Endocrine Lab Studies Flashcards
scope of endocrinology
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)
Increased glucose (hyperglycemia) may be present in
DM-MOST COMMON
Cushing’s disease (hypersecretion of glucocorticoids)
Pheochromocytoma (hypersecretion of adrenaline)
Acute stress
Acromegaly
Glucagonoma (glucagon has opposite affect of insulin)
Pancreatitis
Decreased blood sugar (hypoglycemia)
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)
pathway of diabetes causing excess urination
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
Diabetes Mellitus is characterized by
hyperglycemia
glycosuria
results from inadequate production of utilization of insulin
Normal range of blood sugar (adult)
70-100 mg/dl
“prediabetes”
impaired fasting glucose values
101-125 mg/dl
“prediabetes”
impaired glucose tolerance (2 hr after eating)
140-199 mg/dl
diabetic value
fasting on 2 or more occasions
>126 mg/dl
diabetic value
random with presence of symptoms
>200 mg/dl
diabetic value
2 hrs on 75 GTT
>200 mg/dl
diabetic value
hemoglobin A1c on 2 or more occasions
> 6.5 %
glucose panic values
<40 mg/dl (brain damage)
>400 mg/dl
symptoms of DM
polydyspia
polyphagia
weight loss
polyuria
blood glucose collection tube color
red/tiger
hours that you are required to fast before a fasting blood glucose
8 hours
variance between whole blood glucose (home testing) and plasma glucose (lab testing)
12 %
GTT (glucose tolerance test)
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
HgbA1c
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
eAG
estimated average glucose
a way to convert HgbA1c into blood glucose
A1c goals for control
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)
A1c blood test
fasting is not indicated
collected in a lavender top tube
proinsulin
form in which insulin is stored in the pancreas
(A and B chains combine and form useable insulin)
why would we draw an insulin level?
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
instructions of insulin draw
fasting for 8 hrs
5 ml venous sample packed in ice
progression of insulin resistance
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
C-peptide
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
elevated C-peptide indicates
insulinoma
insulin resistance
decreased C-peptide indicates
diabetes/insulin deficiency
factitious hypoglycemia
pancreatectomy
2ndary gain (as in athletes)
ketones are present most often in
type II DM
what is diabetic ketoacidosis?
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
what are the three types of ketone bodies?
acetone
acetoacetate
beta hydroxybutyric acid
most urine dips only test for
acetone and acetoacetate
when you are treating someone for DKA, treat them and don’t
continue to test for ketones (it will look like things are getting worse)
the betahydroxybutyrate will transform back into acetone and acetoacetate
normal insulin level
6-26 u/mL
