Endocrine

Question 1

Pancreas:
glycosylated hemoglobin

Answer 1

4-6% (normal value)

Question 2

insulin action

Answer 2

-promotes glucose uptake by target cells and glucose storage as glycogen
-prevents fat and glycogen breakdown
-inhibits glucogenesis
-increase protein synthesis

Question 3

Diabetes Mellitus:
3 P’s

Answer 3

-polyuria
-polydipsia
-polyphagia

Question 4

Insulin:
short

Answer 4

regular

Question 5

insulin:
intermediate

Answer 5

NPH

Question 6

insulin:
long acting

Answer 6

lantus

Question 7

insulin:
fast acting

Answer 7

NovoLog

Question 8

Lantus duration

Answer 8

20-26 hours

Question 9

Novolog onset

Answer 9

15 minutes

Question 10

lantus peak

Answer 10

NO PEAK

Question 11

Sick day rules:
what should diabetics not do

Answer 11

do NOT stop taking their insulin or oral agents

Question 12

sick day rules:
how often do we check blood sugar

Answer 12

every 3-4 hours

Question 13

sick day rules:
what do we look in urine for

Answer 13

ketones

Question 14

sick dat rules:
what do we do if we cannot tolerate a diet or become dehydrated

Answer 14

notify care provider

Question 15

what are the causes of DKA
6

Answer 15

-infection, surgery, trauma
-inadequate insulin
-changes to diet/exercise
-pregnancy and growth spurts
-emotional stress
-drugs-steroid therapy and epi/norepi

Question 16

what are the three patho findings of DKA

Answer 16

-hyperglycemia
-ketosis
-metabolic acidosis

Question 17

DKA:
blood glucose

Answer 17

> 250 mg/dl

Question 18

DKA:
bicarb

Answer 18

<18 mEq/L

Question 19

DKA:
pH

Answer 19

low
<7.3

Question 20

DKA:
where will ketones be present

Answer 20

ketonemia-blood
ketonuria-urine

Question 21

DKA:
osmotic diuresis

Answer 21

-dehydration (FVD)
-critical loss of electrolytes

Question 22

DKA main Acid-Base imbalance

Answer 22

metabolic acidosis

Question 23

DKA: what will the ABG look like

Answer 23

metabolic acidosis w respiratory alkalosis compensation

Question 24

DKA:
what electrolyte is most likely to be abnormal

Answer 24

potassium (K)

Question 25

DKA: how do we fix their blood sugar levels

Answer 25

replace insulin continuous IV regular insulin

Question 26

DKA: how do we avoid hypoglycemia

Answer 26

change to IV solution w dextrose when BS is between 200-250

Question 27

DKA: what electrolyte are we most likely going to administer and why

Answer 27

potassium insulin will cause K+ to go back into the cell and cause hypokalemia

Question 28

DKA: how often do we check blood glucose

Answer 28

hourly

Question 29

DKA: how often do we check electrolyte levels

Answer 29

every 4 hours

Question 30

DKA: what do we add to the IV solution when blood glucose reaches 200

Answer 30

dextrose

Question 31

DKA: risk for cerebral edema

Answer 31

change in level of consciousness- first indication w increased ICP

Question 32

DKA: clinical manifestations

Answer 32

-fruity breath odor from volatile acids -hypotension -tachycardia -kussmaul breathing (increased rate and depth)

Question 33

hypoglycemia: clinical manifestation

Answer 33

-rapid onset -tachycardia -cool/ clammy skin -coma and seizures

Question 34

hypoglycemia tx (if conscious)

Answer 34

orally: 1/2 cup juice followed w starch and protein -cheese/crackers -milk/crackers -half sandwich w meat

Question 35

hypoglycemia tx (if uncoscious)

Answer 35

IV Push 1 amp of D50= 50 ml of fluid WITH 25 g of Dextrose=100 calories half life only 30 minutes

Question 36

HHS: blood glucose

Answer 36

>600 mg/dL

Question 37

HHS: arterial pH

Answer 37

greater than 7.3

Question 38

HHS: serum osmolality

Answer 38

>320 mOsm/kg H20 EXTREME DEHYDRATION

Question 39

HHS: Clinical manifestations

Answer 39

profound fluid deficit excessive thirst

Question 40

HHS: Medical Management

Answer 40

1. rapid rehydration 2. insulin administration 3. electrolyte replacement (K+)

Question 41

Pituitary evaluation: lab- urine and blood osmolality

Answer 41

normal: 275-295 mOsm/kg H2O (serum)

Question 42

pituitary secretes what?

Answer 42

ADH -SIADH -DI

Question 43

Diabetes insipidus lacks what

Answer 43

antidiuretic hormone (ADH)

Question 44

diabetes insipidus hydration

Answer 44

extracellular dehydration

Question 45

diabetes insipidus salt

Answer 45

hypernatremia

Question 46

diabetes insipidus BP

Answer 46

hypotension hypovolemic shock

Question 47

diabetes insipidus: 1. urine output? 2. serum osmolality?

Answer 47

1. increase urine output 2. DEHYDRATED (high >300)

Question 48

SIADH: excess ______ secreted into bloodstream

Answer 48

ADH

Question 49

SIADH: too much_______

Answer 49

ADH

Question 50

SIADH: Dilutional __________

Answer 50

hyponatremia -will have lethargy and confusion

Question 51

SIADH: labratory values -what happens to urine osmolality

Answer 51

increased

Question 52

SIADH: urine output

Answer 52

decreased -holding onto urine

Question 53

SIADH: medical management

Answer 53

Sodium replacement -hypertonic saline (3%)

Question 54

A1C goal for diabetics

Answer 54

under 7

Question 55

normal A1C

Answer 55

4-6

Question 56

Cortisol increases what

Answer 56

glucose

Question 57

metformin

Answer 57

diarrhea and CT contrast

Question 58

hypothyroidism levels

Answer 58

High TSH Low T4

Question 59

Hyperthyroidsism

Answer 59

very low TSH High serum T4

Question 60

Thyroid storm

Answer 60

exacerbation of hyperthyroidism "thyroid crisis"

Question 61

thyroid storm -heart

Answer 61

a fib

Question 62

throid storm -thermo

Answer 62

fever

Question 63

thyroid storm -CNS

Answer 63

agitation restless delerium

Question 64

Graves disease is a state of

Answer 64

hyperthyroidism goiter opthalmopathy (buldging eyes)

Question 65

severe hypothyroidism leads to what?

Answer 65

coma (myxedema coma)

Question 66

addisons disease

Answer 66

adrenal cortical insuff

Question 67

bushings syndrome

Answer 67

excessive cortisol

Question 68

pheochromocytoma

Answer 68

tumor of adrenal medulla -must remove tumor