endocrine, urinary, etc. Flashcards
what are the 5 signs of metabolic syndrome?
WE IG HHT
- waist circumference, >40 inches for men or >35 for women
- Triglycerides 150 mg/dL or higher
- HDL < 40 mg/dL in men or < 50 in women (this is the good cholesterol so less is bad)
- BP 130 and/or diastolic 85 or higher
- fasting plasma glucose >100 mg/dL
3 or more need to be present for dx or metabolic syndrome
thyroid hormones produce hormones that…
control the rate at which cells burn the fuel from blood (metabolism)
the parathyroid gland regulates…
calcium and phosphate metabolism
the adrenal gland produces corticosteroids that…
regulate water and sodium balance, the body’s response to stress, the immune system, and metabolism
What are the characteristics of Addison’s disease?
Mrs. Addison (old brown lady)
-adrenal insufficiency (decreased cortisol and aldosterone)
-decreased BP, dehydration (water is out)
-hyperkalemia (potassium)
-decreased glucose
-weigh loss
-generalized weakness
-cold intolerance
-stress, anx, depression
-bronze pigmented skin (MSH)
what are the 2 things aldosterone does?
- retain Na+ and water
- kick out K+
what are the 4 things cortisol does?
- regulates BP
- regulates stress
- decreases inflammation
- glucose formation
Describe the characteristics of Cushing’s?
Mr. Cushing is a big white chubby guy who has a beer belly
- increased ACTH
- elevated cortisol and aldosterone
- increased BP and water retention
- increased glucose
- hypokalemia
- Ruddy appearance
- weight gain, centripetal obesity
- proximal muscle weakness
- increased susceptibility to infection, poor wound healing
distinguish between Cushing’s disease and Cushing’s syndrome?
disease: issue with the pituitary gland (secreting too much ACTH, stimulating adrenal gland and more cortisol released)
syndrome: adrenal gland tumor with secretes more cortisol, or too much corticosteroids
describe the characteristics of hyperthyroidism
think of David
-increased T3 and T4, low TSH
-increased HR
-heat intolerance
-diarrhea
-hyperreflexia
-Grave’s disease (thyroid storm)
-restlessness
-increased glucose absorption
-sweaty
describe the characteristics of hypothyroidism
think of a lazy person on a couch
-decreased T3 and T4, high TSH (keeps secreting so you have less T3 and T4)
-decreased HR
-increased BP
-cold intolerance (need a blanket on the couch)
-decreased glucose absorption, so higher blood glucose
-constipation
-sleepy, tired, proximal muscle weakness
-dry hair and skin
-weight gain and decreased appetite
-decreased perspiration
-prolonged DTR
-Hashimotos (autoimmune, decreased thyroid)
parathyroid has a direct relation to ____ and an inverse relation to ________
calcium, phosphate
what will you see with hyperparathyroidism?
increased Ca+
decreased serum phosphate
(this can demineralize bone which causes bone weakness and decreased density)
symtoms are osteopenia, gout, kidney stones, peptic ulcers, proximal muscle weakness, glove and stocking sensory loss, fatigue etc
what will you see in hypoparathyroidism?
low calcium and high phosphorous
sx: Convulsions, cardiac Arrhythmias, muscle twitching, Tetany, muscle cramps and Spasms, paresthesia of fingertips and mouth, fatigue, weakness
CATS are NUMB
Type 1 DM is when….
pancreas does not produce insulin, insulin dependent DM
sx of DM1
PPP: polyphagia, polyuria, polydipsia (increased hunger, peeing, and thirst
weight loss, dehydration, blurred vision, ketoacidosis (fat is fuel instead of sugar)
at risk of diabetic ketoacidosis (fruity odor )
DM2 is also known as insulin ________ DM
resistant
is ketoacidosis common in DM2?
no it’s rare
what are the three values that dx DM?
- Fasting blood glucose level is >126
- random blood glucose level: >200
- HbA1C: 4-6%, over 10 means immediate insulin therapy
what are the early and late signs of hypoglycemia? glucose is <70?
early: pallor, sweating, shakiness, poor coordination/unsteady gait, tachy, dizziness, excessive hunger
late: slurred speech, drowsiness, confusion, LOC or coma
cold and clammy give me a candy
what are the early and late signs of hyperglycemia? glucose is >300?
early: weakness, dry mouth, frequent/scant urine, deep and rapid respirations, dull senses, confusion, diminished reflexes, excessive thirst
late: fruity odor of breath (ketoacidosis), hyperglycemic coma
**hot and dry sugar high (give insulin)
when should I exercise a pt with DM1?
early morning
why? to avoid hypoglycemia resulting from fluctuations in insulin activity. insulin sensitivity increases with exercise, tissue absorbs insulin, glucose decreases
when should I avoid exercising a pt with DM?
at peak insulin hours (2-4 hours)
example: insulin at 9AM, avoid exercising 11-1PM
what is a safe blood glucose range to exercise in?
101-250.
if blood glucose is <70 or >300, should my pt exercise?
no
if blood glucose is 250-300, can I exercise?
yes but proceed with caution if no DKA
if blood glucose is 70-100 before exercise, what should I do?
give pt a carb snack and wait 15 min then recheck
how can I take care of my diabetic feet?
don’t soak them
no moisturizer between toes
buy shoes in afternoon (swelling)
check for cuts regularly
soft shoes
white socks
alternate between laces and velcro
if your patient with DM2 suddenly gets lightheaded and dizzy working on the treadmill, what should you do?
give them a sugary name
cold and clammy give me a candy
what kind of incontinence is d/t exertion (coughing, sneezing, exercising..)
stress
can be seen postpartum d/t pelvic floor muscle weakness
what kind of incontinence involves a strong desire to void, commonly seen with infections or UMN lesions?
urge
what kind of incontinence is caused by an acontractile or underactive detrusor muscle, urine will typically dribble out?
overflow
what kind of incontinence is d.t mobility/dexterity/cognitive deficits? Can be seen with dementia?
functional
example: can’t unbutton pants fast enough and then pees
**can be seen in late parkinson’s
how would I treat stress incontinence?
strengthen pelvic floor muscles
how would I treat urge incontinence?
treat infection, create a voiding schedule
how would I treat functional incontinence?
improve accessibility, clear clutter from bathroom, prompted/cued voiding
how would I treat overflow incontinence?
double voiding, medication, catheterization
what type of incontinence is seen with DM?
overflow
