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hormone and glucose regulation Flashcards

1
Q

paracrine hormones

A

act on other cells than where they are synthesized

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2
Q

hyposecretion

A

usually caused by a defect, disease, or ageing

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3
Q

hypersecretion

A

usually caused by genetics, tumors, or environment

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4
Q

SIADH

A

caused by CNS trauma, infection or surgery
- hypertension, decreased urine, low osmolality, edema, headache

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5
Q

SIADH treatment

A

diuretics is key, no fluids, 3% NaCl

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6
Q

Diabetes insipidus

A

passing “tasteless” water; opposite of SIADH

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7
Q

DI cause

A

CNS issues, renal dysfunction
- too little ADH, high urine output, high thirst

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8
Q

fluids and synthetic ADH (Desmopressin)

A

DI treatment

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9
Q

thyroid hormones

A

stimulate metabolism

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10
Q

iodine

A

makes up T3 and T4

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11
Q

TRH

A

released from hypothalamus; stimulates TSH release

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12
Q

TSH

A

released from anterior pituitary gland; activates thyroids functional cells

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13
Q

T3

A

20%; very active, potent, short acting
- what binds to receptors

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14
Q

T4

A

80%; long half life and inactive

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15
Q

calcitriol

A

active form of vitamin D; supports calcium absorption in the GI and deposition in bone

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16
Q

calcitonin and PTH

A

serum calcium homeostasis

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17
Q

hashimoto disease

A

common cause of hypothyroidism; slow destruction with high incidence in women

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18
Q

idoine absence

A

common cause of hypothyroidism

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19
Q

myxedema coma

A

severe metabolic insufficiency; due to untreated hypothyroidism

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20
Q

hypothyroid agents

A

treat hypothyroidism

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21
Q

levothyroxine (Synthroid, Eltroxin), liothyronine (Cytomel)

A

hypothyroid agents; treat hypothyroidism
- T4 preferred, long half life, highly PPB, slow onset of action

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22
Q

extra glucose

A

stored as glycogen in liver and muscles as well as triglycerides in adipose cells

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23
Q

fatty acids

A

distributed via lymph to circulation; cannot be used by brain for energy

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24
Q

ketone metabolites

A

made if there is high lipolysis; happens in people who fast
- will cause metabolic acidosis which lowers pH below 7.35

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25
insulin
pancreatic hormone that is synthesized in beta cells
26
insulin actions
glucose cellular uptake, promotes storage formation, prevents glycogen and fat lysis
27
glucagon
synthesized in alpha cells; treat hypoglycemia
28
glucagon actions
promotes glycogenolysis, gluconeogenesis, lipolysis, triggered by low plasma glucose levels
29
high blood glucose pathway
pancrease releases insulin --> cells take up glucose from blood and liver produces glycogen--> blood glucose falls
30
low blood glucose pathway
pancreas releases glucagon--> liver breaks down glycogen--> blood glucose rises
31
beta cells
insulin synthesis and the stimulant is high serum glucose
32
insulin secretion process
glucose enters beta cell--> metabolized by glucokinase into ATP--> closes K channels --> depolarization--> insulin is secreted--> enters hepatic circulation--> 50% is 1st pass metabolized
33
insulin inhibition
somatostatin (D cell produced)
34
synergy hormones released in high glucose demand situation
glucocorticoids, catecholamines, growth hormone
35
glucocorticoids
cortisol; mobilizes utilization of all energy stores
36
catecholamines
epinephrine; stimulates glycogenolysis and later lipolysis
37
growth hormone
increased in long term stress or starvation; inhibits glucose uptake to increase serum glucose--> stimulating higher insulin secretion
38
beta cell destruction
dysfunction of glucose, fat, and protein metabolism causing disabled transport of glucose into cells
39
hyperglycemia
increased glucose in plasma
40
polydipsia
high solute concentration triggering thirst and high osmolality
41
polyuria
high urine production
42
proteolysis
causes weight loss and muscle wasting
42
lipolysis
causes fatty acid oxidation leading to ketones
43
normal blood glucose
6-8
44
diabetes mellitus type 1
sweet urine; genetic/autoimmune; immune reaction to beta cell antigens
45
diabetes mellitus type 2
idiopathic
46
diabetes mellitus diagnosis
fasting glucose > 7; usually diagnosed in early years of life
47
diabetes mellitus treatment
insulin
48
basal insulin levels
5-15
49
peak rise insulin levels
60-90
50
rapid acting insulin
-onset in 10-15 min - peak is 1-2 hours - duration is 3-5 hours - ideal for meal time - pump not IV - can have slow infusion over long time
51
Humalog (Lispro), Novorapid (Aspart), Apidra (Glulisine), Fiasp (Aspart)
rapid acting insulin
52
long acting insulin
-onset in 90 min - plateaus for up to 24 hours - not used for meals; administered 1-2 times daily - Never IV
53
Levemir (Detemir), Lantus (Glargine)
long acting insulin
54
Tresiba (Degludec)
ultra long acting insulin ( >30 hours)
55
short acting insulin
-onset in 30 min - peak in 2-3 hours - duration is 6.5 hours - ideal 30-45 min pre meal - causes higher risk for hypoglycemia
56
Novolin, Humulin R
short acting insulin
57
entuzity
short acting insulin that is 5x more concentrated
58
intermediate acting insulin
-onset 1-3 hours - peak 5-8 hours - duration up to 18 hours - 1-2 times daily - evening snack very important
59
Humulin N, Novolin
intermediate acting insulin
60
total daily insulin
0.55 (U) x Pt. wt. (kg) - give one half background requirement, the other half at mealtime
61
BBIT
basal (long acting insulin) in am, bolus (short/rapid acting) at meals, Inulin correction (short/rapid) if necessary titrate doses to achieve normal levels
62
basal insulin
long acting in AM to avoid hypoglycemia at night
63
carb counting
45-60g/meal -15g = 1 unit rapid acting insulin
64
bolus insulin
rapid or short acting insulin pre meal time (3x a day) - check blood glucose post meal - too high is >10- need more insulin - too low is <4- too much insulin
65
ketones
due to insufficient insulin-glucose transport causing fatty acid breakdown
66
illness and sugar balance
increase in levels due to cortisol release
67
exercise and sugar balance
decreases sugar levels
68
hyperglycemia most telling signs
thirst, fatigue
69
hypoglycemia most telling signs
loss of focus, nervousness, shakiness - rapid onset
70
hyperglycemia
high plasma glucose with a shift of potassium out of cells - high osmolality, low cellular function, ketone accumulation
71
DKA
occurs due to insufficient insulin - N&V, kussmaul breathing, blood and urine ketones, fruity breath
72
regular insulin IV, IV fluids, KCl
DKA treatment
73
hypoglycemia
low blood glucose due to diet change, activity, or too much insulin - weakness, tachycardia, tremors, diaphoresis
74
glucose tablet and apple juice
conscious hypoglycemia treatment
75
50% dextrose and glucagon
unconscious hypoglycemia treatment

nurs 216 (8 decks)

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