Vol.3-Ch.4 "Endocrinology" Flashcards

Question

Which is the outer or inner layer of the adrenal gland?

Answer 1

The outer layer is the Adrenal Cortex | The inner layer is the Adrenal Medulla secretes catecholamine hormones epi and norepi

Answer 2

- Glucocorticoids Cortisol is the most important and it increases the blood glucose levels by promoting Gluconeogenesis and decreasing glucose utilization as an energy source. - Mineralocorticoids Aldosterone is the most important, it contributes to salt and fluid balance in the body by regulating Na & K excretion through the kidneys - Androgenic Hormones (Estrogen, Progesterone, Testosterone) Have the same effect as those secreted by the Gonads

Answer 3

Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) ; both secreted by the Anterior Pituitary

Answer 4

- Placenta Produces Human Gonadotropin (hCG) throughout gestation and is actually what is tested for in at home pregnancy tests - Walls of the heart - Kidneys Release Renin which acts on Angiotensin turning it into Angiotensin I. Angiotensin I is then turned into Angiotensin II in the lungs by Angiotensin Converting Enzyme (ACE). Angiotensin II stimulates the adrenal gland to produce Aldosterone which stimulates water retention in the kidneys causing increase blood volume and blood pressure ``` Kidneys = Makes renin converts Angiotensin into Ang. I Lungs = Make Angiotensin I into II with ACE Adrenal = Makes Aldosterone b/c of Angiotensin II stim Kidneys = Retains water b/c of aldosterone ```

Answer 5

``` Diabetes = "To Siphon" Insipidus = "neutral" Mellitus = "sweet" ``` Insipidus is caused by a lack or inhibition of ADH which causes large amounts of urine output but the urine is neutral in smell and taste Mellitus is caused by a lack of insulin and the excretion of excess glucose causing sweet smelling and tasting urine (enough so that it got its name because the pee attracted bees and ants)

Answer 6

Glucose is the only substance that the BRAIN can readily and efficiently use as an energy source.

Answer 7

The sum of the process that produce the energy and molecules needed for cell growth and repair

Answer 8

- Anabolism "Ana" = "up" ; which is to say that Anabolism is the building up of molecules into more complex molecules. This takes energy to do and therefore requires energy to drive it. - Catabolism "Cata" = "down" ; which is to say that catabolism is the break down of molecules into simpler molecules which gives off or produces energy

Answer 9

Insulin stimulates anabolic pathways, or to say it stimulates the use of energy to build or repair cells Glucagon stimulates catabolic pathways, which is to say it gives off or produces energy from the bodies storage

Answer 10

It attaches to a cells receptors made of a specific protein that reacts specifically with insulin, and it makes that receptor more permeable so that the glucose go enter quickly and easily

Answer 11

- There must be sufficient insulin circulating in the blood to satisfy cellular needs - Insulin must be able to bind to body cells in such a way that adequate levels of stimulation occur (stimulation of the receptor it binds to)

Answer 12

- low or no insulin - high fat and low carb diets - starvation (all either mess with the ability for carbs to be used or the amount of carbs stored in the body)

Answer 13

Adipose cells break down fats into their component free fatty acids, which causes the level of fatty acids in the blood to rise considerably. The fatty acids not used by the body for energy go into the liver where they produce (catabolize into) Acetoacetic acid. When more Acetoacetic acid is released from the liver than can be used by the body it accumulates in the blood along with Acetone and Hydroxybutyric acid (all three together = ketones). As the over all level of these rises it turns into what is called Ketosis. (not exactly diabetic ketoacidosis but this is a major process of it)

Answer 14

- Acetoacetic Acid - Hydroxybutyric Acid - Acetone

Answer 15

Before a meal it should be around 80-90mg/gL | After a meal it should be around 120-140mg/dL

Answer 16

Hypoglycemic = lower than 80 mg/dL | Hyperglycemic = higher than 140 mg/dL may be ok if a little higher right after a meal

Answer 17

Blood is filtered into the glomeruli of the kidneys; blood, glucose, and other substances pass from the blood into the proximal tubule. Water and glucose and other useful things are then reabsorbed (the waste is not and becomes part of the urine) At about 180mg/dL, glucose will no longer fully be absorbed and it will start to be filtered out with the urine.

Answer 18

Osmosis is the tendency of water to migrate across a semipermeable membrane so that the concentration of particles approach equivalence on each side. Osmotic Diuresis can be seen in action when there is more glucose being excreted in urine than there is in the blood, such as with hyperglycemia. When the glucose is going through kidney filtration, it eventually goes into the Proximal tubule and what is necessary can come back but any extra (when its above 180mg/dL in the blood) gets excreted with the urine. The problem arises when water begins to follow the higher concentration of glucose in the urine (apply osmosis here) to be excreted. This leads to excessive water loss with high glucose levels which is characteristics of Glycosuria (presence of glucose in urine)

Answer 19

Type 1 Diabetes Mellitus (Juvenile Onset Diabetes ; Insulin-Dependent Diabetes Mellitus (IDDM)) Is the destruction of Beta cells causing very little or usually no insulin to be secreted by the pancreas. It is less common that type 2 but is more serious and accounts for more deaths. Often hereditary Treatment requires regular daily (multiple times a day) injections of insulin

Answer 20

``` Polydipsia = Extreme thirst Polyuria = Excessive urination Polyphagia = Extreme appetite ```

Answer 21

It is a combo of a moderate decline in insulin production with a decline in response to insulin by the cell receptors (Insulin resistance) Initial therapy often starts with a change in diet and exercise plan. If that does not help often an oral hypoglycemic agent will be prescribed which will stimulate insulin production by beta cells to increase the amount of insulin in the blood. In extreme cases, insulin injections will be prescribed Does NOT cause diabetic ketoacidosis nearly as much as type 1

Answer 22

Profound insulin deficiency coupled with increased glucagon activity. Can be seen in pts who have skipped their insulin injection, high physiological stress, or infections

Answer 23

It is a double edged sword because on one hand you have the excess glucose being secreted out of the urine taking an excessive amount of water with it b/c of osmotic diuresis causing dehydration. While at the same time you have a switch from carb based metabolism to fat based metabolism which will lead to Ketosis. It is the joining of these two processes that causes Diabetic Ketoacidosis

Answer 24

It is a reflex of having low amounts of glucose in cells, even though it is actually low amounts of insulin that is causing it. So it creates more glucose anyway b/c the body thinks that is what is wrong, but really it is just causing the blood sugar levels to rise further

Answer 25

Early signs will include diuresis, and resulting warm/dry skin, elevated heart rate and general feelings of weakness. Also polydipsia, polyuria, and polyphagia. As it progresses you will see Kussmaul's Respirations (rapid, deep breathing) in an effort to reduce CO2 levels, that may have a fruity smell from the acetones being released by the lungs. Additionally the dehydration that has set in by now may cause electrolyte imbalances and specifically a low potassium level may cause heart arrhythmias The entire process can take 12-24 hours

Answer 26

HHS develops when two things happen: - sustained hyperglycemia causes osmotic diuresis sufficient to produce marked dehydration - the water intake is inadequate to replace lost fluids (essentially it is a coma caused from hyperglycemia, possible to see up to 1000 mg/dL, and dehydration. This occurs with normal levels of insulin, just way too much glucose and urinated water + glucose)

Answer 27

Occurs when a pt has taken too much insulin or overexerts themselves and uses almost all available blood glucose. This is obviously bad as glucose is the brains food source so prologues hypoglycemia will cause brain death May start out with restlessness, then move to anger or erratic behavior, and ending in possible seizure or coma

Answer 28

With 50-100mL of Dextrose 50 (D50W) or 0.5-1.0mg of Glucagon (if IV cannot be started) (if there is adequate stored glycogen) if pt awakens and can swallow you can continue therapy orally If you suspect alcoholism remember to also give 100mg of Thiamine

Answer 29

- Hyperthyroidism the presence of excess thyroid hormones in the blood - Thyrotoxicosis a condition that reflects prolonged exposure of body organs to excess thyroid hormones, with resultant changes in structure and function (usually causes Grave's Disease - Hypothyroidism the presence of inadequate thyroid hormones in the blood - Myxedema a condition that reflects long-term exposure to inadequate levels of thyroid hormones, with resultant changes in structure and function

Answer 30

GO OVER THYROID AND ADRENAL GLAND DISORDERS LAST PAGES OF ENDO

Vol.3-Ch.4 "Endocrinology" Flashcards

(54 cards)