PARA603 Flashcards
Endocrine System
What does cortisol do in the body?
‘stress hormone’
controls BP, BM, metabolism, and reduces inflammation
What does aldosterone do?
maintains balance of sodium and potassium in the blood. I.e. salt and water balancing
What is Addison’s Crisis?
Low steroids.
decreased weight, BP, BM, energy and hair loss. salt craving and hyperpigmentation
What is Cushing disease?
High steroids. obese, unusual hair growth, purple skin and high BM.
How do we treat Addison’s Crisis?
Hydrocortisone IV or IM.
Sodium chloride.
Dose and route of Glucose 10%
titrate 10g boluses IV/IO
What is a contraindication for glucagon?
Phaeochromocytoma - Tumour of adrenal glands
What is the dose and route of glucagon?
1mg IM
What is the mode of action of glucagon?
mobilises glycogen reserves (liver and muscle), converting it to usable glucose
What is saline 0.9% indicated for?
Shock/ dehydration in DKA
What is the dose of saline 0.9%?
500ml over 15 minutes
what is the mode of action of saline 0.9%?
isotonic crystalloid that expands volume (DOES NOT REDUCE BLOOD SUGAR LEVEL)
Signs and symptoms of DKA
headache, nausea, vomiting, abdo pain, leg cramps, low GCS, confusion, pear smell breath, tachycardia, hypotension, dehydration, thirsty, excessive urination, deep and laboured breathing.
What do the islets of Langerhans in the pancreas contain?
Alpha and beta cells
what is the role of beta cells (insulin) in the pancreas?
opens receptors in cells to receive glucose
liver stores excessive glucose and glycogen
What is the role of alpha cells (glucagon) in the pancreas?
Liver breaks down glycogen and releases glucose to the blood
How is DKA diagnosed?
D - BM of >11.0 mmol/L or known diabetes mellitus
K - ketones above >3.0 mmol/L
A - bicarbonate concentration of <15.0 mmol/L or venous PH <7.3
Triad of DKA
Hyperglycaemia, ketonemia and acidosis
What is the physical presentation of raised ketones?
Deep and laboured rapid breathing . Nausea and vomiting. sweet smell on breath.
What causes metabolic acidosis?
fatty acids convert into ketones (acidic). they lower the blood PH which causes metabolic acidosis. The body compensates and removes excess hydrogen ion through C02 conversion, causing increased RR and kussmaul breathing
What are the three types of ketones?
1) - Acetoacetate
2) - 3 - Beta - hydroxybutyrate
3) - Acetone
Presentation of Euglycemic DKA
ketones, Acidosis, hypoglycaemia.
often found in pregnancy, surgery, starvation
Medical presentation of HHS
No ketones, hyperglycaemia, T2DM, occurs over days/weeks
S&S of HHS
dehydration, hypotension, tachycardia, increased RR, pyrexia/ hypothermia, confusion, 25% chance of seizure
