Flashcards in Endocrine Disorder Overview Deck (55):
What are hormones targeting?
What needs to be stimulated for hormones to be produced / secreted?
What are the 2 Basic Problems in Endocrine Disorders?
1. Hyposecretion (Decreased or no hormone prodcution)
2. Hypersecretion (Increased hormone production)
What do the 2 basic problems cause to occur?
Inappropriate target cell responses
What is the etiology of Hyposecretion? (6 things)
1. Dietary Deficiency *lack of reactant
2. Metabolism defect *lack of enzyme
3. Immune Disorder
4. Receptor Defects (on target cell d/t damage, inadeq #)
5. No Trophic Stimulation
6. Tx for hyposecretion
What is the etiology of Hypersecretion? (3 things)
1. Increase Trophic Stimulation of gland
2. Defect in Negative feedback
3. Secretory Tumor / Ectopic tumor
Explain how a Secretory tumor works?
Tumor forms in the gland, the tumor advances the secretion.
What is the most common endocrine disease?
What are the hormones in the pancreas? 2 things.
What is the function of the pancreas? Endocrine and Exocrine.
Endocrine: regulates blood sugars
Exocrine: Helps in Digestion
What 2 cells are in the islet of langherhan?
1. Beta cells (secrete insulin)
2. Aplha cells ( secretes glucagon)
What is the function of insulin?
Move glucose across membrane to cells for ATP. If more glucose than the body needs, store it in the liver as glycogen.
*To maintain glucose homeostasis*
What is the function of glucagon?
Takes storage form of glucose, glycogen, from liver into circulation when it is needed.
Define Diabetes Mellitus?
Disorder of insulin (action and or secretion)
What are the two types of insulin deficiency that there can be?
1. Absolute deficiency
2. Relative deficiency
Define absolute deficiency.
pancreas produces no insulin
Define relative deficiency.
produced insulin is abnormal
What is the problem that occurs with Diabetes Melitus in regards to glucose?
Compromised glucose homeostasis.
What are the long term complications that can arise from DM?
Renal, CV, Ocular, Neuro
What are the 2 classifications of Diabetes?
Type 1 A/B
Describe Type 1 A DM
Immune disorder (90-95%)
Define Type 1 B DM
Is type 1 DM absolute or relative deficiency?
Type 2 DM accounts for how much of the total of DM?
What is the ET of Type 1 / Type 2.
Complex trait (polygenic + environment)
What is the ET of Type 1?
1. Familiar (^ risk 10x)
2. Insulin gene on Chrm 11 (10 %)
3. MHC genes on Chrs 6 (40%)
Describe the role of insulin gene on chrm 11?
Proteins regulate division and function of betta cells
Describe the role of MHC genes on chrm 6?
self antigens on the beta cells
What is the ET of Type 2 (MODY)
1. 50% d/t gluokinase gene on chrm 7 - codes for enzyme glucokinase
2. Lifestyle (obesity)
What is the role of glucokinase?
NORMALLY: Phosphate binds to glucose in the cells, therefore glocuse can't move out of the cells.
ABNORMALLY: the absence of glucokinase, glucose will move out of the cells again in the CV causing hyperglycemia
What are the 2 important states of DM?
2. Metabolic Syndrome
What does Prediabetes include? 3 things.
1. IFG (Impaired fasting glucose)
Explain what IFG is, and how this test is done?
Impaired Fasting glucose between 6.1-6.9 mmol/L
- pt. fast for 10 hours
- glucose tested in AM in a fasted state
normal range is 5.0-5.5 .... above that is considered abnormal.
Explain what HbA1c role is in prediabetes state?
- Hyperglycemia, glucose binds to proteins in the blood and makes the proteins less functional
-Measuring the protein to see how much glucose has bound to it.
- 6 - 6.4% considered high
- less than 6 % considered normal
Why is HbA1c the chosen protein to test for in prediabetes state for DM?
- high affinity for glucose and the binding is permanent
Explain the role of IGT in prediabetes state in DM?
-Impaired glucose tolerance
How is the IGT test done in prediabetes state for DM?
- pt. fast over night
- measure glucose concentration (should be 5.0-5.5)
- give pt. glucose solution
- measure pt. 15 minute intervals
- glucose levels increase after 2 hours would NORMALLY go back down
- Prediabetes... fasting level of glucose would already be high. Longer come down from the spike.
Metabolic Syndrome state is predisposition to what?
-Predisposition to Type 2 DM and CV Disease
What does Insulin resistance mean?
Insulin is present, but it is unable to do its job.
1. Insulin Present
2. Hyperglycemic state
3. Insulin unable to bring about hypoglycemic resposne
Explain the 6 step process that are involved in Metabolic Syndrome?
3. Insulin Resistance
5. Abdominal Obesity (Diabesity)
What is the abdominal measurement for men in women for diabesity?
men: greater than or equal to 102 cm
women: greater than or equal to 88 cm
Is type 1 DM usually an early age onset?
In Type 1 DM, what is happening to the beta cells?
Progressive destruction d/t autoimmune disorder (either genetic or enviro trigger (virus?)
In Type 1 DM, how many of the beta cells can be destroyed?
Up to 90%
Is Type 1 DM considered to be absolute or relative deficiency?
Inflammation of the islet
Is Type 2 DM typically an early or later age onset?
Most cases (should be) later age onset
Why would type 2 DM be occurring in younger ages?
Childhood obesity / inactivity
In Type 2 DM are the beta cells being destructed?
No, the beta cells are intact.
Is Type 2 DM considered to be absolute or relative deficiency?
What are the 3 things that relate to Insulin Deficiency in Type 2 DM?
1. delayed secretion
2. defective target cell response
3. Insulin Resistance
T or F: Type 2 can consists of normal, decreased, or increased insulin levels
Which form of DM is considered to be more severe? Type 1 or Type 2?
Type 1. Although Type 2 can become very serious!
What is occurring to the islet cells in Type 2 DM?
- Deposit of amyloid proteins