Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med3: Endocrine > Diabetes part 1 - waldron > Flashcards

Diabetes part 1 - waldron Flashcards

(72 cards)

Start Studying
1
Q

what does anaerobic breakdown by glycolysis yield

A

8-10 ATP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does aerobic respiration by Krebs cycle yield

A

25 ATP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the main subtypes of Diabetes

A

Type 1 (T1DM) and Type 2 (T2DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what populations do we typically see T1DM in

A

children or adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what population do we typically see T2DM in

A

affects more middle-age and older adults with prolonged hyperglycemia due to poor lifestyle and diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what secretes insulin

A

pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

where are the islets of langerhans

A

in the pancrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the two subclasses of endocrine cells

A

alpha cells: glucagon secreting
beta cells: insulin producing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the etiology of T1DM

A

characterized by destruction of pancreatic beta cells, usu caused by autoimmune process
result: absolute destruction of beta cells and absent/extremely low insulin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the etiology of T2DM

A

insidious onset of imbalance btwn insulin levels and insulin sensitivity, causing functional deficit of insulin
insulin resistance is multifactorial but commonly develops from obesity and aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what type of DM have more complex interplay between genetics and lifestyle

A

T2DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does polymorphisms influence the risk for

A

T1DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is MODY

A

mature onset diabetes of young
non-insulin dependent diabetes diagnosed at young age (usu. < 25)
autosomal dominant transmission, does not involve autoantibodies as in T1DM
genetics unclear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is diabetes during pregnancy

A

gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are endocrinopatheis

A

acromegaly, cushings syndrome, glauconoma, hyperthyroidism, hyperaldosteronism, somatostatinomas: all associated with glucose intolerance and DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what ethnic groups have the most prevalence of diabetes

A

native american
non-hispanic black
hispanic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the epidemiology of T1DM

A

peaks 4-6yo and 10-14 yo
F > M with aging (not as much in children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the epidemiology of T2DM

A

onset usually later in life (adolescent obesity causing increase in younger people)
2-6x more prevalent in african american, native american, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what can hyperglycemia alone impair

A

pancreatic beta-cell function and contributes to impaired insulin secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what serum glucose levels are likely to cause symptoms of polyuria and polydipsia

A

> 250 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is insulin resistance

A

excess fatty acids and pro-inflammatory cytokines lead to impaired glucose transport and increased fat breakdown
inadequate production of insulin to compensate for their insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what does chronic hyperglycemia cause

A

non-enzymatic glycation of proteins and lipids measurable via glycated hemoglobin (HbA1c)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what does glycation lead to

A

microvascular damage in retina, kidney and peripheral nerves; higher glucose levels hasten process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does the damage from glycation lead to

A

classic diabetic complications: diabetic retinopathy, nephropathy and neuropathy (preventable blindness, dialysis and amputation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what are the typical presentation of diabetes
polyuria, polydipsia and weight loss (catabolism)
26
what is seen on PE with hyperglycemia
fatigue, poor skin turgor, distinctive fruity odor on their breath (ketosis): if DKA Kussmaul respirations, N/V
27
what will be seen on fundoscopic exam with DM
macular hemorrhages or exudates; neovascularization
28
What is the presentation of T2DM
overweight/obese with signs of insulin resistance acanthosis nigricans, blurry vision, frequent yeast/fungal infections, numbness/neuropathic pain
29
what is the presentation of hyperglycemia
dry mouth increase thirst blurred vision weakness AH frequent urination
30
how do you diagnose DM
fasting plasma glucose (FPG) levels HbA1c (glycosylated Hb) OGTT (oral glucose tolerance testing) Urine "spilling"
31
what is a HbA1c for T2DM
>6.5%
32
what is the diagnostic criteria per the ADA
one of the following: fasting plasma glucose (FPG) > 126mg/dL random glucose > 200 mg/dL with symptoms of hyperglycemia 2-hr plasma glucose > 200 mg/mL during 75g OGTT
33
with is the OGTT
oral glucose tolerance testing 2 hour after ingesting of concentrated glucose solution more sensitive for diagnosing DM and impaired gluocse tolerance but less convenient and reporducible than FPG rare as routine testing except for gestational diabetes and research *best test
34
what is the BG to make the A1c of 7
155BG
35
what is the diagnostic criteria for pre-diabetes
one of the following: FBG >100-125 mg/dL 2-hr OGTT plasma glucose of 140-199 mg/dL HbA1c 5.7-6.4%
36
what tests are useful in the management of chronic (already diagnosed) DM
home glucose testing HbA1c urine albumin serum lipid monitoring
37
what other test is strongly recommended for chronic DM management
monitor thyroid status annually via TSH (higher associated incidence of hypothyroidism)
38
what is a normal PPG level
<139
39
what is a normal HbA1c
< 5.6%
40
what level is a a random plasma glucose considered diabetes
>200
41
what is a normal FPG
<99
42
what is always the first step in DM treatment
diet (carbs and caloric restriction) and exercise ( more than 150min weekly)
43
What is SDOH
social determinants of health access to healthy food, housing, social support, ability to afford meds, etc. need to be considered barriers to care need to be addressed/remove if any treatment is to be effective
44
what are key patient characteristics that need to be assessed with glycemic management
current lifestyle comorbidities clinical characteristics (age, HbA1c, weight, etc) issues such as motivation and depression cultural and socio-economic context
45
what are treatment complication of DM
hypoglycemia too much insulin or medicine / too much exercise / NOT eating an anticipated scheduled meal
46
what is the BG for hypoglycemia
< 50 mg/dL
47
what are the signs/symptoms of hypoglycemia
sleepiness, sweating, pallor, lack or coordination, irritability, hunger
48
what is the treatment for hypoglycemia
glucose tabs, icing, candy vs IM injection/IV if unable to protect airway
49
what are the microvascular disease complications of DM
retinopathy nephropathy neuropathy also - impaired skin healing
50
what is the treatment for diabetic retinopathy
intensive glycemic and blood pressure control advanced: retinal laser photocoagulation, vitrectomy, vascular endothelial growth factor (VEGF) inhibitors etc.
51
what is the leading cause of chronic kidney disease in the US
diabetic nephropathy
52
what is diabetic nephropathy
thickening of glomerular basement membrane, mesangial expansion and glomerular sclerosis; causes glomerular hypertension and progressive decline in GFR systemic HTN may accelerate progression
53
how do you diagnose diabetic nephropathy
urinary albumin
54
when is a urine dipstick positive
only if protein excretion > 300-500mg/day
55
what is the treatment of diabetic nephropathy
intensive glycemic and blood pressure control ACE or ARB: renal protecting, treat HTN and prevent progression of renal disease consider nephrology consult/co-management
56
how often is urinary albumin level monitored
minimally annually
57
what is diabetic neuropathy
result of nerve ischemia: direct effect of hyperglycemia, intracellular metabolic changes that impair nerve function
58
what are the different types of diabetic neuropathy
symmetric polyneuropathy (small and large-fiber variants) autonomic neuropathy radiculopathy cranial neuropathy mononeuropathy
59
what is systemic polyneuropathy
most common - affects distal feet and hands (stocking-glove distribution) paresthesia, dysesthesia, painless loss of touch, vibration, proprioception or temp
60
what is the presentation of small-fiber symmetric polyneuropathy
pain, numbness, loss of temperature sensation with preserved vibration and position sense
61
what is the presentation of large-fiber symmetric polyneuropathy
muscle weakness, loss of vibration and position sense, lack of DTRs; atrophy of intrinsic muscles of feet (foot drop common)
62
what are signs of autonomic neuropathy
orthostatic hypotension exercise intolerance resting tachy dysphagia N/V due to gastroparesis constipation and diarrhea etc
63
what are radiculopathies
most common proximal L2-L4 nerve roots; pain, weakness, atrophy of LEs (diabetic amyotrophy) proximal T4-T12 nerve roots, causes abdominal pain (thoracic polyradiculopathy)
64
what are cranial neuropatheis
dipolpia, ptosis, an isocoria
65
what are mononeuropathies
finger weakness/numbness (median nerve) or foot drop (peroneal nerve) - prone to nerve compressive d/o - CTS can occur at several places simultaneously
66
how are DM complications managed
glycemic control regular foot care management for pain
67
what are macrovascular disease associated with DM
atherosclerosis of large vessels; hyperinsulinemia, dyslipidemias, hyperglycemia angina pectoris/MI TIA/stroke peripheral arterial disease
68
what is the treatment of macrovascular disease
intensive control of atherosclerotic risk factors; multifactorial normalization of PG, lipids, GP smoking cessation ACEi (arb) - renal and cardiovascular management
69
what are diabetic cardiomyopathies
atherosclerosis, HTN esp with LVH, microvascular disease, endothelial and autonomic dysfunction, obesity, metabolic disturbances
70
what are infective complications of DM
prone to bacterial and fungal infections; AE of hyperglycemia on granulocyte and T-cell function increased susceptibility to fungal infection bacterial foot infections (increased osteomyelitis); exacerbated by LE vascular insufficiency, neuropathy
71
What is NAFLD
non-alcoholic fatty liver disease increasingly common in T2DM mainstay of treatment is diet, exercise and weight loss
72
what are routine screenings for DM
foot exam (minimally annually) retinal exam (annually - min every 2 years) HbA1c: based on control and disease severity spot or 24-hr urine (annually with serum creatinine) cardiac (min annual EKG and lipids, BP every visit)

Clin Med3: Endocrine (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions