Which of the following endocrine emergencies typically requires a significant fluid resuscitation as a part of patient management? Mysedema. Hypothyroidiom Hyperadrenal on Diabetic ketoacidosis
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ENDOCRINE SYSTEM Diabetes mellitus A 14-year-old male is brought to the ER being found unresponsive. The patient's mother, who had not seen the child for over 24 hours, came home to find her son lying on the sofa unresponsive. Copious quantities of black colored vomit were evident. The child is a diabetic and gives himself his own medication. His mother was unsure when her son last took his medication. Blood pressure: 101/72; heart rate: 123; respirations: 32; oral temperature: 34.8°C; pulse oximetry: 100% on room air. General: An approximately 65 Kg, thin male who is, in general, responsive only to very loud or painful stimuli. His oropharynx demonstrates very dry mucous membranes and a moderate amount of dried, black material which is strongly Gastrocult positive. His lungs are clear, but display Kussmaul respiratory pattern. Abdomen exam is negative. There are no other pathological findings. 1. How would you proceed from here? Does this patient need an IV? If so, what types of fluid do you want to initiate and at what rate? 2. What basic lab tests would you order? 3. In addition to saline the patient was given a bolus of 10 units of regular insulin IV while waiting for the lab results, do you find it necessary, too risky? 4. A serum glucose determination (Accucheck) was too high to read. How does this affect your differential diagnosis? What additional care would you now render this patient? 5. The results came back shortly thereafter, and showed an arterial blood gas pH of 6.92, CO2 of 9 and a bicarb of 2. The WBC count was 62.6 thousand (62,600), hemoglobin of 14.4 mg/dL, and hematocrit of 43.5%. His chemistry panel demonstrated a serum sodium of 127, potassium 5.2, chloride of 87, CO2 of less than 5, BUN of 32, creatinine 1.5, and a blood sugar of 1,582. The serum ketones were positive at a dilution of 1:32. What is your interpretation of these results? What additional treatment would you add? a. Blood sugar b. Serum ketones c. Dehydration d. Electrolyte changes; What type of acidosis is this? e. BUN and creatinine f. WBC 6. What might trigger a DKA? 7. Would you administer antibiotics?
Adi S.
39) Glucagon is secreted: A) when GIP and GLP-1 are released. B) when blood glucose levels are below normal. C) when the beta cells secrete insulin. D) after consuming a large meal. 40) Which of the following statements is true about the oral antidiabetic drugs that are approved for the treatment of type 2 DM? A) They can be used concurrently with other antidiabetic drugs, including insulin. B) They are also used in the treatment of type 1 DM because some of these drugs cause the insulin secretion. C) They are used in the treatment of ketoacidosis. D) These drugs are ineffective in maintaining glycemic control. 41) Identify an accurate statement about oxytocin. A) Oxytocin is synthesized in the posterior lobe of the pituitary in women. B) A fall in oxytocin levels correlates with orgasm intensity in men and women. C) There is no role for oxytocin as a pharmacologic agent beyond labor and delivery at present. D) Oxytocin is synthesized only in the testes and prostate gland in men. 42) Which of the following is a true statement about the posterior pituitary hormones? A) The secretion of the hormones is controlled by nerve reflexes. B) The hormones are synthesized when they are needed. C) The hormones are released in response to other hormones. D) The hormones travel down nerve axons to the anterior lobe of the pituitary gland. 43) Identify the primary function of antidiuretic hormone (ADH). A) Antidiuretic hormone is a substance that regulates water balance in the body by controlling water loss in the urine. B) Antidiuretic hormone is a substance that regulates water balance in the body by controlling the amount of the sodium ions in the body. C) Antidiuretic hormone is a substance that regulates water balance in the body by controlling the sodium potassium exchange in the body. D) None of these are correct. 44) Which of the following statements is true of diabetes insipidus (DI)? A) Nephrogenic DI is caused by a decreased secretion of ADH. B) Treatment of hypothalamic DI mainly involves replacement therapy with endogenic vasopressin. C) Diabetes insipidus is not related to the other hormone deficiency condition, diabetes mellitus. D) Central DI is caused by a resistance to ADH in the kidney.
Madhur L.
Kalamitie Kate, a physiology student, has been feeling rather poorly lately. She has gained weight recently. She is often constipated and feels lethargic with no energy. She is tired most of the time and has trouble understanding concepts quickly when she studies. Which endocrine disorder is most likely causing these symptoms? Group of answer choices: Hyperthyroidism Diabetes mellitus Hypothyroidism Glucocorticoid deficiency Which is NOT a symptom of untreated diabetes insipidus? Group of answer choices: Intense thirst Increased output of urine Antidiuretic hormone deficiency High blood glucose levels Which will stimulate aldosterone secretion? Group of answer choices: Increased potassium ion levels in the blood Increased blood volume and blood pressure Which answer describes the effects of glucagon release? Group of answer choices: Hyperglycemic hormone; Increases blood glucose levels Hypoglycemic hormone; Lowers blood glucose levels Which of the following is CORRECT for growth hormone? Group of answer choices: Stimulates long bone growth and increased skeletal muscle mass in children Can be helpful in treating pituitary dwarfism in adults Causes decreased blood glucose levels Is secreted by the posterior pituitary Where is thyrotropin-releasing hormone (TRH) produced? Group of answer choices: Hypothalamus Anterior pituitary Posterior pituitary Thyroid gland
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