430 likes | 495 Views
Endocrine System QUIZ SHOW!. Thyroid. Type I DM. Labs. Type 2 DM. 25. 25. 25. 25. 50. 50. 50. 50. 75. 75. 75. 75. 100. 100. 100. 100. 150. 150. 150. 150. Labs: 25 pts. What are the normal values for a Fasting Blood Glucose (FBG)?. A. Answer: Labs 25 pts.
E N D
Endocrine System QUIZ SHOW!
Thyroid Type I DM Labs Type 2 DM 25 25 25 25 50 50 50 50 75 75 75 75 100 100 100 100 150 150 150 150
Labs: 25 pts What are the normal values for a Fasting Blood Glucose (FBG)? A
Answer: Labs 25 pts • 60-100 mg/dl • >126 mg/dl (on two occasions) • Diagnostic for DM • FastingNPO for at least 8 hrs
Labs: 50 pts How will you prepare / instruct your patient regarding a 2 hr Oral Glucose Tolerance Test (OGTT)? A
Answer: Labs 50 pts • A lab test to see how your body metabolizes a large bolus of glucose • NPO for at least 12 hrs before • Blood samples will be drawn at the start of the test, at 30 min intervals for 2 hrs • Normal results: <140 mg/dl (at the end of 2 hrs) • Diagnostic for DM if >200mg/dl on two occasions
Labs: 75 pts What is a glycosylated hemoglobin A1C, what is the preferred level for a diabetic patient and why? A
Answer: Labs 75 pts • Overall glucose control for previous 90-120 days • Ideal level for DM pt: 7% or less • Decreases risk of complications
Labs: 100 pts What three studies are used to make a diagnosis of DM and which one is the preferred method? A
Answer: Labs 100 pts • Fasting Blood Glucose (preferred) (>126 mg/dl) • Random (casual) Blood Glucose (>200 mg/dl + S/S) • 2 hr Oral Glucose Tolerance Test (>200 mg/dl) **Need two abnormal readings (on different days) to confirm dx!
Labs: 150 pts What do you suspect if the lab results reveal an elevated T3 and T4 and a decreased TSH? A
Answer: Labs 150 pts Hyperthyroidism
Type 1 DM: 25 pts What is the probable cause of Type 1 DM and the typical age of onset? A
Answer: Type 1 DM 25 pts • Autoimmune disorder destruction of the beta cells of pancreas (other causes: genetics, viruses, stressors) • Age of onset: • <30 yrs • Most common age: between ages of 11 – 13 yrs
Type 1 DM: 50 pts What are the three classic symptoms of Type 1 DM? A
Answer: Type 1 DM 50 pts • Polyuria • Polydipsia • Polyphagia • Acute onset of S/S
Type 1 DM: 75 pts What medication is used to treat Type 1 DM? Name three types of this medication and give an example of each. A
Answer: Type 1 DM 75 pts • Insulin • Rapid acting: Lispro • Short acting: Regular • Intermediate acting: NPH or Lente • Long acting: Lantus; Ultralente
Type 1 DM: 100 pts When mixing insulin in a syringe, which type of insulin must be drawn up first and how/where can it be given? A
Answer: Type 1 DM 100 pts • Clear to cloudy • Always draw up regular insulin before adding the longer acting insulin • Add air to longer acting insulin vial 1st, then add air to regular insulin vial and withdraw the needed amt. Finally, draw up long acting insulin (without adding air) • Given subcutaneously • Abdomen, arms, Thigh, buttocks
Type 1 DM: 150 pts If a patient is given 10 units of Regular insulin at 0700, is it more important to eat breakfast or lunch & why? A
Answer: Type 1 DM 150 pts • Breakfast! • Regular insulin peaks in 2-3 hrs & needs something to work on • Reminder: Regular insulin can be given SubQ (sliding scale), IVP or continuously via IV gtt or pump
Type 2 DM: 25 pts What are the primary causes and risk factors of Type 2 DM? A
Answer: Type 2 DM 25 pts • Decreased insulin prod / use • Insulin resistance • Insulin insensitivity • Excess glucose prod. • Risk factors: • Obesity / inactivity • Family history • Increasing age (> 40 yo) • HTN / High cholesterol • Ethnicity: Native Americans African Am; Hispanics Caucasians • Hx of Gestational Diabetes
Type 2 DM: 50 pts What are some common S/S of hypoglycemia (name at least four) & how is it treated? A
Answer: Type 2 DM 50 pts • S/S: Shakiness; weakness; hunger Diaphoresis; cool / clammy skin Irritability; Tachycardia; Dizziness Uncoordinated; slurred speech; HA Difficulty concentrating; confusion Lethargy; unresponsiveness; coma • Tx: Ingest rapid-acting carbs Recheck BS in 15 min Repeat tx if <60 mg/dl
Type 2 DM: 75 pts What is the cause of complications related to DM and name at least four common complications? A
Answer: Type 2 DM 75 pts • Cause: Elevated glucose Thickens blood vessels. Dehydration Thicker blood. Decreased perfusion Hypoxia Tissue damage • Common complications: • Heart disease / HTN • Strokes • PVD: amputations and neuropathy • Blindness • Renal disease • Infections
Type 2 DM: 100 pts How can hypoglycemia be prevented? A
Answer: Type 2 DM 100 pts • Balance between diet, exercise and meds • Consistent daily routine • Small frequent meals throughout the day • Daily exercise • Medication education • When / how to take them • When do they peak (make glucose levels low)? • Blood glucose monitoring • Before meals and bedtime (for Type 1 DM) • Daily (in am) (for Type 2 DM)
Type 2 DM: 150 pts . Which two groups of oral diabetic agents cause an increase in insulin production (which can lead to hypoglycemia)? Give an example for each group. A
Answer: Type 2 DM 150 pts • Sulfonylureas • First Generation: Orinase, Dymelor, Tolinase, Diabinese • Second Generation: Glucotrol, Micronase, Amaryl • Meglitinides • Prandin • Starlix
Thyroid: 25 pts What is the primary function of the thyroid gland and how is it regulated? A
Answer: Thyroid 25 pts • Controls the rate of metabolic processes • Controlled by TSH (produced by Anterior Pituitary)
Thyroid: 50 pts What are the three hormones secreted by the thyroid gland and what are their functions? A
Answer: Thyroid 50 pts • T3 and T4 • Regulates the release / utilization of energy • Regulates growth and development • Calcitonin • Lowers calcium levels
Thyroid: 75 pts What are the S/S of hyperthyroidism? A
Answer: Thyroid 75 pts • Increased HR, RR, BP, CO • Wt loss, fatigue, muscle weakness • Nervousness, tremors, rapid speech • Heat intolerance / diaphoresis • Increased appetite / thirst /peristalsis • Mood changes • Insomnia • Goiter (enlarged thyroid gland) • Exophthalmos (bulging eyes)
Thyroid: 100 pts What are the S/S of hypothyroidism and how is it treated? A
Answer: Thyroid 100 pts • Decreased T3 and T4 • Elevated TSH (most commonly) • Decreased HR, BP, CO • Cold intolerance • Lethargy, fatigue, lack of energy • Dry hair and skin, anemia • Wt gain, constipation • Depression, slowed mental processes • Tx: Synthroid; Low calorie diet • S.E. of Synthroid: tachycardia, nervousness
Thyroid: 150 pts What is the treatment of choice for hyperthyroidism in non-pregnant adults? A
Answer: Thyroid 150 pts • **Radioactive Iodine Therapy • Destroys thyroid tissue • High risk for hypothyroidism • Subtotal Thyroidectomy • Can also remove parathyroid glands • Post-op monitoring: • Respiratory distress / edema • Bleeding • Tetany