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endocrine and metabolic systems Flashcards

1
Q

What structures make up the central network controlling the glands within the body?

A
  1. nervous system
  2. hypothalamus
  3. anterior pituitary gland
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2
Q

(true/false) the endocrine system functions are closely linked to the immune system

A

true

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3
Q

What level of blood glucose warrants deferring PT?

A

> 300

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4
Q

What should one do if a patient’s blood glucose is < 100?

A

rule of 15

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5
Q

What should you closely monitor if a patient with DM has retinopathy and/or HTN?

A

blood pressure

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6
Q

Hypoglycemia is indicated when blood glucose is ____.

A

< 70

also indicated if there is a rapid drop of glucose within minutes

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7
Q

What are the early s/s of hypoglycemia?

A
  • pallor
  • shakiness
  • sweating
  • excessive hunger
  • tachycardia/palpitations
  • feeling faint
  • weakness
  • fatigue
  • dizziness
  • poor coordination and balance
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8
Q

What are the late symptoms of hypoglycemia?

A
  • anxiety and irritability
  • blurred or double vision
  • HA
  • slurred speech
  • drowsiness
  • inability to concentrate
  • confusion
  • delusions
  • LOC or coma
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9
Q

(true/false) Both hypoglycemia and hyperglycemia have a rapid onset.

A

FALSE

hyperglycemia has a gradual onset (days)

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10
Q

What are s/s of hyperglycemia?

A
  • weakness
  • thirst/dry mouth
  • scant urination
  • decreased appetite
  • N/V
  • abdominal tenderness
  • dulled sensation and paresthesia
  • confusion
  • diminished reflexes
    **- fruity breath
    **- rapid and weak pulse
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11
Q

A patient with DM should not exercise without eating at least ______ before.

A

at least 2 hours before

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12
Q

What insulin injection site is preferred?

A

abdominal

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13
Q

(true/false) you can inject short-acting insulin into exercising muscles as long as it is warranted.

A

FALSE

if injected into exercising muscles, the insulin will be absorbed more quickly

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14
Q

What intensity of exercise should be prescribed for those with nephropathy and DM?

A

low to moderate

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15
Q

What type of exercise should be avoided in those with retinopathy and DM?

A
  • activities that increase BP to >170 mmHg
  • pounding and jarring activities
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16
Q

What is diabetes insipidus?

A

Lack of secretion of the anti-diuretic hormone vasopressin

allowing unabsorbed water to be lost in the urine

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17
Q

What are the s/s of diabetes insipidus?

A
  • dehydration, thirst
  • increased urination
  • fatigue
  • irritability
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18
Q

What is SIADH?

A

Excess secretion of vasopressin

resulting in marked retention of water

  • decreased urination
  • weight gain w/o visible edema
  • lethargy
  • HA
  • confusion
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19
Q

What is Addison’s disease?

A

Hypofunction of the adrenal cortex (adrenal insufficiency) - decreased cortisol and aldosterone

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20
Q

What is primary adrenal insufficiency called?

A

Addison’s disease

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21
Q

What are the s/s of Addison’s disease?

A
  • dark pigmentation
  • hypotension
  • weakness
  • progressive fatigue
  • decreased tolerance to cold
  • dehydration
  • GI disturbance
  • tendon calcification
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22
Q

What is Cushing’s syndrome?

A

Hyperfunction of adrenal cortex – excess secretion of cortisol

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23
Q

What can cause addison’s disease?

A
  • autoimmune processes
  • infection
  • neoplasm
  • hemorrhage
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24
Q

What can cause secondary adrenal insufficiency?

A
  • prolonged steroid therapy
  • rapid withdrawal of drugs
  • hypothalamic or pituitary tumors
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25
What causes cushings **syndrome**?
- excessive use of corticosteroids - increased cortisol production
26
What causes cushing's **disease**?
pituitary tumor resulting in increased secretion of ACTH ## Footnote - HA - visual changes
27
What is cushing's disease?
excess secretion of **adenocorticotropic hormone (ACTH)**
28
What are the s/s of hypercortisolism (cushing's syndrome/Cushing's disease)?
- "moon face" - buffalo hump on neck - bruise easily - abdominal stretch marks and increased fat pads - masculine traits in women - osteoporosis - decreased glucose tolerance - decreased testosterone - decreased menstrual periods - atrophy - edema - hypokalemia - obesity
29
What is goiter?
enlargement of the thyroid gland due to **TSH** hypersecretion
30
What causes goiter?
iodine deficiency
31
What is thyroiditis?
Inflammation of the thyroid gland due to infection/autoimmune processes | Hashimoto's thyroiditis is the chronic form
32
When hyperthyroidism is present, metabolic processes are (decreased/increased)
increased
33
What are s/s of thyroiditis and goiter?
- dysphagia - difficulty breathing - hoarseness
34
What are the s/s of hyperthyroidism?
- hyperreflexia and tremor - weight loss - fatigue - heat intolerance - palpitations and tachycardia - goiter - diarrhea
35
What medications are used to treat hyperthyroidism?
antithyroid drugs
36
What symptom is associated with a hypermetabolic state?
fatigue
37
What is Graves' disease?
Hyperthyroidism - excessive secretion of the **thyroid hormone**
38
What are s/s of graves' disease?
- tachycardia - fatigue - weight loss - hyperreflexia - increased sweating - heat intolerance - tremor - exophthalmos (bulging eyes)
39
Hypothyroidism (decreases/increases) metabolism
decreases
40
What are the s/s of hypothyroidism?
- constipation - dry hair and skin - hair loss - fatigue - slowed HR - weight gain
41
If hypothyroidism is left untreated, what can it lead to?
myxedema (severe hypothyroidism)
42
What are the s/s of myxedema?
swelling of the hands, feet and face can lead to coma or death
43
What are medical interventions for treatment addison's disease?
- replacement therapy (glucocorticoids, adrenal corticoids) - adequate fluid intake, controlled sodium and potassium - diet with high complex carbs and protein
44
What are the medical treatments for cushing's syndrome/disease (hypercortisolism)?
- decrease ACTH: irradiation or surgical excision of pituitary tumor - monitor weight, electrolytes, and fluid balance
45
Is (hyper or hypo)thyroidism more common?
hypothyroidism
46
Hyperparathyroidism is the excessive secretion of **PTH** causing increased release of what into the bloodstream?
increased release of calcium into the bloodstream
47
What are the s/s of hyperparathyroidism?
- decreased bone strength - fx - weakness and atrophy - hypermobility - kidney stone or failure
48
What is hypoparathyroidism?
Insufficient secretion of PTH causing deficiency of Calcium in the blood
49
What are the s/s of hypoparathyroidism?
- muscle spasms - paresthesia - tetany - cardiac arrythmias - weakness - chvostek sign (facial spasm) - trousseau sign (carpal spasm) - seizures
50
# diagnosis Decrease in the size and number of islet cells resulting in absolute deficiency of insulin secretion
T1DM
51
What population is commonly experiencing hyperthyroidism?
Females, 20-40 yrs
52
What population is commonly experiencing hypothyroidism?
females, 30-60 yrs
53
What population commonly experiences hyperparathyroidism?
females > 60 y/o
54
What type of DM is prone to ketoacidosis?
T1
55
# diagnosis glucose intolerance (high blood sugar) associated with pregnancy
gestational DM
56
Mothers who experience gestational DM often have onset in the _____ trimester
3rd trimester | 4% of pregnancies
57
How long does it take for prediabetics to convert to T2DM?
within 10 years | 10-15%
58
Describe diabetic polyneuropathy.
- bilateral N/T of the hands and feet in stocking-glove distribution - progresses from distal to proximal nerves - weakness - paresthesia, shooting pain, loss of protective sensations
59
What is a mononeuropathy?
Focal nerve damage resulting from vasculitis with ischemia and infarction
60
What do entrapment neuropathies result from?
repetitive trauma to superficial nerves
61
What BMI range is considered as overweight?
25-29.9
62
What BMI range is considered as obesity?
30-39
63
What BMI range is considered as morbid obesity?
> 40
64
What is the normal range of A1c?
< 5.7%
65
What A1c range is indicative of prediabetes?
5.7-6.4%
66
What A1c range is indicative of diabetes?
> 6.5%
67
What are the 3 diagnostic criteria for dx of DM?
1. s/s of diabetes in the presence of a plasma glucose concentration of > 200 mg/dL 2. Fasting plasma glucose > 126 mg/dL 3. A1c is >6.5%
68
What does an A1c test examine?
Avg. blood glucose within the last 2-3 months

NPTE (22 decks)

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