Final: Endo/DM Flashcards
A1C:
Glycated hemoglobin- serum test used to diagnose diabetes and assess blood glucose control over last three-months.
Glycogenesis:
Process of glycogen formation, storing excess glucose
GlucoNEOgenesis:
Amino acids and fats are converted into glucose. Fats are mobilized from stored adipose tissue and broken down into fatty acids and glycerol. The glycerol is used in gluconeogenesis but the fatty acids are not and accumulate in the bloodstream- these are converted into three substances called: ketones
GlycoGENolysis:
Breakdown of body’s stored glycogen to yield glucose. This important process occurs when the body does not have enough circulating glucose from carbohydrate ingestion.
Hyperglycemia:
Elevated blood glucose levels
Hyperinsulinism:
Excess insulin secretion by the pancreatic cells (beta cells)
Hyperinsulinemia
Increased insulin in the blood
Ketonuria:
Urine with ketones
Polyphagia:
Increased appetite and eating
Glucagon:
Stimulates hepatic glycogen breakdown and hepatic gluconeogenesis
Retinopathy:
Retinal hemorrhages, exudates, blindness
Peripheral neuropathy:
Loss of sensation in feet = damage to endoneurial arterial circulation that deceased blood flow to nerves particularly sensory nerves in lower extremities
Negative feedback:
When a function, value, or hormone level in the body changes and the body releases a hormone to reverse the change. Most physiological control is through negative feedback
Positive feedback:
A cycle where a stimulus or hormone produces more of the same response. The most common example of this is in pregnancy with birth and the release of oxytocin to help with uterine contractions. The body continues to release more oxytocin to make contractions stronger.
Upregulation:
An increase in the number of receptors and their sensitivity. The most common reason for upregulation is a reduction in the receptor stimulation by hormones
Downregulation:
A process where prolonged, excessive stimulation of an endocrine gland often results in receptor insensitivity and may decrease its number of receptors
Hypofunction:
Of an endocrine gland occurs when there is an inadequate amount of hormone secreted by the gland
Hyperfunction:
Of an endocrine gland occurs when there is an excessive amount of hormone secreted by the gland
Primary disorder:
Dysfunction caused by the endocrine gland itself
Secondary disorder:
Dysfunction caused by abnormal pituitary activity
Tertiary disorder:
Dysfunction caused by a hypothalamic origin
Thyroxine:
Regulator of body metabolism that influences almost every body system
Goiter:
Enlargement of the thyroid gland with or without thyroid dysfunction. Excess pituitary TSH can stimulate the enlargement of the thyroid gland and cause goiter formation. Low iodine levels cause low thyroid hormone manufactured which the pituitary senses and then attempts to compensate by increasing TSH which incites goiter formation.
Myxedema:
Non-pitting boggy edema around eyes hands, hands, and feet. Tongue and mucous membranes thicken can cause slurred speech due to the accumulation of mucopolysaccharid compound in tissues
Exophthalmos:
Hypertrophy of the eye related to increase connective tissue (bulging of the eye)
Graves dermopathy (pretibial myxedema):
Subcutaneous swelling of the anterior portions of legs, red indurated skin
Type 1 DM
autoimmune, T cells attack beta cells that make insulin
3 P’s: polyuria, polydipsia, polyphagia
hypoglycemia from insulin overdose or activity (inc demand for glucose)
Type 2 DM
insulin resistance -> ramps up production and eventually cannot compensate and is too low on insulin (later in disease process)
hyperinsulinism -> cells are resistant to insulin and high amount of insulin in blood
Metabolic syndrome
Hyperglycemia
Abdominal obesity
Hypertension
High Triglycerides
High LDL
Low HDL
DKA
body lacks the insulin to bring glucose into cells, so turns to fat metabolism instead -> ketones
dehydrated, Kussmauls, fruity breath, hyperglycemia s/s
glucose >250, ketonuria, ABG - pH <7.30, electrolyte imbalances (hypokalemia or false hyperkalemia)
T1DM
HHS
Similar signs to DKA (3 Ps) without ketones and with neuro (seizures, coma, hemiparesis)
glucose >600
T2DM
Gigantism
Secondary disorder of the anterior pituitary - hyperpituitarianism -> GH
disease of children, long bones
Acromegaly
Secondary disorder of the anterior pituitary - hyperpituitarianism -> GH
disease of adults, short bones (hands, feet, jaw)
pituitary adenoma
Grave’s
Primary disorder of the thyroid gland
hyperthyroidism - “speeds up” increased SNS response, weight loss, feeling warm, anxiety, tremor, exopthalmos, a fib
decreased TSH, increased T3/4 (overstimulates thyroid cells)
concern for “thyroid storm” - HF, pulm edema, tachy, dysrhythmia
Hashimoto’s
Primary disorder of the thyroid gland
hypothyroidism - “slows down” decreased SNS response, weight gain, feeling cold, sluggish, constipation, lethargy
increased TSH, decreased T3/4 (presence of antithyroid antibodies -> destroys thyroid cells)
concern for myxedema coma
Addison’s
Primary disorder of the adrenal gland
adrenal insufficiency, autoimmune (destroy adrenal cortical cells)
low cortisol and high ACTH -> “tanned appearance” and hypoglycemia
low aldosterone -> hyponatremic and hyperkalemic
Cushing’s Syndrome
hypercortisolism (any kind)
central obesity, dowager’s hump, HTN, striae, weakness, purpura, osteoporosis
secondary = Cushing’s disease
primary = adrenal tumor
ectopic = lung cancer paraneoplastic
iatrogenic = long-term glucocorticosteroids
Cushing’s Syndrome vs Disease
Syndrome = any kind of hypercortisolism
Disease - secondary from pituitary (adenoma ex)
SIADH
Secondary disorder (?) of the kidney
high ADH, low Na+ -> retain fluids and decreased UOP, dilutional hyponatremia
increased urine osmolarity (concentrated)
decreased serum osmolarity (diluted)
Diabetes Insipidus
Secondary disorder (?) of the kidney
can be central or nephrogenic
low ADH, high Na+ -> constant diuresis/polyuria (increased UOP), dehydrated, hypernatremic
decreased urine osmolarity (diluted)
increased serum osmolarity (concentrated)
