Endocrine Complaints I Flashcards
what are the three mechanisms of pathology in endocrinology?
hormone excess, hormone deficiency, and hormone resistance
what percentage of american adults are found to have a BMI greater than or equal to 25?
70%
what is another name for metabolic syndrome?
insulin resistance syndrome
what are some main risk factors for developing metabolic syndrome?
obesity, sedentary lifestyle, genetics, aging
how do you diagnose metabolic syndrome?
if a patient has any three of the following: central obesity, abnormal lipids, BP is > 130/85, or fasting glucose is >100 mg/dL
what is the main management tool for metabolic syndrome?
lifestyle changes
what diets can be recommended for metabolic syndrome?
mediterranean or DASH diet
what can be said about the time frame of DM II?
there is a long asymptomatic period, so screening is important and should be done with the presence of risk factors
what are the main clinical presentations of someone with type 2 diabetes?
polyuria, polydypsia, polyphagia, rapid weight loss
what is the HbA1c level used to diagnose DM II?
if it is greater than 6.5%
what is the fasting glucose level used to diagnose DM II?
126
what is the 2-hour glucose level used to diagnose DM II?
> 200 on oral glucose tolerance test
what is the special testing for a diabetic foot exam?
you will evaluate for protective sensation with 10-g monofilament and vibratory sensation with 128-Hz tuning fork
what is the management for hormone resistance?
to overcome the resistance, to resensitize the target organs; to decrease the high hormone levels
what is the role of metformin?
it decreases the hepatic glucose production, improves the peripheral glucose uptake slightly
what are the risk factors associated with type I DM?
genetic susceptibility, environmental triggers, immune-mediated destruction of pancreatic beta cells
what are the main clinical presentations of a patient with type I DM?
polydipsia, polyuria, blurred vision, fatigue/weakness, weight loss with hyperglycemia and ketonemia or ketonuria, DKA
which type of diabetes has pancreatic antibodies?
type I
what other autoimmune diseases are associated with type I Dm?
autoimmune thyroiditis, celiac disease, or addison’s disease
what is severe hyperglycemia classified by?
glucose levels higher than 250 mg/ dL
what are 2 disorders that can happen in patients with high blood sugar?
DKA or hyperglycemic hyperosmolar state (HHS)
what classifies DKA?
ketone body formation
what results from hyperglycemic hyperosmolar state (HHS)?
severe dehydration
how should DKA or HHS patients be managed?
not as outpatients
what should be considered in any patient with confusion, altered mental status, or seizure?
hypoglycemia
when acetylcholine increases in sympathetic neurons, what does this lead to?
Cholinergic symptoms of sweating, hunger, and paresthesias
when the adrenal response is stimulated, what does this lead to?
epinephrine, norepinephrine, and cortisol all increase, which leads to the adrenergic symptoms of palpitations, tremor, and anxiety
what sign is associated with dehydration?
poor skin turgor
