Endocrine System (W9)

Question 1

Hormones have ___ effect on target tissues

Answer 1

Specific

Question 2

Endocrine glands are

Answer 2

Ductless

Question 3

Insulin is produced by

Answer 3

Beta cells

Question 4

Insulin works to lower CBG by

Answer 4

Moving glucose into the cell for energy

Question 5

Insulin helps absorb

Answer 5

Amino acids and fatty acids

Question 6

Insulin convert glycogen to the liver for

Answer 6

Later use

Question 7

Glucagon is produced/secreted by the

Answer 7

Alpha cells

Question 8

How does glucagon work to increase CBG

Answer 8

By breaking down glycogen to glucose

Question 9

What does somatostatin do

Answer 9

Works to lower insulin/glucagon when hormone levels are too high

Question 10

In an adult the normal CBG level is

Answer 10

4-6mmol

Question 11

In a pediatric the normal CBG level is

Answer 11

3-6mmol

Question 12

In the first 24hrs of life what is a normal CBG

Answer 12

1.5-3mmol

Question 13

What may cause high CBG

Answer 13

Trauma, post seizure, fever, immediately after a meal, infection

Question 14

What does the thyroid do

Answer 14

Regulates tissue/body metabolism/development

Question 15

What gland regulates the release of thyroid hormones

Answer 15

Pituitary gland

Question 16

Very fast acting insulin

Answer 16

lispro // humulog

Question 17

VERY FAST ACTING INSULIN: onset ___, peak ___, duration ___

Answer 17

0.5-1h // 2-3h // 8-12h

Question 18

Regular fast acting insulin

Answer 18

humulin R // novolin R

Question 19

FAST ACTING INSULIN: peak ___, duration ___

Answer 19

2-5h // 5-8h

Question 20

Intermediate acting insulin

Answer 20

humulin R // novolin R // lente

Question 21

INTERMEDIATE ACTING INSULIN: onest ___, peak ___, duration ___

Answer 21

1-1.5h // 4-12h // 16-24h

Question 22

Long acting insulin

Answer 22

Zinc suspension

Question 23

LONG ACTING INSULIN: onset ___, peak ___, duration ___

Answer 23

4-8h // 16-18h // <23h

Question 24

If pt is hyperglycemic, consider medications to

Answer 24

Encourage the pancreas to produce more insulin which will lower CBG

Question 25

Most common first medication for T2DM

Answer 25

Biguanides: metformin (glucophage)

Question 26

How do bigaunides (metformin; glucophage) work in the body

Answer 26

Inhibits glycogen breakdown to glucose, lowers insulin levels, makes cells more sensitive to insulin

Question 27

Addison’s disease can be

Answer 27

Autoimmune, infectious, neoplastic, traumatic, or vascular

Question 28

Addison’s disease is a destruction of what

Answer 28

The adrenal cortex

Question 29

S/S of Addison’s disease

Answer 29

Chronic fatigue, weight loss, anemia, hyperpigmentation, decreased concentration

Question 30

What is the prehospital tx for pts w adrenal failure/crisis

Answer 30

Hydrocortisone

Question 31

How is hydrocortisone administered

Answer 31

M/IV, 2mg/kg (max sin. dose 100mg), only one dose

Question 32

To give hydrocortisone, paramedics must

Answer 32

Be presented with a vial of it AND pt has age-related hypoglycemia/tension/tachycardia // GI S/S // syncope // <38degrees of hx of fever // altered LOA //

Question 33

An excessive amount of cortisol can be caused by

Answer 33

Prolonged exposure to elevated levels of glucocorticoids, increased Na+ retention (increasing blood volume) = together HTN

Question 34

Pathologies cushings syndrome can cause

Answer 34

Altered fat management (hypercholesteremia), causing atherosclerosis, increased risk of diabetes and infection

Question 35

What hormones are lacking in Addison’s disease

Answer 35

Glucocorticoids (cortisol) and mineralcorticoids (ALD)

Question 36

S/S of Cushing’s syndrome

Answer 36

Moon face, buffalo hump, easy bruising, purple striae, increased facial hair, HTN, osteoporosis, glucose intolerance, psychosis

Question 37

Osteoporosis in Cushing’s syndrome is due to what

Answer 37

The increased glucocorticoids increasing bone reabsorption and decreasing bone formation, making brittle bones

Question 38

What does ALD (produced and secreted by adrenal glands) do

Answer 38

Signals kidney to excrete less Na+ and more K+ (antidiuretic)

Question 39

Hyperaldosteronism causes what

Answer 39

HTN, hypokalemia, muscle spasm/temporary paralysis

Question 40

What causes a goiter (enlarged thyroid gland)

Answer 40

Deficiency in thyroid hormone synthesis/intake = increase in TSH production

Question 41

What problems can a goiter pose

Answer 41

Compression of the trachea, larynx, superior and inferior laryngeal nerve, esophagus

Question 42

Graves’ disease is the generation of antibodies producing what

Answer 42

Excess thyroid hormones

Question 43

Why are excess thyroid hormones produced in Graves’ disease

Answer 43

Overstimulation of thyroid tissue creating organ function changes

Question 44

What is the pathology behind hyperthyroidism

Answer 44

Excessive thyroid hormone synthesis, accelerated metabolism to peripheral tissues = increased CO at rest = less muscle and function. Hyper-response of beta-adrenergic receptors (ie increased catecholamine sensitivity)

Question 45

What is a thyroid crisis

Answer 45

Unbound thyroid hormone, causing nervousness/tremors, heat intolerance, weight loss with an appetite, confusion, dyspnea, palpitations, muscle weakness

Question 46

A thyroid storm is life-threatening due to hyperthyroidism causing

Answer 46

Fever above 40, confusion—>delirium—>seizures—>coma

Question 47

What can cause hypothyroidism

Answer 47

Low metabolic state due to low TH in the blood

Question 48

What can hypothyroidism cause

Answer 48

Lethargy, cold intolerance, dry/coarse skin, facial/extremity swelling, impaired memory, mild weight gain w/o appetite

Question 49

Hashimoto’s thyroiditis is the most common cause of what

Answer 49

Hypothyroidism

Question 50

S/S of myxedema coma

Answer 50

Altered LOA, hypothermia, HoTN, bradycardia/pnea, electrolyte imbalance, delusions/psychosis