ENDOCRINE: TO KNOW Flashcards
normal serum osmolality
275-295
normal urine spec gravity
People who are well-hydrated will have a lower specific gravity (around 1.005). People who are dehydrated will have a higher specific gravity (around 1.030
Normal is 1.010
purpose of hypertonic fluids
pull fluid into vasculature from cells. can help cerebral edema and replace serum sodium
length of action of metformin
half life: 6 hours. 90% excreted by 24hours
rapid insulin OOA, Peak, and DOA
OOA: 5-15 mins
Peak: 1-3 hours
DOA: 4-6 hours
regular insulin OOA, Peak, and DOA
OOA: 30-60 mins
Peak: 1-3 hours
DOA: 6-8 hours
normal HbA1C:
> what is considered prediabetic?
> what is severe
normal: 4.0 -5.6%
> 5.6 is prediabetic
> 7 is bad
K has to be at what point to even start an insulin gtt?
3.8 or higher.
Lab findings in DKA
K, Na, Ca, HCO3, pH
K: high
Na: low (dilution of na by glucose)
Ca: low
HCO3: Low
pH: LOW, met acidosis
Normal anion gap:
< 11-12
when is bicarb replacement indicated in DKA?
when is phosphate replacement indicated in DKA?
only if serum bicarb is less than 6.9, otherwise pH will self correct.
only if PO4 less than 1.0
what does having an anion gap mean?
At what anion gap level do we consider someone to be in metabolic acidosis?
MEANS YOU HAVE A METABOLIC ACIDOSIS
> 12 = metabolic acidosis
What is the goal for dropping glucose each hour in DKA/HHS?
No more than 50-100 mg/dL an hour or 15% of hourly glucose.
2 characteristics of HHS
profound hypovolemia
AMS
main complication of SIADH
SEVERE DILUTIONAL HYPONATREMIA which can cause cerebral edema and seizures. Seizure and fall precautions
how quickly should we correct sodium?
6-8 meQ / day
main cause of hypothyroidism
hashimotos thyroiditis, which is an autoimmune inflammation of the thyroid gland
treatment for hyperthyroidism
anti thyroid drugs (PTU and methimazole)
propanolol (blocks conversion of t4 to t3)
thyroidectomy ( for goiter or tumor)
K, Na, and Ca in DKA
bruh just know this ok
Why is sodium the way it is?
K: ELEVATED. MET ACIDOSIS CAUSES K TO SHIFT OUT OF THE CELL
Na: LOW
Ca: LOW
Na low because hyperglycemia has a dilutional effect on sodium. Water shifts from ICF to ECF d/t osmotic pressure glucose causes
lab findings in HHS
pH: normal or mild acidosis
Na: high. d/t severe dehydration
K: low
Mag: low
phos: low
H/H: high d/t hemoconcentration from dehydration
Urine glucose: highhhhhh
what is ADH?
what does it do?
where is it released from and WHY?
ADH is vasopressin
ADH controls water balance in body. ADH increases water reabsorption in kidneys. Kidneys hold onto water.
released from posterior pituitary in response to low blood pressure and/or increased plasma osmolality
