NR507 Week 7 Quiz Study Guide - 09-02-19
WEEK 7 QUIZ STUDY
GUIDE ENDOCRINE
• Diabetes Insipidus (DI)
o Disorder of posterior pituitary
o Insufficiency of ADH leading to polyuria and polydipsia
o Nephrogenic DI- caused by inadequate response of renal tubules to
ADH (vasopressin) and inability to reabsorb filtered H20 back into the
body
o Usually acquired but can be genetic
o Acquired is r/t disorders and drugs that damage renal tubules- pyelonephritis,
amyloidosis, destructive uropathies, polycystic disease, intrinsic renal dx, all
lead to irreversible DI
o Drugs that induce reversible form= lithium, colchicines, loop diuretics, general
anesthetics
o Total inability to concentrate urine
o Insufficient ADH activity causes excretion of large volumes of dilute urine
increased plasma osmolality thirst mechanism is stimulated induces
polydipsia
o Dehydration develops rapidly without fluid replacement
o Criteria for diagnosis includes- polyuria, polydipsia, low urine specific gravity
and osmolality, hypernatremia, high serum osmolality, continued diuresis
Type 1 DM (T1DM)
• Most common pediatric chronic disease
• Can be autoimmune or nonimmune (idiopathic)
• Autoimmune Pathophys-Environmental-genetic factors (infections, cow’s milk
proteins, lack of Vit D, vaccinations, stress) are thought to trigger cell-mediated
destruction of pancreatic beta cells absolute insulin deficiency
o Loss of tolerance to self-antigens with formation of autoantigens expressed on
surface of pancreatic beta cells and circulate in blood and lymph
o Cellular immunity (T-cytotoxic cells and macrophages) and humoral
immunity (autoantibodies) are stimulated resulting in beta-cell destruction and
apoptosis
• Nonimmune Pathophys- far less common does not have an autoimmune basis for
beta- cell destruction, occurs secondary to other diseases (pancreatitis), mostly Asian
and
African descent. Varying degrees of insulin deficiency
• S/S- glucose in urine d/t renal threshold of glucose is exceeded
o Osmotic diuresis manifested as polyuria and polydipsia
o Wide fluctuations in BGL
o Protein and fat breakdown occurs because of lack of insulin weight loss
o Increased hepatic metabolism of fat leads to high levels of circulating ketones
causing DKA
• Diagnosis includes A1C > 6.5%
o FPG >126
o 2 hr plasma glucose > 200
This study source was downloaded by 100000834306259 from CourseHero.com on 02-14-2022 04:08:43 GMT -06:00
https://www.coursehero.com/file/72370214/NR507-Week-7-Quiz-Study-Guide-09-02-19docx/
, o In patient with symptoms of hyperglycemia and a random glucose > 200
This study source was downloaded by 100000834306259 from CourseHero.com on 02-14-2022 04:08:43 GMT -06:00
https://www.coursehero.com/file/72370214/NR507-Week-7-Quiz-Study-Guide-09-02-19docx/
WEEK 7 QUIZ STUDY
GUIDE ENDOCRINE
• Diabetes Insipidus (DI)
o Disorder of posterior pituitary
o Insufficiency of ADH leading to polyuria and polydipsia
o Nephrogenic DI- caused by inadequate response of renal tubules to
ADH (vasopressin) and inability to reabsorb filtered H20 back into the
body
o Usually acquired but can be genetic
o Acquired is r/t disorders and drugs that damage renal tubules- pyelonephritis,
amyloidosis, destructive uropathies, polycystic disease, intrinsic renal dx, all
lead to irreversible DI
o Drugs that induce reversible form= lithium, colchicines, loop diuretics, general
anesthetics
o Total inability to concentrate urine
o Insufficient ADH activity causes excretion of large volumes of dilute urine
increased plasma osmolality thirst mechanism is stimulated induces
polydipsia
o Dehydration develops rapidly without fluid replacement
o Criteria for diagnosis includes- polyuria, polydipsia, low urine specific gravity
and osmolality, hypernatremia, high serum osmolality, continued diuresis
Type 1 DM (T1DM)
• Most common pediatric chronic disease
• Can be autoimmune or nonimmune (idiopathic)
• Autoimmune Pathophys-Environmental-genetic factors (infections, cow’s milk
proteins, lack of Vit D, vaccinations, stress) are thought to trigger cell-mediated
destruction of pancreatic beta cells absolute insulin deficiency
o Loss of tolerance to self-antigens with formation of autoantigens expressed on
surface of pancreatic beta cells and circulate in blood and lymph
o Cellular immunity (T-cytotoxic cells and macrophages) and humoral
immunity (autoantibodies) are stimulated resulting in beta-cell destruction and
apoptosis
• Nonimmune Pathophys- far less common does not have an autoimmune basis for
beta- cell destruction, occurs secondary to other diseases (pancreatitis), mostly Asian
and
African descent. Varying degrees of insulin deficiency
• S/S- glucose in urine d/t renal threshold of glucose is exceeded
o Osmotic diuresis manifested as polyuria and polydipsia
o Wide fluctuations in BGL
o Protein and fat breakdown occurs because of lack of insulin weight loss
o Increased hepatic metabolism of fat leads to high levels of circulating ketones
causing DKA
• Diagnosis includes A1C > 6.5%
o FPG >126
o 2 hr plasma glucose > 200
This study source was downloaded by 100000834306259 from CourseHero.com on 02-14-2022 04:08:43 GMT -06:00
https://www.coursehero.com/file/72370214/NR507-Week-7-Quiz-Study-Guide-09-02-19docx/
, o In patient with symptoms of hyperglycemia and a random glucose > 200
This study source was downloaded by 100000834306259 from CourseHero.com on 02-14-2022 04:08:43 GMT -06:00
https://www.coursehero.com/file/72370214/NR507-Week-7-Quiz-Study-Guide-09-02-19docx/
