Endocrine Level III

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Author:
saraherin
ID:
266621
Filename:
Endocrine Level III
Updated:
2014-03-18 22:18:30
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SCF level III
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Endocrine Test
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Endocrine notes
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  1. The gland of the endocrine system most responsible for the body's response to stress:
    Adrenals
  2. "Master Gland" and why ?
    Hypothalamus b/c it is the coordinating center for the nervous and endocrine responses to internal and external stimuli
  3. This is caused by too little adrenocortical hormones:
    Adrenal Crisis
  4. These hormones are released by the intermediate lobe of the pituitary gland in response to stress, pain, transcutaneous stimulus and guided imagery:
    Endorphins & Enkephalins
  5. Explain the Diurnal pattern:
    The pattern of the hypothalamus  secretion of corticotropin releasing factor (CRF) in the PM with adrenocortical hormone peak around 0600-0900, and decreasing throughout the day until night time when the levels rise again.
  6. Hormones are secreted directly into _______.
    the bloodstream
  7. Hormones can react with receptors in 2 ways, name them:
    • Receptors 
    • OR 
    • in the Cell Membrane
  8. A long term assessment finding of increased adrenocorticotropic hormones :
    Buffalo Hump from Cushing's syndrome
  9. This temperature intolerance is associated with Hypothyroidism:
    Cold Intolerance
  10. THis temperature intolerance is associated with HYPERthyroidism:
    Heat intolerance
  11. Diagnostic test for adrenal gland disfunction is the ____ test.
    Sputum test - looks for elevated cortisol levels
  12. Replacement therapy for Hypothyroidism :
    • Levothyroxine / Synthroid 
    • Increases O2 consumption, respiration, heart rate, growth & maturation, and metabolism of fats, carbs, and protein
  13. Prednisone may cause _______ in diabetic patients.
    Hyperglycemia
  14. This system controls cellular activity that regulates growth and metabolism through the release of hormones:
    Endocrine system
  15. Define metabolism:
    process of biochemical reaction in the body cells needed to produce energy, repair cells and maintain life
  16. Hormones regulate what functions in the body?
    • Growth
    • Reproduction
    • Fluid & Electrolyte balance
    • Gender differentiation
  17. Insulin inhibits the breakdown of what 3 things?
    • Stored Glucose 
    • Protein 
    • Fat
  18. Name the 3 cell types of the islets of Langerhans:
    • Alpha
    • Beta 
    • Delta
  19. What do Alpha cells release?
    Glucagon
  20. What do the Beta cells release?
    Insulin
  21. What do Delta cells release?
    Somatostatin
  22. Glucagon responds to what?
    Low blood sugar- stimulates mobilization of glycogen from the liver to be broken down into glucose for energy.
  23. Define Glycogenolysis:
    The breakdown of glycogen from the liver into glucose
  24. Define Gluconeogenesis :
    The formation of glucose from non-carb substances
  25. Define Glycosuria:
    The spilling of sugar into the urine because the concentration of glucose in the blood is too high for complete reabsorption.
  26. The breakdown of lipids in the liver and adipose tissue to free fatty acids (FFA) is called _____.
    Lypolysis
  27. When metabolism shifts to breakdown of fats, a patient is at risk for what?
    Increase ketone bodies leading to DKA  diabetic ketoacidosis
  28. What causes DKA?
    Absence of Insulin to block the breakdown stored glucose and the production of new glucose from fat causing HYPERglycemia
  29. In between meals and during periods of fasting what is released from the pancreas?
    • Glucagon is released once BD is <70mg/dl -  
    • This prevents hypoglycemia in most people
  30. Insulin functions to move ____ into what cells?
    • Sugar/glucose into the liver, muscle, and fat cells -
    • taking potassium with it
  31. Beta cells regulate what ?
    Insulin release regulated by blood glucose levels
  32. What function does insulin serve with amino acids?
    moves them into cells for protein synthesis
  33. Name the 4 functions of Insulin:
    • Move glucose into cells 
    • Prevent excess glycogenolysis 
    • Inhibit Lipolysis 
    • Moves amino acids into cells for protein synthesis
  34. What body systems do NOT require insulin for glucose uptake?
    • Brain 
    • Liver
    • Intestine 
    • Renal tubules
  35. Type I DM is cause by what?
    • Destruction of beta cells by:
    • Autoimmune (antibodies)
    • Genetic Predisposition (Human Luekocyte Antigens)
    • Environmental (viral Rubella) & Toxins (Nitrates)
  36. Classic S/S of Type I DM:
    • Hyperglycemia +
    • 3P's
    • Weakness/Fatigue
    • Weight Loss
  37. What causes Polyuria?
    Elevated BS leads to Increased renal blood flow and decrease in osmolarity resulting in  increased urine production/output because water is not reabsorbed by the tubules
  38. Name the 3P's:
    • Polyuria 
    • Polydipsia 
    • Polyphagia
  39. What causes Polydipsia?
    Decreased intracellular volume with increased urine output leads to excessive thirst
  40. Obesity contributes greatly to what type of diabetes?
    • Type II
    • Increased adipose tissue reduces receptor sites 
    • More Muscle = More receptor sites
  41. Pre-diabetic patients have an increased risk for what because of impaired glucose tolerance?
    Cardiac Issues
  42. When fats are used as a primary energy source the serum lipid levels rise and contribute to the accelerated development of __________.
    Artherosclerosis
  43. What causes weight loss in Type I diabetes?
    glucose is not available to the cells, so the body begins to breakdown Fat & Protein stores for energy
  44. What causes Type II DM?
    Combination of insulin resistance and inadequate insulin secretion to compensate.
  45. Typical onset of Type II DM is when?
    After 30 years of age, but may occur at any age
  46. Type II DM clinical manifestations:
    • Polyuria
    • Polydipsia
    • Obesity & fatigue 
    • Irritability
    • Poor wound healing
    • Recurrent Infections 
    • Blurred Vision
  47. Secondary DM may be caused by what?
    • Medical condition (Cushing's or hyperthyroidisn)
    • Drug induced (corticosteriods, thiazides, beta blockers, niacin)
  48. Treatment for secondary DM:
    • TPN 
    • Check BS Q 6 hours 
    • change tubing Q 24 hours
    • ALWAYS taper off TPN
  49. How should diabetic patients exercise:
    • daily same time, same amount
    • Caution during hyperglycemic events (>250 no exercise)
  50. Patient that experience exercise induced hypoglycemia should do what?
    If taking insulin have a carb snack before and after exercise as well as before bedtime.
  51. Short acting Regular insulin should be given when? name one
    • Regular (Humalog R, Novolin R, or Iletin II R)
    • 20-30 minutes before a meal 
    • May be taken alone or with a longer acting insulin
  52. Name the rapid acting insulins:
    • Lispro (Humalog)
    • Aspart (Novolog)
    • Glulisine (Apidra)
  53. Name intermediate acting insulins:
    • NPH (neutral  protamine Hagedorm)
    • (Humulin N)
  54. Name the very long acting insulins:
    • Glargine (Lantus)
    • Detemir (Levemir)
  55. Explain dawn phenomenon:
    Fasting hyperglycemia without prior hypoglycemia
  56. HOw do you treat dawn phenomenon?
    Move dose of NPH from diner to bedtime - this provides longer coverage
  57. What is the somogyi effect?
    • Rebound hyperglycemia after hypoglycemia occurs
    • Usually around 3am hypoglycemia occurs and the liver releases glucose causing a hyper state
  58. How would you treat the somogyi effect?
    Take a snack before bedtime AND/OR decrease NPH bedtime dose
  59. How do the oral agents Sulfonylures & Secretagogues work?
    Enhance/stimulate pancreas to secrete insulin
  60. How do the Biguanides work?
    Reduce/inhibit hepatic glucose production
  61. What caution should be taken if a patient is taking a Biguanide oral agent?
    D/C use prior to contrast dye testing and do not resume until contrast has been completely excreted from the body
  62. Name a biguanide =
    Metforman (Glucophage)
  63. Name the Sulfonylureas:
    • 1st generation: Diabenase (Chlorpropamise)
    • 2nd genration: Amaryl / Glucotrol / Glynase

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