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Nursing 102 > Endocrine System Test 1 > Flashcards

Endocrine System Test 1 Flashcards

1
Q

The endocrine system is an integrated chemical communication & coordination system that enables:

A

Growth and development
Reproduction
Metabolism

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2
Q

What is homeostasis?

A

constant normal balance in response to environmental changes

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3
Q

Where do exocrine glands secrete hormones?

A

into ducts which empty into body cavity or onto a surface (ex: saliva, sweat)

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4
Q

Where do endocrine glands secrete hormones?

A

into the blood stream

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5
Q

What are hormones?

A

Chemical messengers synthesized & secreted by a specific organ or tissue

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6
Q

What do hormones bind to?

A

specific cell receptors either in the cell membrane or within the cell

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7
Q

How are hormones classified?

A

by their chemical strucutre:

  • Lipid soluble or
  • Water soluble (protein)
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8
Q

2 examples of lipid-soluble hormones:

A

steroid and thyroid hormones

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9
Q

2 examples of water-soluble hormones:

A

protein hormones and catecholamines

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10
Q

How are lipid-soluble hormones transported?

A

bound to plasma protein

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11
Q

How are water-soluble proteins transported?

A

circulate freely in blood, not dependent on proteins for transport

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12
Q

How do hormones bind to and interact with target cells or tissue?

A

“Lock and key”

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13
Q

8 Functions of horomones:

A
  1. Reproduction
  2. Response to stress & injury
  3. Electrolyte balance
  4. Energy metabolism
  5. Growth
  6. Maturation
  7. Aging
  8. Neuroendocrine regulation
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14
Q

2 types simple feedback systems:

A
  1. Negative Feedback system

2. Positive Feedback system

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15
Q

What activates the negative feedback system?

A

Imbalance

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16
Q

Negative feedback system: High hormone levels ________ further hormone production.

A

Inhibit

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17
Q

Negative feedback system: Low hormone levels ________ rate of hormone production.

A

Increase

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18
Q

Positive feedback:

A

Increases target action beyond normal (ex: oxytocin)

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19
Q

Complex feedback:

A

involves communication via hormones among multiple glands to increase secretion of hormones.

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20
Q

Intrinsic secretion:

A

secretion of hormones in specific rhythms that originate in brain (ex: Circadian rhythm (24 hours, Ultradian >24 hours)

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21
Q

Extrinsic factors affecting hormone secretions:

A

pain, emotions, sexual excitement, & stress

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22
Q

DM is a chronic multisystem disease related to :

A

carbohydrate, lipid & protein metabolism

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23
Q

Which type of diabetes involves absolute insulin deficiency and onset before 30?

A

Type 1

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24
Q

Which type of diabetes involves insulin deficiency or resistance?

A

Type 2

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25
Where is insulin produced?
Beta cells in the islets of langerhans
26
What do alpha cells secrete?
glucagon
27
What do beta cells secrete?
insulin
28
What maintains normal blood glucose level in a healthy body?
insulin & glucose ratio
29
normal glucose range =
70-120 mg/dl
30
Is the pancreas an exocrine or endocrine gland?
trick question- both!
31
Exocrine function of the pancreas (duct)-
secretes digestive enzymes into the duodenum
32
Endocrine function of the pancreas-
hormone secretion by the islet of langerhans (alpha cells-glucagon, beta cells-insulin)
33
What leads to high blood glucose in type 1 diabetics?
absence of insulin prevents entrance of glucose into cells
34
What are insulin-dependent tissues?
Cells with insulin receptor sites: skeletal muscle & adipose tissue
35
Insulin secretion is promoted by icreased:
blood glucose levels, amino acids, vagal stimulation and GI hormones
36
"Lock and Key" theory=
insulin unlocks the cells door to allow glucose to enter
37
What is the storage form of glucose in the liver?
glycogen
38
what is gluconeogenesis?
breakdown of stored glucose (glycogen)
39
Without insulin the body breaks down ___ & ____ for energy.
body fat & protein (lipolysis)
40
What are 3 main symptoms of hyperglycemia?
3 P's- Polyuria, Polydipsia and Polyphagia
41
What is lipolysis?
breakdown of stored fats and protein for back up energy source
42
With insulin deficiency: 1. Fats break down and release _____. 2. Free fatty acids convert to _____. 3. Ketones accumulate in the blood and cause _____.
1. Free fatty acids (FFA's) 2. ketone bodies 3. metabolic acidosis
43
Signs and Symptoms of metabolic acidosis:
dehydration, hypovolemia, hyperviscosity of blood, hypoxia, kussmaul breathing.
44
Insulin absence causes hypokalemia or hyperkalemia?
Hypokalemia- Potassium deficiency bc of excessive K+ excreted in urine
45
Life threatening side effect of hypokalemia:
cardiac arrhythmias
46
Insulin inhibits ____ (the breakdown of stored glucose in liver)
glycogenesis
47
new glucose from the break down of amino acids is called?
gluconeogenesis
48
Examples of counteregulatory hormones that oppose the effecs of insulin & increase blood glucose levels: (4)
Glucagon, epinephrine, growth hormone, cortisol
49
How do counterregulatory hormones maintain normal blood glucose?
by providing regulated release of glucose for energy
50
What is the primary fuel for the CNS?
glucose
51
Storage form of glucose and fatty acids?
glycogen
52
where is glycogen stored?
in the liver and muscles
53
_____ prevents the break down of adipose tissue to _____.
Insulin; fatty acids
54
When blood sugar is persistently high blood becomes _____
viscous
55
Decreased circluation hinders the bodies ability to _____ & _____.
fight infection; heal
56
What is the renal threshold?
180-200 mg/dl. when blood sugar reaches this level kidneys can no longer reabsorb the glucose and it is excreted in the urine
57
what is urine with sugar in it called?
glucosuria
58
excess glucose excreted in the urine along with fluids & electrolytes:
osmotic diuresis
59
What is type 1 diabetes characterized by?
insulin deficiency
60
Patho of DM 1: progressive destruction of pancreatic _____ cells.
beta
61
Symptoms of DM 1 occur when the pancreas no longer produces any _____
insulin
62
Describe the "honeymoon period"
Euglycemia after initial diagnosis, very little insulin needed, usually lasts 3-12 months
63
What criteria is used to diagnose prediabetes?
Fasting glucose: >100 but <126 | 2-hour plasma glucose: between 140 & 199
64
The onset of diabetes and cv risks can be delayed or prevented by _____ & _____
weight loss & exercise
65
Which is the most frequently occurring type of diabetes?
Type 2 diabetes
66
What is the most powerful risk factor for type 2 diabetes?
obesisty
67
Clinical manifestations of type 1 diabetes:
Polyuria polydipsia and polyphasia | Weight loss, weakness & fatigue, ketoacidosis
68
Clinical manifestations type 2 diabetes:
Fatigue, recurrent infections, prolonged wound healing, visual changes -may also have classic symptoms of type 1
69
3 tests used to Dx diabetes:
1. Fasting plasma glucose level >126 2. Casual plasma glucose measurement >200 + SYMTPOMS (CPCG) 3. Two-hour OGTT >200
70
What does an A1c test measure?
Glycosylated hemoglobin. shows amt of glucose attached to hgb molecules over RBC life time (90-120 days)
71
what is a goal A1c?
<7%
72
What test is used to measure whether a type 2 diabetic patient will need exogenous insulin?
C-Peptide Marker
73
somogyi effect:
rebound effect caused by counterregulatory hormone release. Morning hyperglycemia in response to nighttime hypoglycemia.
74
Somogyi effect Tx:
decrease insulin or add a late night snack
75
somogyi effect symptoms:
HA, nightmares, night sweats
76
Dawn phenomenon:
Hyperglycemia on awakening in the am, usually normal until about 3 am, caused by release of growth hormone (cortisol)
77
Dawn phenomenon Tx:
increase insulin or adjust dosage
78
What are sulfonylureas?
oral agents that stimulate beta cells to produce more insulin in pancreas (ex. glipizide, glimepiride)
79
Adverse reactions of sulfonyureas?
hypoglycemia, increase in CV events, phototoxicity and weight gain
80
What are meglinitides?
oral agents that can be taken from 30 min before up until a meal to increase insulin production by pancreas
81
Rapid acting:
onset-15, peak-1, duration 2-4
82
Short acting:
onset-30, peak 2-4, 6-10
83
intermediate:
onset- 1-2, peak 4-8, duration 10-20
84
long acting
onset 1-2, peak- NONE, duration 24 hours
85
Side effects meglinitides:
wt gain, hypoglycemia
86
biguanides:
reduce glucose production in the liver with out hypoglycemia s/e's. Do not promote weight gain!!
87
when must you hold biguanides?
48 hours prior to anything with IV dyes (CT's and MRI's)
88
Glucosidase inhibitors:
Taken with first bite of main meal to lower post prandial blood glucose: slow down absorption of carbs in small intestine.
89
Which oral agent is most effective for insulin resistant patients?
Thiazolidinediones
90
What is the cornerstone of care for the diabetic?
nutritional therapy!
91
_____ of meal is as important as amount of food eaten
time
92
What percentage of total food intake should be carbs and monounsaturated fats?
45-65%
93
What percentage of diet should be fats?
no more than 25-30%
94
What % should be protein?
<10%
95
What is the #1 predictor of type 2 diabetes?
obesity
96
what are ketones?
by product of breakdown of fatty acids
97
What causes DKA?
profound insulin deficiency
98
hyperglycemia, ketosis, acidosis & dehydration are characteristics of what acute complication of diabetes?
Diabetic Ketoacidosis
99
DKA often precipitated by:
illness or infection and insufficient insulin
100
3 main clinical features of DKA:
hyperglycemia, Dehydration & electrolyte loss, insulin deficiency
101
S/Sx of DKA:
3 P's, dehydration, poor skin turgor, lethargy & weakness, kussmaul respirations, sweet fruity odor, n&v
102
priority for Tx of DKA:
correct fluid/electrolyte imbalance
103
What is HHS?
hyperosmolar hyperglycemic syndrome. Extremely high blood sugar, minimal or absent ketosis
104
Hypoglycemia =
BS <70
105
S/Sx of hypoglycemia:
confusion, irritability, diaphoresis, tremors, hunger, slurred speech, weakness, visual disturbances
106
3 main types of macrovascular disease:
CAD, CV, PVD
107
Common S/sx of neuropathy
numbness in hands and feet
108
Sensory neuropathy effects:
peripheral nerves

Nursing 102 (9 decks)

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