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Internal Medicine > Endocrine > Flashcards

Endocrine Flashcards

1
Q

What are the two types of Type 1 Diabetes

A

1A: Autoimmune destruction of pancreatic B cells

1B: B cell destruction non-immune mediated

both lead to absolute insulin deficiency

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2
Q

4 Common Type 1 DM sxs

A

Wt Loss
Lethargy
Paresthesias
Postural Hypotension

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3
Q

Effects on the liver in T2DM

A

Increased hepatic glucose output

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4
Q

T2DM sxs (4)

A

Confusion
Decreased wound healing
Polys x3
Wt Gain

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5
Q

What are the four ways to dx T2DM

A

8 hr fasting glucose - 2 separate readings [Greater 126]

2hr glucose tolerance testing - [Greater 200]

Random glucose test [Greater 200]

A1C [Greater 5.7-6.4% - Greater 6.4%]

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6
Q

Plasma changes of Diabetes Insipidous (2)

A

Increased plasma osmolality

Decreased urine osmolality

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7
Q

1st line mgmt DM

A

Wt. Loss
Decrease ETOH
ASA
Bp Control

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8
Q

MOA GLP-1s

ADE’s

A

Decreased gastric emptying
Increased Insulin Sensitivity
Wt loss!

ADE= N/V/D

(Glutides)

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9
Q

MOA TZD

ADE’s

A

Insulin sensitizers

Increased risk of fx’s
Bladder Cancer

(ZONES)

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10
Q

MOA AGI’s

ADE

A

Decreased PP glucose

ADE= Dark urine N/V Stomach pain Yellow eyes or skin

(ACARBOSE)

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11
Q

DPP-4 MOA

ADE

A

Inhibits breakdown of GLP-1
Wt Loss!

ADE= Nausea Diarrhea Stomach Pain

(gliptons)

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12
Q

SGLT2 MOA

ADE

A

Pee out the glucose
Inhibit sodium and glucose reabsorption at the proximal tubules.

ADE= Volume depletion AKI Fx’s

(Flozins)

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13
Q

MOA Metformin

ADE

A

Decrease hepatic glucose production
Decrease fasting glucose
Wt Loss!

ADE= Nausea Diarrhea, Dizziness

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14
Q

A1C # of medications indicated

1) 6.5% - 7.5% =

2) 7.5% - 9.0% =

3) -3 months later; still 7.5%- 9.0% =

4) -3months later; A1C still above 9.0% =

A

1) Mono

2) Dual

3) Triple

4) Add insulin

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15
Q

Explain the relationship between higher levels of glucose than sodium

A

Decreases sodium
Due to water increased retention; influx to highest concentration solute (glucose)

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16
Q

Relationship between increased glucose and potassium

A

Increases potassium
-Flow influx outside of cells

-Insulin shifts potassium back into cells; controlling glucose balance.

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17
Q

Bolus insulin is for ____ and Basal insulin is for ____

A

Bolus = Post praindal glucose control

Basal = fasting glucose control

18
Q

Types of bolus insulin

A

Rapid acting
-Lispro
-Aspart
-Glusiline

Short acting
Regular
-Novolog
-Humalog

19
Q

Basal insulin types

A

Intermediate Acting
NPH :
-Humulin
-Novolog

Long Acting
-Glargine
-Determir
-Degludec

20
Q

Onset and Duration of action of bolus insulin

A

Rapid = onset@ 5-15 mins; duration= 4-6 hours

Short = onset @ 30 mins; duration = 2-5 hours

21
Q

Onset and Duration of Action Basal Insulin

A

Intermediate = onset @ 60-90 mins; duration= 16-24 hours

Long = onset @ 2 hours ; duration = 24 hours

22
Q

Sulfonyurea MOA

ADE

A

Insulin secretagogues

ADE= Wt Gain! Hypoglycemia!

(RIDES; ZIDES)

23
Q

Dosage of Insulin

A

0.3mg/kg = Lean/Frail

0.4mg/kg= NML wt.

0.5mg/kg= overweight

0.6mg/kg= obese

Daily dose is divided in half; bolus dose = 1/3

24
Q

3 common brands for GLP-1

A

Ribelsis

Trulicity

Ozempic

25
Q

Common brands for SGLT-2s

A

Invokena

Jiardines

26
Q

Common brands for SU

A

Amaryl

27
Q

Common brands for DPP-4s

A

Januvia

Onyglyza

28
Q

Common brand name for TZDs

A

ACTOS

29
Q

Common brands for AGI’s

A

PRECOS

30
Q

5 complications of DM

A

HTN / HF
Dyslipidemia
Stroke
Retinopathy -> Blindness
Neuropathies

31
Q

Dx criteria for T1DM : DKA

A

BG over 250
pH less than 7.3
Bicarbonate less than 15
+ ketones in the urine

32
Q

DKA treatments

A

Fluids
Electrolytes
Insulin

33
Q

What diabetic patients need to be on a statin as well

A

40-75 y/o with LDL over 70 ; consider PCSK-9 / Ezetemibe

Age 20-39 with high ASCVD Risk

34
Q

T2DM HHS dx criteria

A

BG over 600
Low ketones

35
Q

TXM for HHS

A

Intravascular volume replacement
[sodium-chloride]

36
Q

Hypoglycemia sxs and dx criteria

A

Dx= less than 70

Sxs = tremors; tachycardia; confusion

37
Q

Management and Dx for Level 1 hypoglycemia

A

60-70

15^3
CHO

38
Q

Management and Dx for Level 2 hypoglycemia

A

41-59

[30-15-30]
CHO

39
Q

Management and Dx for Level 3 hypoglycemia

A

Less than 40

Seizures!!!!

glucagon 1mg subQ or 50 mls D50w/ IV

40
Q

Best CHOs to increase glucose (6)

A

Bread
Cereals
Pasta
Rice
Beans

41
Q

What level A1C requires insulin management

A

Above 9%

42
Q

What is the screening criteria for DM

A

35 - 70 y/o ; especially obese! every 3 years

Those with ASVCD risk

Internal Medicine (6 decks)

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