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PNP Certification Exam > Endocrine > Flashcards

Endocrine Flashcards

1
Q

A syndrome with disordered metabolism and inappropriate hyperglycemia due to either an absolute deficiency in insulin secretion or a reduction in its biological effectiveness

A

Diabetes Mellitus

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2
Q

Type 1 diabetes has an _____ onset and is caused by destruction of pancreatic ____ cells. _______ can be found in the blood and urine.

A

Acute onset
Islet cells
Ketones found in the blood and urine

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3
Q

Classic s/sx of type 1 diabetes

A

3 P’s: polyuria, polydipsia, and polyphagia

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4
Q

Children with type 1 diabetes have weight _____ but ______ hunger.

A

loss

increased

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5
Q

In advanced type 1 diabetes, an ophthalmic exam may reveal microaneurysms, or ______ _____ ______.

A

cotton wool spots

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6
Q

Deep tendon reflexes are _______ in advanced disease of type 1 diabetes.

A

diminished

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7
Q

Diagnostic criteria for type 1 diabetes requires a serum fasting BG of greater than ____ on 2 separate occasions.

A

126 mg/dl

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8
Q

If BG is greater than ___ mg/dl AND there is polydipsia, polyuria, and weight loss are present, then the diagnosis must be confirmed by ______ studies.

A

200

Fasting

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9
Q

Hemoglobin A1c is elevated. The normal HgA1c is _ to _%

A

4-6%

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10
Q

Management includes obtaining baseline fasting _______, _____, ______ studies and EKG

A

triglycerides
cholesterol
renal studies

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11
Q

What should the total carbohydrate intake be for a type 1 diabetic?

A

50 to 60% of total caloric intake

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12
Q

Total fats should make up what percent of total caloric intake?

A

25-30%

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13
Q

Total fiber should have ____ grams/1000 calories.

A

25

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14
Q

Protein should make up what percent of total caloric intake?

A

10 to 20%

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15
Q

What does of insulin should a patient presenting with ketones be started on?

A

0.5 units/kg/day

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16
Q

This results when nocturnal hypoglycemia stimulates a surge of counter regulatory hormones that raise blood sugar. This patient is HYPOGLYCEMIC at 3 am and rebounds with an elevated blood sugar at 7 am.

A

The Somogyi effect

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17
Q

This results when tissue becomes desensitized to insulin nocturnally. Blood sugar gets progressively highter throughout the night and is elevated at 7 am. This desensitization is due to presence of growth hormone, which spikes at night.

A

Dawn Phenomenon

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18
Q

What is the treatment for the Somogyi effect?

A

reduce or eliminate night dose of insulin

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19
Q

What is the treatment for the Dawn Phenomenon

A

Add or increase the dose of night time insulin

20
Q

Type 2 diabetes has an _____ onset

A

insidious

21
Q

Type 2 diabetes s/sx include darkened neck skin called ______ _____.

A

Acanthosis nigricans

22
Q

What is typically the first symptom in women with type 2 diabetes?

A

recurrent vaginitis

23
Q

Name four signs that are associated with insulin resistance:

A

Acanthosis Nigricans
Hypertension
Dyslipidemia
Polycystic ovarian disease

24
Q

Screening for DM2 should be completed if there is a _____ history of DM2, race (AA, NA, Hisp, A/PI), or signs are present consistent with DM2.

A

family

25
Q

What age should screening for DM2 begin? Age ___ or onset of _____, then every __ years.

A

Age 10 or onset of puberty then every 2 years

26
Q

What drug is approved by the FDA for treatment of DM2 in children?

A

metformin (glucophage)

27
Q

How does metformin work?

A

It reduces gluconeogenesis

28
Q

A series of clinical disorders associated with increased circulating levels of free thyroxine or triiodothyronine.

A

Hyperthyroidism

29
Q

Most common in children and is associated with diffuse enlargement of thyroid, hyperactivity of the gland, presence of antibodies against different fractions of the thyroid gland.

A

Grave’s disease

30
Q

Hyperthyroidism is more common in ____ , with a ratio of 8:1

A

females

31
Q

Onset of hyperthyroidism is between ages __ and __

A

12 and 14

32
Q

Deep tendon reflexes are _________ in hyperthyroidism.

A

Hyperactive

33
Q

In hyperthyroidism, TSH is ______ and T3/T4 are _______

A

TSH is decreased

T3 and T4 are increased

34
Q

What can be given as a treatment that can reduce the vascularity of the thyroid gland?

A

Lugol’s solution

35
Q

What medication is helpful for symptomatic relief in hyperthyroidism?

A

Propranolol 10-80 mg QID

36
Q

A condition resulting in lack of circulating thyroid hormone

A

Hypothyroidism

37
Q

Hypothyroidism is most often due to __________ ________.

A

Autoimmune thyroiditis

38
Q

______ ________ is a cause of juvenile thyroiditis.

A

Hashimoto’s thyroiditis

39
Q

In neonates, there may be no obvious signs in the first month of life. Then you begin seeing poor _____, _____ and ______.

A

Poor feeding
Bradycardia
Hypotonia

40
Q

For hypothryoidism, think of the old lady….the brake pedal is stuck so you have….

A

constipation, weight gain, weakness, delayed bone age/growth, dry skin thinning hair and brittle nails

41
Q

In hypothyroidism, TSH is ______ while T3/T4 are _____

A 
TSH = elevated
T3/T4 = decreased
42
Q

What drug is helpful in the treatment of hypothyroidism?

A

Synthroid (which is better than levothyroxine–the generic)

43
Q

A child is considered to have short stature if the height falls more than ___ standard deviations below the mean

A

Two

44
Q

Failure to grow more than ___ cm/year also is present in short stature children

A

4 cm/yr

45
Q

If a patient is considered short stature, the primary provide should always assess for ______.

A

Neglect

PNP Certification Exam (12 decks)

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