis (weakened bones)

37
Q

What are the signs and symptoms of graves disease?

A

palpitations
feeling shaky or nervous
weightloss
increased appetite
diarrhoea and increased bowel movements
thin, warm and moist skin
intolerance to heat, excessive sweating
insomnia (difficulty sleeping)
enlarged thyroid gland
hairloss/change in texture (brittle)
menstrual changes
muscle weakness

38
Q

Graves disease can also cause eye problems? these are?

A

gritty irritated eyes
puffy eyes/swelling
bulging eyes
light sensitivity
pain or pressure in eyes
blurred/dbl vision

39
Q

Graves disease is an autoimmune disease but factors can affect flareups such as?

A

stress
virus/infection
pregnancy

40
Q

Management for graves disease ?

A

Beatblockers (propanolol, metaproplol)
antithyroid medications (methimazole - can cause low white blood cell count meaning more prone to infection)

41
Q

What is thyroiditis?

A

This is inflammation (swelling) of your thyroid gland. It typically causes temporary hyperthyroidism at first and then temporary or chronic hypothyroidism

42
Q

What is Hashimotos disease?

A

Is a chronic autoimmune disease, can cause lower than normal levels of thyroid hormone, hypothyroidism, underactive thyroid

43
Q

What are factors which make it more likely to have Hashimoto’s disease?

A

female at birth x10 more likely
increases with age
also with other autoimmune diseases (lupus, Addisons, celiac, T1D, rheumatoid arthritis, pernicious anaemia)

44
Q

What are the signs and symptoms of Hashimoto’s disease?

A

tiredness/ lethargy and excessive sleeping
mild weight gain
constipation
dry skin
feeling cold
bradycardia
joint stiffness and muscle pain
low mood / depression
puffy eyes and face
memory problems and difficulty concentrating
heavy or irregular periods
decreased sex drive
infertility in men and women

45
Q

Causes of Hashimoto’s disease?

A
  • body makes antibodies that attack thyroid for no reason
  • large number of lymphocytes (white blood cells) build up in thyroid
    this build up causes thyroiditis and damages your thyroid
46
Q

What is lupus?

A

an autoimmune disorder that makes your immune system damage your organs and tissues throughout your body,
it causes inflammation that affects your skin, joints, blood and organs (kidneys, lungs, heart)

47
Q

What are the different types of lupus?

A
  • systemic lupus erythematosus (SLE), the most common type ,just called lupus, means you have lupus throughout your body
  • Cutaneous lupus erythematous: Lupus that only affects your skin.
  • Drug-induced lupus: Some medications trigger lupus symptoms as a side effect. It’s usually temporary and might go away after you stop taking the medication that caused it.
  • Neonatal lupus: Babies are sometimes born with lupus. Babies born to biological parents with lupus aren’t certain to have lupus, but they might have an increased risk.
48
Q

What are symptoms of lupus, or a lupus flare up?

A
  • joint , muscle or chest pain (especially when breathing in)
  • headaches
  • rashes (common across face, called butterfly rash)
  • fever
  • hairloss
  • mouth sores
  • fatigue
  • dyspnea
  • swollen glands
  • swollen arms, legs, face
  • confusion
  • blood clots
49
Q

Lupus can also cause other contains such as?

A

photosensitivity
dry eye
depression (and other mental health conditions)
seizures
anemia
raynaurds syndrome
osteoporosis
heart disease
kidney disease

50
Q

What are the causes of lupus?

A

genetic factors
reactions to certain hormones e.g. oestrogen
environmental factors e.g. pollution
health impacts, stress, smoking, other autoimmune conditions may also cause lupus

51
Q

Risk factors for developing lupus?

A

female at birth
age between 15-44
people who have a parent who has lupus
black, hispanic, asian, Native American, Pacific Islanders

52
Q

Management of lupus?

A
  • Hydroxychloroquine: is a disease modifying drug, can slow symptoms of lupus and how they progress
  • Non-steroidal anti-inflammatory drugs, (NSAID’s) - relieve pain and reduce inflammation
  • Corticosteroids, reduce inflammation, prednisone is a common one prescribed for lupus
  • immunosuppressants, they hold back your immune system stop it being so active, can help prevent tissue damage and inflammation
    (may take more medication to manage other specific lupus symptoms e.g. hypertension)
53
Q

What are gall stones?

A

They form in your gallbladder and are concentrated, hardened pieces of bile

54
Q

Symptoms of gallstones?

A

They don’t usually create symptoms unless they create a blockage
- upper (right quadrant) abdominal pain
- nausea and vomiting
- sweating
- fever
- tachycardia
- abdominal swelling and tenderness
- yellowish tint to your skin and eyes
- dark coloured pee and light coloured poo

55
Q

Who are gallstones most common in?

A

the 3Fs Female, Fat, 40yrs
Native American / Mexican more likely

56
Q

What are some causes of gallstones?

A
  • Excess cholesterol (cholesterol is extracted by the liver from your blood to make bile)
  • Excess bilirubin (byproduct of broken down red blood cells)
  • not enough bile salts (makes extra cholestorol-y bile)
  • Cholestasis or gallbladder stasis - means inactivity as if the bile isn’t move through it creates more sediment which creates gall stones
57
Q

What is Guillian-barre syndrome (GBS)?

A

When your immune system responds abnormally and attacks your peripheral nerves and your autonomic nerves. it destroys the myelin sheath (insulation of your nerves)

58
Q

How does Gillian-barre syndrome damaging peripheral nerves affect the pt?

A

your peripheral nerves control muscle movement, pain sensations and temperature and touch sensations

59
Q

Signs and symptoms of Guillain-barre syndrome and how quick do they appear ?

A

The symptoms are rapid onset and will appear over a few days
- parenthesia (muscle weakness and or tingling)
- pain in your limbs and spine
- paralysis of legs arms and facial muscles
- chest muscle weakness and difficulty breathing
- difficulty speaking or swallowing
- imbalance/clumsiness
these will affect both sides of the body starting in your legs and spreading to your arms and face.

60
Q

What does your autonomic nervous system control ?

A

the automatic body functions you need to survive
e.g. HR, BP, digestion
when you lose function of these its called dysautonomia !!

61
Q

What are complications GBS can cause?

A

cardiac arrhythmia
unstable BP
gastrointestinal stasis
bladder control issues/ urinary retention

62
Q

What is the cause of GBS, it is a post-infectious, immune-mediated neuropathy, this means?

A

post infectious (70% of people with GBS have it following some kind of infection)
immune-mediate (means the condition results from an abnormal immune response)
neuropathy (is an umbrella term for diseases that affect your nerves

63
Q

Is GBS chronic?

A

unlike other autoimmune conditions GBS isn’t chronic (life long) it is treatable
(most people make a full recovery with treatment)

pathophysiology (8 decks)

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