In class

🩺 Type 1 Diabetes Mellitus (T1DM)

🧠 Pathophysiology:

• Autoimmune destruction of pancreatic beta cells (which produce insulin).

• NO insulin production → glucose can't enter cells → blood sugar rises (hyperglycemia).

• Body burns fat for energy → produces ketones → risk for DKA (Diabetic Ketoacidosis).

📚 "3 P's" of Type 1 Diabetes Symptoms:

• Polydipsia (excess thirst)

• Polyuria (excess urination)

• Polyphagia (excess hunger)

🛑 Often presents suddenly in children/young adults.

🩺 Type 2 Diabetes Mellitus (T2DM)

🧠 Pathophysiology:

• Insulin resistance → cells ignore insulin signals.

• Beta cells eventually wear out → reduced insulin secretion.

• Blood sugar rises (hyperglycemia), but less chance of DKA (more likely HHS - Hyperosmolar Hyperglycemic State).

📚 "SLOW" for Type 2 Diabetes Symptoms:

• Slow wound healing

• Low energy

• Overweight/obesity

• Weird sensations (tingling/numbness)

🛑 Often develops slowly and seen in adults.

🩺 Thyroid Disorders

🧠 Pathophysiology:

The thyroid gland controls metabolism by releasing T3 (triiodothyronine) and T4 (thyroxine).

Hypothyroidism (underactive thyroid)

• Low T3/T4, High TSH (pituitary trying to stimulate thyroid)

• Slows down body functions.

📚 "Slow and Cold" Symptoms:

• Weight gain

• Cold intolerance

• Fatigue

• Constipation

• Depression

• Dry skin

• Bradycardia (slow HR)

• Puffy face, edema (myxedema if severe)

Mnemonic: "THYROID SLOW"

• Tiredness

• Hair loss

• Yawning (fatigue)

• Reflexes slow

• Overweight

• Intolerance to cold

• Dry skin

Hyperthyroidism (overactive thyroid)

• High T3/T4, Low TSH (pituitary tries to shut down thyroid)

• Speeds up body functions.

📚 "Hot and Fast" Symptoms:

• Weight loss

• Heat intolerance

• Anxiety, nervousness

• Palpitations, tachycardia

• Diarrhea

• Sweating

• Exophthalmos (bulging eyes in Graves’ disease)

Mnemonic: "THYROID HOT"

• Tremors

• High HR

• Yelling (irritable)

• Restlessness

• Overheated

• Intestinal issues (diarrhea)

• Diaphoresis (sweating)

🌟 Quick Nursing Tip:

• Always monitor TSH, T3, and T4 to assess thyroid function.

• Type 1 DM = Insulin required for life.

• Type 2 DM = May manage with diet, exercise, oral meds, or insulin if needed.

🩸 Acute Kidney Injury (AKI)

🧠 Pathophysiology:

• Sudden decline in kidney function over hours to days.

• Kidneys can’t filter waste, balance fluids, or maintain electrolytes.

• Leads to azotemia (↑BUN and creatinine) and oliguria (low urine output).

3 Causes of AKI:

🩻 "P-I-P" Mnemonic

• Pre-renal (↓blood flow to kidneys – eg: dehydration, hypotension)

• Intra-renal (damage to kidney tissue – eg: nephrotoxins, glomerulonephritis)

• Post-renal (obstruction – eg: kidney stones, BPH)

📚 Symptoms of AKI:

• Decreased urine output (<400ml/day)

• Fluid overload (edema, crackles)

• Hyperkalemia (muscle cramps, ECG changes)

• Fatigue, confusion (from toxins)

🩺 Chronic Kidney Disease (CKD)

🧠 Pathophysiology:

• Gradual, irreversible loss of kidney function over months to years.

• Kidneys can't remove wastes, regulate fluids, or control BP.

• GFR (Glomerular Filtration Rate) slowly decreases.

🩻 "5 Stages" of CKD based on GFR:

• Stage 1: Kidney damage with normal GFR (≥90)

• Stage 2: Mild ↓ GFR (60–89)

• Stage 3: Moderate ↓ GFR (30–59)

• Stage 4: Severe ↓ GFR (15–29)

• Stage 5: End-stage (GFR <15 → Dialysis needed)

📚 Symptoms of CKD:

🧠 "AEIOU" Mnemonic for signs dialysis needed:

• Acid-base imbalance (metabolic acidosis)

• Electrolyte imbalance (esp. high K⁺)

• Intoxication (toxin build-up)

• Overload of fluid (pulmonary edema)

• Uremia (nausea, confusion, itchy skin)

Other symptoms:

• Fatigue, anemia (↓erythropoietin)

• Fluid retention (edema, hypertension)

• Uremic frost (white crystals on skin in late stages)

🌟 Quick Nursing Tips:

• Monitor I&O (intake/output)

• Monitor electrolytes (especially K⁺ and Na⁺)

• Control BP (ACE inhibitors common)

• Educate on renal diet: low protein, low sodium, low potassium

• Avoid nephrotoxic drugs (like NSAIDs)

🩺 Summary Table:

🎯 Mnemonics to Remember

• AKI Causes = "P-I-P" → Pre-renal, Intra-renal, Post-renal

• Dialysis Indications = "AEIOU" → Acidosis, Electrolytes, Intoxication, Overload, Uremia

• Metabolic Disorders Overview

  • Involves glucose control.

  • Differentiation between Type 1 and Type 2 Diabetes (etiology, pathogenesis, diagnostics, risk factors, consequences, complications).

  • Insulin's metabolic effects:

    • Increases glucose uptake.

    • Increases glycogen synthesis.

    • Increases triglyceride formation.

    • Enhances protein synthesis.

    • Reduces glucose and protein breakdown.

  • Insulin deficiency:

    • Decreased glucose uptake.

    • Increased blood sugar levels → diabetes.

• Diabetes Mellitus (DM)

  • Metabolic disorder: elevated blood glucose levels.

  • Cause: lack of insulin, insulin deficiency, or tissues' insensitivity to insulin.

  • Clinical definitions: fasting blood glucose levels and oral glucose tolerance test results categorize into normal, pre-diabetes, and diabetes.

  • Leads to reduced glucose utilization → hyperglycemia, glycosuria, dehydration, increased fat mobilization, and protein depletion.

• Type 1 Diabetes Mellitus

  • Peak onset: 11-13 years (rare after 30).

  • Autoimmune destruction of pancreatic β-cells.

  • Symptoms: polyuria, polydipsia, polyphagia, weight loss, fatigue.

  • Ketoacidosis from excessive fat breakdown.

  • Contributing factors: genetic susceptibility, environmental influences (viral infections), nutritional deficiencies.

• Diabetic Ketoacidosis (DKA)

  • Insulin deficiency (primarily in type 1 diabetes).

  • Decreased glucose utilization and increased fat breakdown → heightened ketone production and metabolic acidosis.

  • Symptoms: fruity-smelling breath, deep Kussmaul respirations, nausea, vomiting, abdominal pain, electrolyte disturbances, severe dehydration.

• Type 2 Diabetes Mellitus

  • Primarily from obesity, genetic factors, hypertension, and poor diet.

  • Leads to insulin resistance and relative insulin deficiency.

  • Obesity: increased adipokines and inflammatory cytokines → β-cell dysfunction.

  • Treatment: lifestyle changes (controlled diet and regular exercise) to enhance insulin sensitivity and manage glucose levels.

• Long-term Complications of DM

  • Heart disease, peripheral vascular disease, neuropathy, retinopathy, and renal impairment.

  • Can lead to gangrene (amputations) and increase the risk of cerebrovascular accidents (CVAs).

  • Effective diabetes management is crucial to prevent these outcomes.

• THYROID GLAND DYSFUNCTION

  • Role: regulates metabolism, heat production, and overall growth and development (thyroid hormones).

  • Hypothalamus releases thyrotropin-releasing hormone (TRH) → stimulates anterior pituitary to produce thyroid-stimulating hormone (TSH) → promotes synthesis of T3 and T4 hormones.

  • Understanding causes and symptoms of thyroid dysfunction (hyposecretion and hypersecretion) is essential.

• Hypothyroidism

  • Cause: hyposecretion of thyroid hormones (iodine deficiency, autoimmune destruction, congenital defects).

  • Symptoms: myxedema, reduced basal metabolic rate (cold intolerance and weight gain), neurological depression (fatigue and confusion).

  • Increased TSH levels; goiter due to inadequate iodine intake.

• Hyperthyroidism (Thyrotoxicosis)

  • Cause: issues within the thyroid or pituitary gland → overproduction of T3 and T4.

• Graves’ Disease

  • Cause: thyroid-stimulating immunoglobulins (TRAb).

  • Symptoms: increased metabolic rate, heat intolerance, goiter, exophthalmos (connective tissue deposition), nervous system hyperexcitability (nervousness, irritability, fatigue).

  • Other symptoms: weight loss (despite increased appetite