Endocrine Pathologies Flashcards
What is Diabetes mellitus?
2 marks
Not a single disease but a group of related disorder. All result in hyperglycaemia - high blood sugar.
Two main types - Type 1 and Type 2
What is the disease process (etiology) in diabetes mellitus?
5 marks
Glucose is used by many cells as it’s a good ‘clean’ source of fuel. But to get into cells glucose has to be ‘escorted’ by insulin - a hormone created in the pancreas.
Insulin also helps remove fat from the blood into fat storage cells (lipocytes).
Diabetes develops when insulin is in short supply or insulin-receptor sites have developed resistance, or both occur.
As a result fats & glucose build up in the blood and cells resort to stored fat reserves and then protein for fuel.
What is Insulin Resistance & how is it linked to abdominal fat?
3 marks
A condition where a given concentration of insulin doesn’t have the expected effect on cellular uptake of blood glucose.
It’s usually a result of decreased insulin receptors on cell membranes &/or post-receptor problems inside the cell.
Blood sugar levels climb stimulating the production of more insulin.
Hyperglycaemia & Hyperinsulinaemia occur simultaneously = Type 2 diabetes
IR is directly connected to overloaded abdominal fat cells because these cells are metabolically different from subcutaneous fat cells - they produce many chemicals that have adverse effects on body functions.
Losing 5% or more of overall fat storage can reduce risk of insulin resistance & its associated disorders.
What signs & symptoms might lead you to suspect that a patient had diabetes mellitus? Why is it important that this condition is recognised early?
5 marks
Early symptoms: frequent urination, excessive thirst and increasing appetite (polyuria, polydipsia, polyphagia), along with fatigue, weight loss, nausea & vomiting.
Late signs: neuropathy, impaired vision, kidney dysfunction.
Important to recognise early signs - if left untreated or unmanaged significant irreversible damage can be caused throughout the body.
Briefly describe the potential complications of diabetes.
6 marks
- Cardiovascular disease - high blood glucose damages endothelium causing atherosclerosis, hyper tension and possible stroke & aneurism.
- Oedema - fluid retention due to sluggish blood return from extremities.
- Ulcers, gangrene, amputations - plaque in blood vessels reduces oxygen & nutrients to tissues - so even minor skin lesions don’t heal well leading to dead tissue & infections.
- Kidney disease - renal blood vessels are v vulnerable to atherosclerosis because of high blood pressure from the descending aorta. High blood glucose also affects glomerulus functioning.
- Impaired vision - capillaries in the eyes thicken depriving eye cells of nutrition. Diseased capillaries leak blood & proteins into the retina. Glucose binds with proteins in the lens to form cataracts.
- Neuropathy - poor capillary circulation & excess glucose in blood cause nerve damage - leading to tingling, pain, numbness. If the Vagus nerve is affected - fainting, diarrhoea, constipation & impotence can occur.
Can effect every body system in some way.
Distinguish between Type 1 and Type 2 diabetes.
4 marks
Type 1 is an autoimmune disorder. It can be caused by a variety of factors, including certain drugs or chemicals or a complication of some infections.
WBCs attack the insulin producing cells of the pancreas.
5-10% of cases of diabetes are Type 1, usually evident by 30 years of age.
Type 2 - most likely caused by behaviour (XS fatty, sugary diet & lack of exercise) combined with genetic predisposition.
What is hyperthyroidism?
2 marks
A condition where the thyroid gland produces excess amounts of hormones that stimulate the metabolism of fuel into energy,
How would you recognise hyperthyroidism in a patient?
4 marks
Restlessness, sleeplessness, irritability. Rapid heartbeat - tachycardia, tremor. Unintended weight loss. Irregular periods. Dry skin & hair. Possible eye problems & skin rashes.
What is Graves Disease and what factors may contribute to its onset?
4 marks
A form of hyperthyroidism due to autoimmune factors.
WBCs make antibodies which attack the thyroid gland causing it to grow large & excrete excess thyroid hormones.
Contributing factors are genetics, exposure to x-rays & antiviral medications.
What is hypothyroidism and what are its effects?
6 marks
A condition where circulating levels of thyroid hormone are abnormally low, interfering with the body’s ability to generate energy.
The difficulty turning fuel into energy leads to:
- Decreased heart contractility & low cardiac output
- High levels of LDL, low density lipoproteins (bad cholesterol)
- Low gastrointestinal activity
- Delayed puberty
- Menstrual changes & infertility.
What are the main signs & symptoms of hypothyroidism?
6 marks
Weight gain Fatigue & slow reflexes Low HR Low body temperature & poor cold tolerance Constipation. Puffy, dry skin, brittle/lost hair (often ends of eyebrows) Heavy long periods Goitre Depression
What is Addison disease and what are its main signs and symptoms?
2 marks
Addison disease involves destruction of the adrenal cortex, limiting the secretion of hormone - cortisol, aldosterone & androgenic hormones.
It can result from an infection but is usually an autoimmune condition.
