Endocrine Disorders

Question 1

What is Diabetes

Answer 1

Caused by a relative deficit of insulin secretions from BETA cells or lack of response from target cells (resistance)

Question 2

What is normal BS level

Answer 2

4-8, but everyone’s “normal” can be different

Question 3

Type 1 diabetes

Answer 3

IDDM or juvenile onset. Occurs for often in children, and is an insulin deficit from destruction of the beta cells in an autoimmune reaction. Results in an absolute deficit of insulin

Question 4

Type 2 diabetes

Answer 4

Can be a result of decreased beta cell production, increased insulin resistance or increased production of glucose by the liver

Question 5

How type 2 diabetes is managed

Answer 5

May be controlled by adjusting diet, using glucose through exercise, stimulating beta cell production in pancreas

Question 6

Patho of DKA

Answer 6

BS rises and tries to excrete glucose in urine, so frequent urination and eventually dehydration. When this is prolonged fats and proteins are used and create ketones and the excessive amount in the blood cause ketoacidosis. Ketones bind to bicarbonate resulting in lower pH, altered LOC causing DKA

Question 7

S/S of diabetes

Answer 7

Weight gain, polyuria, polydipsia, polyphagia, fatigue, lethargy

Question 8

Tx of diabetes

Answer 8

Glucose intake must balance with utilization
1. Diet and exercise
2. Oral meds to increase insulin production or reduce insulin resistance
3. Insulin replacement

Question 9

When fixing low BS with food what type of nutrients do you have to give them

Answer 9

Simple sugar for it to be used immediately, and a complex carb so it is stored as glycogen

Question 10

Medication used to stimulate beta cells to secrete more insulin

Answer 10

Glyburide

Question 11

Med used reduce insulin resistance and reduce glucose production

Answer 11

Metformin

Question 12

Hypoglycemia - Low BS

Answer 12

Excessive insulin that causes deficit of glucose in the blood. Often occurs after exercise, vomiting, skipping a meal, medication errors

Question 13

Hypoglycaemia S/S related to impaired nervous function

Answer 13

Poor concentration, slurred speech, lack of coordination, Mimic intoxication

Question 14

Hypoglycaemia S/S relating to SNS stimulation

Answer 14

Increased HR, pale moist skin, anxiety, tremors

Question 15

Tx of Hypoglycaemia

Answer 15

Concentrated carbs (juice, candy). If unconscious glucose of glucagon can be administered IM/IV, but to use glucagon, they must have stored sugars already

Question 16

DKA

Answer 16

Results in insufficient insulin over several days, too many ketones in blood binding to bicarbonate

Question 17

S/S DKA

Answer 17

Related to dehydration - dry mucosa, rapid pulse, low BP
Kussmaul resps, acetone breath, decreased LOC, acidosis, nausea

Question 18

Tx of DKA

Answer 18

Insulin, replacement of fluids, bicarbonate to reverse acidosis

Question 19

What is hyperosmolar hyperglycemia coma

Answer 19

Similar to DKA, high blood sugar leads to severe dehydration which leads to high osmolarity in blood. There is no ketones involved as still some insulin is produced.

Question 20

Chronic complications

Answer 20

Vascular problems, degeneration on vasculature in kidneys, fat accumulation in arteries, ulcers in feet that are slow to heal

Question 21

Neuropathy

Answer 21

Impaired sensation, numbness, tingling, weakness nerve degeneration (incontinence, diarrhea). Common with diabetes

Question 22

Hyperthyroidism

Answer 22

Thyroid makes too much hormones, Graves’ disease when immune system attacks thyroid and it reacts by secreting too much. Causes increase in body functions - increase HR, sweating, weight loss

Question 23

Hyperthyroid S/S

Answer 23

High HR, sweaty, weight loss, polyuria, fine hair, shaky hands

Question 24

Hypothyroid

Answer 24

Can be caused by inflammation of thyroid gland, autoimmune destruction of thyroid. S/S related to slow metabolism

Question 25

S/S hypothyroidism

Answer 25

Fatigue, weakness, weight gain, dry hair, muscle cramps, depression

Question 26

Cortisol

Answer 26

Assists with body’s response to stress, maintains BP and cardiovascular function, regulate metabolism, affects glucose levels in blood

Question 27

Aldosterone

Answer 27

Regulates and maintains salt and potassium balance in the blood, regulated by RAAS

Question 28

Primary adrenal insufficiency

Answer 28

Aka addisons disease, caused by degeneration of glands leading to deficiency of all steroid hormones. Hyperpigmentation of skin usually

Question 29

Secondary adrenal insufficiency

Answer 29

Relatively common, defined as lack of ACTH secretion from pituitary gland, seen in patients who abruptly stop taking corticosteroids

Question 30

Pheochromocytoma

Answer 30

Benign tumor of the adrenal medulla that secretes epi

Question 31

Cushing’s syndrome

Answer 31

Excessive amount of corticosteroids (cortisol, hydrocortisone). These are responsible for stress response and life. These patients are after round, puffy faces,

Question 32

Addisons disease

Answer 32

Deficit of adrenocortical secretions

Question 33

Major effects of addisons disease

Answer 33

Decreased BS levels, poor stress response, fatigue, weight loss, frequent infections, hypotension

Question 34

Addison’s disease emergency

Answer 34

Acute episode of chronic disease, lack of cortisol caused by, emotional distress, noncompliance with meds, infections, dehydration

Question 35

Tx of addison’s disease emergency

Answer 35

Hydrocortisone IM/IV, this replaces depleted cortisol