Endocrine Lab Studies

Question 1

scope of endocrinology

Answer 1

primarily works with hormones

disease may include

-hypo/hyperfunction of pituitary (tumor), thyroid (Hashimotos/Grave’s), pancreas (DM), adrenal (Addison’s/Cushings), gonads, parathyroids (calcium and vitamin D regulation)

Question 2

Increased glucose (hyperglycemia) may be present in

Answer 2

DM-MOST COMMON

Cushing’s disease (hypersecretion of glucocorticoids)

Pheochromocytoma (hypersecretion of adrenaline)

Acute stress

Acromegaly

Glucagonoma (glucagon has opposite affect of insulin)

Pancreatitis

Question 3

Decreased blood sugar (hypoglycemia)

Answer 3

Diabetes Tx (too much insulin)

Addison’s disease (hyposecretion of adrenal hormone)

liver disease (liver no longer liberates glycogon into blood stream)

hypopituitarism (too little growth hormone)

beta cell tumors (insulinoma-too much insulin secretion, pancreatic carcinoma)

Question 4

pathway of diabetes causing excess urination

Answer 4

as sugar increases, kidneys can only absorb 180 mg/dl of glucose, after that, kidneys let glucose go through urine, excess thirst is caused by kidney’s need to have some fluid with which to allow sugar to pass through

Question 5

Diabetes Mellitus is characterized by

Answer 5

hyperglycemia

glycosuria

results from inadequate production of utilization of insulin

Question 6

Normal range of blood sugar (adult)

Answer 6

70-100 mg/dl

Question 7

“prediabetes”

impaired fasting glucose values

Answer 7

101-125 mg/dl

Question 8

“prediabetes”

impaired glucose tolerance (2 hr after eating)

Answer 8

140-199 mg/dl

Question 9

diabetic value

fasting on 2 or more occasions

Answer 9

>126 mg/dl

Question 10

diabetic value

random with presence of symptoms

Answer 10

>200 mg/dl

Question 11

diabetic value

2 hrs on 75 GTT

Answer 11

>200 mg/dl

Question 12

diabetic value

hemoglobin A1c on 2 or more occasions

Answer 12

> 6.5 %

Question 13

glucose panic values

Answer 13

<40 mg/dl (brain damage)

>400 mg/dl

Question 14

symptoms of DM

Answer 14

polydyspia

polyphagia

weight loss

polyuria

Question 15

blood glucose collection tube color

Answer 15

red/tiger

Question 16

hours that you are required to fast before a fasting blood glucose

Answer 16

8 hours

Question 17

variance between whole blood glucose (home testing) and plasma glucose (lab testing)

Answer 17

12 %

Question 18

GTT (glucose tolerance test)

Answer 18

fast 8-12 hrs previous

check fasting glucose level

administer 75 g oral glucose

collect 5-7 ml in red top fasting, then at 1 and 2 hours

Question 19

HgbA1c

Answer 19

glycosylated hemoglobin

(values help monitor control of DM)

• measures glucose control over 3-4 months, measured in a percentage of total RBC
• some of hemoglobin becomes glycosylated (sugar attached to it)
• the more sugar that is in the blood stream over that time, the more Hgb will become glycosylated

Question 20

eAG

Answer 20

estimated average glucose

a way to convert HgbA1c into blood glucose

Question 21

A1c goals for control

Answer 21

AACE says < 6.5%

ADA says _<_7.0%

when A1c is 0.5 > than the patient’s goal intervention is warranted

***if we push it too hard, it may put them at risk for hypoglycemia (acute complication)

Question 22

A1c blood test

Answer 22

fasting is not indicated

collected in a lavender top tube

Question 23

proinsulin

Answer 23

form in which insulin is stored in the pancreas

(A and B chains combine and form useable insulin)

Question 24

why would we draw an insulin level?

Answer 24

helps to determine which type of DM you are talking about

evaluate for insulin deficiency (type I)

evaluate for insulin resistance (elevated insulin level in type II)

evaluate for insulinoma

Question 25

instructions of insulin draw

Answer 25

fasting for 8 hrs

5 ml venous sample packed in ice

Question 26

progression of insulin resistance

Answer 26

as body weight increases, the body becomes less sensitive (more resistant) to your own insulin

as a result, pancreas compensates for this and increases the level of insulin that it secretes

eventually, it reaches a point where insulin secretion no longer continues (becomes tired) at the high level

Question 27

C-peptide

Answer 27

identify sever insulin deficieny

(it is the section of proinsulin that gets cut out when insulin is liberated from the pancreas)

8-10 fast

red top tube

Question 28

elevated C-peptide indicates

Answer 28

insulinoma

insulin resistance

Question 29

decreased C-peptide indicates

Answer 29

diabetes/insulin deficiency

factitious hypoglycemia

pancreatectomy

2ndary gain (as in athletes)

Question 30

ketones are present most often in

Answer 30

type II DM

Question 31

what is diabetic ketoacidosis?

Answer 31

your body starts burning fat and releasing ketones (glucose is not coming into the cell) as a last ditch effort to try to get glucose in

Question 32

what are the three types of ketone bodies?

Answer 32

acetone

acetoacetate

beta hydroxybutyric acid

Question 33

most urine dips only test for

Answer 33

acetone and acetoacetate

Question 34

when you are treating someone for DKA, treat them and don’t

Answer 34

continue to test for ketones (it will look like things are getting worse)

the betahydroxybutyrate will transform back into acetone and acetoacetate

Question 35

normal insulin level

Answer 35

6-26 u/mL