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59 Cards in this Set

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  • Back
what are hormones?
endogenous chemicals that are produced locally and act in different parts of the body
how do hormones maintain homeostasis?
they stimulate or inhibit biological responses
how is hormone concentration controlled?
negative feedback
an endocrine disorder is an _________ in physiological functions
imbalance (deficiency or excess hormones)
what are the 4 endocrine tets and what disease is each used to test for?
plasma hormone concen (thyroid)
integrity of feedback mechanism (thyroid)
plasma substance concen (DM)
measurement of physiological effect (DI)
what does the integrity of feedback mechanism test tell you about the thyroid & anterior pituitary
the thyroid is functioning properly but the anterior pituitary is not
what are the 3 general locations within the body?
intravascular
intracellular
extracellular
insulin is produced as a result of?
hyperglycemia (insulin is the only substance that brings down blood sugar)
what are the 7 roles of insulin in the body?
1. stim glucose uptake
2. promote glucose storage (glycogenesis)
3. inhibits glycogenolysis
4. enhances fat storage (lipogenesis)
5. inhibits lipolysis
6. decr ketogenesis
7. inhibits gluconeogenesis
glycogenesis
storage of glucose as glycogen in muscle & liver
gylcogenolysis
breakdown of glycogen (inhibits production of glucose from liver & muscle)
lipogenesis
fat storage
lipolysis
break down / mobilization of fat for energy
ketogenesis
breakdown of fatty acids to ketone bodies
gluconeogenesis
formation of glucose from non carb sources (amino acids)
what are the 4 counteregulatory hormones that control glucose levels
glucagon
epinephrine
cortisol
growth hormone
where is glucagon produced?
alpha cells of the pancreas
what effect does glucagon have on glucose homeostasis?
glycogenolysis
glucose synthesis
what efect does epi have on glucose homeostasis
glycogenolysis
glucose synthesis
what effect does cortisol have on glucose homeostasis
gluconeogenesis
what effect does growth hormone have on glucose homeostasis?
inhibits uptake of glucose
what are the physiological effects of insuline defiency?
impaired glucose uptake (muscle)
impaired glycogenesis (liver)
impaired insulin induced supression of gluconeogenesis & glycogenolysis
what are the 9 effects of a total lack of insulin in the body (type I DM)
1. incr blood glucose concen
2. incr osmolarity (polyuria & polydipsia)
3. dehydration & electrolyte abnormalities
4. incr lipolysis
5. glycerol incr blood glucose even further
6. ketogenesis
7. ketonemia, acidosis, ketonuria
8. kussmaul breathing
9. ketoacidosis can lead to coma & death
what is kussmal breathing
rapid, deep, labored breathing
trying to compensate for acidosis
8 s/s of type I diabetes
hyperglycemia
polyuria
polydyspia
polyphagia
dehydration
acidosis
kassmaul breathing
hypokalemia
what is type II diabetes?
a relative lack of insulin & insulin resistance
what are the 4 s/s of type II diabetes?
hyperglycemia
polyuria
polydypsia
dehydration
what may be a cause of hypogylcemia?
over-treatment with antidiabetic drugs
what are the 7 s/s of hypoglycemia
hunger
sweat
nervous
sleepy
anxious
clumsy
bg < 70mg/dL
what are the microvascular long term complications of DM?
retinopathy
neuropathy
nephropathy (renal)
what are the macrovascular long term complications of DM?
cerebral vascular
coronary artery
peripheral vascular disease
what are the 4 tests to assess glucose control?
fasting plasma glucose
oral glucose tolerance test
gycosylated hemoglobin
fructosamine
which test is the best indicator of glucose homeostasis?
fasting plasma glucose
what does the fasting plasma glucose test measure?
the ability of endogenous or exogenous insulin to prevent fasting hyperglycemia (trough levels more reproducible)
is FPG used to screen or diagnose?
screen
how is the FPG test conducted
must fast for 8 hours
venipuncture
use seperator tube, add sodium floride, or refrigerate
FPG normal range, prediabetes range, & diagnosis range
normal < 110mg/dL
pre > 100 to <126mg/dL
diagnose >126mg/dL (on 2 occasions)
in an FPG test, the first reading is considered a _________ while the second is a __________
screening
diagnosis
what are some causes of abnormal lab results in the FPG test
improper collection
improper storage
the american diabetic association recommends sreenings for:
those >45 yo (every 3 yrs)
>25kg/m2 + dyslipedemia, vascular disease, polysystic ovarian disease
what are the 5 possible results of a diagnostic test
confirm suspected diagnosis
differentiate among possible diagnoses
determine severity of disease
detect recurrence of disease
monitor therapy
when is the OGT test used?
when a patient has s/s
when FPG suggests prediabetes
what does the OGT test tell you?
the body's ability to secret insulin
body's response to insulin action
OGT test normal range, prediabetes range, provisional dx range, & confirm dx range
nl <140mg/dL
pre >140-200mg/dL
pro >200mg/dL
confirm + raised FPG
how is OGT test conducted
overnight fast
75g oral glucose dose
taken over 5 min
samples taken between 0-2hr
sodium floride tube or assay immedietly
what can cause an abnormal OGT test result?
improper collection
improper storage
malnourished
consume inadequate carbs
bedridden
alcohol
medication that causes hypergylcemia
coffee
smoking
does the gycosylated hemoglobin test monitor short or long term control of glucose?
long term (2-3months)
which subfraction of Hb is used in the gycosylated hemoglobin test?
A1C
calculation for mean daily plasma glucose
10*(A1C + 4)
what is the reference range for the gycosylated hemoglobin test?
>7% suggets poor glucose control
up to 20% for persistent hyperglycemia
what is the specimen for the GH test?
RBC (Hb) not plasma or serum
what can cause abnormal gycosylated hemoglobin test results?
false elevation (uremia, chronic alcohol intake, hypertriglyceridemia, pregnancy)
falsely lowered (pregnancy, hemolysis)
what can't the GH test be used to screen for gestational diabetes?
pregnancy can cause false elevations & depressions
what is the reference range for the GH test?
varies with assay method
how often shouild a patient with good glycemic control get a GH test? a person with poor control?
1-2 times a year
4 times a year
when is the fructosamine test used?
for acute cases - to see how a patient is doing
reference range for the fructosamine test?
<285 umol/L (can vary)
where does the specimen come from for the fructosamine test?
serum or plasma b/c using glycosylated proteins
what can cause an abnormal lab result in the fructosamine test?
falsely elevated (serum Hb concen >100mg/dL, serum bilirubin >4mg/dL, serum ascorbic acid >5mg/dL, methyl dopa & Ca dobesilate)
falsely lower (obesity)