Endocrine

Question 1

Normal changes

Answer 1

delayed and insufficient release of insulin by the beta cells of the Islet cells of langerhans.

glucose metabolism is reduced, causing higher and more prolonged levels of hyperglycemia, which is why it’s not unusual to see high blood glucose levels among nondiabetic older people.

thyroid gland gradually atrophies & thyroid gland activity decreases, resulting in:

• lower basal metabolic rate
• reduced radioactive iodine uptake
• less secretion of thyrotropin
• thyroid function will remain adequate to meet daily needs

release of the adrenocorticotropic hormone decreases, leading to:

• reduced activity of the adrenal gland
• reduced secretion of estrogen, progesterone, androgen, 17-ketosteroids & glucocorticoids

volume of the pituitary decreases

insulin secretion by the beta cells in the pancreas is also affected:

• reduced tissue sensitivity to the insulin
• reduced ability to metabolize glucose
• reduced receptor sensitivity to glucose
• this can increase the risk of hyperglycemia

Question 2

Dupuytren’s contracture

Answer 2

fixed flexion of hands due to a thickening of the fibrous tissue under the skin of the palm and fingers, a risk for persons with DM

Question 3

Goiter

Answer 3

nonmalignant swelling of the thyroid

Question 4

Metabolic syndrome

Answer 4

group of conditions (high triglycerides, low HDL, elevated fasting sugar, elevated bp, & central obesity) occurring together that increase the risk of diabetes, stroke & coronary artery disease

Question 5

major classes of hormones

Answer 5

• steroids (lipid-soluble)
• thyronines (lipid-soluble)
• polypeptides (water-soluble)
• catecholamines (water-soluble)

Question 6

pre-diabetes

Answer 6

-blood glucose levels are high, but is not consistent and high enough to be diagnosed as diabetes

Question 7

gestational diabetes

Answer 7

• DM that develops during pregnancy

- Increased risk of type 2 DM on the mother AND child

Question 8

Secondary DM

Answer 8

-caused by another disease affecting the function of the pancreas (pancreatitis or cystic fibrosis)

Question 9

3 p’s of DM

Answer 9

• Polyuria: excessive urination
• Polydipsia: excessive fluid intake
• Polyphagia: excessive eating

Question 10

3’ “pathy’s” of DM

Answer 10

• Neuropathy
• Retinopathy
• Nephropathy

Question 11

Administering insulin

Answer 11

• insulin is administered via sub q injections (back of the arm, anterior lateral area of the thigh
• needle size for sub q (25-27 gauge; 3/8-5/8 in needle)
• NPH is cloudy
• Long acting insulin can’t be mixed

Question 12

Medications

Answer 12

• Biguanides (metformin): decreases hepatic glucose production and increases glucose uptake/insulin sensitivity
• used as the 1st line of treatment because it has a low risk for causing adverse effects

Question 13

Onset

Answer 13

when the insulin first begins to act in the body

Question 14

Peak

Answer 14

the time when insulin is exerting maximum action

Question 15

Duration

Answer 15

the time the insulin remains in effect