Endocrine Alterations - Learning Objectives
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| What are the mechanisms of hormonal alterations? | Hypersecretion or hyposecretion of various hormones; target cells failing to respond to hormones
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| What are the causes of hypersecretion or hyposecretion of various hormones? | Faulty feedback system, dysfunction of an endocrine gland, altered metabolism of hormones, or hormones are produced by nonendocrine tissues causing elevated levels
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| What do alpha cells secrete? | Glucagon
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| What do beta cells secrete? | Insulin
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| Which hormone promotes glucose uptake (lowers glucose level in the blood)? | Insulin
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| Which hormone increases blood glucose by stimulating muscle glycogenolysis and gluconeogenesis and adipose tissue lipolysis? | Glucagon
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| What are classic symptoms of Type 1 and Type 2 diabetes mellitus? | Polyuria, polydipsia, polyphagia
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| How do cells compensate when they are not receiving glucose (due to insulin deficiency)? | Lack of glucose in cells results in catabolism of fats and proteins.
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| What usually results from cells catabolizing fats and proteins when they lack glucose? | Leads to excessive amounts of fatty acids and their metabolites, known as ketones, in the blood (ketoacidosis). Diabetic ketoacidosis can result and is life-threatening.
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| What type of diabetes has the possible complication of diabetic ketoacidosis? | Type 1
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| What type of diabetes does hyperosmolar hyperglycemic nonketotic syndrome most often occur in? | Type 2
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| The Somogyi effect is thought to be caused by what? | Too much medication in the system at the wrong time (counterregulatory hormones are released in response to detected hypoglycemia, resulting in hyperglycemia).
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| Describe the Dawn Phenomenon. | Early morning rise in blood glucose concentration with no hypoglycemia during the night. It is related to nocturnal elevations of growth hormone (GH), which decreases metabolism of glucose.
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| What are chronic complications of diabetes mellitus? | Hyperglycemia, infection, diabetic neuropathies, microvascular disease, macrovascular disease
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| What A1C level on two separates test indicates diabetes? | 6.5% or higher
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| Diagnosis of hyperglycemia is made when...? | Hyperglycemia > 100 g/dl (fasting and 2h postprandial); A1C level of 6.5% or higher on two separate tests
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| How is Type 2 diabetes treated? | Diet, exercise, medication, reduce alcohol consumption, reduce stress
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| What are complications of type 2 diabetes? | Neuropathy, nephropathy, heart and blood vessel disease, retinopathy, skin problems, osteoporosis
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| Manifestations of diabetes include... | Recurrent infections, slow-healing sores, paresthesias (numbing, tingling), polyuria, polydipsia, polyphagia, weight loss, fatigue, blurred vision
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| What type of diabetes occurs when the body does not produce enough insulin or the cells ignore the insulin? | Type 2 diabetes
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| What are some risk factors for Type 2 diabetes mellitus? | Obesity (especially around the abdomen), inactivity, family history, race, female, age, prediabetes, gestational diabetes, and metabolic syndrome, blood pressure > 130/85, glucose > 100 gm/dl fasting), and HDL <50 mg/dl
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