Endocrine Complaints 1 Flashcards
The study of glands and the hormones they produce
Endocrinology
What are some classic endocrine glands?
Pituitary Pancreas Thyroid Parathyroid Suprarenal
What are the 3 basic mechanisms of pathology for endocrine disorders?
- Hormone excess
- Hormone deficient
- Hormone resistance
How do you measure obesity?
BMI - weight/height^2
Obese BMI
Greater than or equal to 30
Overweight BMI
Between 25-30
Fat cells adapted to store excess energy efficienly
Obesity
____ resistance probably plays a role in obesity
Leptin
What is metabolic syndrome?
Multiple metabolic abnormalities that increase risk for cardiovascular disease and diabetes
Other names for metabolic syndrome?
Syndrome X
Insulin resistance syndrome
Any 3 of the following can diagnose metabolic syndrome
- Central obesity (greater than 35/40 for women/men waist circumference)
- Abnormal lipids
- BP greater than 130/85
- Fasting glucose is greater than 100
Best treatment for metabolic syndrome?
Lifestyle changes - lose weight, exercise, new diet
Insulin resistance leading to ineffective transport of glucose into cells
Type 2 Diabetes Mellitus
Hyperglycemia can lead to _____ damage
organ
Describe the evolution of Type 2 Diabetes
- Hyperinsulinemia to keep glucose levels normal
- Glucose levels start to rise - hyperglycemia
- Insulin production begins to decrease and beta cells die from overproduction
- Chronic hyperglycemia
What is Hemoglobin A1C?
Blood test to measure average blood sugar levels over the past 3 months
Main symptoms that are consequential of elevated glucose for Type 2 Diabetes
Polyuria - excessive peeing Polydipsia - excessive thirst Polyphagia - excessive eating Weight loss/gain, increased hunger Blurry vision Acanthosis nigricans - skin rash Impaired healing Tingling in extremities
What are the criteria to diagnose Type 2 diabetes
- HbA1C greater than 6.5%
- Fasting glucose greater than 126
- 2 hour glucose and random glucose greater than 200
What body part is important to examine with patients who have diabetes?
Foot exam
Treatment for Type 2 diabetes
- Overcome insulin resistance and resensitize organs
- Decrease high hormone levels
* * lifestyle management**
Immune-mediated beta cell destruction in the pancreas
Type 1 Diabetes Mellitus
_____ is one of the most common childhood disease
Type 1 DM
Main symptoms of Type 1 Diabetes
Polyuria Polydipsia Blurred vision WEIGHT LOSS Diabetic ketoacidosis ABSENT insulin/C peptide
Age of onset for Type 1 and 2 DM
Type 1 = Childhood
Type 2 = after puperty
Insulin secretion levels for Type 1 and 2 DM
Type 1 = ABSENT
Type 2 = variable
Insulin sensitivity for Type 1 and 2 DM
Type 1 = Normal when controlled
Type 2 = DECREASED
Pancreatic antibodies yes or no for Type 1 and 2 DM
Type 1 = YES
Type 2 = no
Insulin dependence time for Type 1 and 2 DM
Type 1 = permanent
Type 2 = variable
If a patient has Type 1 DM, what other diseases like to run in packs and may be affecting this patient?
Autoimmune diseases
Treatment for Type 1 DM
Replace hormone - insulin
If glucose levels are higher than _____ assess for acute disorders
250
What are the 2 acute disorders where glucose levels are above 250?
Diabetic ketoacidosis (DKA) Hyperglycemia hyperosmolar state (HHS)
Diabetic Ketoacidosis main sign
Ketone body formation
Hyperglycemic Hyperosmolar state main sign
Dehydration
DKA and HHS management?
ADMIT TO HOSPITAL
In any patient with confusion, altered mental status or seizure, what condition should you consider?
HYPOglycemia
Hypoglycemia symptoms
Confusion, altered mental status, seizure
Glucose less than 70
Hypoglycemia is usually caused by?
Drugs used to treat diabetes
