Test #2 Endocrine ARTICLES - Dwayne Flashcards Preview

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Flashcards in Test #2 Endocrine ARTICLES - Dwayne Deck (66)
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1

Glucogneogenesis?

The break down of fat and muscle for energy

2

Glycogenolysis?

The breakdown of glycogen into glucose

3

Type 2 Diabetes

Non insulin dependent

4

Type 1 Diabetes

Insuiln dependent

5

Type 2 diabetes sub catagories

Obese and nonobese

6

Slow progressing adult insulin dependent DM is called?

(LADA) Latent autoimmune diabetes adult

7

The highest percent of those that have DM have what type?

Type 2

8

Signs and symptoms of DM

polydipsia, polyuria, polyphagia, tiredness, irritability, fungal infections, poor wound healing, deterioration in vision

9

Type 2 DM results from?

Insulin resistance leading to elevated BGL and over working and eventually failing of the beta cells

10

NORMALLY type 1 DM Pt's are under or over weight?

Under weight

11

NORMALLY type 2 DM Pt's are under or over weight?

Over weight

12

T3 or T4 are more potent?

T3

13

T3 or T4 is released more from the thyroid?

T4

14

Anterior or posterior pituitary secretes TSH

anterior

15

Hypothyroid can be caused by?

Hashimoto thyroiditis, thyroidectoy, radioactive iodine anti-thyroid medication and iodine deficiency, Myxedema

16

Hypothyroid S/S?

hypoactive reflexes, depression cold intolerance, muscle fatigue and weight gain
Myocardial contraction, HR, Stroke volume and cardiac output decrese

17

Preop managment

Hypothyroid require less sedation and are prone to resp depression, premedicate w H2 blocker and reglan R/T decrease GI motility

18

Intra-op

Blunted baroreceptor reflex, more susceptible to hypotension with induction agents. Ketamine is recommended, drug metabolism maybe slower

19

Hyperthyroidism?

Graves disease (most common 60-80%), toxic multinodular goiter, toxic adenoma, thyroiditis, TSH secreting pituitary tumor, overdose of thyroid hormone

20

clinical manifestations?

weight loss, hyperactive reflexes, fine tremors, exopthalmos, or goiter

21

Treatment

methimozole, propylthiourcil, propranolol

22

Anesthetic Implications

preferably Euthyroid, antithyroid drugs and beta blockers continue through day of surgery. NO NMB R/T inability to assess the RLN. Treat Hypotension with Neo, not ephedrine, it releases catacholamines.

23

Anesthetic Implications intr-op

Avoid SNS stimulating drugs: ketamine, panc, ephedrine
usually vasodilated and chronically hypovolemic producing sever hypotension during induction
NMB administer w caution R/T thyrotoxicosis is linked to myopathies and mysthenia gravis

24

Post-op : Thyroid storm

most likely onset 6-24 hrs post-op

25

Post-op Hypocalcemia:

due to removal of parathyroid glands, check in 24 hrs

26

Post-op Stridor

Bilat recurrent laryngeal nerve damage

27

Adrenal gland cortex secretes?

mineralcorticoids (aldosterone), androgens and glucocorticoids (cortisol)

28

Adrenal gland medula secretes?

catecholamine's ( epi, norepi, dopamine)

29

Phenochromocytoma

tumor of the chromaffin cells secreting maninly norepi, some epi and dopaimine

30

Phenochromocytoma

80% in the adrenal medulla 20% external