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Flashcards in Diabetes DIAL Deck (29):
1

What is the most definitive diagnosis of diabetes?

HbA1c of 7.2% or greater

2

What is the fastest way to check a patient's blood sugar level?

Dipstick blood glucose

3

What is the most accurate way to check a patient's current blood sugar level?

Serum glucose test

4

If a patient has RBCs with a shortened lifespan what would be considered as a reliable substitute to A1c test to check blood sugar levels?

Serum fructosamine test

5

What constitutes "severe" hypoglycemia?

Altered mental state AND blood sugar of 40 mg/dL or less (must be symptomatic for "severe")

6

What are the typical signs and symptoms of hypoglycemia?

Sweating
Bizarre behavior
Tremor
Coma

7

What is the best treatment for mild hypoglycemia?

Food

8

What patient would glucagon be most ineffective?

Alcoholic with low blood sugar

9

What is glucagon not effective in an alcoholic?

Because glycogen is absent in alcoholics

10

Why is glycogen absent in alcoholics?

Because ethanol is made into acetyl CoA and then FAs and cannot be formed into glycogen

11

What oral hypoglycemic agent is the most dangerous in an overdose for pediatrics?

Glipizide (sulfonylurea)

12

Why are sulfonylureas dangerous in overdose?

The onset can be up to 8 hours and even later, the problems may arise after patient left the ER and is already back home

13

What is the first line of treatment in the hospital if a patient has low plasma glucose?

Give IV glucose

14

What is the appropriate pediatric dose of glucose?

0.5-1 g/kg

15

What is meant by D10W, D25W and D50W?

D10= 10% volume is glucose
D25= 25% volume is glucose
D50= 50% volume is glucose
W= rest of the volume is water

16

What is the osmolarity of 5% glucose and the calculation?

280 mM
5g/mL x 1 mol/180g x 1000mL/1 L= 280

17

Why does DKA occur?

Insulin deficiency

18

What typically is the initial cause of DKA?

GI infections

19

What are typical signs of DKA?

Tachycardia
Tachypnea
Fever
Hypotension
Depressed mental status

20

Why does hypotension and fever occur in DKA?

Hypotension: GI infection leads to diarrhea and dehydration
Fever: GI infection

21

What hormone plays the largest role in ketosis?

Glucagon

22

What two metabolic acids are formed in the blood during DKA?

Acetoacetate
Beta-hydroxybutyrate

23

What is the dominant ketone body in circulation?

Beta-hydroxybutyrate

24

Why is acetoacetate not dominate in blood circulation?

Because it is not stable

25

What occurs to acetoacetate?

Breaks down losing a CO2 and is breathed out

26

What are typical inciting events for DKA?

MI
Sepsis
Inadequate insulin

27

What are the values of K and Na in metabolic acidosis?

K: high
Na: low

28

Anion gap in metabolic acidosis?

High (Na+K)-(Cl+HCO3)

29

Which ketone is tested for in urine dipstick and why?

Acetoacetate since it reacts with the sodium nitroprusside