Hormones
The presence of inadequate thyroid hormones in the blood is known as
Hypothyroidism
Thyroid hormones: triiodothyronine (T3) and thyroxine (T4)
Which is the largest endocrine gland?
Pancreas
*Located in upper left quadrant of abdomen
True or False?
Type 2 diabetes, or "adult onset diabetes," can occur in the pediatric population.
TRUE! "Adult onset" is no longer accurate due to childhood obesity.
The concentration of Dextrose 50% is ___ g/mL.
0.5 g/mL
__________ patients "smell" drunk, whereas __________ patients "look/act" drunk.
Hyperglycemic patients - sweet, fruity breath odor due to acetone
Hypoglycemic patients - no breath odor, appear to be intoxicated
Which hormone stimulates cellular uptake of glucose; increases rate of synthesis of glycogen, proteins, and fats; decreases blood glucose level?
Insulin
Where are the adrenal glands located?
On top of both kidneys
*Also known as suprarenal glands
_________ _________ is a disorder with physical and mental changes that result from having too much cortisol in the blood for a long period of time.
Cushing syndrome (hypercortisolism)
Signs/symptoms: excess sweating, hairiness, hunger, fatigue, HTN, large stretch marks, muscle weakness, anxiety/depression, easy bruising, infertility, insomnia, pot belly, round "moon" face
Opposite is hypocortisolism, or Addison's disease
True or false: You can administer IV D50 through an EJ.
True! Send it!!!
Due to osmosis, glucose loss in urine can cause ____________.
Dehydration
*Glucose (and other sugars and salts) are polar molecules. Due to osmosis, water "follows" these molecules. Reason why diabetes sometimes exhibit excessive urination.
Which hormone stimulates hepatic glycogenolysis and gluconeogenesis, increasing blood glucose levels?
Glycogen
Where in the body is insulin synthesized?
The pancreas - within the beta cells of the islet of Langerhans
Identify the endocrine emergency with the following signs and symptoms:
Polyuria, polydipsia, warm/dry skin, tachycardia, deep/rapid respirations, fruity odor on breath, decreased mental function
Diabetic ketoacidosis
*Hyperglycemic states develop over days or weeks, whereas hypoglycemia can occur rapidly
You must treat a hypoglycemic neonate (BGL <40 mg/dL). The hospital is running low on prepackaged D10% and decided that EMS does not need any of their supply. How will you prepare D10 from D50% on your truck?
Discard 40 mL out of one amp of D50, then draw up 40 mL NS or sterile water. Agitate syringe to mix the solution.
If 50% is 25 mg... 10% is 5 mg, but still in a diluted solution of 50 mL
--> 5/50 = 10%
Antidiuretic hormone is also known as...?
VaSoPrEsSiN
*Can be used to increase BP in patients with vasodilatory shock
Parathyroid hormone works to INCREASE blood calcium levels. Conversely, which hormone works to DECREASE blood calcium levels?
Calcitonin
*Remember calci-TONE-in --> "Tone it down"
Glucagon is produced by the _____ cells in the islets of Langerhans (within pancreas)
Glucagon - alpha cells
Insulin - beta
Diabetic hyperosmolar syndrome is another name for a serious condition caused by extremely high blood sugar levels WITHOUT the presence of ketones.
HHNK (Hyperosmolar Hyperglycemic Nonketotic Syndrome)
or HHS (Hyperosmolar hyperglycemic state)
You respond to a 37-year-old male with a BGL of 60 mg/dL. He is alert and able to provide you with his medical history as well as medications. How should you begin to treat the hypoglycemia?
a. A simple sugar, orally
b. A hypertonic solution of dextrose, IV
c. Ask his wife to make some fettuccini alfredo
A - The patient's airway is not compromised, so he can start with some peanut butter crackers, orange juice, simple sugars, or your glucose gel. A more carb-rich meal will also be needed to maintain the improved blood glucose level. Advise patient to consult with their physician as their insulin dosage may need to be adjusted.
Name a hormone that is an example of a positive feedback mechanism
Oxytocin!
Released from posterior pituitary during labor --> stimulates uterine contractions --> stimulates more oxytocin release --> stimulates MORE uterine contractions --> MORE OXYTOCIN RELEASE! until child is born
Oxytocin and vasopressin are hormones of ~love~ <3 :*
Which hormone contributes to salt and fluid balance by stimulating kidneys to increase potassium excretion and decrease sodium excretion, increasing blood volume?
Aldosterone
Acute head trauma can lead to dysfunction of the hypothalamic neurons secreting antidiuretic hormone (ADH). This condition presents with polyuria and is diagnosed in the first few days after trauma. What is the name of this condition?
Diabetes insipidus
Name the disorder - Thyroid overproduces hormones. Symptoms include anxiety, hand tremor, heat sensitivity, weight loss, puffy eyes and enlarged thyroid.
Grave's disease
What is the mechanism of action of Metformin (Glucophage, Riomet, Glumetza, Fortamet)?
Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. It is used in patients with diabetes mellitus TYPE 2.
Biochemistry:
When there is a lack of insulin, profound hyperglycemia develops because the cells cannot take in glucose. The body's compensatory mechanism for low blood glucose levels within the cells only contributes more glucose.
Name this mechanism!
Gluconeogenesis
*Occurs primarily in the liver, with a small amount taking place in kidney