endocrine system Flashcards
(40 cards)
what causes type 1 diabetes
lack of insulin production due beta cell defect
- caused by autoimmune destruction of pancreatic beta cells.
how doe glucagon cause increase in blood glucose
pancreatic alpha cells of the islets of langerhans produce glucagon
glucagon increases blood glucose levels by inhibiting synthesis of glycogen
causing an increase in the formation of glucose from proteins and fats (gluconeogenesis)
Glucagon treatment in insulin induced hypoglycaemia
1mg every 20 minutes once/twice is there is still no response.
along with carb supplements to replenish glycogen stores when patient regains consciousness.
what is OGTT
oral glucose tolerance test
fast for 8 hours
then given 75 mg of anhydrous glucose/polycal/Rapilose
2 hours after a venuous blood sample is taken
what are the main drug classes to treat type 2 diabetes
1) sulphonylureas (SU)
2) sodium glucose co-transporter 2 inhibitors (SGLT-2i)
3) Biguanides (metformin
4) Thiazolidinediones (glitazones)
5) Dipeptidyl peptidase 4 inhibitors (DPP4i)
6) Glucagon like peptide 1 (GLP-1): incretin mimetics.
Things to monitor for diabetes
Blood Glucose Monitoring: For both Type 1 and Type 2 diabetes.
Pre-meal levels should generally be between 4-7 mmol/L,
post-meal levels should be around 5-9 mmol/L.
HbA1c: For both types, the general target is <48 mmol/mol (6.5%), though i
Blood Pressure: Target for both types is <140/80 mmHg, with more stringent goals (e.g., <130/80 mmHg) for those with kidney damage or cardiovascular risk factors.
Cardiovascular Risk: Annual reviews to assess cardiovascular health (lipids, smoking, etc.) and consider medications like statins are part of routine management. Statin therapy may be more aggressively considered in individuals aged 40-75 with Type 2 diabetes.
Kidney Care: Monitoring for kidney damage with regular albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) testing for both conditions, with a focus on early detection of kidney disease.
Eye and Foot Care: Regular eye exams and foot assessments are critical for detecting diabetic retinopathy and peripheral neuropathy, respectively. More frequent check-ups may be necessary for individuals with existing complications.
(condense this card down)
what is HHS
Hyperosmolar hyperglycaemic state
type 2 diabetes complication
higher than 30mmol for several days
is DKA more common in type 1 or type 2
type 1
DKA signs
type 1
blood glucose higher than 11mmol
polydypsia/poluria/weight loss/abdominal pain/ fruity breath
urinary ketones: higher than 2+
or capilarry blood ketones higher than 3mmol/L
what is DKA
complication of type 1 diabetes, can occur in type 2 too tho
- occurs when body breaks down fat for energy due to lack of insulin, leading to production of ketones.
- ketone levels increase, blood becomes more acidic, body functions disrupted.
testing: blood and urinary ketones
urinary ketones 2+/blood ketones 3mmol/L + are high.
symptoms of DKA
high blood sugar (11mmol/L +)
excessive thirst
weight loss
tachycardia
abdominal pain
urination
nausea
vomiting
pear drop breath
rapid breathing
what counselling to minimise risk of DKA during treatment with SGLT2 inhibitor
advise on signs and symptoms of dka
seek medical attention if: rapid weight loss, nausea, stomach pain, fruity breath occur
stop SGLT2 inhibitor if DKA is present
DKA treatment
fluid replacement
insulin therapy
correction of electrolyte imbalance: potassium levels
treating acidosis by using IV bicarbonate if necessary (if pH less than 6.9)
what is main aspect of diabetic nephropathy
raised urinary albumin excretion: lead to increased risk of CVD
(more than 300mg/24hrs)
- or proteinuria
diabetic nephropathy
- what is it
- testing
changes in glomerulus and interstitial tubules
testing: urine albumin to creatine ratio
serum creatine and eGFR
insulin monitoring
4-6 times a day b4 and after meals
- used to modify insulin dose or diet
Hyperthyroidism diseases
Graves disease
nodular disease
toxic adenoma
subacute tyroiditis: due to inflammation of thyroid gland
what is graves disease
autoimmune condition where abnormal IgG is produced
(TRABS, anti TPO and anti-TG)
- ophthalmopathy
graves disease: ophthalmopathy side effect explained
caused by deposition of glycosaminoglycans into retro orbit, causing t cell activation and stimulation of thyroid stimulating immunoglobulin (TSI)
signs and symptoms of hyperthyroidisim
- tachycardia
- tremor
- nervousness
- weight loss despite increased appetite
- warm skin
- hair thinning/hair loss
Normal TSH levels
0.5-5 microunits/ml
what anti-thyroid drug is preferred during pregnancy
propylthiouracil
inhibits T4 to T3 conversion
what is done before thyroid suregery
anithyroid drugs, lithium, beta blockers until pulse is less than 80 bpm
dose of iodine 800-1200mg/day
what are the 5 main types of hypothroidism
1) Primary autoimmune: most common, often due to Hashimoto’s thyroiditis
2) Primary postpartum
3) Primary subacute granulomatous
4) Primary Iatrogenic: from radioactive iodine treatment for graves disease etc. leads to permanent hypothyroidism
5) Secondary: damage to hypothalamic pituitary axis due to pituitary adenomas etc
