Metabolic Conditions Flashcards
Metabolic syndrome conditions include
high blood pressure
high blood sugar
excess body fat/visceral fat in abdominal area
abnormal cholesterol/triglyceride levels
causes of metabolic syndrome
obesity
inactivity
linked condition to metabolic syndrome
type 2 dm
Risk factors of metabolic syndrome
age
ethnicity: more common in hispanic women
obesity
type 2 DM (F>M)
Non alcoholic fatty liver
sleep apnea
PCOS
clinical manifestations
abdominal obesity
hyperglycemia
hypertension
triglycerides
cholesterol
abdominal obesity
m > 40in waistline
f > 35 in waistline
hyperglycemia
> 110 mg/dL
best marker for hyperglycemia
HBA1C
Normal HBA1C value
<5.7&
triglycerides
HDL: <40 mg/dL (males); <35 mg/dL (females)
LDL: >130 mg/dL
cholesterol
normal amount is <200 mg/dL
clinical presentations of metabolic syndrome
large waist circumference
polydipsia ( inc thirst)
polyuria (inc urine)
fatigue
blurred vision
diabetic triad
polyuria
polydipsia
polyphagia
metabolic syndrome is defined as having > or equal to 3 of the 5 components:
elevated waist circumference
elevated triglycerides or takes drugs for elevated triglycerides
low HDL
elevated BP or htn drug tx
elevated fasting glucose
mechanisms that maintain balance in fluid and electrolytes
thirst mechanism and renal function
dehydration
output > input
causes of dehydration
poor intake
excess output/urination
profuse sweating
vomiting
diarrhea
diuretics
clinical manifestations of dehydration
poor skin turgor
dry mucous membranes
headache
irritability
postural hypotension
incoordination
lethargy
disorientation
uremia
hypovolemic shock
uremia
build up of toxins in blood since kidneys cannot filter; can lead to death
hypovolemic shock
medical and surgical condition in which rapid fluid loss results in multiple organ failure
d/t inadequate circulating volume & subsequent inadequate perfusion; could also lead to death
edema
excess of body fluids with expansion of interstitial fluid volume
causes of edema
heart failure (usually r sided)
kidney disease
premenstrual retention
pregnancy
heat stress
venous obstruction
protein losing kidney disease
starvation
malnutrition
inflammation
obstruction of lymphatic flow
malignancy
manifestations of edema
bipedal edema
weight gain
headache
blurred vision
muscle cramps
twitches
Normal potassium level
3.5-5.5
hypokalemia causes
diarrhea
vomiting
metabolic acidosis
renal tubular disease
alkalosis
diabetes insipidus
hyperaldosteronism
hypomagnesemia
classified as severe hypokalemia
<2.5 meq/l
hypokalemia manifestations
muscle weakness, aches, fatigue
cardiac arrhythmia
abdominal distention
nausea & vomiting
myalgia tremor
muscle cramps
intestinal motility
constipation
abnormal heart rhythm (too slow) leading to cardiac arrest
flaccid paralysis
hyporeflexia
hyperkalemia causes
acute renal failure
metabolic acidosis
diabetic ketoacidosis
sickle cell anemia
SLE
high amount of K+ su[[lement
potassium excretion affected by kidney failure
hypoaldosteronism
rhabdomyolysis
medications for hypokalemia
furosemide
steroids
dialysis
hyperkalemia meds
spironolactone
nsaids
ace inhibitors
hyperkalemia severity divided into
mild = 5.5-5.9
moderate = 6.0-6.4 mEq/L
severe > 6.5 mEq/L
hyperkalemia manifestations
muscle weakness, arrhythmias (tall t wave, prolong p-r interval and qrs duration)
typically no sx
when severe:
muscle pain
muscle weakness or numbness
irritability and anxiety
palpitations
dysrhytmias
dec BP
abdominal cramping and diarrhea
dec urine output
hyperventilation
normal sodium level
135-146 meq/L
2/3 of water located
inside cells
1/3 of water located in
ecf and blood plasma
most important regulator of fluid balance and principal determinant of plasma osmolality
sodium
causes of hyponatremia
water intoxication
tumors
endocrine tumors
manifestation hyponatremia
confusion
decreased mental alertness
convulsions
signs of increased ICP
poor motor coordination
sleepiness
anorexia
hypovolemic meaning & treatment
sodium and water levels both decrease but sodium loss is greater; vomiting/diarrhea
rehydration with isotonic fluids
hypervolemic meaning and treatment
both sodium and water levels increase with greater water increase; fluid retention and conditions such as heart failure, liver cirrhosis, renal/kidney failure
diuresis
euvolemic meaning and treatment
sodium level is normal but thereis increase in body water; excessive water intake, renal insufficiency, inappropriate ADH secretion
restrict free water intake; address underlying cause
Premenopausal women are susceptible to acute ____ with severe brain edema
hyponatremia
Premenopausal women are more susceptible to acute hyponatremia due to
increased vasopression = kidneys retain more water
acute symptomatic hyponatremia <48 hrs is an emergency. t or f.
true
hypernatremia amount
> 145 meq/l
hypernatremia causes
water deficit
excessive water loss
impaired vasopressin release
renal dysfunction
diuretics
hypernatremia manifestations
EXCESSIVE WATER RETENTION
pitting edema, excessive weight gain, pulmonary edema, hypertension, tachycardia, agitation, restlessness, convulsions
calcium normal level
8.4-10.4 mg/dL
hypocalcemia causes
reduced albumin
hyperphosphatemia
hypoparathyroidism
malabsorption of calcium and vitamin D
alkalosis
acute pancreatitis
hypocalcemia manifestations
muscle cramps
tetany
spasm
paresthesia
anxiety
irritiability
twitching convulsions
arrhythmias
hypotension
hypercalcemia causes
hyperparathyroidism
tumor
hyperthyroidism
vitamin A intoxications
hypercalcemia manifestations
fatigue
depression
mental confusion
nausea
vomiting
increased urination
occasional cardiac arrhythmias
normal magnesium level
1.8-2.4
hypomagnesemia causes
hemodialysis
blood transfusion
chronic renal disease
hepatic cirrhosis
chronic pancreatitis
hypoparathyroidism
malabsorption syndromes
severe burns
excess loss of body fluids
alcolohism
starvation
diarrhea
inc urinary loss
poor absorption from intestines
hypomagnesemia manifestation
hyper-irritability
confusion
leg and foot cramps
tremor
nystagmus
seizures
cardiac arrest
hypermagnesemia causes
renal failure
diabetic acidosis
hypothyroidism
addison’s disease
dehydration
use of antacids
hypermagnesemia manifestation
hyporeflexia,
muscle weakness
drowsiness
lethargy
confusion
bradycardia
hypotension
problems in magnesium leads to
dec bp, heart disease, and type 2 diabetes
hypermagnesemia symptoms develop with levels more than
4 meq/L
normal chloride levels
98-107 mg/dL
abnormal chloride levels are usually d/t
metabolic acidosis and alkalosis
hypochloremia causes
congestive heart failure
prolonged diarrhea
chronic lung disease
metabolic alkalosis
laxative use
diuretics
corticosteroids
bicarbonates
hypochloremia frequently accompanies
hyponatremia
hypochloremia manifestations
fluid loss
dehydration
weakness
fatigue
difficulty breathing
diarrhea/vomiting
rigid extremities
tetany
tremors/twitching slight
seizures
slow shallow respiration
hyperchloremia causes
kidney prob
diabetes
severe dehydration
increased salt
respiratory alkalosis
hyperchloremia manifestations
fatigue
muscle weakness
excessive thirst
dry mucous membrane
high BP
edematous
decreased LOC
rapid blowing respirations to remove acid build up through lungs
in hyperchloremia, urine output is closely monitored. t or f.
true because pt is treated with diuretics to decrease bp
Normal phosphate level
3-4.5 mg/dL
phosphate has an inverse relationship with
calcium
high phosphate levels are associated with _____
chronic kidney diseases needing phosphate binding medications
low levels of phosphate are usually associated with
malignancy and hyperparathyroidism
good sources of phosphate include
dairy, nuts, chicken, pork, organ meats
hypophosphatemia causes
genetic
hospitalized individuals (fluid loss)
alcoholism
severe burns
diabetic ketoacidosis
faconi syndrome
hyperparathyroidism
chronic diarrhea
vit d deficiency
fanconi syndrome
fanconi syndrome
disorder of kidney tubule function
excessive glucose, bicarbonate and phosphates, uric acid, potassium
too much excretion –> dec phosphate
manifestations of hypophosphatemia
muscle weakness
fatigue
bone pain
bone fractures
loss of appetite
irritability
numbness
confusion
slowed growth in children
tooth decay
late baby teeth
hyperphosphatemia causes
kidney problem
hypoparathyroidism
cell damage
high vitamin D levels
diabetic ketoacidosis
muscle damage
infections
hyperphosphatemia manifestations
muscle cramps
numbness
tingling around mouth
bone and joint pain
weak bones
rashes
itchy skin
normal pH levels
7.35-7.45
metabolic acidosis causes
diabetes
renal insufficiency
diarrhea
diabetic ketoacidosis
metabolic acidosis manifestation
hyperventilation
deep respiration
weakness
muscular twitches
malaise
nausea
vomiting
diarrhea
headache
dry skin
poor skin turgor
may eventually lead to stupor or coma
metabolic alkalosis causes
excess vomiting, excess diuretics, hypokalemia, peptic ulcer disease, excessive antacids
metabolic alkalosis manifestations
hypoventilation
depressed respirations
dysrhythmias
prolonged vomiting
weakness
muscle twitching
irritability
agitation
confusion
coma (death)
respiratory acidosis
increased co2 decrease pH
respiratory alkalosis
decreased co2 increased pH
metabolic acidosis ___ hco3, ___ pH
decreased HCO3, decreased pH
metabolic alkalosis ___ hco3, ___ pH
increased hco3, increased pH
hypothyroidism due to
decreased thyroid gland activity
decreased thyroid releasing hormones
hashimoto’s disease (autoimmune disorder affecting thyroid gland)
antithyroid meds
decreased body function
hashimoto’s disease
brain fog
goiter
constipation
menstrual changes
fatigue
dry skin
brittle nails
symptoms of hypothyroidism
weight gain
mental and physical lethargy
dry skin and hair
low bp
constipation
cold intolerance
goiter
puffy face
brittle nails
muscle or joint pain
slow heart rate
irregular and heavy periods
depression
dec sweating
may lead to death
hypothyroidism red flags
exercise intolerance
weakness
apathy
exercise induced myalgia
reduced cardiac output due to low BP
hyperthyroidism due to
hyperactive thyroid gland
enlarged thyroid
increased thyroxine secretion
grave’s disease
thyroid storm
increased metabolic processes
grave’s disease
autoimmune disorder that results in overproduction of thyroid hormone
buldging eyes
immune system attacks thyroid gland
thyroid storm
life threatening health condition associated with untreated hyperthyroidism
inc bp, hr, and body temp
fatal without prompt treatment
hyperthyroidism symptoms
nervousness and anxiety
hyperreflexia
tremor
hunger
weight loss or gain
short and light periods
fatigue
heat intolerance
palpitations
tachycardia
diarrhea
inc sweating
bulging eyes
nail thickening
hyperthyroidism red flags
exercise intolerance
fatigue
common sx between hyper and hypothyroidism
fatigue
insomnia
hair loss
addison’s disease
decreased production of cortisol and aldosterone
failure of adrenocortical function
addison’s disease etiology
ion, neoplasm, hemorrhage
cushing’s disease
decreased production of cortisol by adrenal cortex
excessive glucocorticoids
cushing’s disease etiology
pituitary tumor
addison’s disease signs
primary adrenal insufficiency
low cortisol
alopecia
hypoglycemia
low mood
frail and weak
low libido in females
low temp
amenorrhea in females
darkened skin
hypokalemia
st elevation
low bp
fatigue
hyponatremia
salt craving
cushing’s disease sign
excess cortisol production
moon face (rosy cheeks)
hyperglycemia
truncal obesity
buffalo hump (fat pad on back)
slow wound healing
hirsutism
skin thinning
hypokalemia
high bp
weak bones (osteoporosis)
hypernatremia
purple or red striae
addison’s disease = LOW MEASUREMENTS EXCEPT
hyperkalemia
cushing’s disease = HIGH MEASUREMENTS EXCEPT
hypokalemia
gaucher’s disease
inability to break down a particular fat
accumulates in liver, spleen and bone marrow
pain, bone damage, death
signs of gaucher’s disease
pathological fracture
hepatomegaly
collapsed vertebrae
bone pain and bone crisis
erlenmeyer flask deformity
splenomegaly
thrombocytopenia
anemia
osteonecrosis
bone marrow infiltration
osteopenia
type 1 diabetes
genetic
patches seen on arms
pancreas unable to produce enough insulin
develop at young age
cannot be prevented
insulin therapy
type 2 diabetes
insulin resistance
older age
prevented with lifestyle change
both diabetes share common
frequent urination
increased thirst
extreme hunger
unintentional weight loss
fatigue
blurry vision
wounds heal slow
numbness and tingling in hands and feet
benefit from lifestyle modifications
diabetes insipidus
condition can cause production of large amounts of diluted urine from drinking fluid
aka primary polydipsia or dipsogenic diabetes insipidus
damage to thirst regulation in hypothalamus
central diabetes insipidus
lack of vasopressin
hypotonic urine
nephrogenic diabetes insipidus
renal resistance to vasopressin
excessive hypotonic urine
primary polydipsia
excessive fluid intake
excessive hypotonic urine
