endocrine final - Sheet1 Flashcards
What is Diabetes Insipidus (DI)?
A condition caused by a deficiency in ADH production or a decreased renal response to ADH, leading to excessive urination and thirst.
What are the causes of Diabetes Insipidus?
Brain tumor, head injury, brain surgery, CNS infections, renal damage or disease.
What are the manifestations of Diabetes Insipidus?
Excessive urination and thirst, generalized weakness, sleep disturbances, confusion, hypovolemia, hypernatremia, tachycardia, hypovolemic shock.
How is Diabetes Insipidus diagnosed?
Urine specific gravity and osmolality tests, BMP, and tests to differentiate causes.
What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A condition where excessive ADH is released, causing water retention despite low or normal plasma osmolality.
What are the risk factors for SIADH?
Age >65, cancer diagnosis, brain tumors, head trauma, meningitis/encephalitis, and certain drugs (e.g., antidepressants, antipsychotics).
What are the manifestations of SIADH?
Low urine output, increased body weight due to water retention, dyspnea on exertion (DOE), fatigue, dilutional hyponatremia.
How is SIADH diagnosed?
H&P, BMP, simultaneous measurements of urine and serum osmolality.
What is Diabetes Mellitus (DM)?
A chronic multisystem disease characterized by poor insulin production or impaired insulin utilization.
What are the common diagnostic methods for DM?
HgbA1C ≥6.5%, fasting plasma glucose ≥126 mg/dL, 2-hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test, random plasma glucose ≥200 mg/dL with symptoms of hyperglycemia.
What does HgbA1C measure?
It measures long-term glucose control by determining the amount of glucose attached to hemoglobin over the past 2-3 months.
What is the significance of HgbA1C?
It helps assess the effectiveness of diabetes treatment and whether changes need to be made.
What is Type 1 Diabetes Mellitus (Type 1 DM)?
An autoimmune disorder where the body destroys insulin-producing beta cells, leading to no insulin production and high blood glucose levels.
What are the risk factors for Type 1 DM?
Genetic predisposition, exposure to viruses.
What are the manifestations of Type 1 DM?
Polydipsia, polyuria, polyphagia, weakness, fatigue, weight loss, electrolyte abnormalities.
What is the onset of Type 1 DM?
Onset is rapid and often leads to diabetic ketoacidosis (DKA).
What is Type 2 Diabetes Mellitus (Type 2 DM)?
A condition with inadequate insulin secretion, insulin resistance, and other factors, leading to high blood glucose levels.
What are the risk factors for Type 2 DM?
Overweight/obesity, older age, family history, non-white ethnic groups, and growing incidence in children due to childhood obesity.
What are the manifestations of Type 2 DM?
Polyuria, polydipsia, polyphagia, weakness, fatigue, recurrent infections, prolonged wound healing, vision changes, renal failure symptoms.
What is Metabolic Syndrome?
A condition where individuals have 3 of the following 5 factors: hyperglycemia, abdominal obesity, hypertension, high triglycerides, low HDL levels.
What is the association between Metabolic Syndrome and Type 2 DM?
Individuals with metabolic syndrome are at higher risk of developing Type 2 DM.
What is Diabetic Ketoacidosis (DKA)?
A life-threatening condition caused by a profound deficiency of insulin, leading to hyperglycemia, ketosis, acidosis, hyperkalemia, and severe dehydration.
In which type of diabetes is DKA most common?
Type I diabetes, but it can also occur in Type II diabetics during periods of physiologic stress.
What are the main etiologies of DKA?
Infections, inadequate insulin dosage, undiagnosed Type I diabetes, poor self-management, and neglect.
What are the two primary factors that contribute to DKA?
- Absolute or relative insulin deficiency. 2. Increased release of counterregulatory hormones (glucagon, catecholamines, cortisol, and growth hormone).
How do counterregulatory hormones contribute to DKA?
These hormones increase blood sugar levels, exacerbating the insulin deficiency, which worsens the hyperglycemia and ketosis in DKA.
What does glucagon do in DKA?
It tells the liver to release stored glucose (glycogen), increasing blood glucose levels.
What do catecholamines do in DKA?
They stimulate glucagon secretion from the pancreas and interfere with the tissue disposal of glucose, worsening hyperglycemia.
What does cortisol do in DKA?
It acts on the liver, muscle, adipose tissue, and pancreas to release more sugar into the bloodstream.
What does growth hormone do in DKA?
It increases gluconeogenesis, further contributing to hyperglycemia.
What are the key manifestations of DKA?
Polyuria, polydipsia, polyphagia, hyperglycemia, acetone (fruity) breath, ketonuria, Kussmaul respirations, nausea/vomiting, lethargy, weakness, confusion, dehydration signs (tachycardia, hypotension).
What is the classic sign of DKA related to breathing?
Kussmaul respirations (deep, rapid breathing to compensate for acidosis).
What are Kussmaul respirations?
Deep, rapid breathing to help expel CO2 in an attempt to compensate for acidosis.
What are the classic signs related to ketones in DKA?
Acetone breath (fruity odor) and ketonuria (presence of ketones in urine).
How is DKA diagnosed?
Blood glucose >250 mg/dL, ABG pH <7.3, serum bicarbonate <16 mEq/L, and ketonuria.
