endoncrine patho Flashcards
type 1 DM is related to destruction of the pancreas alpha cells that produce insulin
False –> it is the beta cells that secrete insulin
what do alpha cells secrete?
glucagon, which makes the liver release glucose into the blood
what does insulin do?
fat cells take in glucose from the blood .. transporter
fatigue or weakness in hyperglycemia is caused by the lack of glucose going into body cells?
true
who has the highest risk for Type 2 DM
A) an obese 12 yr old with normal labs
B) a thin 35 yr old with high HDL level
C) an overweight 55 r old male with HTN and high LDL
overweight 55yr olf with HTN and high LDL
a client with diabetes mellitus arrives at the hospital with a blood glucose level of 639 mg/dl. What assessment data would suggest type 2 diabetes mellitus rather than than 1?
negative for ketones in the urine
a person with type 1 diabetes is experiencing sweating tremors and just feeling uncoordinated. The cause may be:
Hypoglycemia from too much insulin
Hypoglycemia from increased activity
both a and b
both a and b
when you exercise, do you need more or less insulin?
less insulin , because the insulin is having more of an effect
a patient with a history of long term well controlled DM may have
_____ due to macrovascular
_____ due to microvascular
cardio and peripheral vascular disease due to macrovascular complications
nephropathy and retinopathy due to microvascular issues
where does a primary disorder originate from?
the endocrine gland
where does a secondary disorder originate from?
the pituitary
where does a tertiary disorder originate from?
the hypothalamus
Graves disease (primary hyperthyroidism)
TRH:
TSH
TH (T3/(T4)
TRH: decrease
TSH: Decrease
TH (T3/T4): increased
Pituitary Adenoma (secondary hyperthyroidism)
TRH
TSH
TH (T3/T4)
dont worry about TRH
TSH: increased
TH (T3/T4): increased
Hypothyroidism (primary)
TRH
TSH
TH
TRH: incrased
TSH: incraeased
TH (T3/T4) : decreased
Hypothyroidism lesion on hypothalamus (tertiary)
TRH: decreased
TSH: decreased
TH (T3/T4) : decreased
Hypothyroidism lesion on the pituitary (secondary)
TRH: normal or increased
TSH: decreased
TH (t3/T4) : decreased
Which resident of a long-term facility might likely have Hashimotos Disease?
A) an 80yr old woman who has been uncharacteristically gaining weight, feeling cold, and increased in TSH
A) an 80yr old woman who has been uncharacteristically gaining weight, feeling cold, and increased in TSH
a pt with hypothyroidism admitted indicated she is “freezing”: BP is 80/45. What condition might she be experiencing?
A) thyrotoxic crisis
B) Myxedema Coma
B) Myxedema Coma
life threatening end stage expression of hypothyroidism
manifestations are: Coma, hypothermia, cardiovascular collapse, hypoventilation, hyponatremia, lactic acidosis, risk for SIADH
more frequent in winter months
What is the most common cause of Hyperthyroidism?
graves disease– autoimmune stimulation of the thyroid gland by thyroid stimulating immunoglobulins
low TSH, high T3/T4
a pt with bronzed skin, weakness, hypotension, and fatigue has labs checked and shows hyponatremia, hyperkalemia, hypoglycemia, and elevated ACTH
What might his condition be and why are the lab values the way they are?
elevated ACTH: when you have too low cortisol, the pituitary puts out more ACTH, which causes melanocytes to produce more melanin
elevated ACTH causes melanocytes to produce more
hyperkalemia –> more aldosterone
hypoglycemia –> more aldosterone
Whats the difference between Cushings Syndrome and Cushings Disease?
Syndrome: anything that causes too much cortisol in the body
Disease: is the pituitary caused form of Cushings Syndrome (excessive ACTH production due to pituitary tumor)
HPA axis
hypothalamus puts our CRH –>
Anterior Pituitary puts our ACTH –>
Adrenal Cortex puts out cortisol –> neg feedback
what is the difference between Gigantism and Acromegaly?
both are increased growth hormone
in children giganstism is the overgrowth of long bones due to increased activity of the epiphyseal plates
in adults there ___—-??
T/F: Hypopituitarism can result in low thyroid, growth hormone, antidiuretic and cortisol levels
true
