Endocrine disorders

Question 1

2 Basic problems for endocrine disorders

Answer 1

hyperfunction

hypofunction

Question 2

Hyperfunction

Answer 2

increase in hormone secretion/action

Question 3

Hypofunction

Answer 3

decrease or no hormone secretion or action

Question 4

Hypofunction etiology

Answer 4

• dietary deficiency
• metabolic defect
• no trophic stimulation cause atrophy
• receptor defects (distorted or damaged shape)
• suppresive therapy (surgery/Tx for hypersecretion)
• immune disorders (anitbodies bind to receptor sites)

Question 5

Hyperfunction etiology

Answer 5

• excessive trophic stimulation
• defect in negative feedback loop leads to no suppression
• Secretory tumor ( tumor cells will be same so have same secretion)

Question 6

ectopic tumor

Answer 6

located somewhere else ex. cell in lung that secretes hormone

Question 7

non functioning tumor

Answer 7

destroys normal secretory cells that can lead to hypofunction

Question 8

commonest endocrine disorder, affects approx

Answer 8

diabetes mellitus (2.5 mil)

Question 9

diabetes mellitus has ______ or ________ insulin defects

Answer 9

absolute or relative

Question 10

absolute insulin defects

Answer 10

no insulin produced

Question 11

relative insulin defects

Answer 11

insulin produced not able to recognize

Question 12

Diabetes mellitus is a complex disease that affects

Answer 12

protein metabolism, lipid metabolism and carbohydrate metabolism

Question 13

Diabetes melliuts has defective

Answer 13

insulin secretion or action which leads to widespread metabolic defects (proteins, carbohydrates & lipids)

Question 14

Diabetes melliuts is ________ if uncontrolled

Answer 14

life threatening

Question 15

Impact of diabetes

Answer 15

Cardivascular, occular, renal, nueroimplications

these will develop approx 10 yrs, with better management takes longer to dev, with bad management happens sooner

Question 16

classification of diabetes has 2 types

Answer 16

• type 1

- type 2

Question 17

Type 1 affects

Answer 17

10 % of individuals with diabetes

Question 18

Type 2 affects

Answer 18

90% of individuals with diabetes

Question 19

Type 1 is __________ insulin deficiency

Answer 19

absolute, destruction of cells that create insulin (beta cells)

Question 20

Type 1a

Type 1b

Answer 20

1a (immune mediated 90-95%)

1b (idiopathic destruction of beta cells 5-10%)

Question 21

Type 2 beta cells are

Answer 21

intact and it is relative insulin deficiency

Question 22

Etiology of both type 1 and type 2

Answer 22

complex trait (polygenic + environmental) 
enivormental ex. viral infection & obesity

Question 23

Type 1 has

Answer 23

juvenile onset (early onset)

Question 24

LADA

Answer 24

progressive form of type 1

latent autoimmune diabetes in adults

Question 25

MHC genes

Answer 25

-majorhistocompatability complex code for cells to be able to identify as self to immune system

Question 26

Type 1 etiology (genes) & others

Answer 26

- MHC genes on chromosome 6 (40%) - Insulin gene on chromosome 11 (10%) -function division of beta cells - T cell hypersensitivity to Beta cell antigen - familial risk (increase x10)

Question 27

Type 2 is Mo

Answer 27

mature happens later in life

Question 28

MODY

Answer 28

maturing onset diabetes in young -this is a growing condition

Question 29

Type 2 etiology

Answer 29

-50 % due to glucokinase gene on chr 7

Question 30

Glucokinase

Answer 30

adds phosphate to glucose catalyze by enzyme glucokinase. therefore glucose cannot stay in cell and moves out

Question 31

Prediabetes

Answer 31

metabolic stage before onset of DM

Question 32

prediabetes has an imparied

Answer 32

- impaired fasting glucose - Abnormal oral glucose tolerance test - increase

Question 33

several characteristics of Metabolic syndrome

Answer 33

- abdominal obesity w > 88 m >102 - HTN - hyperlipidemia (increase LDL, Low HDL, High triglycerides) - impaired fasting glucose - Impaired glucose tolerance - Insulin resistance (insulin present but can't do job)

Question 34

insulin resistance

Answer 34

absence of hypoglycemic response to hyperglycemia in the presence of insulin

Question 35

Type 1 diabetes is a progressive autoimmune destruction of

Answer 35

beta cells up to 90 % of cells are destroyed

Question 36

type 2 diabetes beta cells

Answer 36

intact, but dysfunctional no autoimmunity

Question 37

Type 2 diabetes, relative insulin deficiency from:

Answer 37

- Insulin resistance - Deranged secretion (may have less secretion than needed) - Defective target cell response - hepatic glucogenis

Question 38

Type 2 diabetes has has ____, _____ or _____ in insulin levels

Answer 38

normal, increase or decrease

Question 39

need insulin to move _____ into cells

Answer 39

glucose

Question 40

Patho of Type 1 & Type 2 Diabetes

Answer 40

- insulin deficiency - impaired glucose utilization & increase in hepatic gluconeogenesis - Hyperglycemia (11-67mmol/L) - renal threshold exceeded - glucosuria - increase in osmotic pressure in filtrate - fluid enters filtrate - polyuria - dehydration - polydipsia (

Question 41

Manifestations of diabetes

Answer 41

- polyuria & (frequencey) - Polydipsia - Polyphagia - wt loss (type 1) - obesity (type 2) - complications

Question 42

polyuria

Answer 42

excessive peeing

Question 43

polydipsia

Answer 43

excessive thirst

Question 44

polyphagia

Answer 44

excessive hunger, hungry all the time (losing all calories in urine)

Question 45

glucosuria

Answer 45

Increased glucose in urine

Question 46

The 3 acute complications of diabetes (life threatening):

Answer 46

- Diabetic ketoacidosis (DKA) - Hyperosmolar hyperglycemic state (HHS) - Hypoglycemia leading to Hypoglycemic coma

Question 47

Diabetic ketoacidosis usually happens in type _____

Answer 47

1

Question 48

Diabetic ketoacidosis

Answer 48

- severe insulin deficiency (can't take glucose into cells) - glucagon excess (hormone that breaks glycogen in glucose)

Question 49

3 main features of diabetic ketacidosis

Answer 49

- hyperglycemia - ketosis (formation of ketones) - metabolic acidosis

Question 50

glucogenesis

Answer 50

formation of carbohydrate from non-carbohydrate sourve

Question 51

Hyperosmolar hyperglycemic state is more common in

Answer 51

Type 2 and elderly

Question 52

Hyperosmolar hyperglycemic state is due to

Answer 52

- increase in insulin resistance | - excessive increase in carbohydrate intake (or if don't take oral meds)

Question 53

Hypoglycemia usually in type

Answer 53

1

Question 54

Hypoglycemia due to

Answer 54

- insulin overdose (double dose of insulin or oral meds) - missed meal - overexertion

Question 55

Hypoglycemia is a blood glucose level of

Answer 55

less than 4 mmol/L

Question 56

Hypoglycemia causes

Answer 56

altered cerebral function and activation of ANS

Question 57

Treatment of Hypoglycemia

Answer 57

- 15g - 20g Carbohydrates po | - inject glucagon

Question 58

Hypoglycemic coma

Answer 58

- brain depends exclusively on glucose for metabolic needs - brain cells are insulin independent - brain deprived of glucose - loss of consciousness

Question 59

Brain cells are_____independent

Answer 59

Brain cells are insulin independent (can take in glucose without insulin) erythrocytes are also insulin independent

Question 60

Treatment of Hypoglycemic coma

Answer 60

- 1mg glucagon subcut or IM | - 20-50 ml 50 % glucose IV

Question 61

chronic complications of diabetes are due to

Answer 61

metabolic changes & vascular damage

Question 62

Chronic complications of diabetes

Answer 62

- microvascular - macrovascular - CAD & MI - CVA (stroke) - PVD - infections (particularly foot & UTI)

Question 63

Microvascular complications of diabetes

Answer 63

- retinopathy - nephropathy - neuropathy

Question 64

glycosylated protiens

Answer 64

glucose + protien