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Podiatry Yr1 Clinical Demonstrator Lectures > Endocrine Disorders > Flashcards

Endocrine Disorders Flashcards

1
Q

Recap: what is homeostasis

A

Maintains the body’s internal environment within physiologically defined limits

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2
Q

Which 2 body systems work together to achieve homeostasis

A

Nervous & endocrine systems

Neuroendocrine system - nerve impulses and hormones

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3
Q

Endocrine system:
Glands and organs of this system

A

Hypothalamus
Pituitary
Thyroid/ parathyroid
Thymus
Adrenal Gland
Kidney
Pancreas
Ovary
Testes

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4
Q

The thyroid gland release which hormone

A

Thyroid

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5
Q

What is the function of the thyroid hormone

A

Regulate body’s overall metabolism

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6
Q

Which gland release adrenaline and aldosterone and cortisol

A

Adrenal Gland
Adrenaline - inner part
Aldosterone and cortisol. - outer part

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7
Q

What is the function of the hormones released by the adrenal gland

A

Maintain salt levels, blood pressure, kidney function, overall fluid levels in body

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8
Q

Which gland controls the activities of other endocrine glands

A

Pituitary

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9
Q

Hormones released by the pituitary gland

A

Thyroid stimulating Hormone (TSH)
Follicle-Stimulating Hormone (FSH)
Luteinizing Hormone (LH)
Prolactin (PRL)
Growth Hormone (GH)

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10
Q

Endocrine glands of the pancreas release?

A

Insulin and glucagon (alpha cells in pancrea)

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11
Q

Function of insulin and glucagon

A

controls blood sugar and overall glucose metabolism

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12
Q

What is gluconeogenesis

A

Generation of glucose from non carbs

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13
Q

Glycogenesis

A

formation of glycogen from glucose

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14
Q

Glycogen

A

stored glucose

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15
Q

glycolysis

A

converts glucose into ATP (adenosine triphosphate)

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16
Q

Lipogenesis

A

encompasses the processes of fatty acid synthesis

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17
Q

Diabetes Mellitus

A

Metabolic/endocrine disorder of multiple aetiology characterised by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism.

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18
Q

Sign of diabetes

A

Polydipsia – excessive thirst
Polyurea- Excessive urination
Polyphagia – excessive eating
Decrease inflammatory respond
Diabetic ketoacidosis (DKA)
Excessive fatigue
weight gain
slow healing
excess sleep
Blurred vision

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19
Q

Diabetic Ketoacidosis is (DKA)

A

Is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly clinical emergency

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20
Q

Symptoms of DKA

A

needing to pee more than usual
feeling verythirsty
being sick
tummypain
breath that smells fruity (like pear drop sweets, or nail varnish)
deep or fast breathing
feeling very tired or sleepy
Confusion
passing out

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21
Q

Diabetes Type 1

A

Body cannot make insulin at all.
Daily injections

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22
Q

Aeitiology of diabetes type 1

A

insulitis - chronic inflammation of the islets
autoimmune activity - islet cell antibodies

23
Q

Diabetes mellitus type 2

A

Body cannot produce enough insulin to meet demands

Acquired condition
Main cause poor diet, sedentary lifestyle, family history

24
Q

HbA1c

A

Excess glucose sticks to red blood cells. increase in blood viscosity
Tested quarterly, RBC are active for around 2-3months
Keeping it low reduces risk of complications
6..5 or 48mmol is the target

25
Q

True /False

HbA1c score 48mmol/mol is poor
(old score 6.5)

A

False

It ideal- great

26
Q

HbA1c score of 64mmol/mol is great
(old score 8)

A

False

Poor

27
Q

Hypo-glycaemia

A

Blood glucose levels low below 4mmol/L

28
Q

Symptoms of hypo-glycaemia

A

shaking, sweating, confused,may appear drunk, disturbed vision, aggressive

29
Q

Treament of hypoglycaemia

A

Glucose , food/drink, injection of glucagon

30
Q

Hyper-glycaemia

A

Blood glucose levels to high.above 64 mmol/L

31
Q

Symptoms of hyperglycaemia

A

Thirst, weakness, nausea, vomiting, breathless, confusion, coma

32
Q

Treatment of hyperglycaemia

A

Prompt hospital treatment

33
Q

Chronic complications of Micro-vascular in DM type 2

A

Damage to smaller blood vessels
Neuropathy
Sensory
Motor
Autonomic
Retinopathy
Nephropathy

34
Q

Chronic complications of Macro-vascular in Dm type 2

A

Damage to larger blood vessels
Peripheral Arterial Disease
Cardiovascular Disease
Stroke

35
Q

Risk Factors of DM2

A

Obesity
Hypertension
Smoking
High Cholesterol
Hx of heart disease or stroke
Sedentary lifestyle
Cardiovascular disease (heart attack/stroke)
Genetics (fixed)
White and 40+
African-Caribbean, black African, or south Asian and 25+

36
Q

Foot in Diabetes

A

Distal polyneuropathy
Deformity
Atrophic/Anhydrotic skin
Peripheral arterial disease
Ulceration
Charcot foot

37
Q

Charcot foot

A

Charcot – complex complication of diabetes
Affects bones joints and soft tissues of foot and ankle
Destructive effect of uncontrolled inflammation

Normal foot pressure is on met heads and heel.
Charcot is on the mid foot/arch
Increase temperature (difference between feet 2 degrees)

38
Q

Medication

A

Metformin - decrease glucose output , inhibit gluconeogenesis

39
Q

Thyroid

A

Makes thyroine (T4) and Triodothyronine (T3)

  • heart rate
    thoughts feelings
    energy levels
    temp

neccessay for all cells in the body to work normally.

40
Q

Hyperthyroidism

A

The thyroid gland produces more thyroid hormones than is needed by the body
Typically starts between ages 20-40
Women 10 times more likely than men
Most common occurrence in Graves Disease (Thyrotoxicosis)

41
Q

HYPERTHYROIDISM- Sign. symptoms

A

Thyroid enlargement – Goitre
Bulging eyes
Heat intolerance
Increased irritability
Heart palpitations / atrial Fibrillation
Tremor
Weight loss
Insomnia
Increased bowel habits
Restless legs syndrome

42
Q

Signs & symptoms in feet

A

Increased pulse rate
Ankle oedema (pitting and non pitting)
Onycholysis
Muscular aches and pains
Hyperhydrosis
Pre tibial myxedema
Brisk tendon reflexes
Thyroid acropachy (clubbing lie nails)

43
Q

Management (hyperhirosis)

A

Carbimazole – inhibits thyroid production

Beta blockers / calcium channel blockers – symptom control

Thyroidectomy

Radioiodine – radioactive iodine drink – destroys thyroid

44
Q

Hypothyroidism

A

Underactive thyroid producing too little thyroid hormone causing all metabolic processes to slow down.
Affects 1-2% of population

45
Q

Primary / secondary treatment of hypothyroidism

A

Primary
Treatment of hyperthyroidism
End result of thyroiditis
Congenital
Surgical removal of thyroid gland

Secondary

Disease of pituitary gland
Disease of Hypothalamus
Lithium treatment

46
Q

Signs & symptoms of hypothyroidism

A

All metabolic process ‘slow down’
Weight gain or increased difficulty in losing weight
Intolerance to cold
Fatigue/Lethargy
Muscle stiffness, cramps and aches
Croaky hoarse voice
Constipation
Brittle hair
Depression
Slow reflexes

47
Q

Signs and symptoms in the feet - hypothyroidism

A

Leukonychia
Hair loss
Brittle hair/nails
Dry skin prone to fissures (anhidrosis)
Pain in MTPJs
Slow reflexes
Entrapment neuropathies common e.g. tarsal tunnel syndrome

48
Q

Podiatric implications

A

Skeletal
Pain in wrists and MTPJs

Dressings
Inadine dressings (active ingredient: providone-iodine) contra-indications

Weight gain
Gait and functional implications
Myopathy
Stiffness, cramps muscle pains

Neuropathy
Reflexes slowed (motor)
Entrapment neuropathies more common (Tarsel tunnel)

Mental Health
Depression

49
Q

Management of hypothyroidism

A

Levothyroxine

50
Q

Name 4 podiatric imlications of hypothyroidism

A

slower reflexes, pain in mtpj’s

51
Q

What are the chronic complications of Diabetes Type 2

A

Microvascular - neuropathy, nephropathy, retinopathy

macrovascular - PAD, CVD, Stroke

52
Q

True/False
The treatmet of hyperglycaemia includes glucose food/drinks

A

False

53
Q

How would you nterpret a HbA1c level of 59mmol/L

A

Fine or reasonable

54
Q

What medication is used to manage hypothyroidism

A

levothyroxine

Podiatry Yr1 Clinical Demonstrator Lectures (5 decks)

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