Endocrine & Hematologic Emergencies Flashcards
Define
Diabetes Mellitus
A disorder of glucose metabolism, such that the body has an impaired
ability to get glucose into the cells to be used for energy.
Glucose cannot get into the cell, the cell goes unfed, and the level
of glucose in the blood remains high and continues to rise
Insulin allows glucose to ____
Enter and nourish the cells
issa key
Define
Type 1 Diabetes
an autoimmune disorder in which the individuals immune system produces antibodies against the pancreatic beta
cells
Without the insulin from the pancreatic beta cells, the patient must
obtain insulin from an external source
Signs & symptoms
Type 1
Polturia, Polydipsia, Polyphagia, AMS, body aches
Define
Diabetic Keto-Acidosis
The bodys cells do not receive enough gluccose for energy, the body begins to burn fat
Textbook says:
A form of hyperglycemia in uncontrolled diabetes in which certain acids accumulate when insulin is not available.
What is Ketones?
Acid Waste
Signs & Symptoms
Diabetic Keto-Acidosis
Define
Type 2 Diabetes
caused by resistance to the effects of insulin at the
cellular level
There are typically fewer insulin receptors.This leads to increase of BS
This developes later in life. Based on a unhealthy lifestyle. Insulin resistance
Signs & symptoms
Type 2 diabetes
Recurrent infection, change in vision, or numbness in the feet, weakness, drowsiness
Define
hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
In type 2, hyperglycemia leads to a state of dehydration due to the discharge of fluids from all body systems and eventually out through the
kidneys, leading to a much more ominous situation of fluid imbalance
Signs & Symptoms
hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
Hyperglycemia
Altered mental status, drowsiness, lethargy
Severe dehydration, thirst, dark urine
Visual or sensory deficits
Partial paralysis or muscle weakness
Seizures
the patient may become
unconscious or have seizure activity due in part to the severe
dehydration that results.
Name the 3 types of hematology emergencies
- Sickle Cell
- Hemophillia A
- Thrombophillia
True or false
People with sickle cell often experience hypoxia
True
Define
Hemophilia
A decreased ability to create a clot after an injury
How long does it take a healthy person to form a blood clot after injury?
13 seconds after a small cut &
no longer than 7 minutes following a more serious injury
Define
Thrombophilia
clotting more than normal
a disorder in the body’s ability to maintain the
viscosity and smooth flow of blood through the venous and arterial
systems.
Define
Deep Vein Thrombosis
(DVT)
Clots that form deep in the veins, usually the legs
a common medical problem in
sedentary patients and in patients who have had recent injury or
surgery
Define
Acidosis
The buildup of excess acid in the blood or body tissues that can result from a primary illness.
Define
Hyperosmolar Hyperglycemic Nonketotic Syndrome
(HHNS)
A lifethreatening condition resulting from high blood glucose that typically occurs in older adults and which causes altered mental status, dehydration, and organ damage.
What primary illnesses cause Metabolic Acidosis?
too much acid production or loss of bicarbonate
- DKA
- Lactic Acidosis
- Severe Sepsis
- Shock
- Severe Heart failure
- Severe trama
- Prolonged seizures
- Renal failure
- severe dehydration
What primary illnesses cause Respiratory Acidosis?
lungs cant remove enough carbon dioxide
- COPD
- Severe Asthma attack
- Pneumonia
- Pulmonary Edema
- Upper Airway Obstruction
- Stroke
- Head Injury
- Overdose
- Neuromuscular diseases
Define
Kussmaul Respirarion
Deep, rapid breathing; usually the result of an accumulation of certain acids when insulin is not available in the body.
Define
Polydipsia
Excessive thirst that persists for long periods despite reasonable fluid intake; often the result of excessive urination
Define
Polyphagia
Excessive eating; in diabetes, the inability to use glucose properly can cause a sense of hunger.
Define
Polyuria
The passage of an unusually large volume of urine in a given period; in diabetes, this can result from the wasting of glucose in the urine
Define
Sickle Cell Disease
A hereditary disease that causes normal, round red blood cells to become oblong, or sickle shaped.
Define
Thrombosis
A blood clot, either in the arterial or venous system
Define
Vasoocclusive Crisis
Ischemia and pain caused by sickle-shaped red blood cells that obstruct blood flow to a portion of the body.
The pancreas produces and stores two hormones that play a major role in glucose metabolism:
glucagon and insulin
What is the pancreas’ main role immediately after you start eating?
The pancreas releases digestive enzymes into the small intestine to help break down carbohydrates, fats, and proteins. It also releases insulin into the bloodstream.
What is the role of insulin released by the pancreas after a meal?
Insulin helps glucose (sugar) from the bloodstream enter cells throughout the body to be used for energy or stored. It also signals the liver to take up glucose and store it as glycogen
What is the liver’s primary action in response to the insulin released after a meal?
The liver takes up glucose from the blood and stores it as glycogen for later use. This process is called glycogenesis.
What happens to blood glucose levels in the hours after a meal as your body uses energy?
Blood glucose levels begin to decrease as cells use glucose for fuel.
What does the pancreas do when blood glucose levels start to fall between meals?
The pancreas reduces its release of insulin and starts to release glucagon.
What is the main role of glucagon, released by the pancreas between meals?
Glucagon signals the liver to release stored glucose back into the bloodstream to raise blood glucose levels.
How does the liver increase blood glucose levels in response to glucagon?
The liver breaks down stored glycogen into glucose and releases it into the blood. This process is called glycogenolysis.
What happens if you haven’t eaten for a longer period and your glycogen stores in the liver start to get low?
The liver can also produce new glucose from non-carbohydrate sources like amino acids and glycerol. This process is called gluconeogenesis
What eventually signals you to feel hungry again?
As blood glucose levels continue to fall and the body starts to run low on readily available energy, various signals (including hormones like ghrelin) are sent to the brain, triggering the sensation of hunger.
Why does someone with diabetes experience polyuria?
the kidney’s filtration system becomes overwhelmed and glucose spills
into the urine. The increased amount of glucose in the urine causes
more water to be pulled out of the bloodstream into the urine
Increased urine production and urination also cause dehydration
and increased thirst, which can lead to severe electrolyte abnormalities. An increase in fluid consumption, called
Polydipsia
The patient with DKA will generally have a fingerstick glucose level higher than?
400 mg/dL
Define
Type 2 diabetes
A resistance to the effects of insulin at the cellular level
In type 2 diabetes there are typically fewer insulin receptors
Define
Hyperosmolarity
very concentrated blood as a result of relative dehydration
How does HHNS differ from hyperglycemia?
In hyperglycemia, patients respond by polydipsia causing polyuria. In HHNS, however, the patient cannot drink enough fluid to keep up with the exceedingly high glucose levels in the blood
Questions for a patient with diabetes
- Do you take insulin or any pills that lower your blood sugar?
- Do you wear an insulin pump? Is it working properly?
- Have you taken your usual dose of insulin (or pills) today?
Have you eaten normally today? - Have you had any illness, unusual amount of activity, or stress?
True or false
The
odd-shaped cells do not protect the individual from contracting malaria.
False
This protection is useful to people who live in sub-Saharan Africa where
malaria is common
Sickle Cell
The sharp and misshapen cells lead to?
dysfunction in oxygen
binding and unintentional clot formation
What is the normal life span of red blood cells?
110 to 120 days
Name some complications with sickle cell
Vasoocclusive crisis, stroke, splenic sequestration, sepsis, aplastic crisis, priapism
Define
Anemia
abnormally low number of RBCs
RBCs contain hemoglobin, an iron-containing pigment that is responsible for 97% of the transport of oxygen from the lungs to the cells of the body
What hormone is missing in type 1 diabetes mellitus?
insulin
Without insulin, nutrition in the form of glucose
cannot get into the cell and the cell cannot function normallly
Symptoms
Sickle cell
pain in the joints, fever,
respiratory distress, and abdominal pain
