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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

A
24
Q

Symptoms of hyperthyroidism

A
25
Q

Hypothyroidism: What are infants especially at risk for?

A

Cold stress & hypoglycemia (use all of their glucose to warm up)

26
Q

Interventions for hypothyroidism

A

Airway, slow breathing
Cardiac monitor
Falls risk
Keep warm
Lifelong meds hormone replacement

27
Q

Interventions for hyperthyroidism

A

Airway (goiter w/resp. distress)
Cardiac monitor
Keep cold
Thyroid Storm!!

28
Q

What is symptoms of a thyroid storm?

A

Life-threatening

Hyperpryexia (>101.3)
Extreme tachycardia (>130)
Exaggerated symp (weight loss, diarrhea, chest pain)

29
Q

What does the posterior pituitary and the adrenal medulla regulate together? With what hormones?

A

BP
Posterior pituitary- ADH/vasopressin
Adrenal medulla- epi, norepi

30
Q

Symptoms of impaired adrenal cortex &
Nurse interventions

A

Low sugar - hypoglycemia
Low salt - low perfusion/BP

31
Q

Symptoms of overactive adrenal cortex &
Nurse interventions

A

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
Q

When is a lab/test is treatment, not screening?

A

When we already know what the problem is.

33
Q

What are symptoms of suppressed posterior pituitary and adrenal medulla?

A

Low BP/perfusion!

34
Q

What are symptoms of overactive posterior pituitary and adrenal medulla?

A

High BP/perfusion!!

35
Q

Function of pancreas & liver in glucose regulation

A

Pancreas: makes insulin & glucagon. Liver: stores glucose as glycogen and releases it between meals. Can make own glucose through glyconeogenesis.

36
Q

Insulin

A

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
Q

When does blood glucose return to normal after a meal?

A

2 hrs

38
Q

Glycogenolysis

A

Liver breaks down glycogen to release glucose.
Triggered by glucagon hormone

39
Q

Gluconeogenesis

A

Liver synthesizes its own glucose from muscle (aminos/lactic acid). Not optimal bc it weakens muscle & increases acidity. Occurs in starvation

40
Q

Glucagon

A

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
Q

What lab is used to test for gestational diabetes (10% of women)?

A

Oral glucose tolerance test
(Oral instead of the various blood tests)

42
Q

Hemoglobin A1c lab

A

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
Q

What does high urine ketones indicate?

A

Hyperglycemia
(like diabetic keto acidosis, where instead liver will break down fat for energy, producing ketones).

44
Q

Hypoglycemia: adrenergic symptoms

A

Cold
Sweating/clammy
Tremor
Hunger
Tachycardia
Palpitations
Nervous

45
Q

Hypoglycemia: CNS symptoms

A

ALOC
+ headache & double vision

46
Q

Hyperglycemia symptoms

A

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
Q

Glucose: infant considerations & those most at risk

A

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
Q

What to do for hypoglycemia?

A

1st - check blood glucose
Give glucose/carbs (oral, subq, IM, IV)
Don’t give orally if ALOC!
Fall precautions

49
Q

What to do for hyperglycemia?

A

1st - check blood glucose
Give insulin (mostly for diabetes, if it happens once you cab just wait)

50
Q

What are Sick Day Rules?

A

Sick = high cortisol = high blood sugar.

Check BG every 4hrs minimum!
Still take meds

51
Q

What is thyroxine and triiodothyronine?

A

T4
T3
The two main thyroid hormones.

52
Q

Calcitonin

A

Thyroid hormone that lowers calcium in the blood (opposes parathyroid hormone).

53
Q

What is the prioritization order for this whole block?

A

1st acute vs chronic
2nd ABCDE (notes)

54
Q

What effect does overactive adrenal cortex have on immune function and why?

A

Have increase in steroids (glucocorticoids raise blood sugar) which lower inflammation = poor wound healing, high risk of infection.

55
Q

Best way to prevent hypoglycemia in an infant?

A

Keep them warm

56
Q

Hemoglobin A1c lab: what number indicates diabetes?

A

> 6.5

2.5 (5 decks)

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