Week 8 - Endocrine Disorders Flashcards
What is DM 1?
Autoimmune destruction of beta cells in the pancreas
Antibodies to beta cells are present in 75% of cases
in type 2 DM, insulin levels are high because
Loss of insulin sensitivity
90% of diabetics are type (1 or 2)?
Type 2
Types of Secondary diabetes
Result of pancreatic disease, hormone disturbances, drugs, malnutrition
What is glucose intolerance during pregnancy?
Gestational diabetes
Risk factors for Type I DM (5)
Poor protein digestion (environmental and dietary)
Enteroviruses and rotavirus which are common in children
Vitamin D deficiency
Omega 3 FA deficiency
Nitrates
Risk factors for type 2 DM
Obesity
Family history
Low adiponectin [increases/decreases] risk of DMII?
Increases
PCOS [increases/decreases] risk of DMII?
Increases
Increased waist/hip ratio [increases/decreases] risk of DMII?
Increases
Sx of DM
Polyuria (urination)
Polydipsia (thirst)
Polyphagia (hunger)
Fatigue Blurred visitor Poor wound healing Periodontal disease (gum disease) Frequent infections
What is peripheral neuropathy?
Pain, burning, tingling, numbness of feet and lower legs
Autonomic neuropathy?
Causes Sx related to dysfunction of an organ system (e.g. urinary incontinence, diarrhea / constipation, sexual dysfunction)
What is the MC complication of diabetes?
Diabetic neuropathy
- Damage to the nerves as a result of diabetes
- Can affect different parts fo the body, mild to severe Sx
How to Dx DM? (4 tests)
Fasting blood glucose
Postpandrial glucose
Glucose tolerance test
Glycosylated hemoglobin (HbA1C)
What is the Fasting blood glucose test?
Blood draw after 10-16hr fast
What are normal Fasting blood glucose levels?
Impaired?
DM?
70-99 mm/dL
Impaired: >110 dL and <126 mg/dL
DM: >126 mg/dL
What is the postpandrial glucose test?
Taken 2 hours after a meal
DM levels from a postpandrial glucose test?
> 200 mg/dL
What is the glucose tolerance test?
Patient drinks glucose solution
Blood samples taken every 30-120 minutes
Normal glucose tolerance test (GTT) levels?
Pre-diabetes?
Dm?
1 hour: <150 mg/dL
2 hour: <120 mg/dL
Pre-diabetes:
2 hour: 140-180 mg/dL
DM:
1 hour: >180
2 hour: >150
Normal HbA1c levels?
DM levels?
5-7%
DM: Up to 20%
Graves’ disease is an autoimmune condition that is an example of
Hyperthyroidism
Too much T3/T4 circulating in the blood
In Graves’ disease, TSH is [low/high]
Low TSH (produced by pituitary)
Auto-antibody is binding the the TSH receptor which keeps a constant, unregulated T3/T4 production.
Symptoms of Graves’ disease
Exophthalmos
Diffuse goiter
Tachycardia; warm, thin, moist skin
Weakness, sweating, weight loss, nervousness, loose stools, heat intolerance, irritability, fatigue
Tests to Dx Graves’ disease
Physical exam
Ultrasound for thyroid gland
Laboratory diagnosis: T3/T4 levels
Hashimoto’s thyroiditis is hyper/hypothyroidism?
Hypothyroidism
Antibodies are generated against thyroid peroxidase (TPO)
Sx of Hashimoto’s
Fatigue, sluggishness Increased cold sensitivity Constipation Pale, dry skin Weight gain Goiter Menorrhagia (excessive menstrual bleeding)
Tests to Dx Hashimoto’s disease
Hormone test: T4/T3 are low and TSH is high (opposite of graves)
Antibody test to confirm presence of antibodies against TPO
What is happening in hypoadrenalism?
Adrenal cortex does not produce enough glucocorticoids (e.g. cortisol), mineralcorticoids (e.g. aldosterone), and sex steroids (e.g. testosterone)
Addison’s disease is [excessive / deficient] amount of cortisol
Deficient
Cushing’s disease is [excessive / deficient] amount of cortisol
Excessive
What does aldosterone do?
Regulates blood pressure by increasing sodium reabsorption and water in the kidney and increasing elimination of potassium
DHEA is used to
Make sex hormones: androgen (from testes) and estrogen (from ovaries)
Sx of hypoadrenalism:
Chronic fatigue Muscle weakness Loss of appetite, nausea, vomiting, diarrhea Weight loss Abdominal pain Low BP Irritability and depression Hypoglycemia HA Sweating Irregularly /absent menstrual periods Hyperpigmentation - Addison’s disease
How to Dx hypoadrenalism
ACTH stimulation test CRH stimulation test Ultrasound to visualize adrenal glands Tuberculin skin test (to see if adrenal insufficiency is related to TB) Antibody blood tests Hormonal blood tests
