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2.3 > Medical act 2.3 > Flashcards

Medical act 2.3 Flashcards

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1
Q

explain which oral meds to use for T2DM

A

metformin - reduces insulin resistance
repaglinide - increases insulin sensitivity

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2
Q

whats is insulin deficiency

A

decreased hormone secretion and insulin resistance

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3
Q

define Diabetes mellitus

A

deficiency of insulin secretion by beta cells in islets of langerhans or deficiency due to lack of response of cells to insulin

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4
Q

explain use of metformin

A

only in t2dm patients
used to lower blood glucose
reduces production of glucose
increases insulin severity in muscles 0 which helps absorb glucose better and lowers blood circulating glucose
disappearance of DM symptoms eg dry mouth, polyuria, thirst

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5
Q

explain use of gliclazide

A

used for t2dm
- increases insulin release in pancreas - means more glucose uptake from blood - decrease in blood glucose

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6
Q

which form of insulin replacement is the rapid onset acting insulin? how long does it last?

A

injection in the abdomen, starts within 20mins, lasts for 2-8hrs

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7
Q

where is the slow onset long acting insulin injected?

A

leg (lasts 24hrs)

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8
Q

describe meds for T1DM

A

insulin replacement (injections or pump device)
insulin fluid injected into the blood circulation

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9
Q

when should insulin dose should be adapted, under which circumstances?

A
  • infection + high fever
  • throwing up
  • operation
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10
Q

explain hypoglycemia

A

too much insulin, too low blood glucose in blood (common in T1DM, due to heavy exertion, error in dosage, skipping a meal after taking insulin, throwing up)

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11
Q

when hypoglycemia is going for too long, what are the consequences?

A

neurological functioning affected (since NS uses fats and proteins for synthesis)

leads to poor conc, dizzy gait, slurred speech, lack of coordination

  • INCREASES SYMPATHETIC NS STIMULATION so
  • increased heart rate
  • pale moist skin
  • fear tremor
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12
Q

treatment for hypoglycemia

A

immediate quick carb intake eg sweet juice

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13
Q

what is diabetic ketoacidosis

A

insufficient insulin, too high blood glucose

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14
Q

Signs symptoms of diabetic ketoacidosis

A
  • dehydration
  • deep rapid breathing
  • acetone breath
  • metabolic acidosis - loss of consciousness
  • electrolyte imbalance (abdominal cramps, nausea, vomiting, weakness)
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15
Q

treatment for diabetic ketoacidosis

A

supplement insulin, electrolytes, fluids

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16
Q

name which complications can happen in T1DM

A

hypoglycemia
diabetic ketoacidosis

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17
Q

name which complications can happen in T2DM

A

Hyperosmolar hyperglycemic nonketonic coma

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18
Q

name symptoms of hyperosmolar hyperglycemic nonketonic coma

A
  • hyperglycemia
  • dehydration
  • neurological deficits
  • muscle weakness
  • difficult speech
  • anormal reflex
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19
Q

which complications is hard to diagnose

A

hyperosmolar hyperglycemic no ketonic coma

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20
Q

explain microangiopathy

A

disease of small vessels
obstruction or tearing of capillaries or arteries

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21
Q

explain macroangiopathy

A

affects large blood vessels
can lead to atherosclerosis - myocardial or heart attack
wounds
amputation

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22
Q

whats ischemia

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A

blood flow so oxygen restricted in a part of the body

23
Q

neuropathy symptoms

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A

numbness; tingling; weakness; incontinence, diarrhea

24
Q

explain medical treatment step 1 - step 4

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A

Step 1: metformin.

Step 2: metformin + sulfonylureumderivaat eg gliclazide

Step 3: add long acting insulin (intermediate, NPH insulin)

Step 4: intensify insulin treatment

25
normal blood glucose values?
Target blood glucose values: fasting 4.5-8mmol/l; 2hrs postmeal: <9mmol/l
26
non drug advice for T2DM
sufficient exercise, no smoking, lose weight, BMI <25, healthy diet
27
where do you find baroreceptors (lecture on heart) and function of it?
in aorta wall and internal carotid artery; detects changes in blood pressure
28
what happens when sympathetic NS is more active?
tachycardia, increase HR and contractility
29
what happens when parasympathetic NS is more active?
bradycardia: decrease in heart rate
30
stroke volume?
- volume of blood pumped from one ventricle in one contraction - average: 70mL per contraction
31
influencing factors of stroke volume?
- stimulation sympathetic NS - blood volume - venous return - peripheral resistance
32
systemic vasoconstriction is a response to what?
sympathetic stimulation - high
33
systemic vasoconstriction is a response to what?
decrease in sympathetic stimulation (low)
34
whats average stroke volume
70mL per contraction
35
whats cardiac output and norm values?
amount of blood pumped through each ventricle each minute 5000L per min
36
whats is blood pressure? systolic and diastolic?
- pressure of blood against arterial walls - Systolic pressure: pressure of blood at the time of ejection from left ventricle - Diastolic pressure: pressure of blood when the ventricles are relaxed - Normal : 120 / 80 mmHg at rest
37
describe which hormones are stimulated that lead to vasoconstriction
adrenaline + noradrenaline (SNS activated) antidiuretic angiotensin
38
what happens to CO and PR with high Blood Pressure ?
high PR, no change in CO
39
ar asthma and COPD restrictive or obstructive?
obstructive
40
Function of ACTH? Adrenocorticotropic hormone.
Stimulates adrenal cortex to secrete cortisol.
41
Function fo ADH, vasopressin?
increase reabsorption of water by kidneys
42
Function of insulin?
lowers blood glucose levels, transports glucose into cells
43
whats an endocrine disorder?
Either deficiency or too much hormones
44
pathophysiology of depression?
disorganized emotions; decrease activity of excitatory neurotransmitters in brain (NE, serotonin)
45
symptoms of depression
- prolonoged period of sadness - lack of empathy - cant find pleasure in doing anything - loss of selfesteem - lack of energy - decreased appetite - low libido - thoughts about suicide, death - conc. problems - sleep disorders - insomnia, hypersomnia - hopelessness
46
3 stages of stress
GAS: general adaptation syndrome alarm stage: ++ of SNS, adrenal glands, hypothalamus resistance stage exhaustion stage
47
is lung cancer restrictive or obstructive pulmonary disease?
restrictive
48
rule out heart failure using these 4 subdomains
1. CCQ complaints and limitations + dyspnea MRC 2. FEV1 airway obstruction 3. Frequency of exacerbations - lung attacks 4. nutritional status - weight, BMI
49
explain vital lung capcity
IRC + ERC = so max amount of air you can exhale after maximal inhalation
50
whats is FVC
forced vital capacity = total amount of air exhaled during FEV test (spirometry test)
51
normal ratio between FEV1/ FVC?
70%. 0.75-0.8
52
difference between FEV1 and FVC
The FEV1 measures how much air you can exhale in one second. The FVC measures the total amount of air you can exhale forcefully in one breath.
53
what happens to RV with obstructive disorders?
much higher RV bc more air left in lungs after max exhalation
54
explain respiratory acidosis
lower respiratory rate means less CO2 is eliminated which means higher conc of H+ leading to acidosis

2.3 (5 decks)

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