Endocrine and GI Flashcards

0
Q

What can stimulate the liver to produce more glucose?

A

Increase hormone production

Cortisol

Glucagon

Epinephrine

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1
Q

Number 1 cause of dka

A

Infection

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2
Q

What meds put u at risk for hhs?

A
Glucocorticoid 
Diuretics
Phenytoin (Dilantin)
Propranolol
Calcium channel blockers
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3
Q

Med conditions that put u at risk for hhs

A

Mi
Cerebral vascular injury
Sepsis

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4
Q

Which will cause myoclonus jerking, seizures, and reversible paralysis? DKA OR HHS

A

HHA

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5
Q

DKA GLucose

A

⬆️300

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6
Q

HHS glucose

A

⬆️600

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7
Q

HHS

A

Osmolarity ⬆️320

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8
Q

Monitor glucose every hour

What is goal glucose?

A

⬇️200

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9
Q

Correcting acidosis too fast can do what to k

A

Hypok

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10
Q

How often should old people check glucose when sick?

A

1-4 hrs

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11
Q

Hhs osmolarity

A

Above 320

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12
Q

Notify provider if glucose is above

A

240

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13
Q

Severe acidotic state

A

PH less than 7.15

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14
Q

What kind of fluid replacement is the gold?

A

To replace half the estimated fluid deficit over the first eight hours

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15
Q

The second half of fluid replacement is given over how many hours

A

The next 16 hours that way within the first 24 hours of treatment fluid deficit should be corrected

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16
Q

What is the order of fluids given in DKA and HHS?

A
  1. 9% normal saline
  2. 45% normal saline

5% dextrose (when glucose becomes 200 to prevent hypoglycemia and resolve ketosis)

17
Q

What should potassium be before insulin administration?

A

At least 3.3

18
Q

Difference in primary and secondary adrenal insufficiency

A

Primary
#⃣ deficient in both glucocorticoids in mineralocorticoids
Secondary
#⃣deficient in glucocorticoids alone

19
Q

What is the first sign of hypoglycemia

A

Change in mental status

20
Q

Counterregulatory hormones with the sympathetic nervous system response and hypoglycemia

A

Glucagon, epinephrine, cortisol, and growth hormone

21
Q

What is the best clinical indicator of effective treatment for hypoglycemia?

A

Neurological status

22
Q

Cortisol level in adrenal crisis

A

⬇️10 mg/dL

23
Q

What is cosyntropin

A

Synthetic ACTH

24
Q

Standard dose of cosyntropin

A

250 mcg (with a result of an increase in cortisol level of 7 to 9 from baseline)

25
Q

ACTH stimulates this glucocorticoid to release

A

Cortisol

26
Q

I’ll dust around is a mineralocorticoid that has what effect

A

It’s made in the adrenal Cortex and regulates the bodies electrolyte and water balance in the renal tubules

27
Q

Adrenal crisis lab value of glucose

A

Less than 50

28
Q

Adrenal crisis lab value of cortisol

A

Less than 10

29
Q

Adrenal lab value of potassium

A

Either greater than 6.6

Or less than 3.0

30
Q

Adrenal crisis lab value for sodium

A

Greater than 150 or less then 130

31
Q

Adrenal crisis BUN value

A

Greater than 20

32
Q

Adrenal crisis pH value

A

Less than 7.3

33
Q

What fluid is given initially in adrenal crisis until signs and symptoms of hypovolemia stabilize?

A

5% dextrose and normal saline

34
Q

The patient may need how much of this fluid in the first 12 to 24 hours of adrenal insufficiency?

A

As much as 5 L

35
Q

How is hyperkalemia treated in adrenal crisis?

A

With fluid and glucocorticoid replacement, it may not have to be treated specifically

36
Q

What drug can be given IV push before the cortisol test is done

A
Dexamethasone phosphate (Decadron)
4 mg every eight hours until cosyntropin test has been done
37
Q

What do thyroid hormones bind to

A

Globulin, T4 binding pre-albumin, and albumin

38
Q

What is the relationship between T4 and T3

A

95% of thyroid hormones in the body or T4,T4 converts into T3, T3 is more potent than T4

39
Q

Peak times

A

Insulin