Pancreatic Gland Disorders Flashcards Preview

Med Surg III Exam 1 > Pancreatic Gland Disorders > Flashcards

Flashcards in Pancreatic Gland Disorders Deck (44):
1

what kind of gland in the pancreas?

endocrine and exocrine

2

alpha cells prodce

glucagon

3

glucagon does what?

increase the blood glucose levels by stimulating the level and other cells to release stored glucose (glycogenolysis)

4

beta cells produce

insulin

5

insulin does what?

lowers blood glucose levels by facilitating the entrance of glucose into the cells for metabolism

6

delta cells produce

somatostatin

7

somatostatin does what?

regulate the release of insulin and glucagon

8

what is diabetes?

defect in the secretion of insulin or action of insulin

9

Chronic hyperglycemia is associated with

long term damage and dysfunction and impairment of tissues organs - eyes kidneys, nerves heart and BVs

10

how do kidneys try to restore glucose blood levels?

excreting excess glucose

11

DM1 pathophysiology

autoantibodies are specific to beta cells

12

what are some characteristics of DM1

decreased utilization of glucose, increased fat mobilization, and impaired protein utilization

13

DM2 pathophysiology

endogenous insulin produce but have difficulty with effective insulin action at the cellular level

14

characteristics of DM2

normal to elevated insulin levels, insulin produced is ineffective because cells are resistance to attachment

15

action of insulin

transports glucose into the cell for use as energy and storage as glycogen -- turns food into energy;
glucose levels elevated -- beta cells increase secretion of insulin to transport/dispose glucose into peripheral tissue -- lowers blood glucose levels and reestablishes homeostasis

16

DM1 also known as

insulin - dependent diabetes

17

DM1 autoimmune -

destroyed beta cells - defects in the production/secretion of insulin

18

DM2 also known as

non-insulin dependent DM

19

onset of DM2

adult - resistance to insulin action an inadequate compensatory insulin secretory response

20

characteristics of DM2

1. no drop in insulin levels at first
2. failure to express enough glucose transporters in skeletal muscles
3. oral durgs help
4. beta cells become exhausted and eventually will require insulin
5. controlled with diet, exercise, and oral hypoglycemic med

21

how does insulin work?

transports glucose to cells; glucose absorbed into blood and is detected by pancreas which then secretes insulin that helps initiate transport to muscles

22

Type 2 - lots of glucose in blood stream becaus:

insulin doesn't work at the skeletal muscle level .... insulin still binds to insulin receptor but it's not able to signal GLUT4 protein to go to cellular surface and merge with cell membrane to produce a channel for glucose to allow the glucose to come into the muscle

23

Fasting Plasma Glucose

diabetes: >126
pre-diabetes: >100 and < 126
normal: <100

24

2 hour OGTT

diabetes: > 200
pre-diabetes: >140 and < 140

25

s/s of type 1 diabetes

polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability

26

s/s of type 2

polyuria, polydipsia, polyphagia, weight loss, extreme fatigue and irritability +
infections, blurred vision, slow to heal, paresthesis

27

medical management of of diabetes

1. diet modification (2)
2. oral medication (2)
3. IM insulin injection (1 and prolonged 2)
4. Insulin pump (2)

28

complication of diabetes

ketoacidosis (500-700 mg/dL) --> fruity breath
skin lesions
infection
neuropathy
CAD, stroke, PVD
MS problems (CTS, duputytrens, trigger finger, OP)
Kidney failure (nephropathy)
Vision impairment (retinopathy)

29

PT implications of diabetes

monitor glucose levels - exercise can cause hypo

30

Hypoglycemia PT implications

no exercise <70
s/s: sweating, hunger, trembling, anxiety, blurred vision and confusion

31

Hyperglycemia PT implications

no exercise >300
s/s: increased thirst, fatigue, blurred vision

32

contraindications to exercise

poor control of glucose levels, poorly controlled retinopathy, HTN, neuropathy, nephropathy, dehydration, extreme environment temperatures

33

Exercise does what to insulin?

increase insulin sensitivity, thus lowering blood glucose levels = allows body to utilize blood glucose

34

exercise does what with metabolism?

increase carb metabolism (lowers glucose levels), increases HDL, decreases triglycerides, BP, stress and Tension

35

s/s of hypoglycemia of <70

nausea, hunger, nervous, cold/clammy, tachycardia, paresthesias, trembling

36

s/s of hypoglycemia of <55

anxiety, confusion, blurred vision/dizziness/HA, weakness, poor coordination, slurred speech

37

s/s of hypoglycemia if <35

seizure, LOC

38

if hypoglycemic, follow what rule:

15:15

39

HbA1c

glucose can attach to hemoglobin and have glycosilated hemoglobin

40

HbA1c is an indication of what?

average amount of BG from previous 3 months

41

Excellent control (HbA1c)

less than or equal to 6; BG < 115

42

good control (HbA1c)

7-8; BG 150-180

43

Action suggested (HbA1c)

level of 0-14; BG 215-380

44

muscle contraction does 2 things:

1. encourage the up-take of glucose
2. getting GLUT4 to surface w/o help of insulin