Other Systems 1 Flashcards by Lauren Wolfe

Metabolic syndrome dx

Consists of signs/symptoms that are risk factors and are strongly linked to T2DM, CVD, stroke

3 or more must be present for dx

“WEIGHHT”
- waist expanded
- impaired glucose
- HTN
- HDL
- triglycerides

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Glands of endocrine system

Hypothalamus > anterior pituitary and posterior pituitary

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Anterior pituitary hormones

ACTH (adrenocorticotrophic)
TSH (thyroid stimulating hormone)
FSH and LH (ICSH men; follicle, leutinizing, interstitial)
GH (growth hormone)
Prolactin

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ACTH

adrenocorticotrophic > adrenal cortex > cortisol, aldosterone

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TSH

Thyroid stimulating hormone > thyroid gland > triiodothyronine (T3), thyroxine (T4)

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FSH and LH (ICSH)

follicle, leutinizing, interstitial (men) > ovaries and testes > estrogen, progesterone, testosterone

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growth hormone > bones and tissues > growth, metabolism

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Prolactin

prolactin > milk production in breasts

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Cortisol

regulates gluconeogenesis and BP
reduces stress and inflammation

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Aldosterone

retains sodium and water
kicks out K+

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hypothalamus function

responsible for regulation of the ANS (body temperature, appetite, sweating, thirst, sexual behavior, rage, fear, blood pressure, sleep)

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pituitary gland function

secretes endorphins
Reduces sensitivity to pain

Controls ovulation
Works as a catalyst for the testes and ovaries to create sex hormones

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thyroid gland function

produces hormones that act to control the rate at which cells burn the fuel from food

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parathyroid gland function

regulate calcium and phosphate metabolism

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adrenal gland function

produces corticosteroids that will regulate water and sodium balance, the body’s response to stress, the immune system, and metabolism

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Addison’s disease

Causes: infections, neoplasms, hemorrhage, autoimmune process

Adrenal insufficiency - DECREASED cortisol and aldosterone

SXS:
decreased BP, dehydration
hyperkalemia
decreased glucose
bronze pigmented skin (inc melanocyte stim)
weight loss, anorexia, GI disturbances
Generalized weakness (asthenia)
Intolerance to cold/stress, anxiety/depression

Cushing’s disease

Causes: pituitary tumor w/ increased ACTH secretion

Elevated cortisol and aldosterone

Sxs:
increased BP, water retention
hypokalemia
increased glucose
redness (ruddy), skin striae
weight gain, centripetal obesity, round moon face
proximal m. weakness and atrophy
increased susceptibility to infection, osteoporosis (buffalo hump), poor wound healing

Cushing’s disease vs syndrome

Cushing’s disease: pituitary adenoma > inc ACTH secreted by PITUITARY GLAND > stims adrenal gland > inc CORTISOL released

Cushing’s syndrome: adrenal gland tumor > adrenal gland secretes more CORTISOL > drug toxicity (starts in adr. gl.; no inc in ACTH)

Sxs common for both

Hyperthyroidism sxs

Inc T3, T4 > low TSH
Inc HR, dec BP
High BMR
Heat intolerance
Inc glucose absorption
Restlessness
Silky hair, moist palm
Weight loss
Sweaty
Hyperreflexia
Sunken/protruding eyes (exophthalmos)
Grave’s disease

Inc risk of osteoporosis
Inc risk frozen shoulder

Hypothyroidism sxs

“Lazy person”

Dec T3, T4 > Inc TSH
Dec HR, inc BP
Low BMR
Cold intolerance
Dec glucose absorption
Sleepiness
Proximal m. weakness
Constipation
Brittle nails, dry skin/hair
weight gain
Not sweaty
Prolonged DTRs
Swelling of hands/feet, puffiness in face (myxedema)
Hashimoto’s disease

Inc risk of diabetes
Inc frozen shoulder

Hyperparathyroidism cause and sxs

Elevated calcium, low phosphate
> can demineralize bone = bone weakness and dec density

Sxs: osteoporosis, gout, arthralgia, kidney stones, renal insufficiency, peptic ulcers, proximal m. weakness, fatigue, depression, confusion, drowsiness, glove/stocking sensory loss

“Bones, stones, groans, moans, sensory”

Hypoparathyroidism cause and sxs

Low calcium, elevated phosphate

Convulsions, cardiac arrhythmias, m. twitching, tetany, muscle cramps/spasms, paresthesia of fingertips/mouth, fatigue, weakness

“CATS are numb”

Type 1 DM

Insulin dependent, pancreas produces no insulin

Congenital

Sxs: polyphagia, polyuria, polydipsia, weight loss, blurred vision, dehydration, ketoacidosis (rare in T2DM)

Type 2 DM

Insulin resistance, tissues do not allow insulin absorption but pancreas continues to create

Secondary to other dysfunctions

Sxs similar to T1DM, but rare occurrence of ketoacidosis (metabolic)

Normal fasting blood glucose level

>126 mg/dL

Normal random blood glucose level

>200 mg/dL

Normal HbA1C level

4-6%

Hypoglycemia levels and early/late signs

<70 mg/dL early - Pale, sweating - shaky - poor coordination, unsteady gait - tachycardia, palpitations - dizziness/fainting - excessive hunger late - slurred speech, drowsiness, confusion - LOC and coma "Cold and clammy - give them a candy"

Hyperglycemia levels early/late signs

>300 mg/dL early - weakness - dry mouth - excessive thirst - frequent, scant urine - deep, rapid respiration - dull senses, confusion late - fruity odor (acetone breath) - hyperglycemic coma 3 Ps Kussmaul's breathing (metabolic acidosis) "Hot and dry - sugar high"

Exercise and diabetes

100-250 mg/dL = safe to exercise 70-99 mg/dL = provide 15g carb snack every 20 min and check BG 250-300 mg/dL = proceed with caution if no ketoacidosis <70 or >300 = exercise contraindicated Avoid exercise during peak insulin hours (2-4 hours) to prevent hypoglycemiaa Insulin should be injected into abdomen or non-active extremity to reduce speed of absorption Insulin should be reduced after exercise Avoid extreme hot/cold temp Exercise best in morning

Diabetic foot care

Screen feet daily Wash but do not soak feet in warm water daily Toenails cut Snug, soft shoe; alternate shoes clean, white, non wrinkled socks

FITT for DM

Freq: 3-7 days/week Intensity: 11-13 RPE, can increase to 17 Time: 150 min/week, can increase to 300 Type: mod intensity aerobic exercise utilizing larger muscle groups

Stress incontinence definition and treatment

Involuntary leakage of urine during cough, sneezing, or exertion. Can be seen postpartum, pelvic floor muscle weakness tx: strengthen pelvic floor (levator ani: pubococcygeus, iliococcygeus, puborectalis, coccygeus)

Urge incontinence definition and treatment

Involuntary contraction of the detrusor muscle with a strong desire to void (urgency). Can be seen with infections, Parkinson’s disease, UMN lesions tx: treat infections, voiding schedule

Overflow incontinence definition and treatment

Incontinence caused by an acontractile or underactive detrusor muscle. Bladder is over-distended, can not empty completely, and urine dribbles or leaks out. Can be seen with benign prostatic hyperplasia, DM tx: double voiding, medication, catheterization

Functional incontinence definition and treatment

Incontinence due to mobility, dexterity, or cognitive deficits. Can be seen with dementia, lower extremity weakness tx: Clear clutter, improve accessibility, and prompted voiding (alarms, reminders)

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Other Systems 1 Flashcards

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