Endocrine 01 - Diabetes pt 2

Question 1

Unexplained weight loss and easy fatigability
Islet autoantibodies
Ketoacidosis
Irritability, drowsiness, and loss of consciousness
Dehydration, electrolyte abnormalities, osmolality, and acid-base disturbances
Honeymoon remission
After ketoacidosis, may briefly revert to normoglycemia without requiring therapy

Answer 1

Type 1 Diabetes

Question 2

Often asymptomatic
Weight loss initially only but not at diagnosis
Hyperosmolar nonketotic coma, severe dehydration
Secondary to osmotic diuresis
HTN, dyslipidemia, and atherosclerosis associated
Frequent/recurrent infections, poor wound healing, blurring of vision, and numbness or tingling in the extremities

Answer 2

Type 2 Diabetes

Question 3

presents with fruity breath b/c of breakdown of ketones, causes polyuria b/c hyperglycemia goes out thru kidney along w/ water.

Answer 3

Diabetic Ketoacidosis

Question 4

4 levels/percentages to Diagnose DM

Answer 4

Glycated hemoglobin (Hb1C) ≥6.5%
Fasting plasma glucose (FPG) ≥126 mg/dL
Two-hour plasma glucose ≥200 mg/dL during an oral glucose test
In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis + a random plasma glucose ≥200 mg/dl

Question 5

Mammograms usually start at __, unless patient has an increased risk then they start earlier.

Answer 5

40 years old

Question 6

Defined by a fasting plasma glucose of 100-125mg/dL

This represents a group that is both at higher likelihood of developing type 2 diabetes

Answer 6

IFG (Impaired fasting glucose)

Question 7

Define IFG

Answer 7

Impaired fasting glucose
Defined by a fasting plasma glucose of 100-125mg/dL
This represents a group that is both at higher likelihood of developing type 2 diabetes

Question 8

2h after a glucose load of 75g it is 140-199mg/dL

Associated with increased risk of developing DM & IHD

Answer 8

IGT (Impaired Glucose Tolerance)

Question 9

Define IGT

Answer 9

Impaired glucose tolerance
2h after a glucose load of 75g it is 140-199mg/dL
Associated with increased risk of developing DM & IHD

Question 10

If a person is Diabetic, the goal is to get their BP UNDER:

Answer 10

under 130/80

Question 11

What causes GDM? (Gestational diabetes)

Answer 11

Insulin resistance related to the metabolic changes of late pregnancy increases insulin requirements and may lead to IGT (Impaired Glucose Tolerance). Usually normalizes post-partum

Question 12

3 fetal complications of GDM

Answer 12

Macrosomia (they are very large)
Prematurity
Respiratory distress syndrome (trouble breathing after birth)

Question 13

3 maternal complications of GDM

Answer 13

Hypertension
Spontaneous abortion
Cesarean delivery (b/c baby is too large)

Question 14

__ Refers to the clustering together of certain cardiovascular risk factors associated with insulin resistance and hyperinsulinemia

Answer 14

Metabolic syndrome

Question 15

Individuals with metabolic syndrome have an increased risk of __ and __

Answer 15

cardiovascular disease and stroke

Question 16

Having “Dyslipidemia” usually involves either of what? (2)

Answer 16

high triclycerides and/or low-HDL

Question 17

Identifies individuals at increased ___ risk

Answer 17

cardiovascular

Question 18

Top 2 treatment GOALS of DM:

Answer 18

Alleviate symptoms (polyuria, polyphagia, etc)
Minimize development of long-term complications

Question 19

Hypoglycemia symptoms (4)

Answer 19

hands shake, lethargic, sweating, altered mental status

Question 20

Since high blood pressure is a risk factor for Diabetes (among other things) what 2 meds control it? When use which?

Answer 20

ACE Inhibitors - may cause a chronic cough as a side effect. If so:
ARBs

Question 21

How often should Hb1C levels be measured?

Answer 21

Measure quarterly if unstable (every 3 months)

Question 22

Why is a foot exam important w/ Diabetes?

Answer 22

Glove and Stocking - nerve damage, and fungal infections can occur without patient realizing due to Diabetes.
Also check their pulses/reflexes.

Question 23

What level may also be measured for Type 1 Diabetes?

Answer 23

Lvl of TSH