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Nursing 102 > Endocrine System Test 1 > Flashcards

Endocrine System Test 1 Flashcards

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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
Q

Where is insulin produced?

A

Beta cells in the islets of langerhans

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26
Q

What do alpha cells secrete?

A

glucagon

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27
Q

What do beta cells secrete?

A

insulin

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28
Q

What maintains normal blood glucose level in a healthy body?

A

insulin & glucose ratio

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29
Q

normal glucose range =

A

70-120 mg/dl

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30
Q

Is the pancreas an exocrine or endocrine gland?

A

trick question- both!

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31
Q

Exocrine function of the pancreas (duct)-

A

secretes digestive enzymes into the duodenum

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32
Q

Endocrine function of the pancreas-

A

hormone secretion by the islet of langerhans (alpha cells-glucagon, beta cells-insulin)

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33
Q

What leads to high blood glucose in type 1 diabetics?

A

absence of insulin prevents entrance of glucose into cells

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34
Q

What are insulin-dependent tissues?

A

Cells with insulin receptor sites: skeletal muscle & adipose tissue

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35
Q

Insulin secretion is promoted by icreased:

A

blood glucose levels, amino acids, vagal stimulation and GI hormones

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36
Q

“Lock and Key” theory=

A

insulin unlocks the cells door to allow glucose to enter

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37
Q

What is the storage form of glucose in the liver?

A

glycogen

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38
Q

what is gluconeogenesis?

A

breakdown of stored glucose (glycogen)

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39
Q

Without insulin the body breaks down ___ & ____ for energy.

A

body fat & protein (lipolysis)

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40
Q

What are 3 main symptoms of hyperglycemia?

A

3 P’s- Polyuria, Polydipsia and Polyphagia

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41
Q

What is lipolysis?

A

breakdown of stored fats and protein for back up energy source

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42
Q

With insulin deficiency:

  1. Fats break down and release _____.
  2. Free fatty acids convert to _____.
  3. Ketones accumulate in the blood and cause _____.
A
  1. Free fatty acids (FFA’s)
  2. ketone bodies
  3. metabolic acidosis
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43
Q

Signs and Symptoms of metabolic acidosis:

A

dehydration, hypovolemia, hyperviscosity of blood, hypoxia, kussmaul breathing.

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44
Q

Insulin absence causes hypokalemia or hyperkalemia?

A

Hypokalemia- Potassium deficiency bc of excessive K+ excreted in urine

45
Q

Life threatening side effect of hypokalemia:

A

cardiac arrhythmias

46
Q

Insulin inhibits ____ (the breakdown of stored glucose in liver)

A

glycogenesis

47
Q

new glucose from the break down of amino acids is called?

A

gluconeogenesis

48
Q

Examples of counteregulatory hormones that oppose the effecs of insulin & increase blood glucose levels: (4)

A

Glucagon, epinephrine, growth hormone, cortisol

49
Q

How do counterregulatory hormones maintain normal blood glucose?

A

by providing regulated release of glucose for energy

50
Q

What is the primary fuel for the CNS?

A

glucose

51
Q

Storage form of glucose and fatty acids?

A

glycogen

52
Q

where is glycogen stored?

A

in the liver and muscles

53
Q

_____ prevents the break down of adipose tissue to _____.

A

Insulin; fatty acids

54
Q

When blood sugar is persistently high blood becomes _____

A

viscous

55
Q

Decreased circluation hinders the bodies ability to _____ & _____.

A

fight infection; heal

56
Q

What is the renal threshold?

A

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
Q

what is urine with sugar in it called?

A

glucosuria

58
Q

excess glucose excreted in the urine along with fluids & electrolytes:

A

osmotic diuresis

59
Q

What is type 1 diabetes characterized by?

A

insulin deficiency

60
Q

Patho of DM 1: progressive destruction of pancreatic _____ cells.

A

beta

61
Q

Symptoms of DM 1 occur when the pancreas no longer produces any _____

A

insulin

62
Q

Describe the “honeymoon period”

A

Euglycemia after initial diagnosis, very little insulin needed, usually lasts 3-12 months

63
Q

What criteria is used to diagnose prediabetes?

A

Fasting glucose: >100 but <126

2-hour plasma glucose: between 140 & 199

64
Q

The onset of diabetes and cv risks can be delayed or prevented by _____ & _____

A

weight loss & exercise

65
Q

Which is the most frequently occurring type of diabetes?

A

Type 2 diabetes

66
Q

What is the most powerful risk factor for type 2 diabetes?

A

obesisty

67
Q

Clinical manifestations of type 1 diabetes:

A

Polyuria polydipsia and polyphasia

Weight loss, weakness & fatigue, ketoacidosis

68
Q

Clinical manifestations type 2 diabetes:

A

Fatigue, recurrent infections, prolonged wound healing, visual changes
-may also have classic symptoms of type 1

69
Q

3 tests used to Dx diabetes:

A
  1. Fasting plasma glucose level >126
  2. Casual plasma glucose measurement >200 + SYMTPOMS (CPCG)
  3. Two-hour OGTT >200
70
Q

What does an A1c test measure?

A

Glycosylated hemoglobin. shows amt of glucose attached to hgb molecules over RBC life time (90-120 days)

71
Q

what is a goal A1c?

A

<7%

72
Q

What test is used to measure whether a type 2 diabetic patient will need exogenous insulin?

A

C-Peptide Marker

73
Q

somogyi effect:

A

rebound effect caused by counterregulatory hormone release. Morning hyperglycemia in response to nighttime hypoglycemia.

74
Q

Somogyi effect Tx:

A

decrease insulin or add a late night snack

75
Q

somogyi effect symptoms:

A

HA, nightmares, night sweats

76
Q

Dawn phenomenon:

A

Hyperglycemia on awakening in the am, usually normal until about 3 am, caused by release of growth hormone (cortisol)

77
Q

Dawn phenomenon Tx:

A

increase insulin or adjust dosage

78
Q

What are sulfonylureas?

A

oral agents that stimulate beta cells to produce more insulin in pancreas (ex. glipizide, glimepiride)

79
Q

Adverse reactions of sulfonyureas?

A

hypoglycemia, increase in CV events, phototoxicity and weight gain

80
Q

What are meglinitides?

A

oral agents that can be taken from 30 min before up until a meal to increase insulin production by pancreas

81
Q

Rapid acting:

A

onset-15, peak-1, duration 2-4

82
Q

Short acting:

A

onset-30, peak 2-4, 6-10

83
Q

intermediate:

A

onset- 1-2, peak 4-8, duration 10-20

84
Q

long acting

A

onset 1-2, peak- NONE, duration 24 hours

85
Q

Side effects meglinitides:

A

wt gain, hypoglycemia

86
Q

biguanides:

A

reduce glucose production in the liver with out hypoglycemia s/e’s. Do not promote weight gain!!

87
Q

when must you hold biguanides?

A

48 hours prior to anything with IV dyes (CT’s and MRI’s)

88
Q

Glucosidase inhibitors:

A

Taken with first bite of main meal to lower post prandial blood glucose: slow down absorption of carbs in small intestine.

89
Q

Which oral agent is most effective for insulin resistant patients?

A

Thiazolidinediones

90
Q

What is the cornerstone of care for the diabetic?

A

nutritional therapy!

91
Q

_____ of meal is as important as amount of food eaten

A

time

92
Q

What percentage of total food intake should be carbs and monounsaturated fats?

A

45-65%

93
Q

What percentage of diet should be fats?

A

no more than 25-30%

94
Q

What % should be protein?

A

<10%

95
Q

What is the #1 predictor of type 2 diabetes?

A

obesity

96
Q

what are ketones?

A

by product of breakdown of fatty acids

97
Q

What causes DKA?

A

profound insulin deficiency

98
Q

hyperglycemia, ketosis, acidosis & dehydration are characteristics of what acute complication of diabetes?

A

Diabetic Ketoacidosis

99
Q

DKA often precipitated by:

A

illness or infection and insufficient insulin

100
Q

3 main clinical features of DKA:

A

hyperglycemia, Dehydration & electrolyte loss, insulin deficiency

101
Q

S/Sx of DKA:

A

3 P’s, dehydration, poor skin turgor, lethargy & weakness, kussmaul respirations, sweet fruity odor, n&v

102
Q

priority for Tx of DKA:

A

correct fluid/electrolyte imbalance

103
Q

What is HHS?

A

hyperosmolar hyperglycemic syndrome. Extremely high blood sugar, minimal or absent ketosis

104
Q

Hypoglycemia =

A

BS <70

105
Q

S/Sx of hypoglycemia:

A

confusion, irritability, diaphoresis, tremors, hunger, slurred speech, weakness, visual disturbances

106
Q

3 main types of macrovascular disease:

A

CAD, CV, PVD

107
Q

Common S/sx of neuropathy

A

numbness in hands and feet

108
Q

Sensory neuropathy effects:

A

peripheral nerves

Nursing 102 (9 decks)

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