[FINALS] Endocrine System 2

Part 2

Fasting Plasma Glucose

What test is considered the best indicator of overall glucose homeostasis and reflects glucose from hepatic production?

8-12 hours

How many hours should a patient be on NPO and hold insulin or oral hypoglycemic agents (OHAs) before a FBG test?

False

True or False: Before an FBG test, the patient should be on NPO, including water.

True

True or False: Impaired fasting glucose is higher than normal but not enough to be considered DM.

1. 70-110 mg/dl

2. 110-125 mg/dl

3. More than or equal to 126 mg/dl

Fill in the blanks.
FASTING BLOOD GLUCOSE

1. Normal: __

2. Impaired Fasting Glucose __

3. Diabetic: __

Oral Glucose Tolerance Test (OGTT)

What test is used for transitional gestational glucose tolerance?

Hospitalized clients and patients with a FBS of >140mg/dl

What are the exceptions to performing an OGTT?

At least 150 grams for 3 days

Before an Oral Glucose Tolerance Test (OGTT), how many grams of carbohydrates should the patient consume, and for how many days should they be taken?

Coffee, alcohol, or smoking

What should be avoided 36 hours before an OGTT?

FBS and urine sample

During an OGTT, what should be obtained before administering the glucose solution?

Diarrhea and abdominal cramps

What are the side effects associated with an OGTT?

Glycosylated Hemoglobin (HBa1c)

What test reflects blood glucose levels for the past 3-4 months?

1. Less than 5.6%

2. 5.7-6.4%

3. >6.5%

4. <7%

Fill in the blanks.

GLYCOSYLATED HEMOGLOBIN (HBa1c)

1. Normal: __

2. Pre-diabetic: __

3. Diabetic: __

4. Target Control for those with DM: __

2-hour postprandial blood sugar

What laboratory test checks the efficiency of insulin?

1. <140 mg/dl

2. 141-199 mg/dl

3. Greater than or equal to 200 mg/dl

Fill in the blanks.
2-Hour Postprandial Blood Sugar

1. Normal: __

2. Pre-diabetic: __

3. Diabetic: __

At midnight

During a Dexamethasone Suppression Test for Cushing’s Disease, when is dexamethasone given?

24-hour urine specimen

What is required in a Vanillylmandelic Acid Test?

Pheochromocytoma

What disease is detected in a VMA test?

Coffee, tea, vanilla, chocolate, banana

What should be avoided during urine collection for a Vanillylmandelic Acid (VMA) test?

High doses of aspirin and NSAIDs

What substances can inhibit catecholamines and should therefore be avoided during a VMA test?

0.7-6.8 mg/24 hours

What is the normal range for a Vanillylmandelic Acid (VMA) test?

Humalog (Lispro)

Name a rapid-acting insulin.

Humulin R (Regular), Semi Lente

Name the two types of short-acting insulin.

Humulin N (NPH), Humulin L (Lente), Humulin 70/30

Name the three types of intermediate-acting insulin.

Humulin U

Name a long-acting insulin.

Lantus

Name a very long-acting insulin.

5-15 minutes, 1 hour, 2-4 hours

Fill in the blanks.

RAPID ACTING INSULIN

1. ONSET: __

2. PEAK: __

3. DURATION: __

0.5-2 hours, 2-4 hours, 4-6 hours

Fill in the blanks.

SHORT ACTING INSULIN (HUMULIN R)

1. ONSET: __

2. PEAK: __

3. DURATION: __

1-2 hours, 4-6 hours, 8-12 hours

Fill in the blanks.

SHORT ACTING INSULIN (SEMI LENTE)

1. ONSET: __

2. PEAK: __

3. DURATION: __

2-4 hours, 4-10 hours, 10-16 hours

Fill in the blanks.

INTERMEDIATE ACTING INSULIN (NPH, LENTE)

1. ONSET: __

2. PEAK: __

3. DURATION: __

0.5-1 hour, dual

Fill in the blanks.

INTERMEDIATE ACTING INSULIN (HUMULIN 70/30)

1. ONSET: __

2. PEAK: __

6-10 hours, 18-30 hours

Fill in the blanks.

LONG ACTING INSULIN (HUMULIN U)

1. ONSET: __

2. DURATION: __

1 hour, 24 hours

Fill in the blanks.

VERY LONG ACTING INSULIN (LANTUS)

1. ONSET: __

2. DURATION: __

Peak

This is considered the time of the most concentrated effect of insulin, during which the patient is at greatest risk for hypoglycemia.

Humulin R (Regular)

What type of insulin can be given via IV?

Abdomen, upper arm, thigh

What are the three usual sites during insulin administration?

Refrigerated

Unopened insulin vials should be __ to prolong shelf life and potency.

At room temperature

Opened insulin vials should be __ to maintain stability and prevent pain during administration.

28 days

How long does insulin remain potent after opening?

Sulfonylureas (Chlorpropamide, Glyburide)

What type of beta cell stimulator is longer in duration? Name examples.

Non-sulfonylureas (Meglitinides, Nateglinide)

What type of beta cell stimulator is shorter in duration but more rapid? Name examples.

Sulfonamides, high doses of Aspirin, Alcohol, and Anticoagulants

What should be avoided when taking Sulfonylureas?

Disulfiram-like reaction

A patient with diabetes mellitus presents with hypotension, flushing, nausea and vomiting, headache, and chest pain during assessment. The patient mentioned drinking with friends the night before. What is the most likely cause?

Biguanides (Metformin) and Thiazolidinediones (Pioglitazone)

What are the two types of Insulin Sensitizers?

Diarrhea and abdominal discomfort

What are the side effects of taking Metformin?

Alpha Glucosidase Inhibitors (Acarbose)

What drug classification is used to decrease the incidence of hyperglycemia after meals by inhibiting a specific enzyme?

Bedtime Insulin, Daytime Sulfonylureas

What does BIDS stand for?

Dawn phenomenon

This refers to the early rise of glucose due to the natural release of hormones.

With meals (gastric irritants) but best taken in the morning

When is the best time to take artificial glucocorticoids?