endocrine Flashcards
1
Q
functions of endocrine system:
enables body to ______ energy
A
metabolize
2
Q
functions of the endocrine system:
_____, _____, and develop
A
- reproduce
- grow
3
Q
endocrine system maintains ______
A
homeostasis
4
Q
endocrine system responds to _____ and ____
A
stress and injury
5
Q
2 major classes of hormones
A
- steroids
- thyronines
6
Q
age related changes have a _______ response
A
compensatory
7
Q
effects of aging:
thyroid gland ____ and activity decreases
A
atrophies
8
Q
____ metabolic rate with aging
A
lower
9
Q
reduced ____ _____ uptake with aging
A
radioactive iodine
10
Q
less secretion and release of ______ w aging
A
thyrotropin
11
Q
diminished ____ function with aging
A
adrenal
12
Q
_______ secretion decreases
A
ACTH
13
Q
decreased secretion of ACTH further reduces ____, ____, ______, _______ and _____
A
- estrogen
- progesterone
- androgen
- 17-ketosteroids
- glucocortiocoids
14
Q
volume of _____ gland decreases
A
pituitary
15
Q
decreased volume of pituitary gland causes _____ _____ hormone level reduction
A
somatotropic growth
16
Q
seventh leading cause of death in older adults
A
type 2 diabetes
17
Q
glucose intolerance due to increased amounts of ____ ___ in obese older adults
A
fat tissue
18
Q
___% of older adults have diabetes
A
20
19
Q
symptoms of type 2 diabetes
A
- hypotension
- periodontal disease
- stroke
- gastric hypotony
- impotence
- neuropathy
- confusion
- glaucoma
- Dupuytens contracture
20
Q
fasting blood sugar recommended every ___ years for persons over ___ years
A
- 3 years
- 45
21
Q
most effective test for diabetes
A
glucose tolerance test
22
Q
ADA recommends ____g of carbs ingested several days before blood work
A
150g
23
Q
test should be performed more than once to avoid
A
false positive results
24
Q
criteria for diagnosis of type 2 diabetes:
symptoms and random blood glucose concentration greater than or equal to _____ mg/dL
A
200
25
criteria for diagnosis of type 2 diabetes:
fasting blood glucose concentration greater than or equal to ____mg/dL
126
26
criteria for diagnosis of type 2 diabetes:
blood glucose concentrations 2 hours after oral glucose intake greater than or equal to ____mg/dL
200
27
criteria for diagnosis of type 2 diabetes:
glycosylated hemoglobin (HbA1C) greater than or equal to ___%
6.5%
28
meds that decrease glucose tolerance (5)
- furosemide
- diuretics
- estrogen
- ethacrynic acid
- nicotinic acid
29
meds that lower blood sugar levels (3)
- MAIOs
- propanolol
- high dosage of salicylates
30
hypoglycemia:
blood glucose less than ____mg/dL
70
31
hyperglycemia s/s (6)
- increase in urination
- increase in appetite, followed by lack of appetite
- weakness, fatigue
- blurred vision
- headache
- glycosuria
32
hypoglycemia s/s (5)
- cold, clammy skin
- numbness of fingers, toes, mouth
- tachycardia
- nervousness, tremors
- faintness, dizziness
33
diabetes management:
choose foods low in _____ fat and ___ fat
- saturated
| - trans
34
_______ respirations are the body's attempt to reverse metabolic acidosis through the exhalation of CO2
Kussmaul
35
teach pt about prevention, recognition, and management of hypoglycemia if pt is taking _____ or ______
- sulfonylureas
| - metformin
36
diabetic ketoacidosis most likely to occur in pts with type ___
1
37
s/s of diabetic ketoacidosis (4)
- hyperglycemia
- ketosis
- acidosis
- dehydration
38
what is it called when ketone bodies are excreted in the urine?
ketonuria
39
during ketonuria, _____ that are cations are excreted with the anionic ketones to try to maintain _____ _______
- electrolytes
| - electrical neutrality
40
insulin deficiency stimulates the production of glucose from _____ _____ in the liver furthering hyperglycemia
-amino acids
41
s/s of dehydration in DKA (3)
- dry mucous membranes
- tachycardia
- orthostatic hypotension
42
acetone is noted on breath as a sweet, fruity odor in what condition?
diabetic ketoacidosis
43
common causes of hyperosmolar hyperglycemia syndrome (5)
- UTIs
- pneumonia
- sepsis
- acute illness
- newly diagnosed type 2 diabetes
44
what is it called when a pt w diabetes is able to make enough insulin to prevent diabetic ketoacidosis but not enough prevent severe hyperglycemia, osmotic diuresis, and extracellular fluid depletion?
hyperosmolar hyperglycemia syndrome
45
HHS causes severe ______
hyperglycemia
46
HHS causes ______ ______ depletion
extracellular fluid
47
HHS causes ____ ______
osmotic diuresis
48
HHS often related to impaired ______ ______
thirst sensation
49
HHS related to functional inability to replace _____
fluids
50
the main difference between HHS and DKA is that the pt with HHS usually has enough circulating ______ so that ketoacidosis does not occur
insulin
51
lab values for HHS:
blood glucose greater than ____mg/dL
600
52
lab values for HHS:
marked increase in serum _____
osmolality
53
HHS treatment:
when blood glucose falls to about ____mg/dL IV fluids containing ______ are given to prevent hypoglycemia
- 250
| - dextrose
54
first goal of therapy for DKA is to begin _____ and ______ replacement
fluid and electrolyte
55
obtain serum _____ level before starting insulin in pt with DKA
-potassium
56
3 major types of glucose lowering agents
- insulin
- oral agents (OAs)
- noninsulin injectable agents
57
_____ (injected) insulin is needed when a pt has inadequate insulin to meet specific metabolic needs
exogenous
58
type ___ diabetes is a progressive illness
2
59
rapid acting insulin:
-peak: ___min- __ hours
30 min-3 hours
60
rapid acting insulin examples (3)
- Humalog
- Novolog
- Apidra
61
rapid acting insulin duration: __-___ hours
3-5 hours
62
short acting insulin examples (2)
- Humulin R
| - Novolin R
63
short acting insulin duration:
__-___ hours
5-8 hours
64
intermediate acting insulin examples (2)
-NPH-- Humulin N, Novolin N
65
intermediate acting insulin duration:
___-___ hours
12-18 hours
66
long acting insulin examples (3)
- Lantus
- Levemir
- Tresiba
67
long acting insulin duration:
__-___ hours
16-24 hours
68
inhaled insulin example (1)
afrezza
69
inhaled insulin duration:
___1/2-___ hours
2 1/2-3 hours
70
fastest subcutaneous absorption is from the ______
abdomen
71
what is it called when a high dose of insulin causes a decline in blood glucose levels during the night causing counterregulatory hormones to be released?
Somogyi effect
72
what counter regulatory hormones are release during somogyi effect (4)
- glucagon
- ephinephrine
- growth hormone
- cortisol
73
if the pt has morning hyperglycemia, checking blood glucose levels between
___ and ____a.m. for hypoglycemia to determine if the cause is the Somogyi effect
2-4am
74
_______ and _____ are excreted in increased amounts in the morning may be the cause of _____ ______
- growth hormone and cortisol
| - dawn phenomenon
75
dawn phenomenon tends to be most severe during ______ and _____ adulthood bc _______ ______ is at its peak
- adolescents and young adulthood
| - growth hormone
76
treatment for somogyi effect:
reducing ________ of _____
bedtime _____
- dosage of insulin
| - snack
77
treatment for dawn phenomenon:
increase in ____
adjustment of ___________time
- insulin
| - administration
78
most widely used oral agent
metformin
79
_____ is the most effective first line treatment for type 2 diabetes
metformin
80
primary action of ______ is to reduce glucose production to the liver
metformin
81
the primary action of metformin is to reduce ____ production by the _____
- glucose
| - liver
82
_____ is a major side effect of sulfonylreas
hypoglycemia
83
primary action of ______ is to increase insulin production by the pancreas
-sulfonylureas
84
______ are more rapidly absorbed and eliminated by pancreas than sulfonylreas so they are less likely to cause hypoglycemia
meglitinides
85
______ ______ inhibitors work by slowing down carb absorption in the small intestine
alpha glucosidase inhibitors
86
alpha glucosidase inhibitors slow down the absorption of ______ in the _____ intestine
- carbohydrates
| - small
87
if alpha glucosidase inhibitors are taken with the first bite of each main meal, they are most effective in lowering ______ blood glucose
postprandial
88
_______ most effective for pts with insulin resistance
thiazolidinediones
89
Avandia (thiazolidinediones) is associated with adverse ______ events
cardiovascular
90
Pioglitazone (Actos) can worsen ____ ____ and is associated with increased risk of ______ cancer
- heart failure
| - bladder
91
sulfonylreas carries risk for _____due to delayed clearance in older adults
hypoglycemia
92
administer metformin _____ meals
after
93
take sulfonylureas ____ hour before meals
half hour
94
The recommendation for pts who use multiple insulin injections a day or insulin pumps is to monitor their blood glucose ___-___ times a day
4-8
95
_____ _______ agent is _____(short/long) acting with less adverse effects on older adults
- insulinotropic anti diabetic agent
| - short
96
med class with the lowest risk of hypoglycemia
thiazolidinediones
97
hemoglobin A1C used to monitor effectiveness of disease control over a
__-__ week period of time
6-12
98
triglyceride levels below ____mg/dL is ideal
150
