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AH Exam 3 > Hormonal Regulation > Flashcards

Hormonal Regulation Flashcards

1
Q

Where is insulin secreted from?

A

The pancreas

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2
Q

(T/F) Insulin stops glucose creation in the liver

A

True

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3
Q

What does low insulin levels do?

It releases three things

A

Releases glucose from liver
Releases fat from adipose tissue
Releases protein from skeletal muscle

When insulin is secreted, it stops glucose creation from liver, encourages fat storage in adipose, and increases protein synthesis.

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4
Q

Which Diabetes type is a combo of inadequate insulin secretion and insulin resistance?

A

Type 2

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5
Q

Which Diabetes type is autoimmune?

A

Type 1

Insulin making cells in the pancreas (islet cells) are destroyed

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6
Q

Which Diabetes type has fast onset and characterized by the three P’s?

A

Type 1

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7
Q

What are the three P’s of Type 1 Diabetes? Name them and what they mean.

A

Polydipsia: Excessive thirst
Polyphagia: Excessive hunger
Polyuria: Excessive urination

-Phagia suffix means to swallow/eat (ex: Aphagia is the inability (a) to swallow (phagia))
-Dipsia suffix means thirst (ex: polydipsia is excess (poly) thirst (dipsia))

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8
Q

(T/F) Type 1 Diabetes will need outside insulin (exogenous insulin) for life

A

True

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9
Q

(T/F) Type 2 Diabetics can still make their own insulins

A

True

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10
Q

What are other clinical manifestations aside from the 3 P’s for Diabetes?

There are four

A

Weight loss
Weakness
Recurrent infections/Poor healing
Vision problems

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11
Q

What is the gold standard for diabetes diagnosis?

A

A1C of 6.5% or higher

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12
Q

What do we want diabetics A1C to be?

A

Less than 7.0%

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13
Q

(T/F) Biguanides is a non-insulin drug

A

True, only for Type 2 DM

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14
Q

What is the mechanism of action for biguanides?

A

Increase insulin sensitivity, reduce glucose production in the liver

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15
Q

What is a drug in the Biguanides class?

You need to know this, it’s a highlighted drug

Begins with M

A

Metformin

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16
Q

What are the education points for Metformin?

There are two

A

GI side effects
Must be held 48 hrs before and after IV contrast

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17
Q

What do Glucagon-Like Peptide-1 (GLP-1) Receptors Agonists do?

There are three things

It’s a Glucagon AGONIST. what would that do to glucose and by proxy insulin?

A

Increase insulin from pancreas, stop glucagon release, slow gastric emptying

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18
Q

What is a drug in Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists?

Highlighted drug

A

Liraglutide (Victoza)-SQ

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19
Q

What are the Rapid/Immediate-Acting insulin drugs (onset of 10-30 mins-for meals)

There are 3

A

Aspart (NovoLog)
Glulisine (Apidra)
Lispro (Humalog)

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20
Q

What drug is short-acting insulin (onset of 30-60 min-for meals)

There is 1

A

Regular Insulin (Humulin R, Novolin R)

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21
Q

Which drug is intermediate-acting insulin (12-18 hours, potential for hypoglycemia at 4-12 hours)

There is 1

A

NPH (Humulin N, Novolin N)

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22
Q

What are the long-acting insulin drugs (Duration 16-24 hours, no defined peak, low risk of hypoglycemia)

There are three

A

Degludec (Tresiba)
Detemir (Levemir)
Glargine (Basaglar, Lantus, Toujeo)

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23
Q

What are the combination insulin drugs? (Short or rapid mixed with intermediate acting (usually 2x daily)

There are two

A

Aspart protamine/Aspart 70/30 (NovoLog Mix 70/30)
NPH/Regular 70/30 (Humulin 70/30, Novolin 70/30)

Remeber at least brand names

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24
Q

What is the A1C goal for patients with diabetes?

A

Less than <7.0

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25
Q

Which drugs can impair insulin actions?

There are 3, think group and not specific medicayion

A

Corticosteriods
Certain Antihypertensives (thiazide diuretics, beta-blockers)
Certain Antipsychotic Medications

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26
Q

What are the clinical manifestations of DKA in regards to blood glucose, pH, and HCO3?

A

Blood Glucose: 250+
pH: <7.30
HCO3: <16

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27
Q

What are clinical manifestations of DKA?

There are four, two important ones

A

Dehydration (dry mucous membranes, tachycardia, orthostatic hypotension)
FRUITY BREATH
Kussmaul respirations (respiratory compensation)

Fruity breath, kussmaul

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28
Q

Which disorder is the “Rule of 15” for?

A

Hypoglycemia

Rule of 15: Ingest 15-20g fast-acting carbohydrates, Recheck glucose 15 min later - if <70, repeat above, Notify HCP if no improvement after 2-3 doses, Hospital setting - may use 50% dextrose IV or glucagon IM

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29
Q

What does the blood glucose have to be to have a clinical manifestation of hypoglycemia?

A

<70

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30
Q

What disease is characterized by extensive degeneration and destruction of liver cells?

A

Liver Cirrhosis and Failure

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31
Q

What is the liver tissue replaced with in liver cirrhois and failure?

A

Scar tissue (fibrosis)

32
Q

What are clinical manifestations of liver cirrhosis or failure?

There are five

He’s staring at you, look at his eyes. She’s pulling down his nose to check the true skin down. He’s showing his belly. What’s that on their skin, it looks like an Arachnide

A

Jaundice (bilirubin buildup)
Edema and ascites
Liver enlargement
Hematologic problems (LIVER PATIENTS BLEED)
Skin lesions-spider angiomas

33
Q

What is a complication of liver cirrhosis?

A

Portal hypertension

34
Q

What are things that happen because of portal hypertension?

Portal hypertension is increased blood pressure in liver and surrounding structures. What happens to those surrounding structures?

A

Spleen enlargement
Enlargement of surrounding veins
Ascites

35
Q

What is the main characteristic of hepatic encephalopathy?

A

Mental status changes

36
Q

What is the main characteristic of hepatorenal syndrome?

A

Kidney failure

37
Q

What is the gold standard of liver cirrhosis and failure diagnosis?

A

Liver biopsy

38
Q

What is management for ascites?

There are two

Ascites is fluid in third spacing, think what you would do to help that.

A

Sodium restriction (2g/day)
Diuretics (Spironolactone, Furosemide)

39
Q

What are the managements for varices and bleeding?

There are two

A

Avoid NSAIDs (ibuprofen, aspirin)
Avoid high risk bleeding procedures

40
Q

What is management for treating portal hypertension?

There are 2

A

Beta-Blockers
Vasopressin

41
Q

What drug is used to prevent hepatic encephalopathy during liver cirrhosis?

A

Lactulose: Decreases ammonia by trapping ammonia in gut with lacative effect to expel from body

42
Q

What are health risks associated with obesity?

There are two named

A

Type 2 Diabetes-High insulin and insulin resistance
Metabolic Syndrome

43
Q

What is the BMI scale for overwieght and obese?

A

25-29.9: Overweight
30+: Obese

44
Q

(T/F) When asking/doing history or exam for obesity, be non-judgmental, sensitive, and use leading questions

A

True

Duh

45
Q

Metabolic syndrome characterized by insulin __ realted to ___ visceral fat

Fill in the blank

A

Resistance

Excess

46
Q

The anteripr pituitary gland makes which hormone?

A

TSH (Thyroid stimulating horomone)

47
Q

In response to TSH, the thyroid makes what two hormones?

A

T3 and T4

48
Q

What is Goiter? Is it a symptom or a disease with thyroid gland problems?

Throat

A

Enlarged thyroid gland; Symptom

49
Q

What is thyroiditis?

Think what -itis means

A

Inflammation of thyroid gland

50
Q

What can cause thyroiditis?

A

Hashimoto thyroiditis (Chronic autoimmune)

51
Q

In Autoimmune Hashimoto, T3 and T4 levels are _ and TSH levels is _

Fill in the blank

A

Low; High

52
Q

What group of drugs can help manage acute thyroiditis?

A

Antiinflammatories (NSAIDs, Corticosteriods)

53
Q

What can cause hyperthyroidisim?

There are 3

A

Graves disease (autoimmune disease)
Excess iodine
Thyroid cancer

54
Q

Hyoerthyroidism is characterized by _ TSH levels and _ T3 and T4 levels

Fill in the blank

A

Low
High

55
Q

What are clinical manifestations of hyperthyroidism?

Think speeding up

There are five; It’s so hot, HES LOOKING AT YOU, Pregnant women are big in stomach but not supposed to be big where

A

Goiter
Exophthalmos (eye bulging)
Increased appetite, weight loss
High BP, High HR
Heat intolerance

56
Q

What is a life-threatening complication of hyperthyroidism?

A

Acute Thyrotoxicosis (thyroid Storm)

Severe tachycardia, heart failure, shoc, high temp

57
Q

What group of drugs are used to manage hyperthyroidism? What two drugs are in this category?

A

Antithyroids; Propylthiouracil (PTU)
Methimazole

58
Q

What drug inhibits thyroid horomone synthesis and relase-often used before surgery? Name a drug in it.

A

Iodine; Saturated Solution of Potassium Iodine (SSKI)

Used for hyperthyroidism

59
Q

Which drug class decreases heart rate, tremors, nerveousness? Name a drug in this class.

For hyperthyroidism

A

Beta-Adrenergic Blockers; Propranolol

Think Adrenergic, ADRENaline, adrenaline makes you go fast, it’s opposite of that

60
Q

What radiaction therapy can be used for hyperthyroidism?

It was in another drug class

A

Radioactive Iodine Therapy (RAI)

Teaching point is radiation exposure to others

61
Q

What are the primary and secondary causes of hypothyroidism?

A

Primary: Thyroid problem
Secondary: Problem with the pituitary gland

62
Q

What are clincial manifestations of hypothyroidism?

Think slowing down

There are five

A

Low appetite, weight gain
Faitgue (weakness, slow movements)
Dry skin, pallor
Cold intolerance
High cholesterol

63
Q

(T/F) Hashimoto thyroiditis can cause hypothyroidism

A

True, think that if your immune system is having an exaggerated response and destroying thyroid cells, eventually you will have a deficiency in the thyroid horomone

64
Q

Hypothyroidism is characterized by _ TSH levels and _ T3 and T4 levels

A

High
Low

65
Q

What are diagnostic tests for hypothyroidism?

There are three, think of the symptoms and put it to tests

A

TSH, free T3 and T4
Antithyroid Antibodies (for Hashimoto thyroiditis)
Cholesterol levels

66
Q

What is a complication of Hypothyroidism?

A

Myxedema Coma

Medical emergency, impaired conciousness or coma, Low temp, low BP, low respirations

67
Q

What drug is used to manage hypothyroidism?

A

Levothyroxine (synthroid): Synthetic T4

Teaching points: Started low and slow, taken 30-60 min before food or other meds on an empty stomach (usuallu early morning)

68
Q

What is hyperparathyoridism characterized by?

A

Hypercalcemia: Fatigue, weakness, osteroporosis, kidney stones, cardiac changes

69
Q

What drugs are used to manage hyperparathyroidism?

There are two

A

Loop diuretics (Furosemide)-Encourages fluid and calcium loss
Bisphosphonates (Alendronate): Encourage calcium to go back into bone

70
Q

What is the clinical manifestation of hypothyroidism?

A

Hypocalcemia: Tetany, spasms, anxiety

71
Q

Acromegaly is the overproduction of growth hormone by the _ due to benign tumor

A

Anterior Pituitary gland

72
Q

Cushing Syndrome is characterized by _ cortisol levels

Fill in the blank

A

High

73
Q

Cushing synfrome is caused by medications or tumors that secrete what hormone?

Which gland makes corticosteriods?

A

ACTH (Adrenal cortex stimulating hormone)

74
Q

Addison’s Disease is characterized by _ cortisol levels

Fill in the blank

A

Low

75
Q

(T/F) Addison’s Disease is mostly autoimmune

A

True, antibodies against adrenal cortex causing low function of adrenal cortex and decreased corticosteriods

76
Q

Does Addison’s Disease have early or late symptoms? What are they

There is six, I’ll take knowing two important ones

A

Late; Hyperpigmentation, fatigue, weight loss, anorexia, nausea, weakness

AH Exam 3 (1 decks)

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