Term
| indications for sulfonylurea agents |
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Definition
| non-obese, NIDDM2 not controlled by diet and exercise. |
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Term
MOA of sulfonylureas
examples: |
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Definition
- hypoglycemic activity
- stimulating the islet tissue to secrete insulin
ex:
2nd gen: glipizide (Glucotrol), glyburide (Micronase, Diabeta)
3rd Gen glimepiride (Amaryl) |
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Term
| When to use insulin? (according to test) |
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Definition
| After diet, exercise, and hypopglycemics have failed. |
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Term
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Definition
BMI = [(Wt lbs/(Ht in.) x (Ht in.)] x 703
OR
BMI = [(Wt kg/(Ht m) x (Ht m)]
OR
BMI = [(Wt kg/(Ht cm) x (Ht cm)] x 10,000 |
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Term
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Definition
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Term
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Definition
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Term
| ALT (alanine transaminase): |
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Definition
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Term
| AST (aspartate aminotransferase): |
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Definition
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Term
| BUN (blood urea nitrogen): |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
Gamma-GT (gamma-glutamyl transpeptidase):
((GGT)) |
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Definition
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Term
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Definition
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Term
| LDH (lactate dehydrogenase): |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| initially high respiratory alkalosis, subsequent high anion gap acidosis. |
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Term
| lithium, phenobarbitol, and acetaminophen do not cause an increase in ______ ______ |
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Definition
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Term
| How do you tell solid vs. cystic thyroid nodules? |
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Definition
|
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Term
| Best way to assess a (solid) thyroid nodule for malignancy? |
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Definition
|
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Term
| When do I care about antithyroglobulin antibodies? |
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Definition
| they are elevated in Hashimoto throiditis which often co-exsists with malignancy. |
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Term
| Explain 123 I imaging for me... |
|
Definition
Iodine is tagged and scanned to assess uptake of the thyroid.
- Malignancy is hypocfunctioning (cold)
- Benign is hyperfunctioning (hot)
- HOT NODULES ARE GOOD!!! |
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Term
| Drug of choice for hyperthyroid sx. Why? |
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Definition
| Beta-blocker (Propranolol) relieves tachycardia, diaphoresis, and anxiety associated with Graves Dz. |
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Term
| MOA propylthiouracil (PTU) |
|
Definition
| inhibits thyroid hormone synthesis |
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Term
| What are the group of sx associated with hyperthyroid? |
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Definition
| adrenergic (use a beta-blocker to reduce them) |
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Term
| Hypothyroid is associated with which menstrual irregularity? Why? |
|
Definition
Menorrhagia (increased menstrual flow)
- altered metabolism of sex steroid hormones. |
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Term
| Hyperthyroid is associated with which menstrual irregularity? |
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Definition
| Oligomenorrhea (decreased menstrual flow) or even amenorrhea. |
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Term
| Menorrhagia vs. Oligomenorrhea |
|
Definition
Menorrhagia (increased menstrual flow)
Oligomenorrhea (decreased menstrual flow) |
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Term
| Why are ACE inhibitors nephroprotective in diabetics? |
|
Definition
| With elevated SBP, there is an increase in microalbuminuria, normotensive diabetics may have nocturnal HTN, ACE inhibitors impede this progression. |
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Term
| When are thyroid antibodies elevated? |
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Definition
| Graves dz and Hahsimoto's thyroiditis. |
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Term
| metabolic thyroid molecule |
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Definition
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Term
| What races have an increased prevelence of DM2? |
|
Definition
| African-Americans, Hispanics, and Pima Indians. |
|
|
Term
| Is gender a factor of DM2? |
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Definition
|
|
Term
| When is most likely to be dx with DM2? |
|
Definition
| middle aged/older people who are overweight |
|
|
Term
| intense thirst, polyuria, hyperuricemia, low urine osmolality, low urine sodium. NML serum sodium. |
|
Definition
| central diabetes insipidus |
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Term
|
Definition
| synthetic arginine vasopressin (antidiuretic hormone) analogue; exerts antidiuretic effects and increases plasma factor VIII and von Willebrand factor levels |
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Term
|
Definition
| Vasopressin normally limits the amount of urine the body produces. Normally, the hypothalamus gland in the brain makes vasopressin, and the pituitary gland stores the hormone. Without vasopressin, the kidneys do not work properly. The result is a rapid loss of water from the body in the form of dilute urine. |
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Term
| Test for diabetes insipidus |
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Definition
| vaspressin challenge (causes resolution of sx) |
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|
Term
| What does water restriction do to diabetes insipidus? |
|
Definition
| leads to dehydration and hypernatremia |
|
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Term
| class and MOA of dopamine |
|
Definition
- Class: Inotropes/Pressors
- Mechanism Of Action: stimulates alpha- and beta1-adrenergic and dopaminergic receptors |
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Term
| What does dopamine do to a normotensive person? |
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Definition
|
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Term
| Connection of Beta=blockers and glycemic control. |
|
Definition
| beta-blockers are known to precipitate and mask sx of hypoglkycemia in diabetic pts. |
|
|
Term
skin warm and dry, pulse 52, BP 128/62
- lethargic, disoriented without focal neurologic findings. |
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Definition
|
|
Term
| inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase |
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Definition
|
|
Term
| DM2 tx for obese pt with normal serum creatinine. (after diet and exercise) |
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Definition
|
|
Term
| MOA metformin (glucophage) |
|
Definition
- decreases hepatic glucose production
- decreases intestinal glucose absorption
- increases insulin sensitivity |
|
|
Term
| When is insulin attempted in DM2? |
|
Definition
|
|
Term
|
Definition
- Weakness (99%)
- Pigmentation of skin (98%)
- Weight loss (97%)
and
- Abdominal pain (34%)
- Salt craving (22%)
- Diarrhea (20%) |
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|
Term
| BP of pt with adrenal insufficiency |
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Definition
|
|
Term
- what is widened pulse pressure?
- When is it seen? |
|
Definition
- 80 mm Hg difference between systolic and diastolic.
- seen in elderly persons with isolated HTN. |
|
|
Term
| signs of autonomic neuropathy (when is it seen?) |
|
Definition
- orthostatic hypotension
- gastroparesis
- impotence
- alternating diarrhea/constipation
- incomplete bladder emptying
--seen in DM |
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Term
|
Definition
|
|
Term
| first sign of peripheral neuropathy |
|
Definition
| decreased vibratory sense |
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Term
| abd pain, altered bowel habits, and bloating. |
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Definition
|
|
Term
| episodic palpitations with sweating, weight loss and nervousness. |
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Definition
|
|
Term
| hyperactivity, irritability, heat intolerance, increased appetite, weight loss, altered bowel habits, weakness, a-fib |
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Definition
|
|
Term
| weakness, abd pain, fever, confusion, N/V/D |
|
Definition
| adrenocorticoid insufficiency |
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Term
| DM1, hyperglycemia > 250 mg/dL, blood pH < 7.3 |
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Definition
|
|
Term
| Dx criteria for diabetic ketoacidosis |
|
Definition
| DM1, hyperglycemia > 250 mg/dL, blood pH < 7.3 |
|
|
Term
| dx of hyperglycemic hyperosmolar coma |
|
Definition
| blood pH > 7.3 (no assiciated acidosis), this is nonketotic |
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Term
|
Definition
|
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Term
|
Definition
| GLYCOSATED Hgb is found in RBCs and coorelates to the amount of glucose available to the cell over the cell's 2-3 month lifespan. |
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Term
| a polypeptide hormone secreted by the alpha cells of the islets of Langerhans in response to hypoglycemia, acetylcholine, some amino acids, and growth hormone; it stimulates glycogenolysis in the liver and stimulates the release of insulin by the pancreat |
|
Definition
|
|
Term
| a protein hormone secreted by the beta cells of the pancreatic islets, serving as a hormonal signal of the fed state; it is secreted in response to elevated blood levels of glucose and amino acids and promotes efficient storage and use of these fuel molec |
|
Definition
|
|
Term
- a rebound phenomenon occurring in diabetes mellitus
- overtreatment with insulin induces hypoglycemia, which initiates the release of epinephrine, corticotropin, glucagon, and growth hormone, which stimulate lipolysis, gluconeogenesis, and glycogenol |
|
Definition
| Somogyi phenomenon (effect) |
|
|
Term
| Somogyi phenomenon (effect) |
|
Definition
- a rebound phenomenon occurring in diabetes mellitus
- overtreatment with insulin induces hypoglycemia, which initiates the release of epinephrine, corticotropin, glucagon, and growth hormone, which stimulate lipolysis, gluconeogenesis, and glycogenolysis, which in turn result in hyperglycemia. |
|
|
Term
| Tx Somogyi phenomenon (effect) |
|
Definition
|
|
Term
|
Definition
- Can occur in Type 1 or 2 diabetes.
- morning mild hyperglycemia caused by reduced tissues sensitivity to insulin.
- The insensitivity is cause by spikes of growth hormone release at the onset of sleep. |
|
|
Term
|
Definition
| - often fatal complication of long-term hypothyroidism in which the patient is comatose with hypothermia, depression of respiration, bradycardia, and hypotension; usually seen in elderly patients during cold weather. |
|
|
Term
|
Definition
1. hypothyroidism in adults.
- weight gain
- fatigue
- puffy appearance
- dry, waxy swelling of the skin with abnormal deposits of glycosaminoglycans in skin (mucinosis) and other tissues, associated with primary hypothyroidism. The edema is nonpitting, and there are distinctive facial changes including swollen lips and a thickened nose. |
|
|
Term
|
Definition
- cause by prolonged hypothyroidism
- comatose
- hypothermia
- depression of respiration,
- bradycardia
- hypotension |
|
|
Term
- weight loss
- fatigue
- diarrhea
- vomiting
- anorexia
- salt craving
- postural dizziness
- pigmentation of buccal mucosa
- pale face and extensor surfaces
- hyponatremia
- hyperkalemia
- hypoglycemia |
|
Definition
|
|
Term
| s/s adrenal insufficiency |
|
Definition
- weight loss
- fatigue
- diarrhea
- vomiting
- anorexia
- salt craving
- postural dizziness
- pigmentation of buccal mucosa
- pale face and extensor surfaces
- hyponatremia
- hyperkalemia
- hypoglycemia |
|
|
Term
| s/s adrenal insufficiency |
|
Definition
- weight loss
- fatigue
- diarrhea
- vomiting
- anorexia
- salt craving
- postural dizziness
- pigmentation of buccal mucosa
- pale face and extensor surfaces
- hyponatremia
- hyperkalemia
- hypoglycemia |
|
|
Term
| the big 3 s/s to remember on the PANCE for adrenal insufficency |
|
Definition
- salt craving
- pigmentation of buccal mucosa
- pale face and extensor surfaces |
|
|
Term
| Na, K and Glu in adrenal insufficiency |
|
Definition
- hyponatremia
- hyperkalemia
- hypoglycemia |
|
|
Term
- fatigue
- HA
- inappropriate sweating
+/- orthostatic hypotension |
|
Definition
|
|
