MKSAP Endocrinology and Metabolism Flashcards Preview

Internal Medicine > MKSAP Endocrinology and Metabolism > Flashcards

Flashcards in MKSAP Endocrinology and Metabolism Deck (11):
1

Diagnosis of type II DM

Must have 1 of these:
1. fasting blood glucose >126 mg/dL
2. random blood glucose >200 mg/dL with symptoms of hyperglycemia (polyuria, polydipsia, or blurred vision)
3. 2-hr oral glucose tolerance test of at least 200
4. HGB A1c of >6.5%

2

Impaired fasting glucose

Fasting plasma glucose level of 100 to 125

3

Impaired glucose tolerance

Plasma glucose at the 2 hr mark is 140-199

4

Metabolic syndrome

- BP >/= 130/85
- triglyceride level >/=150
- HDL cholesterol /=110
- waist circumference >40 in for men

5

Treatment for pre-diabetes

- Diet and exercise

6

Secondary diabetes

Hyperglycemia due to Cushing's syndrome, acromegaly, pancreatitis, pancreatic cancer, drugs, or genetic syndromes

7

Management of hyperglycemia in hospitalized pts

Basal and preprandial insulin
- Sliding scale regular insulin associated with increased hyperglycemia and hypoglycemia.

8

Management of diabetic retinopathy and macular edema

Treatment: pan-retinal photocoagulation

9

Types of diabetic retinopathy

1. Nonproliferative - hard exudates, microaneurysms, minor hemmorhages, no associated visual decline
2. Proliferative - cotton wool spots and neovascularization associated with visual loss ---->retinal ischemia -----> scarring and fibrosis ------> retinal detachment or leaking of vasculature -----> macular edema

10

Diagnosing and treating diabetic ketoacidosis

Tests to order: serum glucose (> 250), electrolytes (serum CO2

11

Treatment for hyperglycemic hyperosmolar syndrome

- Begin IV fluids w/ normal saline
- When normal BP and urine output is restored, start hypotonic solution.
- Replace half of TBWD during first 24 hrs and the next half over the next 2-3 days.
- Only give insulin later.

Diagnostic criteria:
1. plasma glucose >600
2. arterial pH >7.3
3. serum bicarbonate >15
4. serum osmolality >320
5. absent urine or serum ketones