Final: Endo/DM

Question 1

A1C:

Answer 1

Glycated hemoglobin- serum test used to diagnose diabetes and assess blood glucose control over last three-months.

Question 2

Glycogenesis:

Answer 2

Process of glycogen formation, storing excess glucose

Question 3

GlucoNEOgenesis:

Answer 3

Amino acids and fats are converted into glucose. Fats are mobilized from stored adipose tissue and broken down into fatty acids and glycerol. The glycerol is used in gluconeogenesis but the fatty acids are not and accumulate in the bloodstream- these are converted into three substances called: ketones

Question 4

GlycoGENolysis:

Answer 4

Breakdown of body’s stored glycogen to yield glucose. This important process occurs when the body does not have enough circulating glucose from carbohydrate ingestion.

Question 5

Hyperglycemia:

Answer 5

Elevated blood glucose levels

Question 6

Hyperinsulinism:

Answer 6

Excess insulin secretion by the pancreatic cells (beta cells)

Question 7

Hyperinsulinemia

Answer 7

Increased insulin in the blood

Question 8

Ketonuria:

Answer 8

Urine with ketones

Question 9

Polyphagia:

Answer 9

Increased appetite and eating

Question 10

Glucagon:

Answer 10

Stimulates hepatic glycogen breakdown and hepatic gluconeogenesis

Question 11

Retinopathy:

Answer 11

Retinal hemorrhages, exudates, blindness

Question 12

Peripheral neuropathy:

Answer 12

Loss of sensation in feet = damage to endoneurial arterial circulation that deceased blood flow to nerves particularly sensory nerves in lower extremities

Question 13

Negative feedback:

Answer 13

When a function, value, or hormone level in the body changes and the body releases a hormone to reverse the change. Most physiological control is through negative feedback

Question 14

Positive feedback:

Answer 14

A cycle where a stimulus or hormone produces more of the same response. The most common example of this is in pregnancy with birth and the release of oxytocin to help with uterine contractions. The body continues to release more oxytocin to make contractions stronger.

Question 15

Upregulation:

Answer 15

An increase in the number of receptors and their sensitivity. The most common reason for upregulation is a reduction in the receptor stimulation by hormones

Question 16

Downregulation:

Answer 16

A process where prolonged, excessive stimulation of an endocrine gland often results in receptor insensitivity and may decrease its number of receptors

Question 17

Hypofunction:

Answer 17

Of an endocrine gland occurs when there is an inadequate amount of hormone secreted by the gland

Question 18

Hyperfunction:

Answer 18

Of an endocrine gland occurs when there is an excessive amount of hormone secreted by the gland

Question 19

Primary disorder:

Answer 19

Dysfunction caused by the endocrine gland itself

Question 20

Secondary disorder:

Answer 20

Dysfunction caused by abnormal pituitary activity

Question 21

Tertiary disorder:

Answer 21

Dysfunction caused by a hypothalamic origin

Question 22

Thyroxine:

Answer 22

Regulator of body metabolism that influences almost every body system

Question 23

Goiter:

Answer 23

Enlargement of the thyroid gland with or without thyroid dysfunction. Excess pituitary TSH can stimulate the enlargement of the thyroid gland and cause goiter formation. Low iodine levels cause low thyroid hormone manufactured which the pituitary senses and then attempts to compensate by increasing TSH which incites goiter formation.

Question 24

Myxedema:

Answer 24

Non-pitting boggy edema around eyes hands, hands, and feet. Tongue and mucous membranes thicken can cause slurred speech due to the accumulation of mucopolysaccharid compound in tissues

Question 25

Exophthalmos:

Answer 25

Hypertrophy of the eye related to increase connective tissue (bulging of the eye)

Question 26

Graves dermopathy (pretibial myxedema):

Answer 26

Subcutaneous swelling of the anterior portions of legs, red indurated skin

Question 27

Type 1 DM

Answer 27

autoimmune, T cells attack beta cells that make insulin

3 P’s: polyuria, polydipsia, polyphagia

hypoglycemia from insulin overdose or activity (inc demand for glucose)

Question 28

Type 2 DM

Answer 28

insulin resistance -> ramps up production and eventually cannot compensate and is too low on insulin (later in disease process)

hyperinsulinism -> cells are resistant to insulin and high amount of insulin in blood

Question 29

Metabolic syndrome

Answer 29

Hyperglycemia
Abdominal obesity
Hypertension
High Triglycerides
High LDL
Low HDL

Question 30

DKA

Answer 30

body lacks the insulin to bring glucose into cells, so turns to fat metabolism instead -> ketones

dehydrated, Kussmauls, fruity breath, hyperglycemia s/s

glucose >250, ketonuria, ABG - pH <7.30, electrolyte imbalances (hypokalemia or false hyperkalemia)

T1DM

Question 31

HHS

Answer 31

Similar signs to DKA (3 Ps) without ketones and with neuro (seizures, coma, hemiparesis)

glucose >600

T2DM

Question 32

Gigantism

Answer 32

Secondary disorder of the anterior pituitary - hyperpituitarianism -> GH

disease of children, long bones

Question 33

Acromegaly

Answer 33

Secondary disorder of the anterior pituitary - hyperpituitarianism -> GH

disease of adults, short bones (hands, feet, jaw)

pituitary adenoma

Question 34

Grave’s

Answer 34

Primary disorder of the thyroid gland

hyperthyroidism - “speeds up” increased SNS response, weight loss, feeling warm, anxiety, tremor, exopthalmos, a fib

decreased TSH, increased T3/4 (overstimulates thyroid cells)

concern for “thyroid storm” - HF, pulm edema, tachy, dysrhythmia

Question 35

Hashimoto’s

Answer 35

Primary disorder of the thyroid gland

hypothyroidism - “slows down” decreased SNS response, weight gain, feeling cold, sluggish, constipation, lethargy

increased TSH, decreased T3/4 (presence of antithyroid antibodies -> destroys thyroid cells)

concern for myxedema coma

Question 36

Addison’s

Answer 36

Primary disorder of the adrenal gland

adrenal insufficiency, autoimmune (destroy adrenal cortical cells)

low cortisol and high ACTH -> “tanned appearance” and hypoglycemia
low aldosterone -> hyponatremic and hyperkalemic

Question 37

Cushing’s Syndrome

Answer 37

hypercortisolism (any kind)

central obesity, dowager’s hump, HTN, striae, weakness, purpura, osteoporosis

secondary = Cushing’s disease
primary = adrenal tumor
ectopic = lung cancer paraneoplastic
iatrogenic = long-term glucocorticosteroids

Question 38

Cushing’s Syndrome vs Disease

Answer 38

Syndrome = any kind of hypercortisolism

Disease - secondary from pituitary (adenoma ex)

Question 39

SIADH

Answer 39

Secondary disorder (?) of the kidney

high ADH, low Na+ -> retain fluids and decreased UOP, dilutional hyponatremia

increased urine osmolarity (concentrated)
decreased serum osmolarity (diluted)

Question 40

Diabetes Insipidus

Answer 40

Secondary disorder (?) of the kidney

can be central or nephrogenic

low ADH, high Na+ -> constant diuresis/polyuria (increased UOP), dehydrated, hypernatremic

decreased urine osmolarity (diluted)
increased serum osmolarity (concentrated)