endocrine and metabolic systems Flashcards
What structures make up the central network controlling the glands within the body?
- nervous system
- hypothalamus
- anterior pituitary gland
(true/false) the endocrine system functions are closely linked to the immune system
true
What level of blood glucose warrants deferring PT?
> 300
What should one do if a patient’s blood glucose is < 100?
rule of 15
What should you closely monitor if a patient with DM has retinopathy and/or HTN?
blood pressure
Hypoglycemia is indicated when blood glucose is ____.
< 70
also indicated if there is a rapid drop of glucose within minutes
What are the early s/s of hypoglycemia?
- pallor
- shakiness
- sweating
- excessive hunger
- tachycardia/palpitations
- feeling faint
- weakness
- fatigue
- dizziness
- poor coordination and balance
What are the late symptoms of hypoglycemia?
- anxiety and irritability
- blurred or double vision
- HA
- slurred speech
- drowsiness
- inability to concentrate
- confusion
- delusions
- LOC or coma
(true/false) Both hypoglycemia and hyperglycemia have a rapid onset.
FALSE
hyperglycemia has a gradual onset (days)
What are s/s of hyperglycemia?
- weakness
- thirst/dry mouth
- scant urination
- decreased appetite
- N/V
- abdominal tenderness
- dulled sensation and paresthesia
- confusion
- diminished reflexes
**- fruity breath
**- rapid and weak pulse
A patient with DM should not exercise without eating at least ______ before.
at least 2 hours before
What insulin injection site is preferred?
abdominal
(true/false) you can inject short-acting insulin into exercising muscles as long as it is warranted.
FALSE
if injected into exercising muscles, the insulin will be absorbed more quickly
What intensity of exercise should be prescribed for those with nephropathy and DM?
low to moderate
What type of exercise should be avoided in those with retinopathy and DM?
- activities that increase BP to >170 mmHg
- pounding and jarring activities
What is diabetes insipidus?
Lack of secretion of the anti-diuretic hormone vasopressin
allowing unabsorbed water to be lost in the urine
What are the s/s of diabetes insipidus?
- dehydration, thirst
- increased urination
- fatigue
- irritability
What is SIADH?
Excess secretion of vasopressin
resulting in marked retention of water
- decreased urination
- weight gain w/o visible edema
- lethargy
- HA
- confusion
What is Addison’s disease?
Hypofunction of the adrenal cortex (adrenal insufficiency) - decreased cortisol and aldosterone
What is primary adrenal insufficiency called?
Addison’s disease
What are the s/s of Addison’s disease?
- dark pigmentation
- hypotension
- weakness
- progressive fatigue
- decreased tolerance to cold
- dehydration
- GI disturbance
- tendon calcification
What is Cushing’s syndrome?
Hyperfunction of adrenal cortex – excess secretion of cortisol
What can cause addison’s disease?
- autoimmune processes
- infection
- neoplasm
- hemorrhage
What can cause secondary adrenal insufficiency?
- prolonged steroid therapy
- rapid withdrawal of drugs
- hypothalamic or pituitary tumors
What causes cushings syndrome?
- excessive use of corticosteroids
- increased cortisol production
What causes cushing’s disease?
pituitary tumor resulting in increased secretion of ACTH
- HA
- visual changes
What is cushing’s disease?
excess secretion of adenocorticotropic hormone (ACTH)
What are the s/s of hypercortisolism (cushing’s syndrome/Cushing’s disease)?
- “moon face”
- buffalo hump on neck
- bruise easily
- abdominal stretch marks and increased fat pads
- masculine traits in women
- osteoporosis
- decreased glucose tolerance
- decreased testosterone
- decreased menstrual periods
- atrophy
- edema
- hypokalemia
- obesity
What is goiter?
enlargement of the thyroid gland due to TSH hypersecretion
What causes goiter?
iodine deficiency
What is thyroiditis?
Inflammation of the thyroid gland due to infection/autoimmune processes
Hashimoto’s thyroiditis is the chronic form
When hyperthyroidism is present, metabolic processes are (decreased/increased)
increased
What are s/s of thyroiditis and goiter?
- dysphagia
- difficulty breathing
- hoarseness
What are the s/s of hyperthyroidism?
- hyperreflexia and tremor
- weight loss
- fatigue
- heat intolerance
- palpitations and tachycardia
- goiter
- diarrhea
What medications are used to treat hyperthyroidism?
antithyroid drugs
What symptom is associated with a hypermetabolic state?
fatigue
What is Graves’ disease?
Hyperthyroidism - excessive secretion of the thyroid hormone
What are s/s of graves’ disease?
- tachycardia
- fatigue
- weight loss
- hyperreflexia
- increased sweating
- heat intolerance
- tremor
- exophthalmos (bulging eyes)
Hypothyroidism (decreases/increases) metabolism
decreases
What are the s/s of hypothyroidism?
- constipation
- dry hair and skin
- hair loss
- fatigue
- slowed HR
- weight gain
If hypothyroidism is left untreated, what can it lead to?
myxedema (severe hypothyroidism)
What are the s/s of myxedema?
swelling of the hands, feet and face
can lead to coma or death
What are medical interventions for treatment addison’s disease?
- replacement therapy (glucocorticoids, adrenal corticoids)
- adequate fluid intake, controlled sodium and potassium
- diet with high complex carbs and protein
What are the medical treatments for cushing’s syndrome/disease (hypercortisolism)?
- decrease ACTH: irradiation or surgical excision of pituitary tumor
- monitor weight, electrolytes, and fluid balance
Is (hyper or hypo)thyroidism more common?
hypothyroidism
Hyperparathyroidism is the excessive secretion of PTH causing increased release of what into the bloodstream?
increased release of calcium into the bloodstream
What are the s/s of hyperparathyroidism?
- decreased bone strength
- fx
- weakness and atrophy
- hypermobility
- kidney stone or failure
What is hypoparathyroidism?
Insufficient secretion of PTH causing deficiency of Calcium in the blood
What are the s/s of hypoparathyroidism?
- muscle spasms
- paresthesia
- tetany
- cardiac arrythmias
- weakness
- chvostek sign (facial spasm)
- trousseau sign (carpal spasm)
- seizures
diagnosis
Decrease in the size and number of islet cells resulting in absolute deficiency of insulin secretion
T1DM
What population is commonly experiencing hyperthyroidism?
Females, 20-40 yrs
What population is commonly experiencing hypothyroidism?
females, 30-60 yrs
What population commonly experiences hyperparathyroidism?
females > 60 y/o
What type of DM is prone to ketoacidosis?
T1
diagnosis
glucose intolerance (high blood sugar) associated with pregnancy
gestational DM
Mothers who experience gestational DM often have onset in the _____ trimester
3rd trimester
4% of pregnancies
How long does it take for prediabetics to convert to T2DM?
within 10 years
10-15%
Describe diabetic polyneuropathy.
- bilateral N/T of the hands and feet in stocking-glove distribution
- progresses from distal to proximal nerves
- weakness
- paresthesia, shooting pain, loss of protective sensations
What is a mononeuropathy?
Focal nerve damage resulting from vasculitis with ischemia and infarction
What do entrapment neuropathies result from?
repetitive trauma to superficial nerves
What BMI range is considered as overweight?
25-29.9
What BMI range is considered as obesity?
30-39
What BMI range is considered as morbid obesity?
> 40
What is the normal range of A1c?
< 5.7%
What A1c range is indicative of prediabetes?
5.7-6.4%
What A1c range is indicative of diabetes?
> 6.5%
What are the 3 diagnostic criteria for dx of DM?
- s/s of diabetes in the presence of a plasma glucose concentration of > 200 mg/dL
- Fasting plasma glucose > 126 mg/dL
- A1c is >6.5%
What does an A1c test examine?
Avg. blood glucose within the last 2-3 months
