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356 Cards in this Set
- Front
- Back
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TBW (definition)
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Total Body Water....total sum of fluids within all body compartments
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portion of TBW that is ICF?
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2/3
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portion of TBW that is ECF?
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1/3
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ICF (definition)
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intracellular fluid...all fluid within cells
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ECF (definition)
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extracellular fluid....all fluid outside of cells
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ISF (definition)
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interstitial fluid...space between cells and outside the blood vessels...part of ECF
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IVF (definition)
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intravascular fluid....blood plasma
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ISF and IVF are part of....
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ECF
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infants expected TBW....
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75-80%
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children and adolescent TBW....
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60-65%
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TBW decreases with...
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age
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what 3 things cause a decrease in TBW with age?
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1) decreased muscle mass
2) increased fat cells 3) decreased ability to regulate sodium and water balance |
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what causes water movement between ICF and ECF?
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potassium
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what elements can easily move across capillary membranes, contributing to water movement between intravascular and interstitial fluid?
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water, sodium, glucose
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Plamsa proteins (albumin) maintain effective osmolarity how?
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by generating plasma oncotic pressure
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how much fluid is lost as wastes are metabolized?
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100 mL per 100 calories
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what systemic manifestations can reduce TBW?
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fever and increased respiratory rate
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problems with what 4 organ systems can cause loss of water?
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kindeys
GI tract skin lungs |
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sensible water loss
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urine and feces
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insensible water loss
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lungs and skin...occurs without awareness
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2 types of pressure in water filtration?
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capillary hydrostatic pressure
interstitial oncotic pressure |
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what is integrity in the capillary membrane key in?
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movement of water and solutes
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diffusion (definition)
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movement of particles along a concentration gradient from an area of higher concentration to lower concentration
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osmosis (definition)
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movement of water across semipermeable membranes
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osmotic pressure (definition)
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pressure needed to prevent movement of water acroos a semipermeable membrane (prevent osmosis)
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what are 4 factors of water movement?
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type and thickness of membrane
size of molecules concentration of molecules solubility of molecules in membrane |
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osmolarity concentration of x in....
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concentraion in 1 L of solution
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osmolarity refers to....
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fluids outside the body
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osmolality (definition)
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osmolar concentration in 1 kg of water
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osmolality refers to...
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fluids inside the body
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osmolality controls...
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the distribution and movement of water between body compartments
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what is an example of osmolality
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kidneys ability to produce a concentrated or dilute urine
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hydrostatic pressure pushes...
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water
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hydrostatic pressure arises from ..
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heart contraction
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hydrostatic pressure favors movement of....
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plasma water into ISF
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colloid osmotic pressure helps maintain
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plasma membrane
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where does osmotic pressure pull water from?
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at end of arterial and venous ends of capillary
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osmotic pressure is maintained by....
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plasma proteins (albumin)
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what causes edema?
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movement of water into interstital space causing accumulation of water into tissue
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localized edema
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limited to site of trauma
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generalized edema
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uniform distribution
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third-space accumulation (definition)
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loss or trapping of ECF into transcellular spaces (serous cavities), pericaridial sac, peritoneal cavity, and pleural cavity
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hydrothorax (definition)
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excessive fluid into the pleural cavity
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ascites (definition)
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excessive fluid in the peritoneal cavity
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effusion (definition)
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term used for fluid in the serous cavities (blood, plasma proteins, inflammatory cells (pus))
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brawny edema is characterized by
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thick and hardened skin
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nonpitting edema is caused by
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plasma proteins accumulated into tissue spaces and coagulated; occurs with local infection or trauma
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pitting edema is caused by
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accumulation of interstitial fluid exceeds the absorptive capacity of tissue, water is mobile and can be translocated with finger pressure
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what balance is regulated by
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ADH (antidiurhetic hormone)
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thirst is triggered by ....
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hypothatlamus and angiotensin II
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adipsia
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absence of thirst
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polydipsia
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excessive thirst
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hyperdipsia
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decrease in thirst sensation
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what 2 things regulate water balance?
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ADH or vasopressin
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ADH and vasopressin are secreted form the...
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pituitary gland
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ADH is secreted when....(2)
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plasma osmolality increases due to...
1) water deficit 2) sodium excess or circulating blood volume decresases and BP drops |
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Diabetes insepidus literally means
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tasteless diabetes
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Diabetes insepidus is caused by a deficiency of...
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ADH
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Diabetes insepidus is caused by a deficiency of ADH triggered by what 2 possibilities?
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decrease in ADH synthesis
kindeys inability to respond to ADH |
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clinical manifestations of Diabetes insepidus
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excessive dilute urination (polyuria)
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3 types of Diabetes insepidus
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neurogenic
primary drug related |
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neurogenic Diabetes insepidus
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kidneys do not respond to ADH
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primary Diabetes insepidus
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defect in pituitary gland
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drug- related Diabetes insepidus
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interefere with kidneys response
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SIADH
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failure of negative feedback system to regulate ADH
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SIADH causes...
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water retention with dilutional hyponatremia
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hyponatremia (definition)
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decreased osmolarity
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what are 4 possible causes of SIADH?
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neoplasia
neurologic disorders lung disease meds |
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tonicity (definition)
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change in water content resulting in cellular sweeling/shrinking
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isotonic (definition)
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same concentration of particles as ICF or ECF
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hypotonic (definition)
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lower concentration of particles/dilute
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hypotonic results in...
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cellular swelling
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hypertonic (definition)
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higher concentration of particles
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hyperonic results in...
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cellular shrinking
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What does sodium have to do with ECF?
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it maintains proper ECF osmolality and maintains ECF volume
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what in addition to Na influences body water distribution?
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Cl-
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how does sodium affect K+ and Cl-?
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affects the concentration, excretion and absorption
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sodium combines with what 2 things to help regulate acid base balance?
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Cl- and bicarbonate (HCO3)
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sodium does what with nerves?
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aids impulse transmission in nerve muslce fibers
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hypo sodium
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<135
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chloride maintains what?
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serum osmolality
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what helps chloride to maintain serum osmolatily?
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Na
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how does Cl play a role in maintaining acid-base balance?
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through production of HCl
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potassium maintains what 2 things?
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cell electroneutrality and cell osmolality
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how does potassium affect the heart?
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by affecting cardiac muscle contraction and electrical conductivity
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postassium aids what regarding nerves?
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neuromuscular transmission of nerve impulses
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any alteration in potassium balance will result in....
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acid-base imbalance
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too little potassium...
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muscular weakness (progressively severe...legs to lungs)
smooth muslce antony delays in cardiac cycle bradycardia av block paroxysmal arterial tachy |
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what are the ECG changes related to too little potassium?
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ST segment depression
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too much potassium s/s.
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neuromuscular irritabilitiy
muslce weakness, loss of tone, paralysis |
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What are ECG changes related to mildly high K levels?
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narrow, taller T wave and shortened QT interval
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What are ECG changes related to severely high K levels?
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widened QRS interval; prolonged PR interval, wide flat P wave
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function of calcium
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affects activation, excitation, and contraction of cardiac and skeletal muslce
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too much calcium has what symptoms...
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fatigue
weakness dysrhythmias, bradycardia cardiac arrest bone pain osteoporosis |
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too little calcium has what symptoms?
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increased neuromuscular excitability
tingling muscle spasm convulstions tetany cardiac arrest |
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what can too little calcium do to an ECG?
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prolonge the QT interval...lead to cardiac arrest
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function of phosphorous
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essential component of bones and teeth and helps maintain cell membrane integrity
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too little phosphorous will lead to...
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s/s r/t decreased oxygen
blood cell dysfunction coma convulsions confusion |
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too much phosphourus will lead to...
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s/s of low calcium levels
calcification of soft tissues in lungs, kidneys, joints |
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funciton of magnesium
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acts on the myoneural junction, affecting neuromuscular irritability and contractility of cardiac and skeleltal muscle
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too little magnesium leads to...
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behavioral changes
increased reflexes muscle cramps ataxia tetany tachycardia hypotension |
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too much mangesium leads to....
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skeletal smooth muscle contraction
excess nerve function hypotension bradycardia respiratory distress |
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acid base balance is maintained by mechanisms that ____, _____, and _______ acids and bases...
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generate, buffer, eliminate
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normal pH
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7.35-7.45
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acids are generated as byproducts of...
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metabolism
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respiratory regulation of pH
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eliminate CO2
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renal regulation of pH
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concserve HCO3 and eliminate H+ ions
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Hydrogen ions
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maintain membrane integrity
speed up metabolic enzyme reactions |
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metabolic disorders of the acid-base system...
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produce alterations in bicarbonate concentration and result from addition or loss of nonvolatile acid or alkali from ECF
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Nonvolatile
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not eliminated by the lungs, buffered by body then excreted by the kidneys
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volatile
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excreted by lungs
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acidosis (metabolic)
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reduction in pH due to decreased HCO3
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alkalosis (metabolic)
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elevated pH due to increased HCO3
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Respiratory disorders of acid base balance involve...
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PCO2
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acidosis (Respiratory)
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decrease in pH -> decrease in ventilation and increase in PCO2
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alkalosis (Respiratory)
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increase in pH -> increase in alveolar ventilation and decrease in PCO2
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Repiratory assessment: PCO2
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35-45 mm Hg
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Repiratory assessment: PO2
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80-100 mm Hg
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PO2
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blood oxygenation level
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metabolic assessment: HCO3
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22-26 mEq/L
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concentration of anion (-) should be _____ ____ concentration of cations (+)
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equal to
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in the anion gap the difference between Na + K and Cl + HCO3 should be
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~ 10-12 mEq/L
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increase in anion gap causes (2)
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lactic acidosis and ketoacidosis
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decrease in anion gap causes (3)
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hyperkalemia
hypercalcemia hypermagnesemia r/t low albumin |
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primary
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renal or respiratory adjustments to changes in pH
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compensatory
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adjust pH toward normal WITHOT correcting the underlying cause
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mixed
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both primary and compensatory change in acid-base balance
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Metabolic acidosis (patho)
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pH < 7.35 (decreased pH, decreased HCO3)
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what are 6 possible causes of metabolic acidosis?
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diabetic ketoacidosis
salicylate overdose shock sepsis diarrhea renal failure |
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metabolic acidosis diagnostics
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anion gap, ABG's (arterial blood gas)
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respiratory acidosis patho
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pH < 7.35
hypoventilation decreased pH, increased CO2 |
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6 possible causes of respiratory acidosis
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drug OD
pulmonary edema chest trauma neuromuscular disease COPD |
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metabolic alkalosis patho
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> 7.45
increased pH, increased HCO3 |
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3 possible causes of metabolic alkalosis
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loss of gastric uices
antacids OD potassium wasting diuretics (loss of H+) |
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metabolic alkalosis manifestations
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often asymptomatic or s/s of hypokalemia or volume depletion
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Respiratory alkalosis patho
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pH > 7.45
increased pH decreased CO2 |
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6 causes of Respiratory alkalosis
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anxiety
high altitudes pregnancy fever hypoxia initial stages of pulmonary emboli |
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manifestations of Respiratory alkalosis
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associated hyperexcitability
decreased CNS blood flow |
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4 fat soluble vitamins
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vitamin A, vitamin D, vitamin E, vitamin K
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Water soluble vitamins (5)
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thiamine (B1)
Riboflavin (B2) Niacin Pyridoxine pantothenic acid |
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Vitamin A
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fat soluble,
vision, skin, bone growth, immunity |
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Vitamin D
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absorption of calcium, bones/teeth
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Vitamin E
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antioxidant; prevents cell membrane injury
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Vitamin K
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clotting
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Thiamine
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carb metabolism
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riboflavin
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ox-redux reactions
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niacin
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ox-reducs reactions
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pyridoxine
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metabolism of AA's, heme synthesis
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pantothenic acid
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energy metabolism
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B12
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nucleic acid synth, red cell devel., nerve function
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folic acid
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AA and nucleo-protein metabolism, red cell formation
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Biotin
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fat synthesis
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Vitamin C
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antioxidant, collagen synth, wound healing
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Anorexia
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lack of a desire to eat despite physiologic stimuli that would normally produce hunger
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vomitting
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forceful emptying of the stomach and intestinal contents through the mouth
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Nausea
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subjective experience of near vomitting
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Retching
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nonproductive vomiting
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projectile vomiting
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a spontaneous vomiting that does not follow nausea or retching...cuzsed by direct stimulation of the vomitiong center by neurologic lesions of brain stem or GI obstruction
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contipation
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infrequent or difficult defecation
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diarrhea
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increased frequency of bowl movements
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GI bleeding (upper)
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esophagus, stomach, or duodenum
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GI bleeding (lower)
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below the ligament of treitz, or bleeding from the jejunum, ileum, colon, or rectum
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dysphagia (2 types)
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mechanical obstructions
functional obstructions |
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achalasia
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denervation of smooth muscle in the esophagus and lower esophageal sphincter relaxation...loss of esophageal peristalsis and failure of lower esophageal sphincter to relax
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GER (gastroesophageal Reflux)
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reflux of chyme from the stomach to the esophagus
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reflux esophagitis
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inflammation of the esophagus caused by GER
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hiatal hernia
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protrusion of the upper part of the stomach through diaphragm into thorax
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pyloric obstruction
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blocking or narrowing of the opening between the stomach and the duodenum
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intestinal obstruction and ileus
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any condition that prevents the flow of chyme through the intestinal lumen
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simple obstruction (intestinal obstruction)
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mechanical blockage of lumen by lesion
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functional obstruction (intestinal obstruction)
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failure of motility (paralytic ileus)
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bowel sounds with bowel obstruction
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increased
high-pitched at first, then silent |
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s/s of bowel obstruction
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vomitus
abdominal distention constipation with failure to pass flatus |
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gastritis
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inflammatory disorder of the gastric mucosa
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acute gastritis erodes...
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surface epithelium
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chronic gastritis generally occurs in the...
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elderly
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chronic gastritis
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thinning and degeneration of stomach wall
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2 types of chronic gastritis
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chronic fundal gastritis (type A)
chronic antral gastritis (type B) |
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what causes both fundal and antral gastritis?
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H. pylori
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what is unique to fundal gastritis?
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degeneration of gastric mucosa
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peptic ulcer disease
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a break or ulceration in the protective mucosal lining of the lower esophagus, stomach, or duodenum
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what are the most common peptic ulcers?
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duodenal ulcers
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duodenal ulcers occur most often in...
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young people
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Duodenal ulcer clinical...
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chronic intermittent gastric pain 2-3 hours after eating
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where do gastric ulcers occur?
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in antral region of the stomach adjacent ot the acid-secreting mucosa of the body
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age group for gastric ulcers?
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55-65 years
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patho of gastric ulcers...
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increased mucosal permeability to H+ ions
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stress ulcer
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acute peptic ulcer that is related to severe illness, neural injury, or systemic trauma
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s/s of stress ulcer
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bleeding
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ischemic ulcers
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stress ulcer that develops within hrs of multipsystem trauma
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cutting ulcer
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type of ischemic ulcer that results from burn injury
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chuching ulcers
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stress ulcer associated with severe head trauma/brain surgery
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inflammatory bowel disease
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chronic, relapsing inflammatry bowel disoreders of unknown origin
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ulcerative colitis
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chronic inflammatory disease that causes ulceration of the colonic mucosa (sigmoid colon and rectum)
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age group for ulcerative colitis
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20-40 yrs
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risk factors for ulcerative colitis (3)
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jewish descent
familial history caucasians |
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s/s of ulcerative colitis
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intermittent remission and exacerbation
diarrhea (10-20 a day), blood stool, continuous cramping dehydration, weight loss |
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ulcerative colitis pts are increased risk for...
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colon cancer
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chrohns disease
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inflammatory disease of large and small intestine...can affect any part of GI tract, mouth to anus
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crohn disease causes...
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"skip lesions"
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s/s of crohn disease
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diarrhea, colonic bleeding, weight loss, lower abdominal pain
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Diverticulosis
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asymptomatic diverticuar disease
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diverticula
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herniations of mucosa through the muscle layers of the colon wall esp. the sigmoid colon
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diverticulitis
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the inflammatory stage of diverticulosis
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appendicitis
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inflammation of the vermiform appendix
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most serious complication of appendicitis is...
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peironitis
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IBS
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functional GI disorder
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IBS affects...
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20% of worldwide population
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Portal hypertension
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abnormally high BP in the portal venous system > 10 mm HG (normal is 3 mm Hg)
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portal hypertension is caused by...
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resistance to portal blood flow
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ascites
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accululation of fluid in peritoneal cavity (third spacing)
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what is the most common cause of ascites?
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cirrhosis
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hepatic encephalopathy
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complex neurological syndrome that develops rapidly during fulminant hepatitis or slowly during chronic liver disease
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with hepatic encephalophathy nervous system cells are vulnerable to...
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neurotoxins absorbed from the GI tract
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Jaundice
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(icterus)
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obstructive jaundice
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common bile duct occlusion
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hemolytic jaundice
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involves disturbance of hepatocyte function and obstruction
excessive hemolysis of RBC's |
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Hepatitis A
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feces, bile, and serum of infected indivuduals...usually transmitted by the fecal-oral route
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hepatitis B
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transmitted parenteral or sexually....serum virus
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Hepatitis C is transmitted...
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transmitted parenteral or sexual,
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which hepatitis is responsible for most post-transfusion heps?
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C,
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Hep C is impicated in infection related to...
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IV drug use
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50-80% of Hep C pts result in...
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chronic hepatitis
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sequence of hepattitis
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prodromal phase
Icteric phase recover phase |
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prodromal phase of hepatitis
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2 weeks after exposure ends with appearance of jaundice
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icteric phase of hepatitis
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begins 1-2 weeks after prodromal phase, lasts 2-6 weeks
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recover phase
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6-8 wks after exposure
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Chronic actie hepatitis
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persistance of clinical manifestations after acute hepatitis (BC orD)
>6 months |
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Fulminant hepatitis
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severe impairment or necrsis of hepatocytes...potential liver failure
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s/s of fulminant hepatitis
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anorexia, vomiting, abd pain, progressive jaundice, ascites, GI bleeding, encephalopathy
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Cirrhosis
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irreversible inflammatory disease that disrupts liver function and even structure
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what is the leading cause of death in the US?
|
cirrhosis
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in cirrhosis, decreased hepatic function is caused by...
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nodular and fibrotic tissue synthesis (fibrosis)
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patho of cirrhosis
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obstructed bilary channels cause portal hypertention -> shunting of blood from liver -> hypoxic necrosis
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another term for cholelithiasis
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gallstones
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gallstone formation is most commonly
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cholesterol
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s/s of cholelithiasis
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abd pain, jaundice, referred pain (shoulders, scapula)
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cholecystitis
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inflammation of gallbladder or cystic duct
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what causes cholecystitis?
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gallstones
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what results from the pressure caused by distention of the gallbladder?
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ischemia, necrosis, perforation
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s/s of cholecystitis
|
fever, leukocytosis, rebound tenderness, abdominal muscle guarding, elevated serum bilirubin, alkaline phosphatase
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what are possible causitive factors of stomach cancer?
|
H. Pylori, heavily salted/preserved foods, low intake of fruits and veggies, tobacco/alcohol consumption
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s/s progression of stomach cancer
|
asymptomatic -> vague -> loss of apetite
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late s/s of stomach cancer
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unexplained wt loss, increased abd pain, vomiting, change BM, anemia
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Colon and Rectum cancer has what common trend?
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family clustering
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Colon and Rectum cancer is common in what age group?
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>50 yrs
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s/s of ascending colon cancer
|
poypoid...palpable mass in RLQ, anemia, dark red/mahogany mixed stools
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s/s of descending colon cancer
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button like mass....progression abd distention, pain, vomiting, constipation...bright red blood on surface of stool
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Diabetes insepidus is caused by an insufficiency of....
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ADH
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Diabetes insepidus leads to....
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excessive fluid excretion
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onset of Diabetes insepidus is...
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acute
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s/s of Diabetes insepidus
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polyuria, nocturia, continuous thirst, polydipsia, low urin specific gravity, low urine osmolality
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SIADH
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syndrome of inappropriate antidiuretic hormone
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SIADH is caused by...
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excessive excretion of ADH
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SIADH leads to..
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excessive water retention
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how do you diagnose SIADH?
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serum hypoosmolality and hyponatremia
urine hyperosmoality urine sodium excr. matches sodium intake normal adrenal and thyroid function absence of condition that alter volume status |
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s/s of SIADH
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hyponatermia
thrist, impaired taste, anorexia |
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Hypofunction
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anterior pituitary disorder...underproduction of hormone
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panhypopituitarism
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absence of all pituitary hormones
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what type of hypofunction is most cerious?
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ACTH deficiency
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ACTH deficiency leads to....
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weakness, nausea, anorexia, fever, postural hypotension
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symptoms of hypopituitarism
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chronically unfit
weakness of fatigue loss of apetite impairment of sexual function cold intolerance |
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what causes 95% of acromegaly cases?
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somatotrope adenoma
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acromegaly
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soft tissue growth
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T4
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thyroxine
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T4 is responsible for...
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thyroxine is responsible for cellular metabolism
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T3
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trilodothyronine
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T3
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trilodothyronine is responsible for regulating cellular metabolism
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thryocaclitonin
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calcitonin
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thyrocalcitonin is responible for
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calium regulation
...acts on kindey's and bones to decrease sodium calcium levels |
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T3 and T4 are collectively known as...
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thyroid hormone
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Thyroid homrone stimulates...
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body growth
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thyroid hormone increases
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metabolic rate, HR
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the goal of the thyroid hormone
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maintain metabolism and regulate growth and development
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what is necessary for thyroid gland to synthesize and secrete hormones?
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iodine
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TH production is dependent on what?
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adequate TSH production
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how does the hypothalmus regulate the pituatiry secretion of TSH?
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negative feedback
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goiter
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enlargement or hypertrophy of thyroid gland
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goiter is compensatory for...
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inadequate TH
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what is the main complication of goiter?
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respiratory difficulties r/t compression of the neck
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4 causes of hyperthyroidism
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autoimmune responses
neoplasms excessive intake of thyroid meds excess secretion of TSH from anterior pituitary |
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hyperthyroidism
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hyperfunction of thyroid gland leading to excess TH
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excess TH leads to...
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hypermetabolic state -> increased metabolic rate, O2 consumption by tissues, heat production
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3 disorders related to hyperthyroidism
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graves disease
goiter thyroid storm |
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with hyperthyroisism all symptoms increase except...
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wt loss
fluid volume sex drive |
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classic s/s of hyperthyroidism
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wt loss, nervousness, exophthalmos, increased appetitite, palpitations, heat intolerance
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with hypothyroidism, all symptoms decrease except...
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wt gain
fluid volume |
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clinical manifestations of hypothyroidism
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intolerance to cold, facial/eyelid edema, dull, blank expression, brittle nails and hair, lethargy, muscle weakness, constipation
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hyperparathyroidism leads to....
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hypercalcermia, bone damage, renal damage
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primary cause of hyperparathyroidism
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adenoma or hyperplasia of one parathyroid gland
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secondary cuase of hyperparathyroidism
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gland response to chronic hypocalcermia (renal failure)
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tertiary cause of hyperparathyroidism
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loss of response to serum calcium levels
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hyperparathyroidism
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increased PTH
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elevated PTH doeswhat to calcium?
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increased reabsorption of calcium in kidneys
release of calcim by bones |
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elevated PTH does what to phosphourus?
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increased excretion by kidneys
increased release from bones |
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elevated PTH does what to pH?
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increased bicarbonate excretion and decreased acid exretion leads to hypokalemia and metabolic acidosis
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neuro s/s of hyperparathyroidism
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depression, psychosis, paresthesias, decreased neuromuscular irritability, impaired vision, altered LOC
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cardiovascular s/s of hyperparathyroidism
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HTN
dysrhythmias |
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GI s/s of hyperparathyroidism
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nausea, constipation, abd pain, ulcers, GI bleeding, thirst, anorexia, pancreatitis
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renal s/s of hyperparathyroidism
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calculi, hypercalcuria, hyperphosphaturia
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muscoloskeletal s/s of hyperparathyroidism
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muscle atrophy and weakness, bone pain, osteoporosis
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metabolic s/s of hyperparathyroidism
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acidoses, weight loss, polyuria, polydipsia, dehydration
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Hypoparathyroidism
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decreased PTH
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Hypoparathyroidism leads to...
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hypocalcermia, hyperphosphatemia, hyperreflexia, altered sensorium
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cause of Hypoparathyroidism
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damage or removal of parathyroid gland during thyroidectomy
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neuro s/s of Hypoparathyroidism
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hyperactive reflex, increased ICP, irritability, parsthesias of lips
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cardio s/s of Hypoparathyroidism
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dysrhythmias
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GI s/s of Hypoparathyroidism
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malabsorption syndromes; abd cramps
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musculoskeletal s/s of Hypoparathyroidism
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carpopedal spasms, facial grimacing, muscle spasms, tetany
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renal s/s of Hypoparathyroidism
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renal colic
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integumentary s/s of Hypoparathyroidism
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sry, scaly skin, hair loss, brittle nails
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Diabetes Mellitus type I
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absolute insulin deficiency
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Diabetes Mellitus type II
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insulin resistance with an insulin secretory deficit
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Diabetes Mellitus type I resluts of pancreatic damage
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pancreatic cells damaged -> to uncontrolled glucose production by liver -> hyperglycemia
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what is the glucose renal threshold?
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180-200
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affect of hyperglycemia on fluids
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fluids follow glucose so massive fluid dumping
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loss of fluids from Diabetes Mellitus leads to...
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polydipsia
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Diabetes Mellitus type I on carbs
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lack of insulin leads to body's inability to utilize carbs...therefore proteins and fats are used for energy....unexplained weight loss
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fat use in Diabetes Mellitus type I results in...
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ketone bodies in urine
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ketone build up in the body from Diabetes Mellitus type I causes...
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acidosis
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polyphagia
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excessive hunger
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classic signs of Diabetes Mellitus type I
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3 p's...polyuria, polydipsia, polyphagia
weight loss ketones glucosuria fatigue n/v adb pain |
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life threatening glucose range?
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675
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Diabetes Mellitus type II does what to beta cell?
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decrease in weight and number
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Diabetes Mellitus type II leads to...
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hyperglycermia
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s/s Diabetes Mellitus type II
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ketones not present
excess weight 3 p's....polyuria, polydipsia, polyphagia blurred vision |
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Diabetes Mellitus type II hyperosmolar hyperglycemic nonketotic syndrome
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>1000 glucose
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Somoyigi effect
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hypoglycermia during H.S. with rebound hyperglycemia in am
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patho for somogyi effect
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counterregulatory hormones stimulated by hypoglycermia
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somogyi effect is more common in which type of DM?
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Diabetes Mellitus type I
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what is a contributor to somogyi effect?
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excessive carb intake
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dawn phenomenon
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early morning rise in glucose without hypoglycermia during night
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dawn phenomenon is related to...nocturnal GH elevation
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nocturnal GH elevation
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insulin shock occurs as a result in what % of type I infections
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90%
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glucose values of insulin shock?
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45-60 mg/dL
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s/s of insulin shock
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pallor, tremor, anxiety, tachycardia, palpiatations, diaphoresis
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3 Microvasculature complications
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neuropathies
nephropathies retinopathies |
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3 macrovascular complications
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CAD
Stroke PVD |
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what is the most common cause of death in Type II DM?
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CAD
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leading cause of ESRD
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nephropathies
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leading cause of acquired blindnes in US
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retinopathies
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s/s of cushings syndrome
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truncal obesity
moon face buffalo hump purple striae glucose intolerance |
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cushing syndrome
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excessive level of cortisol, regardless of cause
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primary cushings
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benign or malignant adrenal tumor
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iatrogenic cushings
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long-term glucocorticoid therapy
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most common cause of cushings syndrome
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iatrogenic
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addisons disease
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chronic adrenocortical insufficiency
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addisons disease is a reslut of
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destructino of adrenal glands
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addisons results in
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decreased productino of cortisone and aldosterone
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nuero s/s of addisons disease
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neurosis, depression
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cardio s/s of addisons disease
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hypotension, ecg changes (tall, peaked T waves)
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musculoskeletal s/s of addisons disease
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muscle weakness, fatigue
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skin s/s of addisons disease
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hyperpigmentation (bronzing)
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GI s/s of addisons disease
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diarrhea, N/V, anorexia
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reproductive s/s of addisons disease
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decreased libido, scant pubic hair
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metabolic s/s of addisons disease
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hyperkalemia, hyponatremia, hypoglycermia, weight loss
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