Endocrine 1
Which 2 glands control the function of glands?
Hypothalamus
Pituitary gland
Osteitis Fibrosa Cystica is associated with...
Hyperparathyroidism
This type of diabetes has a juvenile, abrupt onset due to the decrease in number and size of islet cells
Type 1 DM (Insulin-dependent)
S/s of dehydration
Decreased skin turgor, dry mucous membranes, postural hypotension, headache, irritability, incoordination, lethargy, disorientation
Acid-base balance is achieved by which two systems/organs
Lungs and kidneys
Insulin _____ hepatic glucose production, while glucagon _____ hepatic glucose production
suppresses; stimulates
True/false:
Acute hypoparathyroidism is a medical emergency
true, this can be life-threatening due to the lack of blood calcium. This can lead to cardiac arrythmias and seizures.
What level of BG indicates impaired glucose tolerance?
What level of BG is considered DM?
A1C?
100-125 mg/dL
> 126 mg/dL
4-6% (goal is to stay 7%)
Circulatory congestion (edema, excessive weight gain) is due to an excess of which electrolyte?
Sodium
Water intoxication leads to (hyper/hypo)natremia. We should observe for signs of
Hyponatremia
confusion, decreased mental alertness, sleepiness
Which disorder is associated with exophthalmia?
Hyperthyroidism
Which endocrine disorder should PTs be concerned with easy bruising and impaired wound healing?
Cushing's syndrome/disease (hypercortisolism)
What considerations should be make for a person with DM with retinopathy?
What about DM with neuropathy?
Avoid exercises that dramatically increase BP ( >170mmHg SBP), avoid bouncing/jarring movements
Neuropathy: limit WB if significant, increased fall risk with balance and gait disturbances
You know someone is experiencing metabolic alkalosis when you see _______. You know someone is experiencing metabolic acidosis when you see _______.
hypoventilation; hyperventilation
Excessive vomiting, excessive diuretic intake, hypokalemia and excessive antacid intake can all lead to
metabolic alkalosis
what is Addison's disease?
How does it present?
Adrenal insufficiency, leading to reduction of cortisol and aldosterone secretion
s/s: hyperpigmentation (bronze-colored skin), hypoglycemia, hypotension, progressive fatigue, GI disturbance, may cause potassium elevation
These are the PT implications for which endocrine disorder?
Bone pain (especially spine)
Appropriate weight-bearing secondary to risk of fractures
care with joint mobilization
Proper hydration and monitor for fatigue
Hyperparathyroidism. Excessive PTH results in demineralization of bone, leading to decreased bone strength and density.
These are the s/s associated with hyperglycemia. At what level of BG would you seek out immediate medical treatment?
Polyuria/scant urination, Polydipsia, Decreased appetite, dry mouth, flushed, dry face, weak and rapid pulse, fruity smelling breath
> 300mg/dL
ECG changes and s/s for
a. hypokalemia
b. hyperkalemia
s/s: muscle weakness, aches, abdominal distension, N/V
b. Tall T wave, prolonged PR interval and QRS duration
s/s: muscle weakness. symptoms don't occur until very high levels. less harmful
dog
idk
In hyperthyroidism, thyroid-stimulating hormone levels are _____, while in hypothyroidism, thyroid-stimulating hormone levels are _____.
TSH levels are decreased; TSH levels are increased
What is the Chvostek sign?
Trousseau sign?
What are these associated with?
Chvostek sign: facial spasm due to percussion of the facial nerve
Trousseau sign: Carpal spasm
Hypoparathyroidism
What are the red flag values for exercising with DM?
< 70mg/dL or > 250mg/dL
>300 at risk for DKA
BG levels: 280 mg/dL
pH: 7.25
pCO2: 40mmHg
HCO3-: 18
metabolic acidosis
differentiate between osteoporosis and osteomalacia
Osteoporosis is due to a decrease in bone mass that results in increased fracture risk
Osteomalacia is due to Vitamin D deficiency, leading to bone softening. X-rays show transverse, fracture-like lines in affected bones
Pagets: Excessive bone resorption; bone is larger, less compact, more vascular and more susceptible to fractures
This syndrome can result from a tumor on the pituitary gland and/or excessive corticosteroid use.
What are the s/s?
Cushing's Syndrome (Hypercortisolism)
Excessive corticosteroid use= Increased blood cortisol levels
Tumor on the pituitary gland= increased release of ACTH--> stimulates increased cortisol release from the adrenal cortex.
s/s: Buffalo hump, slender arms, hypertension, hyperglycemia, thinning of skin, osteoporosis
List some risk factors for metabolic syndrome
Waist size > 40 in (men); > 35 in (women)
Cholesterol: low HDL, <40mg/dL (men); < 50mg/dL (women)
Fasting BG > 100mg/dL
TG level >150mg/dL or using cholesterol medicine
High BP </=135/ >/=85
List some ideal exercise strategies for someone with DM
Do not inject insulin into the working muscle. The abdomen is preferred.
Do not exercise during peak insulin times (the combination of exercise + insulin produces hypoglycemia effect).
The best time to exercise a person with DM is 1 hr after a meal.
Increase carb intake prior to exercise.
These are causes and s/s for which electrolyte imbalance
causes: hypoparathyroidism, malabsorption of calcium and vitamin D, vitamin D deficiency
s/s: muscle cramps, tetany, spasms, paresthesia, arrythmias, hypotension
Hypocalcemia
hypermagnesemia vs hypomagnesemia
Hypo: foot and leg cramps, hyperirritability, confusion
Hyper: hyporeflexia, muscle weakness, lethargy, confusion, bradycardia, hypotension