Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine Podiatric > wk 5- endocrinolgoical > Flashcards

wk 5- endocrinolgoical Flashcards

1
Q

what is diabetes mellitus

A

Impaired glucose uptake into the cell resulting in hypergycaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

microvascular complications of DM

A
  1. Retinopathy (retinal capillary microaneurysms, neovascularization and macular oedema)
  2. Nephrophathy (Thickening of the glomerular basement membrane, mesangial expansion and glomerular sclerosis)
  3. Neuropathy (nerve ischemia or damage, predisposes patients to ulceration and joint degeneration)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

macrovascular complications of DM

A
  1. CAD
  2. Stroke
  3. PAD
  4. Immune dysfunction- predisposes to infection due to effect of hyperglycemia on neutrophil and t cell function (fungal infection of the foot and bacterial infection of the tissue/bone more common)- tinea, cellulitis, osteomyelitis.
    and nutrients, o2 arent available for healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

diagnosing DM

A

BG: >7mmol/L fasting
or
>11mmol/L random + symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T1DM is what

A

autoimmune disorder. autoantigens activate a T cell mediated immune response that leads to destruction of pancreatic beta cells, which is responsible for insulin production.
Genetic component.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

symptoms of T1DM

A

increased urination(polyuria),
increased thirst (polydipsia)- body’s attempt to remove excess glucose,
dehydration,
weight loss,
nausea,
vomiting,
weakness,
fatigue,
immunocompromised,
poor wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T1DM emergency

A

diabetic ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

management of T1DM

A
  1. Dietary modification
  2. Physical activity
  3. Insulin
    -Basal bolus regimen: long acting insulin once daily, very short acting insulin given with each meal

-Mixed insulin regimen: intermedite and short acting insulin twice daily

-Insulin pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T2DM is what

A

insulin resistance due to insensitivity of receptor cells.
resistence of the liver to effects of insulin result in persistent unregulated hepatic glucose production and resistance of peripheral tissues to the effects of insuling results in reduced uptake of glucose into cells
Obesity and weight gain cause this type, a link to genetic susceptibility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

symptoms of T2DM

A

increased urination(polyuria),
increased thirst (polydipsia)- body’s attempt to remove excess glucose,
dehydration,
weight gain,
nausea,
vomiting,
weakness,
fatigue,
immunocompromised,
poor wound healing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T2DM emergency

A

hyperosmolar hyperglycaemia state (hypergymaeia with dehydration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T2DM mangement

A
  1. education
  2. Lifestyle modifications
  3. oral hypoglycemic agents (single or combined)
    - Metformin (reduced hepatic gluconeogenesis)
    - Sulphonylureas (increase insulin secretion)
    - DPP-4 inhibitors (increase insulin secretion)
  4. Insulin (single or combined with metformin)
    - Regimes
    - Pump
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how often do diabetes need to be checked

A

every 3-6months
-BP
-weight
-HBA1C

every day
-BG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are pre diabetes diagnosing levels

A
  1. Impaired fasting glucose
    Fasting glucose measurement >6.0mmol/L but <7.0mmol/L
  2. Impaired glucose tolerance
    Random or post-prandial glucose measurement >7.7mmol/L but <11.1mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

obesity is defined as

A

BMI>30

caused by long standing imbalance between energy intake and energy expenditure,
things that also play a role

  1. genetics (BMR, hormones)
  2. medications
  3. sleep
  4. enviornment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

overweight is defined as

A

BMI 25-30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

management of obesity

A
  1. physical acivity and diet (lifestyle)- mediteranian and 30mins
  2. medications
    orlistat inhibits pancreatic lipase = reducing absorption of fat
    phentermine is appetite suppressant (tolerance)
  3. surgery
    gastric band or sleeve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is metabolic syndrome

A

At least 3 of the following conditions:
-Excessive abdominal fat (>102cm M and 88cm F)

-hypertension (.130/85MMhG)

-abdnormal fasting glucose (>5.5mmol/L) or insulin resistance

-dislipidaemia or hyperlipidemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pathophysiology of metabolic syndrome

A

depends on
1. amount and
2. distribution of body fat (central obesity apple shape increases risk of metabolic syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

loss of 5-10% bw can do what?

A

improve diabetes, dyslipdemia, and hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

complications of metabolic syndrome

A

Fatty liver disease
Gout
Obstructive sleep apnoea
PCOS
Infertility in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how much bw loss can reverse metabolic syndrome

A

7%

23
Q

what is hypothyroidism

A

Deficiency of thyroid hormone

  1. Primary (thyroid gland disease, most common)

-Hashimoto’s thyroiditis: chronic autoimmune inflammation of thyroid gland
- Post therapeutic hypothyroidism: caused by medical, surgical or radio iodine destruction of the thyroid gland for hyperthyroidism

  1. secondary (disease of hypothalamus or pituitary gland)

-tumours

24
Q

symptoms and clincal signs of hypothyriodism

A

tiredness,
weight gain,
cold intolerance,
goltre,
dry coarse skin,
muscle weakness/stiffness,
anameia
braycardia
oedema
dyslipidemia

25
Q

treatment of hypothyroidism

A

levothyroxine or L-thyroxine

26
Q

diagnosis of hypothyroidism

A

measurement of serum TSH then T4 measured.

HYPO
in primary - TSH elevated and T4 low
in secondary- TSH elevated and T4 normal

HYPER
TSH is low and T4 elevated

27
Q

what is hyperthyroidism

A

Overactivity of thyroid hormone

  1. graves disease most common, autoimmune antibody against TSH receptor

specific symptoms:
- goitre
-protuding eyes
-infiltrative dermopathy

  1. thyroditis, acute inflammation of thyroid gland
  2. toxic multinodular goitre
  3. solitary toxic thyroid nodules
28
Q

symptoms and clinical signs of hyperthyroidism

A

weight loss,
increased appetite,
tremor,
heat intolerance,
stiffness,
muscle weakness, breathlessness,
goitre,
onycholysis,
sweating
tremor,
hyperkinesis,
tachycardia,
warm,
protuding eyes

29
Q

management for hyperthyroidism

A
  1. carbimazole
  2. surgery- goitre
  3. beta blocker for tremor, palpitations and sweating
30
Q

osteoporosis

A

Metabolic disease of bone caused by an imbalance between bone resorption (osteoclasts) and formation (osteoblasts)

Primary- increased osteoclast activity and lack of calcium and vitamin D

Secondary- conditions/diseases causing an increase in osteoclast acitvity or restricting parathyroid action to promote calcium/Vitamin D

31
Q

diagnosis of osteoporosis

A

DEXA scan to find BMD through a T score
Normal: higher than -1
Osteopenia: -1 - -2.5
Osteoporosis: -2.5+

or imaging

32
Q

clinical features of osteoporosis (regional bone loss) on radiograph

A
  • decrease in bone mineral density
    -changes in trabecular pattern
    -cortical thinning
33
Q

treatment of osteoporosis

A
  1. manage risk factors
  2. weight bear
  3. antiresportive medications
    - bisphosphonates
    - denosumab
    - raloxifene
34
Q

what is osteomalacia

A

Normal bone quantity but not mineralised (weakened bone)

due to inadequate intake of vitamin D (lactose intolerance, lack of sun, malabsorption, advanced renal disease)

looser zone fractures

35
Q

what is rickets

A

infant/young children version of osteomalacia (vitamin D deficiency)

can be
calcipenic: low serum calcium levels due to insufficient intake or metabolism of vitamin D/calcium

which can be caused by
1. lack of sun
2. renal disease
3. rapid bone resorption

phosphopenic: low serum levels of phosporus due to renal phosphate wasting

36
Q

radiographic features of rickets

A

Widened growths plates.
decrease in Bone mineral density
Cortical thinning
Scoliosis may be present.
bowing deformities
greenstick fractures

37
Q

symptoms of rickets

A

Muscle weakness
Enlarged wrists and ankles.
Long bones exhibit curvatures.
Waddling gait.
Pain may be present.
Growth may be hindered

38
Q

what is renal osteodystrophy

A

combination of renal insufficiency and secondary hyperparathyroidism with resultant widespread calcifications

renal insufficiency = increased phosphorous levels = parathyroid hormone stimulated to reduce levels of phosphorous (secondary hyperparathryoidism)

high levels of parathyroid hormone = increase osteoclastic acivitiy = bone resorption = increased serum calcium and phosphorous which is depositited into soft tissues

39
Q

renal osteodystrophy radiogrphic features

A

-loosers zones
-brown tumor
-osteosclerosis
-widen growth plate
-varus deformity of femurs
-soft tissue calcification
-osteopenia

40
Q

what is pagets disease

A

Tumour like process, continuous destruction of bone and replacement by a soft, poorly mineralised matrix (abnormal bone remodelling), most patients are asymptomatic, tibia is common

41
Q

pagets disease radiographic features/ clincial signs

A

Localised pain and tenderness
Increased focal temperature
Increased bone size
coarsened trabecular pattern
Bowing deformities
Kyphosis of spine
Decreased ROM

42
Q

what is hypopituitarism and symptoms

A

Deficiency of pituitary function, onset often insidious

Symptoms:
Decreased sex hormones (infertility, amenorrhea, impotence, atrophy)
Decreased thyroid stimulating hormone (hypothyroidism)
Decreased ACTH (fatigue, hypothermia, infection)

43
Q

what is giantism

A

Excessive growth hormone from anterior pituitary gland prior to growth plate closure (children), causes larger build

44
Q

what is acromegaly

A

Excessive growth hormone in adults, causes large/enlarged extremeities

45
Q

what is galactorhoea

A

Excessive prolactin secretion due to pituitary adenoma

46
Q

what is hyperparathryoidism

A

Parathyroids produce parathyroid hormone which

  1. Increase calcium and decrease phosphate resportion by kidney
  2. Increases vitamin D production
  3. Increases osteoclast activity

adenomas cause majority and hyperplasia

secondary hyperparathyrodism with hypertrophy from renal failure

47
Q

clinical features of hyperparathyroidism and diagnosis

A

stones (renal stones)
bones (osteoporosis/penia)
abdonimal groans (pain/pancreaitis)
psychic moans (behavioural disturbance and thirst)

diagnosis
increased serum calcium
decreased serum phosphate

48
Q

cushings syndrome is

A

Increased cortisol in the body

due to
Adrenal adenoma
pituitary adenoma
Iatrogenic
Ectopic ACTH production

49
Q

symptoms of cushings syndrome

A

Weight gain
Muscle weakness
Back pain
polyuria/polydipsia
Thin skin
Hypertension
Pathological fractures
Striae
Proximal myopathy
Bruising

50
Q

diagnosis of cushing syndrome

A

24 hour urine free cortisol excretion/imaging

51
Q

hyperaldosteronism what is it

A

excess production of aldosterone

due to
1. adenoma
2. hyperplasia

results in
* Increase retention Na → high serum sodium
* Increase loss K → low serum potassium
* Fluid retention
* Hypertension

52
Q

what is addisons disease

A

Hypofunctioning of adrenal cortex

Cortisol and aldosterone deficiency

Autoimmune typically, can be due to destruction of gland

53
Q

symptoms and clinical features of addisons

A

May be asymptomatic until: metabolic stress, surgery or severe infection

Clinical features:
* Weakness & fatigue
* Cold intolerance
* Orthostatic hypotension
* Pigmentation (esp. skin folds and mucous membranes, Addison’s “tan”)
* Abnormal CHO, fat and protein metabolism-weight loss, hypoglycaemia
* Inability to concentrate urine – dehydration

54
Q
A

Medicine Podiatric (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions