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Flashcards in Endocrine disorders Deck (64):
1

2 Basic problems for endocrine disorders

hyperfunction
hypofunction

2

Hyperfunction

increase in hormone secretion/action

3

Hypofunction

decrease or no hormone secretion or action

4

Hypofunction etiology

-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)

5

Hyperfunction etiology

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

6

ectopic tumor

located somewhere else ex. cell in lung that secretes hormone

7

non functioning tumor

destroys normal secretory cells that can lead to hypofunction

8

commonest endocrine disorder, affects approx

diabetes mellitus (2.5 mil)

9

diabetes mellitus has ______ or ________ insulin defects

absolute or relative

10

absolute insulin defects

no insulin produced

11

relative insulin defects

insulin produced not able to recognize

12

Diabetes mellitus is a complex disease that affects

protein metabolism, lipid metabolism and carbohydrate metabolism

13

Diabetes melliuts has defective

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

14

Diabetes melliuts is ________ if uncontrolled

life threatening

15

Impact of diabetes

Cardivascular, occular, renal, nueroimplications
(these will develop approx 10 yrs, with better management takes longer to dev, with bad management happens sooner)

16

classification of diabetes has 2 types

-type 1
-type 2

17

Type 1 affects

10 % of individuals with diabetes

18

Type 2 affects

90% of individuals with diabetes

19

Type 1 is __________ insulin deficiency

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

20

Type 1a
Type 1b

1a (immune mediated 90-95%)
1b (idiopathic destruction of beta cells 5-10%)

21

Type 2 beta cells are

intact and it is relative insulin deficiency

22

Etiology of both type 1 and type 2

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

23

Type 1 has

juvenile onset (early onset)

24

LADA

progressive form of type 1
latent autoimmune diabetes in adults

25

MHC genes

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

26

Type 1 etiology (genes) & others

-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)

27

Type 2 is Mo

mature happens later in life

28

MODY

maturing onset diabetes in young -this is a growing condition

29

Type 2 etiology

-50 % due to glucokinase gene on chr 7

30

Glucokinase

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

31

Prediabetes

metabolic stage before onset of DM

32

prediabetes has an imparied

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

33

several characteristics of Metabolic syndrome

-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)

34

insulin resistance

absence of hypoglycemic response to hyperglycemia in the presence of insulin

35

Type 1 diabetes is a progressive autoimmune destruction of

beta cells up to 90 % of cells are destroyed

36

type 2 diabetes beta cells

intact, but dysfunctional no autoimmunity

37

Type 2 diabetes, relative insulin deficiency from:

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

38

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

normal, increase or decrease

39

need insulin to move _____ into cells

glucose

40

Patho of Type 1 & Type 2 Diabetes

-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 (

41

Manifestations of diabetes

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

42

polyuria

excessive peeing

43

polydipsia

excessive thirst

44

polyphagia

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

45

glucosuria

Increased glucose in urine

46

The 3 acute complications of diabetes (life threatening):

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

47

Diabetic ketoacidosis usually happens in type _____

1

48

Diabetic ketoacidosis

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

49

3 main features of diabetic ketacidosis

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

50

glucogenesis

formation of carbohydrate from non-carbohydrate sourve

51

Hyperosmolar hyperglycemic state is more common in

Type 2 and elderly

52

Hyperosmolar hyperglycemic state is due to

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

53

Hypoglycemia usually in type

1

54

Hypoglycemia due to

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

55

Hypoglycemia is a blood glucose level of

less than 4 mmol/L

56

Hypoglycemia causes

altered cerebral function and activation of ANS

57

Treatment of Hypoglycemia

-15g - 20g Carbohydrates po
-inject glucagon

58

Hypoglycemic coma

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

59

Brain cells are_____independent

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

60

Treatment of Hypoglycemic coma

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

61

chronic complications of diabetes are due to

metabolic changes & vascular damage

62

Chronic complications of diabetes

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

63

Microvascular complications of diabetes

-retinopathy
-nephropathy
-neuropathy

64

glycosylated protiens

glucose + protien