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RRCCPA Clinical Medicine I > Labs of Endocrine- Schoenwald > Flashcards

Labs of Endocrine- Schoenwald Flashcards

1
Q

What is DM Type 1?

A
  • Autoimmune destruction of pancreatic islet B cells

- Insulin DEPENDENT

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2
Q

What is DM Type 2?

A
  • Tissue insensitivity to insulin

- Obesity and adult onset

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3
Q

What is the MC endocrine disorder in the US?

A

DM Type 2

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4
Q

Do patients with gestational diabetes have a higher chance of developing type 1 or type 2 diabetes?

A

-30-50% chance of developing type 2 diabetes later

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5
Q

What test is used to screen for diabetes?

A
  • Glucose

- Usually measured fasting and 2 hour post prandial

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6
Q

PEARL: What test should you perform if glucose is abnormal?

A

-assess if fasting vs nonfasting

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7
Q

What is a normal fasting glucose level?

A

< 110 mg/dl

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8
Q

What fasting glucose result would indicate dx for diabetes?

A

Fasting glucose >126 on 2 separate occasions diagnostic for diabetes

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9
Q

What is a post prandial glucose?

A

Measures glucose 2 hours after a meal

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10
Q

If post prandial glucose level remains elevated at 2 hours what does this indicate?

A

Diabetes

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11
Q

A glucose level of > ____ mg/dl confirms dx of diabetes?

A

200

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12
Q

If a glucose level is 140 to 200 mg/dl what test should you do?

A

Glucose tolerance test

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13
Q

When do you order a glucose tolerance test (two most common reasons)?

A
  1. Pregnancy/women with hx of large birth weights or stillbirths
  2. Abnormal 2 hour post prandial glucose not diagnostic of diabetes (140mg/dl-200 mg/dl)
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14
Q

What are the normal glucose tolerance test results (fasting, 1 hr, 2 hr, 3 hr)?

A
  • fasting <110 mg/dl
  • 1 hour <200 mg/dl
  • 2 hour <140 mg/dl
  • 3 hour 70-115 mg/dl
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15
Q

What is the glucose tolerance test criteria for dx diabetes?

A
  • Fasting glucose >126 mg/dl

- 2 hour glucose >200 mg/dl

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16
Q

What are 6 things that can cause elevated glucose?

A
  1. Stress
  2. Caffeine
  3. IV fluids containing dextrose (should not be given to diabetic pts)
  4. Pregnancy
  5. Drugs (prednisone, estrogen)
  6. Smoking
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17
Q

What are 3 things to remind patients before a glucose tolerance test?

A
  1. Fast for 8-12 hours
  2. Don’t smoke during the test
  3. No exercise 24 hours prior to test
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18
Q

HbA1c allows for a ____ month measurement of glucose levels

A

3

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19
Q

What is a normal HbA1c %?

A

4-5.7% roughly

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20
Q

What is a HbA1c % that indicates poor glucose control?

A

> 6.5% roughly

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21
Q

Is fasting required for an HbA1c?

A

No

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22
Q

What HbA1c % is prediabetic?

A

5.7% to 6.4%

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23
Q

What three tests diagnose diabetes?

A
  • HgbA1c>6.5% or
  • Fasting glucose >126 mg/dl or
  • OGTT with 2 hour level at 200 mg/dl or higher.
24
Q

Is ketoacidosis more common in Type 1 or Type 2 diabetes?

A

Type 1

25
Q

What causes ketoacidosis?

A

Insulin deficiency resulting in protein breakdown and increased hepatic glucose production

26
Q

In ketoacidosis, lipolysis ocurrs and causes free fatty acid conversion to what two ketone bodies?

A

beta-hydroxybutyric acid & acetoacetic acid

27
Q

What are 4 symptoms of ketoacidosis?

A
  1. Dehydration
  2. Lethargy
  3. Acetone smelling breath
  4. Occasionally coma
28
Q

A glucose level of > 300 mg/dl is indicative of what medical condition?

A

Ketoacidosis

29
Q

Are bicarbonate and pH levels in ketoacidosis low or high?

A

Low

30
Q

PEARL: What is the initial treatment of ketoacidosis?

A

insulin administration with K+

We need K+ to bring insulin into the cells (K+ is like a carrier for insulin)

31
Q

How is ketoacidosis detected? (what test)

A

Urinalysis (urine ketone test)

32
Q

A urine ketone test is able to dect _______________ & unable to detect _____________

A

Acetoacetatic acid, beta-hydrohybutyrate

33
Q

What does a microalbumin test indicate?

A

glomerular damage, predictive of nephropathy

34
Q

What is a microalbumin test?

A

A urinemicroalbumintest is a test to detect very small levels of a blood protein (albumin) in your urine.

35
Q

A microalbumin test is used to detect early signs of what?

A

Amicroalbumintest is used to detect early signs of kidney damage in people who are at risk of developing kidney disease.

36
Q

Why do we check urine albumin annually in diabetics?

A
  • to look for any kidney damage

- diabetes causes glomerular permeability to exceed reabsorption

37
Q

Microalbumin can be affected by ________________

A

hydration status

38
Q

What calculation corrects for hydration status?

A

Correct for hydration status by utilizing:

(urine microalbumin/urine creatinine) x 1000

39
Q

TSH is secreted by the __________

__________

A

Anterior pituitary

40
Q

What regulates the release of T3 and T4?

A

TSH from the anterior pituitary

41
Q

Hypothyroidism causes _______ TSH and _______ T4

A

Elevated, decreased (deficiency)

42
Q

Hyperthyroidism causes _______ TSH and _______ T4

A

Low, Excessive

43
Q

What lab test would you order to test for Hypo/Hyperthyroidism?

A

TSH

44
Q

What does a low T4 indicate?

A

Hypothyroidism

45
Q

What does a high T4 indicate?

A

Hyperthyroidism

46
Q

What is the most accurate measure of thyroid status?

A 
Free T4 (measures unbound T4)
-determines how well T4 is working
47
Q

What does a high T3 indicate?

A

hyperthyroidism

48
Q

What does a low T3 indicate?

A

hypothyroidism

49
Q

What does a T3 measure?

A

Indirectly estimates number of binding sites on thyroid bound by T3

50
Q

Hyper or Hypothyroidism is a major contributor to new onset AFib?

A

Hyperthyroidism

51
Q

If someone has new onset AFib, what lab test should you order?

A

TSH

52
Q

The parathyroid is responsible for ________ _________

A

calcium metabolism

53
Q

What is the mc cause of primary hyperparathyroidism?

A

Adenoma of the parathyroid gland. Results in hypercalcemia.

54
Q

______ & calcium are directly related

A

Albumin

55
Q

What is the calculation that is used to determine calcium levels?

A

Serum calcium + (0.8 x (4-albumin))

RRCCPA Clinical Medicine I (49 decks)

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