Diabetes

Question 1

what is the normal plasma glucose level?

Answer 1

Homeostatic mechanisms of the body generally maintain glucose at a level <6.0 nmol/L

Question 2

autonomic symptoms, able to self-treat

Answer 2

mild hypoglycemia

Question 3

autonomic and neuroglycopenic symptoms, able to self–treat

Answer 3

moderate hypoglycemia

Question 4

unable to self-treat, requires assistance, unconsciousness may occur

Answer 4

severe hypoglycemia

Question 5

what is the blood glucose for severe hypoglycemia?

Answer 5

<2.8 mmol/L

Question 6

Generally hypoglycemia occurs when BG levels are between _____

Answer 6

2.5-3.3 mmol/L

Question 7

etiology in diabetes

Answer 7

• relative excess of insulin in the blood

- deficits in glucose counterregulation

Question 8

____ occur due to an abrupt cessation of glucose delivery to the brain

Answer 8

neuroglycopenic symptoms

Question 9

treatment for mild to moderate hypoglycemia

Answer 9

15 g carb - 2.1 mmol/L increase within 20 mins

Question 10

treatment for severe-conscious hypoglycemia

Answer 10

20g carb - 3.6 mmol/L increase at 45 mins

Question 11

treatment in unconscious person with severe hypoglycemia >5 years of age

Answer 11

• 1 mh glucagon SC or IM

- IV glucose 10-25 over 1-3 mins

Question 12

Acid-base imbalance specifically metabolic acidosis due to ketoacidosis is always present in ___

Answer 12

DKA

Question 13

Electrolyte imbalances occurs due to

Answer 13

metabolic acidosis and osmotic diuresis

Question 14

The result of glycogenolysis and gluconeogenesis is

Answer 14

hyperglycemia

Question 15

total body deficit of water in adults in DKA

Answer 15

5-7 L

Question 16

total body deficit of water in adults in HHNKS

Answer 16

7-12 L

Question 17

acteone breath and Kussmaul-Kein respiration present

Answer 17

DKA

Question 18

glucose > 14 mmol/L

Answer 18

DKA

Question 19

glucose > 34 mmol/L

Answer 19

HHNKS

Question 20

pH is usually normal in ….

Answer 20

HHNKS

Question 21

has severe ECFV depletion (osmolality >320)

Answer 21

HHNKS

Question 22

• Is an alternative metabolic pathway for tissues not requiring insulin for glucose transport.
• These include the kidney, RBCs, blood vessels, eye lens, and nerves

Answer 22

Polyol Pathway

Question 23

sorbitol + fructose -> increased intracellular osmotic pressure -> cell injury

Answer 23

polyol pathway

Question 24

basement membrane components in the microcirculation

Answer 24

Glycoproteins or AGEs

Question 25

chronic complications arise from a decrease in O2 delivery in small vessels

Answer 25

Tissue oxygenation/oxidative stress

Question 26

defect in RBC ->

Answer 26

release of O2 Hgb impaired

Question 27

chronic hyperglycemia ->

Answer 27

increases production of ROS

Question 28

intracellular hyperglycemia increases the synthesis of DAG which activates ___

Answer 28

protein kinase C

Question 29

vascular damage and associated disease of the retina, kidney and nerves can be caused by activation of ___ in these blood vessels.

Answer 29

PKC

Question 30

characterized by thickening of the basement membrane, endothelial cell hyperplasia, thrombosis and pericyte degeneration

Answer 30

microvascular disease

Question 31

involves retina, nerves, kidneys and GI tract

Answer 31

microvascular disease

Question 32

may involve the spinal cord, posterior root ganglia or the peripheral nerves

Answer 32

somatic neuropathy

Question 33

Neuropathic pain may be managed with

Answer 33

tricyclic antidepressants, anticonvulsants and opioid analgesia.

Question 34

What glomerular changes are seen in nephropathy?

Answer 34

• capillary basement membrane thickening
• diffuse glomerular sclerosis
• nodular glomerulosclerosis

Question 35

what is one of the 1st clinical manifestations of nephropathy?

Answer 35

microalbuminuria

Question 36

The underlying pathophysiology of macrovascular complications is

Answer 36

atherogenesis or atherosclerosis

Question 37

most common cause of death in people with T2DM, common in T1DM as well

Answer 37

CAD - coronary artery disease

Question 38

what type of stroke in more common?

Answer 38

Ischemic

Question 39

goal for A1C

Answer 39

<7%