endocrine patho Flashcards
up regulation
body will create more of those receptors if needed
down-regulation
too many receptors –> get rid of some –> desensitization
what mechanism does the endocrine system work on
negative feedback mech (endocrine tissue will stop secreting hormones when homeostasis is restored)
why is pancreas a compound duct
it is both exocrine (release products into ducts) and endocrine (release into bloodstream)
primary site for insulin receptors
skeletal muscles (pull sugar from blood to muscle for energy)
what happens with lack of glucose to the brain
slurred speech, combative, mini stroke
glucagon vs glycogen
glucagon release triggers glycogen to convert to glucose
how to treat hypokalemia when given insulin
insulin pushes K back into cells = hypokalemia
give pt INSULIN + D5W
which cells release insulin (what happens when they are blocked?)
beta cells –> why beta blockers mask effects of hyperkalemia
s/s of hyperglycemia
polyuria, polydipsia, polyphagia
ketones released in urine due to fat breakdown for energy
type i diabetes
absolute deficiency of insulin, autoimmune
occurs mainly in childhood/puberty
type ii diabetes
insulin resistance
adult onset
–> due to obesity, sedentary lifestyle, lack of exercise
secondary diabetes
caused by drugs (glucocorticoids)
gestational diabetes
glucose intolerance due to onset of pregnancy, will have higher change in the future to dev. diabetes
basal insulin
pancreas secretes a little bit throughout the day to help with the energy if need for abrupt increase of energy
WHICH DRUG IS OKAY FOR MOM AND BABY
insulin
- placenta = antagonize insulin
non pharm tx for diabetes
lifestyle change, diet, exercise, weight loss
–> this can only work if pt is motivated
other pharm tx (other than insulin)
manage HTN (ACE inhibitor or ARB)
manage lipids (STATINS)
prandial insulin
insulin secretion in response to meals
correctional insulin
correct elevations in blood glucose due to illness/stress, done around meals
sliding scale
- which types of insulins use this
guide for insulin units depending on BG levels
- rapid or short acting
why do we not give insulin PO
destroyed by gastric acid
where is the fastest rate of absorption in the body for insulin
SUBCUT = abdomen –> arm –> thigh –> butt
how often should u change insulin tubing
q24hr
t/f: bioavailability is the same with all insulins
false
s/s of hypoglycemia
tachycardia, tremors, confusion, agitation, diaphoresis = EARLY
coma, LOC, death = late
s/s of hyperglycemia
polyuria, polyphage, polydipsia
adverse effects of insulin
lipohypertrophy, lipoatrophy, somogyi phenomenon
lipohypertrophy
increase fat mass at inj site –> spongy cellulite –> delayed absorption
lipoatrophy
antibody formation –> fat destruction –> skin depression
how often should you change insertion sites on portable insulin pumps
q3 days
incretin hormone (GLP-1, GIP)
released at same time as insulin by small intestines –> tells pancreas to release more insulin
what is incretin hormone inactivated by
DPP-4
amylin hormone
role in PPBG metabolism
what should you do if there is BG >275
check urine for ketones
normal fasting bg levels
70-110
normal non fasting bg levels
<140
pre-diabetes fasting
110-125
diabetes bg levels (how to dx diabetes)
2 fasting bg of >126
diabetes non fasting bg levels
> 200
HgA1C levels that indicate diabetes
> 7%
