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Questions and Answers
Which complication is characterized by hyperglycemia and a change in metabolism due to low insulin levels?
Which complication is characterized by hyperglycemia and a change in metabolism due to low insulin levels?
Which sign is NOT typically associated with diabetic ketoacidosis?
Which sign is NOT typically associated with diabetic ketoacidosis?
What is the immediate treatment for a patient experiencing hypoglycemic shock who is conscious?
What is the immediate treatment for a patient experiencing hypoglycemic shock who is conscious?
What is a potential consequence of untreated hypoglycemia?
What is a potential consequence of untreated hypoglycemia?
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Which patient population is most likely to experience diabetic ketoacidosis?
Which patient population is most likely to experience diabetic ketoacidosis?
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Which condition is a major risk factor for developing hyperosmolar hyperglycemic state?
Which condition is a major risk factor for developing hyperosmolar hyperglycemic state?
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What is a primary method of compensation in response to diabetic ketoacidosis?
What is a primary method of compensation in response to diabetic ketoacidosis?
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What type of breathing is often seen in individuals with ketoacidosis?
What type of breathing is often seen in individuals with ketoacidosis?
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What primary condition is characterized by decreased serum bicarbonate levels and decreased serum pH?
What primary condition is characterized by decreased serum bicarbonate levels and decreased serum pH?
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What is a common manifestation of Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK)?
What is a common manifestation of Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK)?
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Which of the following is NOT a chronic complication of diabetes?
Which of the following is NOT a chronic complication of diabetes?
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Which electrolyte imbalance is primarily indicated by symptoms such as abdominal cramps and lethargy?
Which electrolyte imbalance is primarily indicated by symptoms such as abdominal cramps and lethargy?
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How can hyperglycemia in HHNK lead to severe dehydration?
How can hyperglycemia in HHNK lead to severe dehydration?
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Which chronic complication of diabetes affects small capillaries and can lead to tissue necrosis?
Which chronic complication of diabetes affects small capillaries and can lead to tissue necrosis?
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Which of the following symptoms is commonly associated with decreased turgor from severe dehydration in diabetes?
Which of the following symptoms is commonly associated with decreased turgor from severe dehydration in diabetes?
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What treatment is essential for addressing the fluid and electrolyte loss in metabolic acidosis?
What treatment is essential for addressing the fluid and electrolyte loss in metabolic acidosis?
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What is a common characteristic of metabolic acidosis associated with diabetes?
What is a common characteristic of metabolic acidosis associated with diabetes?
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Which complication is most commonly associated with unmanaged hyperglycemia in diabetes?
Which complication is most commonly associated with unmanaged hyperglycemia in diabetes?
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What is a common chronic complication of diabetes?
What is a common chronic complication of diabetes?
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What electrolyte imbalance is often observed in diabetic patients, especially during episodes of severe hyperglycemia?
What electrolyte imbalance is often observed in diabetic patients, especially during episodes of severe hyperglycemia?
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Which condition is characterized by extremely high blood glucose levels without significant ketoacidosis?
Which condition is characterized by extremely high blood glucose levels without significant ketoacidosis?
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What role do beta cells of the pancreas play in diabetes management?
What role do beta cells of the pancreas play in diabetes management?
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In the context of diabetes, what does glucosuria indicate?
In the context of diabetes, what does glucosuria indicate?
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Which of the following is an effective method to reduce insulin resistance?
Which of the following is an effective method to reduce insulin resistance?
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Flashcards
Metabolic Acidosis
Metabolic Acidosis
A condition where serum bicarbonate levels and pH decrease, often resulting from dehydration and reduced renal compensation.
HHNK (Hyperosmolar Hyperglycemic Nonketotic Coma)
HHNK (Hyperosmolar Hyperglycemic Nonketotic Coma)
A serious complication of type 2 diabetes characterized by severe dehydration, electrolyte imbalances, and high blood sugar without ketone production.
HHNK Manifestations
HHNK Manifestations
HHNK is characterized by hyperglycemia, severe dehydration (seen in reduced skin turgor, high heart rate, rapid breathing), and electrolyte imbalances leading to neurological and muscular issues.
Microangiopathy
Microangiopathy
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Macroangiopathy
Macroangiopathy
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Peripheral Neuropathy
Peripheral Neuropathy
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Diabetic Retinopathy
Diabetic Retinopathy
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Diabetic Nephrosclerosis
Diabetic Nephrosclerosis
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Hypoglycemia
Hypoglycemia
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Hypoglycemic Shock
Hypoglycemic Shock
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Diabetic Ketoacidosis (DKA)
Diabetic Ketoacidosis (DKA)
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Signs of Hypoglycemia
Signs of Hypoglycemia
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Signs of DKA
Signs of DKA
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Treatment for Hypoglycemic Shock (conscious)
Treatment for Hypoglycemic Shock (conscious)
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Treatment for Hypoglycemic Shock (unconscious)
Treatment for Hypoglycemic Shock (unconscious)
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Treatment for DKA
Treatment for DKA
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Type 2 Diabetes
Type 2 Diabetes
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Glucosuria
Glucosuria
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Insulin Deficit
Insulin Deficit
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Polydipsia
Polydipsia
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Polyuria
Polyuria
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HbA1c Test
HbA1c Test
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Treatment Principles for Type 2 Diabetes
Treatment Principles for Type 2 Diabetes
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Study Notes
Introduction to Pathophysiology
- Course taught by Dr. Mouadh Abdelkarim
- Covers endocrine system disorders, specifically
- Insulin and Diabetes Mellitus
- Parathyroid Hormone and Calcium Disorders
- Pituitary Hormones Disorders
- Thyroid Disorders
- Adrenal Gland disorders
Major Endocrine Glands
- Hypothalamus
- Pituitary gland
- Pineal gland
- Thyroid
- Parathyroid glands
- Thymus
- Adrenal glands
- Pancreas
- Ovaries
- Testes
Location of Endocrine Glands
- Diagram showing locations of various endocrine glands in the body.
- Parathyroid gland is located on the posterior side of the thyroid gland.
- Other glands are depicted in their anatomical positions (e.g., pituitary, thyroid, adrenal, pancreas, ovaries, and testes).
Endocrine System
- Hormones function as chemical messengers
- Target receptors
- Negative feedback systems
- Chemical structure
- Peptide
- Steroid
Classification by Chemical Structure
- Steroids: Lipids that directly enter the cell nucleus to initiate transcription.
- Nonsteroids: Require a secondary messenger system to activate transcription in the nucleus.
Sources of Major Hormones and Their Primary Effects
- Table listing major hormones, their origin, and primary effects. (Specific hormone/effect details provided in the table.)
Control of the Endocrine System
- Endocrine and nervous systems regulate metabolic activities.
- Negative feedback
- Positive feedback (e.g., blood clotting, childbirth).
- Certain hormones act as antagonists (e.g., calcitonin and parathyroid hormone, insulin and glucagon).
Endocrine Disorders
- Disorders relate to impaired control or feedback.
- Excess hormone levels
- Caused by tumor, impaired excretion by liver/kidney, or congenital factors
- Deficit of hormone or reduced effects
- Caused by tumor, decreased tissue receptors, or increased antagonistic hormone production. Poor nutrition, atrophy, or surgical removal of the gland. Congenital factors
Diagnostic Tests
- Blood tests (e.g., checking serum hormone levels, radioimmunoassay, or immunochemical methods).
- Urine tests
- Stimulation or suppression tests
- Scanning, ultrasound, MRI
- Biopsy
Treatment
- Deficits treated with replacement therapy.
- Excessive secretions treated with medications, surgery, or radiation.
1- Insulin and Diabetes Mellitus
- Diabetes mellitus arises from inadequate insulin effects on receptor tissues
- Deficit in insulin secretion
- Production of insulin antagonists
- It leads to abnormal carbohydrate, protein, and fat metabolism.
- Some tissues can transport glucose without insulin
- CNS, kidney, myocardium, gut, skeletal muscle
- Skeletal muscle can partially meet tissue needs without insulin
Types of Diabetes
- Type 1:
- Autoimmune destruction of beta cells in pancreas.
- Insulin replacement is required.
- Acute onset in children/adolescents
- Not linked to obesity.
- Genetic factors may play a role.
- Metabolic changes
- Excessive amounts of fatty acids & metabolites
- Ketones in the blood
- Type 2:
- Noninsulin-dependent.
- Oral hypoglycemic medications may be used.
- Caused by decreased production of insulin and/or increased resistance by body cells to insulin.
- Onset is slow and insidious, usually in older than 50 years.
- Associated with obesity.
- A component of metabolic syndrome.
- Increasing incidence in teens and young adults.
A- Type 1 Diabetes
- Metabolic changes in catabolism of fats and proteins, producing ketones in the blood.
Diabetic Ketoacidosis (DKA)
- Occurs in insulin-dependent clients, commonly seen in type 1 diabetes.
- High blood glucose levels
- Mobilization and use of lipids to meet cellular needs result from production of ketoacids.
- May be initiated by infection or stress.
- May result from error in dosage, infection, change in diet, alcohol intake, or exercise.
- Signs/Symptoms
- Kussmaul respirations (rapid, deep)
- Acetone breath (sweet, fruity smell)
- Lethargy and decreased responsiveness indicate central nervous system depression & decreased blood flow.
- Causes decreased serum bicarbonate and decreased serum pH.
- Complications lead to dehydration and electrolyte imbalances
2- Parathyroid Hormone and Calcium
- 4 parathyroid glands release PTH in response to a drop in serum calcium.
- Magnesium needed to activate PTH release.
- Effects of PTH on bone, kidney, and intestines.
- Actions of PTH on bone (osteoclastic activity)
- Mobilization of Ca+ from bone/demineralization which increases serum Ca++ levels.
- Hypoparathyroidism leads to hypocalcemia.
- Causes of Hypoparathyroidism: Tumor, congenital lack, surgery/radiation, autoimmune.
- Normal control & feedback of calcium- diagram included.
- Hyperparathyroidism leads to hypercalcemia.
- Causes of hyperparathyroidism: Tumor, secondary to renal failure, paraneoplastic syndrome.
- Common effects of parathyroid hormone imbalance- table included (hypo/hyper symptoms).
3- Pituitary Hormones
- Adenomas are the most common cause of pituitary disorders.
- Adenomas can affect the skull (headaches, seizures, drowsiness, visual deficits)
- Hormones secretion dependent on specific cells/location leading to excessive or decreased hormone release.
- Growth hormone (GH) control diagram provided.
- Dwarfism (GH deficit before puberty)
- Gigantism (excess GH before puberty/fusion of epiphysis)
- Acromegaly (excess GH secretion in adults- often associated with adenomas)
Antidiuretic Hormone (ADH)
- Diabetes insipidus-deficit of ADH.
- May originate in neurohypophysis
- Possible genetic problems
- Can be caused by head injury/surgery
- Requires replacement treatment
- Inappropriate ADH syndrome (SIADH)
- Excess ADH
- May be temporary/triggered by stress; from an ectopic tumor
- Treatment with diureics and sodium supplements
4- Thyroid Disorders
- Two thyroid hormones: T4 (thyroxine), T3 (triiodothyronine)
- Released in response to TSH.
- Hyperthyroidism (Graves' Disease), Hypothyroidism results from pituitary or thyroid malfunction.
- Goiter: enlarged thyroid gland
- Endemic goiter (iodine deficiency)
- Goitrogens (block synthesis of T3 & T4)
- Toxic goiter (due to thyroid hyperactivity).
- Hypothyroidism (iodine deficit, Hashimoto's Thyroiditis, tumor, gland removal)
- Cretinism- results from untreated congenital hypothyroidism (during pregnancy)
- Hypothyroidism manifestations-symptoms listed.
- Comparison of Hypothyroidism and Hyperthyroidism-table included.
5- Adrenal Glands
- Adrenal medulla
- Pheochromocytoma (neuroendocrine tumor, secretes epinephrine, norepinephrine)
- Adrenal cortex
- Cushing syndrome (high glucocorticoid levels)
- Causes: pituitary adenoma, adrenal adenoma, etc.
- Symptoms: appearance change, high blood glucose, hypertension, muscle weakness
- Addison disease (deficiency adrenocorticoid)
- Causes: autoimmune reaction, hemorrhage, infection
- Symptoms: low blood glucose, inadequate stress response, weight loss, low sodium, high potassium, hypertension
- Cushing syndrome (high glucocorticoid levels)
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