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2.5 > Glucose/Hormonal Reg > Flashcards

Glucose/Hormonal Reg Flashcards

1
Q

Acromegaly

A

Too much growth hormone causes gigantism.

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2
Q

Autocrine vs endocrine vs paracrine action

A

Autocrine: cell targets itself. Signal binds to its own receptors.
Paracrine: cell targets a nearby cell.
Endocrine: cells releases signals into the bloodstream.

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3
Q

Neuroendocrine action

A

The hypothalamus signals neuroendocrine cells to release hormones into the bloodstream.

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4
Q

Euglycemia

A

Normal blood glucose

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5
Q

Cortisol

A

Primary stress hormone - increases glucose in the blood (is a glucocorticoid)

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6
Q

Glucocorticoids

A

Increases blood glucose & liver glycogen!
Steroids hormones (also called corticosteroids) produced by adrenal cortex. (Also lowers inflammation and immune response)
Includes cortisol

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7
Q

Negative feedback

A

Reduces the change to bring the system back to baseline. Insulin brings the blood glucose back to baseline after a meal.

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8
Q

What hormone does the kidney make?

A

Erythropoietin, which signals the bone marrow to make RBCs

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9
Q

What produces cytokines and what do they do?

A

WBCs
Signaling proteins that fight inflammation (tells immune cells what do to)

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10
Q

What type of hormones does the hypothalamus produce?

A

Releasing hormones (1st step, like TRH (TSH is then produced by the pituitary)).

Inhibiting hormones.

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11
Q

What does the anterior pituitary regulate?

A

Growth (GH) and Metabolism (TSH)

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12
Q

What does the thyroid (and anterior pituitary) regulate?

A

Metabolism!

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13
Q

What does the Adrenal Cortex regulate?

A

Salt
Sugar
Sex
Steroids

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14
Q

What does the adrenal medulla regulate?

A

BP (fight or flight)
Epinephrine, Norepinephrine, dopamine

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15
Q

How are peptides & proteins transported and why?
What about all other hormones?

A

Peptides/proteins - freely circulate bc they’re water soluable
Anything else (steroids/thyroid) - need transport carriers bc they’re lipid soluable.

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16
Q

Hormone problems: are autoimmune conditions modifiable?

A

No (genetic)

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17
Q

Hormone problems: is hormone therapy modifiable?

A

Yes

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18
Q

Hypothyroidism: will TSH, T3, and T4 be low or high?

A

TSH high
T3/T4 low

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19
Q

What hormones does a 24hr urine test measure?

A

Catecholamines (epi, norepi, dopamine)

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20
Q

What does a stimulation/suppression test confirm?

A

Stimulation: confirms hypofunction
suppression: confirms hyperfunction

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21
Q

Hormone problem: why would you do a radiological scan?

A

To look for a tumor that is suppressing or stimulating the gland.

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22
Q

What is exopthalmos, and what is it a symptom of?

A

Eye bulging. Hyperthyroidism

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23
Q

Symptoms of hypothyroidism

24
Q

Symptoms of hyperthyroidism

25
Hypothyroidism: What are infants especially at risk for?
Cold stress & hypoglycemia (use all of their glucose to warm up)
26
Interventions for hypothyroidism
Airway, slow breathing Cardiac monitor Falls risk Keep warm Lifelong meds hormone replacement
27
Interventions for hyperthyroidism
Airway (goiter w/resp. distress) Cardiac monitor Keep cold Thyroid Storm!!
28
What is symptoms of a thyroid storm?
Life-threatening Hyperpryexia (>101.3) Extreme tachycardia (>130) Exaggerated symp (weight loss, diarrhea, chest pain)
29
What does the posterior pituitary and the adrenal medulla regulate together? With what hormones?
BP Posterior pituitary- ADH/vasopressin Adrenal medulla- epi, norepi
30
Symptoms of impaired adrenal cortex & Nurse interventions
Low sugar - hypoglycemia Low salt - low perfusion/BP
31
Symptoms of overactive adrenal cortex & Nurse interventions
High Sugar- hyperglycemia High Salt- fluid overload/high BP +weight gain in abdomen and back High Sex High steroids- lowers inflammation and immune response
32
When is a lab/test is treatment, not screening?
When we already know what the problem is.
33
What are symptoms of suppressed posterior pituitary and adrenal medulla?
Low BP/perfusion!
34
What are symptoms of overactive posterior pituitary and adrenal medulla?
High BP/perfusion!!
35
Function of pancreas & liver in glucose regulation
Pancreas: makes insulin & glucagon. Liver: stores glucose as glycogen and releases it between meals. Can make own glucose through glyconeogenesis.
36
Insulin
Insulin must send glucose into the cells for the cells to be able to use it. Only hormone that lowers blood glucose. Promotes storage of glucose & fat.
37
When does blood glucose return to normal after a meal?
2 hrs
38
Glycogenolysis
Liver breaks down glycogen to release glucose. Triggered by glucagon hormone
39
Gluconeogenesis
Liver synthesizes its own glucose from muscle (aminos/lactic acid). Not optimal bc it weakens muscle & increases acidity. Occurs in starvation
40
Glucagon
Pancreatic hormone that tells the liver to release stored glucose. Increases blood glucose when it is low/between meals. Increases during exercise to feed body.
41
What lab is used to test for gestational diabetes (10% of women)?
Oral glucose tolerance test (Oral instead of the various blood tests)
42
Hemoglobin A1c lab
Looks at the % of glucose on the surface of RBCs. Measures avg blood sugar over the past 3 mo. Used for chronic management. >6.5 = diabetes (hyperglycemia)
43
What does high urine ketones indicate?
Hyperglycemia (like diabetic keto acidosis, where instead liver will break down fat for energy, producing ketones).
44
Hypoglycemia: adrenergic symptoms
Cold Sweating/clammy Tremor Hunger Tachycardia Palpitations Nervous
45
Hypoglycemia: CNS symptoms
ALOC + headache & double vision
46
Hyperglycemia symptoms
Polyuria (glucose pulls fluid out of cells) Polydispia - extremely thirsty Polyphagia - extremely hungry No glucose in cells: Weight loss Fatigue Infection/can’t heal Blurred vision (sugar in eye vessels)
47
Glucose: infant considerations & those most at risk
High risk for hypoglycemia: esp. if cold, they don’t have glucose stores. Use a heal stick, not finger stick. Risk: preterm/weak, sick, cold Mother has diabetes! (Infant use to lots of glucose so they have high insulin levels at birth)
48
What to do for hypoglycemia?
1st - check blood glucose Give glucose/carbs (oral, subq, IM, IV) Don’t give orally if ALOC! Fall precautions
49
What to do for hyperglycemia?
1st - check blood glucose Give insulin (mostly for diabetes, if it happens once you cab just wait)
50
What are Sick Day Rules?
Sick = high cortisol = high blood sugar. Check BG every 4hrs minimum! Still take meds
51
What is thyroxine and triiodothyronine?
T4 T3 The two main thyroid hormones.
52
Calcitonin
Thyroid hormone that lowers calcium in the blood (opposes parathyroid hormone).
53
What is the prioritization order for this whole block?
1st acute vs chronic 2nd ABCDE (notes)
54
What effect does overactive adrenal cortex have on immune function and why?
Have increase in steroids (glucocorticoids raise blood sugar) which lower inflammation = poor wound healing, high risk of infection.
55
Best way to prevent hypoglycemia in an infant?
Keep them warm
56
Hemoglobin A1c lab: what number indicates diabetes?
>6.5

2.5 (5 decks)

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