Exam (elaborations)
AG-ACNP Boards – Endocrine: Questions And Answers
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AG-ACNP Boards – Endocrine: Questions And Answers
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AG-ACNP Boards – Endocrine: Questions And AnswersSerotonin Syndrome Right Ans - *Similar to NMS but caused by
serotinergic medications, and has HYPERreflexive muscle activity and clonus
*onset <12h
*caused by combination of serotinergic drugs or overdose on one drug
*treated with Cyproheptadine if drug withdrawal does not produce symptom
improvement
Malignant hyperthermia Right Ans - *most common triggering agents =
volatile anesthetic gases, such as halothane, sevoflurane, desflurane,
isoflurane, enflurane
OR
*depolarizing muscle relaxants suxamethonium and decamethonium used
primarily in general anesthesia
-->Remember!! Sux absolutely contraindicated in hyperkalemia
ADH Right Ans - antidiuretic hormone (vasopressin)
-causes migration of aquaporins
-controls WATER concentration
Aldosterone Right Ans - -controls sodium/potassium concentration and
hydrogen ion secretion
Diabetes (Type I) Right Ans - *Most common in adolescents by may occur
in adulthood, often following viral illness
*Selective autoimmune mediated destruction of the pancreatic Beta cells
resulting in absolute lack of insulin production.
-will not have C- peptide present in blood--substance produced when pro-
insulin is cleaved to form active insulin
,*strongly associated with human leukocyte antigens with Islet cell antibodies
found in approximately 90% of patients within 1st year of diagnosis
*Marked by development of ketosis d/t absolute lack of insulin
-causes body to break down fatty acids for energy production
S/S of Type I Diabetes Right Ans - *3Ps: Polyuria, Polydipsia, Polyphagia
-nocturnal enuresis
-weight loss
-weakness/fatigue
differential for unplanned weight loss Right Ans - -DM1
-cancer
-hyperthyroidism
-HIV
-TB
Lab/Diagnostics of Type I DM Right Ans - Random plasma glucose >200
Serum fasting blood sugar >126 on 2 separate occasions
ketonemia or ketonuria or both
Impaired glucose tolerance (pre-diabetic) Right Ans - FBG >100 BUT < 125
HgbA1c (Normal) Right Ans - *5.5-7
<6=good control for diabetic
Management of Type I DM Right Ans - - Ketones present = Insulin therapy
mandatory!!
Insulin starter regimen Right Ans - *0.5 u/kg/day giving 2/3 of the dose in
the AM and 1/3 of the dose in the evening
, conventional split dose therapies Right Ans - *morning dose 2/3rd NPH,
1/3 regular
*evening dose 1/2 NPH, 1/2 regular
Novolog (insulin aspart), humalog (lispro) Right Ans - *Rapid acting
Glargine (Lantus) Right Ans - *onset of action of 1/2 hour to 1 hour
*peak effect in 2 to 4 hours
*duration of action of 6 to 8 hours
NPH insulin Right Ans - *onset of insulin effect of 1 to 2 hours
*peak effect of 4 to 6 hours
*duration of action of more than 12 hours
Diet teaching Right Ans - *Carbs 55-60%
*fats 20-30%
*Protein 10-20%
Diabetes Mellitus (type 2) defined Right Ans - *Most common type; >90%
diabetes in the US
*Circulating insulin exists enough to prevent ketoacidosis
*Caused by either tissue insensitivity to insulin or an insulin secretory defect
resulting in resistance and/or impaired insulin production
Metabolic Syndrome Right Ans - Waste Circumference: >40 inches in men
and >35 inches in women (BMI 25-34.9 = obese; >34.9 = morbidly obese)
BP: >130/85--only need one number
Triglycerides >150
FBG >100
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