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Flashcards in Endocrine Lab Studies Deck (35):
1

scope of endocrinology

primarily works with hormones

disease may include

-hypo/hyperfunction of pituitary (tumor), thyroid (Hashimotos/Grave's), pancreas (DM), adrenal (Addison's/Cushings), gonads, parathyroids (calcium and vitamin D regulation) 

2

Increased glucose (hyperglycemia) may be present in 

DM-MOST COMMON

Cushing's disease (hypersecretion of glucocorticoids)

Pheochromocytoma (hypersecretion of adrenaline)

Acute stress

Acromegaly 

Glucagonoma (glucagon has opposite affect of insulin)

Pancreatitis

3

Decreased blood sugar (hypoglycemia)

Diabetes Tx (too much insulin)

Addison's disease (hyposecretion of adrenal hormone)

liver disease (liver no longer liberates glycogon into blood stream)

hypopituitarism (too little growth hormone)

beta cell tumors (insulinoma-too much insulin secretion, pancreatic carcinoma)

4

pathway of diabetes causing excess urination

as sugar increases, kidneys can only absorb 180 mg/dl of glucose, after that, kidneys let glucose go through urine, excess thirst is caused by kidney's need to have some fluid with which to allow sugar to pass through

5

Diabetes Mellitus is characterized by

hyperglycemia

glycosuria

results from inadequate production of utilization of insulin

6

Normal range of blood sugar (adult)

70-100 mg/dl 

7

"prediabetes"

impaired fasting glucose values

101-125 mg/dl

8

"prediabetes"

impaired glucose tolerance (2 hr after eating)

140-199 mg/dl

9

diabetic value

fasting on 2 or more occasions

>126 mg/dl

10

diabetic value

random with presence of symptoms

>200 mg/dl

11

diabetic value

2 hrs on 75 GTT

>200 mg/dl

12

diabetic value

hemoglobin A1c on 2 or more occasions

> 6.5 %

13

glucose panic values

<40 mg/dl (brain damage)

>400 mg/dl

14

symptoms of DM

polydyspia

polyphagia

weight loss

polyuria

 

15

blood glucose collection tube color

red/tiger

16

hours that you are required to fast before a fasting blood glucose

8 hours

17

variance between whole blood glucose (home testing) and plasma glucose (lab testing)

12 %

18

GTT (glucose tolerance test)

fast 8-12 hrs previous

check fasting glucose level

administer 75 g oral glucose

collect 5-7 ml in red top fasting, then at 1 and 2 hours

19

HgbA1c

glycosylated hemoglobin

(values help monitor control of DM)

-measures glucose control over 3-4 months, measured in a percentage of total RBC

-some of hemoglobin becomes glycosylated (sugar attached to it)

-the more sugar that is in the blood stream over that time, the more Hgb will become glycosylated

20

eAG

estimated average glucose

a way to convert HgbA1c into blood glucose

21

A1c goals for control

AACE says < 6.5%

ADA says <7.0%

when A1c is 0.5 > than the patient's goal intervention is warranted

***if we push it too hard, it may put them at risk for hypoglycemia (acute complication)

22

A1c blood test

fasting is not indicated

collected in a lavender top tube

23

proinsulin

form in which insulin is stored in the pancreas

(A and B chains combine and form useable insulin)

24

why would we draw an insulin level?

helps to determine which type of DM you are talking about

evaluate for insulin deficiency (type I)

evaluate for insulin resistance (elevated insulin level in type II)

evaluate for insulinoma

25

instructions of insulin draw

fasting for 8 hrs

5 ml venous sample packed in ice

26

progression of insulin resistance

as body weight increases, the body becomes less sensitive (more resistant) to your own insulin

as a result, pancreas compensates for this and increases the level of insulin that it secretes

eventually, it reaches a point where insulin secretion no longer continues (becomes tired) at the high level

27

C-peptide

identify sever insulin deficieny

(it is the section of proinsulin that gets cut out when insulin is liberated from the pancreas)

8-10 fast

red top tube

28

elevated C-peptide indicates

insulinoma

insulin resistance

29

decreased C-peptide indicates

diabetes/insulin deficiency

factitious hypoglycemia

pancreatectomy

2ndary gain (as in athletes)

30

ketones are present most often in

type II DM

31

what is diabetic ketoacidosis?

your body starts burning fat and releasing ketones (glucose is not coming into the cell) as a last ditch effort to try to get glucose in

32

what are the three types of ketone bodies?

acetone

acetoacetate

beta hydroxybutyric acid

33

most urine dips only test for 

acetone and acetoacetate

34

when you are treating someone for DKA, treat them and don't

continue to test for ketones (it will look like things are getting worse)

the betahydroxybutyrate will transform back into acetone and acetoacetate

35

normal insulin level

6-26 u/mL

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