Pancreas
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
Diabetes Assessment
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Adult Onset
- Insulin Resistance
- Obesity
- Onset During Pregnancy
- Glucose Intolerance
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
Diabetes Insipidus Assessment
- Polyuria
- Nocturia
- Low Specific Gravity (USG)
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Confusion
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Diabetic Ketoacidosis (DKA) Signs and Symptoms
- Kussmaul respirations
- Dehydration
- Abdominal Pain
- Nausea/vomiting
- Psychosis
- Fruity breath Odor
Diabetic Ketoacidosis (DKA) Diagnosis and Labs
- Blood glucose Increased > 250 mg/dL
- Anion gap metabolic acidosis
- Decreased pH < 7.3
- Decreased serum bicarbonate < 18
- Plasma ketones
- Hyperkalemia
Diabetic Ketoacidosis (DKA) Treatment
- IV Normal Saline
- Regular Insulin Drip
- Potassium (K+)
- Glucose
- Treat Underlying Cause
- Venous pH
- Serum Bicarbonate (HCO3)
Diabetic Glomerulonephropathy
- Nonenzymatic Glycosylation of Glomerular Basement Membrane
- Nonenzymatic Glycosylation of Arterioles
- Hyperfiltration
- Increased GFR
- Hyaline Arteriolosclerosis
- Mesangial Expansion
- Type IV Collagen Deposition
- Kimmelstiel Wilson Lesions
- Nephrotic
Dawn Phenomenon
- Increased Hormone Production
- Hyperglycemia Upon Awakening
- Long-Acting Evening Insulin
- Change Administration Times
- Insulin Pump
- Closely Monitor Glucose Levels
- Between 2-6AM
- Limit Carbohydrates Before Bedtime
Hyperglycemia
- Insulin Resistance
- Too Little Insulin/Medication
- Infection/Illness
- Corticosteroids
- Elevated Blood Glucose
- Polyphagia
- Polydipsia
- Polyuria
- Hypotension
- Fatigue/Drowsiness
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Metabolic Syndrome
- Dyslipidemia
- Central Obesity
- Insulin Resistance
- Hypertension
- Increased C-Reactive Protein (CRP)
- Increased Fibrinogen
- Increased Risk Cardiovascular Disease
Thyroid Gland
- TSH Stimulates T3 and T4 Release
- Metabolism Regulation
- Blood Calcium Sensor
- Calcitonin Release
- Blood Calcium Decreases
- Bone Building
Parathyroid Gland
- Blood Calcium Sensor
- Parathyroid Hormone
- Bone Resorption
- Blood Calcium Increases
- Vitamin D Activation
- Calcium Absorption From The Small Intestine
Hyperthyroidism Assessment
- Heat Intolerance
- Exophthalmos
- Warm, Moist Skin and Silky Hair
- Tremors
- Goiter
- Diarrhea
- Weight Loss
- Tachycardia
- Hypertension
- Amenorrhea
- Decreased TSH with Elevated Free T4
- Radioactive Iodine Uptake (RAIU)
Hyperthyroidism Interventions
- Propylthiouracil (PTU)
- Methimazole (Tapazole)
- Iodine
- Beta Blockers
- Radioiodine Ablation
- Thyroidectomy
- Thyrotoxicosis
- Post-Surgery Hypocalcemia
Hypothyroidism Assessment
- Weight Gain - Edema
- Lethargy
- Cold Intolerance
- Bradycardia
- Hypertension
- Brittle Nails and Dry Skin
- Constipation
- Goiter
- Prolonged Menses
- Slowed Thinking
- Decreased Free T4
- Increased TSH
Hypothyroidism Intervention
- Levothyroxine (Synthroid)
- Liothyronine (Cytomel)
- Myxedema Coma
- Lifelong Replacement Hormone
- Monitor Vital Signs
- Fluids and Fiber
- Low Calorie, Low Fat Diet
- Medication Education
- No Switching Brands
Thyroid Storm
- Diarrhea
- Liver Failure
- Insulin Resistance
- Tachycardia
- Lid lag
- Change in LOC (Altered Mental Status)
- High fever
- Propranolol (Or Esmolol)
- PTU (Thionamides) Initially
- Iodine Solution (Lugol Iodine)
- Glucocorticoids
- Cooling Blanket
Thyroid Storm Causes
- Sepsis
- Thyroid Trauma
- Surgery
- Childbirth
- Grave's Disease
- Excessive Thyroid Hormone Ingestion
- TSH-secreting Tumors
- Hyperfunctioning Goiter or Nodule
- McCune Albright Syndrome
Graves' Disease Characteristics
- Women 20-40 years old
- Anti-TSH Receptor Antibodies
- Ophthalmopathy
- Exophthalmos
- Hyperthyroidism
- Goiter
- Pretibial Myxedema
Graves' Disease Labs and Treatment
- Decreased TSH
- Increased T3
- Increased T4
- Radioactive Iodine Uptake (RAIU)
- Beta blocker
- Methimazole
- Radioiodine Ablation
Hashimoto's Thyroiditis
- Hypothyroidism with Bouts of Hyperthyroidism
- Enlarged, Nontender Thyroid
- Autoimmune
- Anti-Thyroid Peroxidase (TPO)
- Anti-Thyroglobulin
- Hurthle Cells
- Lymphoid Follicles
- HLA-DR5 and HLA-DR3
- Increased Risk Of Non-Hodgkin Lymphoma
Hypercalcemia
- > 10.5 mg/dL Ca2+
- Pathologic Fractures
- Lethargy
- Hypercoagulation
- Constipation
- ECG Changes
- QT Shortening
- No Calcium Intake
- Chelating Drugs
- Calcitonin
- Bisphosphonates
- Loop Diuretics instead of Thiazide Diuretics
- Increased Risk for Renal Calculi
- Increase Fluids
Hypercalcemia Causes
- Two CHIMPANZEES Acronym
- Thyroid Disorders
- Calcium Supplements
- Hyperparathyroidism
- Iatrogenic (Drugs, immobility)
- Milk-Alkali Syndrome
- Paget's Disease of Bone
- Acromegaly or Addison's Disease
- Neoplasms
- Zollinger-Ellison Syndrome
- Excessive Vitamin A
- Excessive Vitamin D
- Sarcoidosis
Hypercalcemia Treatments
- Treat Underlying Disorder
- Hydration
- Dialysis
- Calcium Restriction
- Bisphosphonates
- Calcitonin
- Cinacalcet
- Glucocorticosteroids
- Denosumab
Hypocalcemia
- Muscle Spasms
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Oral and IV Replacement of Ca2+
- Seizure Precautions
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
Hypocalcemia Treatments
- Treat Underlying Disorder
- IV Calcium Gluconate
- Cardioprotective
- Calcium Carbonate
- Calcium Citrate
- Vitamin D Supplements
- Treat Hypomagnesemia
Adrenal Gland (Basic)
- Adrenal Cortex
- RAAS Stimulates Aldosterone
- CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
- Cortisol Released
- Androgens Released
- Adrenal Medulla
- Epinephrine & Norepinephrine
Adrenal Gland (Advanced)
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
Steroid Hormones
- Nuclear Membrane
- Long-Lived and Slow-Acting
- Cholesterol-Derived
- Intracellular Receptors
- DNA Transcription
- Testosterone
- Aldosterone
- Estrogen
- Cortisol
Addison's Disease Assessment
- Deficiency of Cortisol and Aldosterone
- Irritability
- Hyperkalemia
- Muscle Weakness
- Skin Hyperpigmentation
- Hyponatremia
- Hypotension
- Hypoglycemia
- Addisonian Crisis
Addison's Disease Intervention
- Hydrocortisone
- 2/3 Dose in Morning
- 1/3 Dose in Late Afternoon
- Fludrocortisone
- Androgen Replacement Therapy
- Salt Additives
- Increase Dosage During Stress and Infection
- Medic Alert Bracelet
- Lifelong Hormone Therapy
Pheochromocytoma
- Adrenal Medulla Tumor
- Increased Catecholamines
- Episodic Hypertension
- Diaphoresis
- Abdominal or Chest Pain
- Surgery
- Antihypertensives
- Phenoxybenzamine
- Metyrosine (Demser)
- Do Not Palpate Abdomen
Cushing's Syndrome Assessment
- Increased Cortisol Levels
- Truncal Obesity
- Purple Abdominal Striae
- Buffalo Hump
- Decreased Bone Density
- Moon Face
- Thinning Skin
- Hyperglycemia
- Hypertension
- Long Term Glucocorticoid Use
- Immunosuppression
Hypothalamus
- Anterior Pituitary Stimulated Through the Hypophyseal Portal
- GHRH
- GnRH
- TRH
- PIF
- CRF Released During Stress
- Posterior Pituitary Stimulated Through Neural Control
Anterior Pituitary
- Hypothalamic Control
- FLAT PeG Mnemonic
- Follicle-Stimulating Hormone (FSH)
- Lutenizing Hormone (LH)
- Adrenocorticotropic Hormone (ACTH)
- Thyroid-Stimulating Hormone (TSH)
- Prolactin (PRL)
- Growth Hormone (GH)
Posterior Pituitary
- Neuroendocrine Reflex Stimulation (By Hypothalamus)
- Vasopressin
- Increased Water Retention (In Kidneys)
- Oxytocin
- Increased Uterine Contraction
- Mammary Glands Contraction