Care Ii Test 4

Front 1

Glucagon is secreted by which cells?

Back 1

Alpha cells

Front 2

Characterized by destruction of pancreatic beta cells.

Back 2

Type I diabetes

Front 3

The genetic tendency for Type I diabetes is associated with certain ___ types.

Back 3

Human leukocyte antigen (HLA)

Front 4

What is the acute complication of diabetes Type I? Type II?

Back 4

Type I: DKA (Diabetic ketoacidosis)
Type II: Hyperglycemic hyperosmolar nonketotic syndrome

Front 5

Byproducts of fat breakdown that disturb the acid-base balance of the body when they accumulate in excessive amounts.

Back 5

Ketone bodies

Front 6

(Type I/Type II) is more common, and affects approximately 90-95% of people with the disease.

Back 6

Type II

Front 7

The two main problems of people with Type II diabetes are:

Back 7

Insulin resistance and impaired insulin secretion

Front 8

A major danger of alcohol consumption by the patient with diabetes is (hyper/hypoglycemia).

Back 8

Hypoglycemia: If a person with diabetes consumes alcohol on an empty stomach, there is an increased likelihood of hypoglycemia because alcohol can decrease the normal physiologic reactions int he body that produce glucose (p. 1205).

Front 9

True/False. Patients who have blood glucose levels exceeding 250 and/or who have ketones in their urine should not exercise.

Back 9

True. They should not begin exercising until the urine test results are negative for ketones and the blood glucose level is closer to normal. Exercising with elevated blood glucose levels increases the secretion of glucagon, growth hormone, and catecholamines. The liver then releases more glucose, and the result is an increase in the blood glucose level. (P. 1206)

Front 10

___ is a blood test that reflects average blood glucose levels over a period of approximately 2-3 months.

Back 10

HBA1c

Front 11

The target level of HbA1c for diabetics is:

Back 11

Less than 7%

Front 12

Humalog (Lispro), Novolog (Aspart), and Apidra (Glulisine) are all considered ___ insulins, and peak within 1 hour.

Back 12

Rapid-acting. They have an onset of 10-15 minutes have a 2-4 hr duration.

Front 13

Regular insulin has an onset within ___, peaks within ___, and has a duration of ___.

Back 13

Onset: .5-1 hr
Peak: 2-3 hr
Duration: 4-6 hr

Front 14

NPH onset, peak, and duration.

Back 14

Onset: 2-4 hr.
Peak: 4-12 hr
Duration: 16-20 hr

Front 15

Lantus onset, peak, and duration.

Back 15

Onset: 1 hr
Peak: NO PEAK
Duration: 24 hr

Front 16

This type of insulin is usually taken after food.

Back 16

NPH

Front 17

This type of insulin may be taken alone or in combination with a longer-acting insulin.

Back 17

Regular

Front 18

This type of insulin is usually administered 20-30 minutes before a meal.

Back 18

Regular

Front 19

Which is the only cloudy insulin?

Back 19

NPH

Front 20

This is the only insulin approved for IV use.

Back 20

Regular insulin

Front 21

___ is characterized by a relatively normal blood glucose level until approximately 3 am, when blood glucose levels begin to rise. This is through to result from nocturnal surges in growth hormone secretion, which create a greater need for insulin in the early morning hours in patients with TYPE 1 DIABETES.

Back 21

Dawn phenomenon

Front 22

The dawn phenomenon is more characteristic of (Type I/Type II) diabetes.

Back 22

Type I

Front 23

Nocturnal hypoglycemia followed by rebound hyperglycemia.

Back 23

Somogyi effect

Front 24

The progressive increase in blood glucose from bedtime to morning.

Back 24

Insulin waning

Front 25

___ is approved for treatment of both type I and type II diabetes.

Back 25

Symlin

Front 26

___ is derived from a hormone that is produced in the small intestine and has been found to be deficient in Type II diabetes. It is normally released after food is ingested to delay gastric emptying and enhance insulin secretion, resulting in dampening of the rise in blood glucose levels after meals and a feeling of satiety.

Back 26

Byetta

Front 27

A frosted, whitish coating that shows up inside intermediate-acting insulin bottles as a result of exposure to extremes in temperature.

Back 27

Flocculation

Front 28

What are Charcot joints?

Back 28

Joint deformities that result from abnormal weight distribution on joints resulting from lack of proprioception from diabetic neuropathy.

Front 29

Hormones produced by the anterior pituitary?

Back 29

Growth hormone (GH)
Adrenocorticotropic hormone (ACTH)
Thyroid-stimulating hormone (TSH)
Follicle-stimulating hormone (FSH)
Luteinizing hormone (LH)

Front 30

Posterior pituitary hormones?

Back 30

Antidiuretic hormone (ADH)
Prolactin
Oxytocin

Front 31

Oversecretion of the anterior pituitary gland most commonly involves ACTH or GH and results in:

Back 31

Cushing's syndrome or acromegaly

Front 32

Insufficient secretion of GH during childhood results in:

Back 32

Dwarfism

Front 33

The most common disorder related to posterior lobe dysfunction is:

Back 33

Diabetes insipidus

Front 34

___ tumors give rise to Cushing's synrome.

Back 34

Basophilic tumors; These have features largely attributable to hyperadrenalism, including masculinzation and amenorrhea in females, truncal obesity, hypertension, osteoporosis, and polycythemia.

Front 35

___ tumors represent 90% of pituitary tumors.

Back 35

Chromophobic tumors; these tumors usually produce no hormones but destroy the rest of the pituitary gland, causing hypopituitarism.

Front 36

Name the three hormones produced by the thyroid.

Back 36

T3, T4, Calcitonin

Front 37

Inadequate secretion of thyroid hormone during fetal and neonatal development results in:

Back 37

Cretinism (stunted physical and mental growth as a result of general depression of metabolic activity).

Front 38

The most common cause of hypothyroidism in adults is ___.

Back 38

Autoimmune thyroiditis, or Hashimoto's disease.

Front 39

___ refers to the accumulation of mucopolysaccharadies in subcutaneous and other interstitial tissues.

Back 39

Myxedema

Front 40

True/False. Hypothyroidism is inevitably connected to CAD.

Back 40

True. Any patient who has had hypothyroidism for a long period is almost certain to have elevated serum cholesterol, atherosclerosis, and CAD. (P. 1257)

Front 41

True/False. Thyroid hormones can decrease blood glucose levels.

Back 41

False. Increase.

Front 42

___ is the most common type of hyperthyroidism.

Back 42

Graves' disease.

Front 43

The presenting symptom of thyrotoxicosis is:

Back 43

Nervousness

Front 44

Hypothyroidism: (Decreased/Increased) appetite; weight (loss/gain)

Hyperthyroidism: (Decreased/Increased) appetite; weight (loss/gain)

Back 44

Hypothyroidism: decreased appetite; weight gain

Hyperthyroidism: increased appetite; weight loss

Front 45

A life-threatening condition manifested by cardiac dysrhythmias, fever, and neurologic impairment.

Back 45

Thyroid storm

Front 46

How should SSKI be administered?

Back 46

With a straw, to prevent staining of teeth.

Front 47

The most common type of goiter.

Back 47

Endemic (iodine-deficient) goiter

Front 48

True/False. Chemotherapy is used to treat thyroid cancer.

Back 48

False

Front 49

Secondary hyperparathyroidism occurs as a result of...

Back 49

Phosphorus retention, increased stimulation of the parathyroid glands, and increased parathormone secretion.

Front 50

True/False. Thiazides are prescribed for hyperparathyroidism.

Back 50

False. Thiazides are avoided, because they decrease the renal excretion of calcium and further elevate serum calcium levels.

Front 51

Frontal bossing and prognathism is characteristic of ___.

Back 51

Acromegaly

Front 52

Acromegaly in children is referred to as:

Back 52

Gigantism

Front 53

What is prognathism?

Back 53

Chin protrusion associated with acromegaly

Front 54

What drug is used to treat acromegaly?

Back 54

Octreotide-- it reduces GH levels.

Front 55

What sort of diet might an acromegaly patient be on?

Back 55

Low sodium, usually as a result of CHF.

Front 56

SIADH can lead to (increased/decreased) sodium and chloride levels.

Back 56

Decreased.

Front 57

T/F. SIADH patients are at risk for seizures.

Back 57

True

Front 58

Two types of diabetes insipidus are:

Back 58

Neurogenic and nephrogenic

Front 59

What mental s/s will DI have?

Back 59

Confusion, lethargy from brain dehydration

Front 60

DI will have (increased/decreased) serum sodium.

Back 60

Increased

Front 61

The water deprivation test is used for which disease?

Back 61

Diabetes insipidus

Front 62

If, during the water deprivation test, the urine osmolality is greater than 9%, then the patient has (nephrogenic/neurogenic) DI.

Back 62

Neurogenic

Front 63

How would you treat nephrogenic DI? (Select all that apply)
A) Desmopressin intranasally
B) Thiazide diuretics
C) Low sodium diet
D) Tegretol

Back 63

B, C

Front 64

In DI, you use a (hypertonic/hypotonic) IV solution.

Back 64

Hypotonic

Front 65

Calcitonin (increases/decreases) serum calcium.

Back 65

Decreases

Front 66

Toxic multinodular goiter is also known as:

Back 66

Plummer's disease

Front 67

T/F. Plummer's disease is autoimmune.

Back 67

False

Front 68

T/F. Acute thyroiditis is most commonly viral.

Back 68

False: Fungal or bacterial

Front 69

Hyperthyroid patients will have (elevated/decreased) serum glucose.

Back 69

Elevated

Front 70

Hyperthyroid patients will have (increased/decreased) cardiac output.

Back 70

Increased

Front 71

Hyperthyroid patients will have (hyper/hypo)calcemia and (increased/decreased) libido.

Back 71

Hypercalcemia and increased libido

Front 72

Hyperthyroidism is characterized by (elevated/decreased) TSH levels and (elevated/decreased) free T4 levels.

Back 72

Decreased TSH, elevated free T4

Front 73

What test do you use to differentiate Graves disease from other forms of thyroiditis?

Back 73

RAIU: Radioactive iodine uptake test

Front 74

What med will you use to treat hyperthyroidism?

Back 74

PTU, methimazole

Front 75

The most widely recommended treatment of hyperthyroidism?

Back 75

Radioactive iodine

Front 76

An autoimmune process where the thyroid enlarges and becomes inefficient in converting iodine into thyroid hormone and compensates by enlarging.

Back 76

Hashimoto's thyroiditis

Front 77

Hashimoto's thyroiditis is associated with (hyper/hypo)thyroidism.

Back 77

Hypothyroidism

Front 78

What life threatening event is associated with hypothyroidism?

Back 78

Myxedema

Front 79

Hypothyroidism = (elevated/decreased) TSH level and (elevated/decreased) T4 level.

Back 79

Increased TSH, decreased T4

Front 80

Hyperparathyroidism leads to neuromuscular (weakness/twitching and irritability).

Back 80

Weakness

Front 81

Hypoparathyroidism can lead to neuromuscular (weakness/twitching and irritability).

Back 81

Twitching and irritability

Front 82

What tests should you perform for hypoparathyroid patients?

Back 82

Chvostek's/Trousseau's

Front 83

Why do you administer SSKI or Lugol's sodium properatively for thyroidectomies?

Back 83

They reduce thyroid activity and vascularization of the gland, which makes the surgery safer.

Front 84

Acute tetany can occur as a result of (hypo/hyper)parathyroidism.

Back 84

Hypoparathyroidism

Front 85

What is the primary focus of acute thyrotoxicosis?

Back 85

Fever

Front 86

Hypoaldosteronism is also known as:

Back 86

Addison's disease

Front 87

Pheochromocytoma is a condition of the adrenal (cortex/medulla).

Back 87

Medulla

Front 88

Cushing's disease is a condition of the adrenal (cortex/medulla).

Back 88

Cortex

Front 89

Addison's disease is characterized by what electrolyte imbalance?

Back 89

Hyperkalemia-- more than 7 meq/L

Front 90

T/F. Patients with Cushing's disease have a tanned or bronzed appearance.

Back 90

False. Patient's with Addison's disease have a tanned or bronzed appearance, as a result of MSH stimulation.

Front 91

What life threatening condition is associated with hyperaldosteronism?

Back 91

Addisonian crisis

Front 92

What are the five H's of pheochromocytoma?

Back 92

Hypertension, headache, hyperhidrosis (excessive sweating), hypermetabolism, and hyperglycemia.