Module 12 Exam 2 Flashcards Preview

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Flashcards in Module 12 Exam 2 Deck (82):
1

What is diabetes mellius

a group of metabolic diseases characterized by hyperglycemia

2

what does hyperglycemia result from

and insulin deficiency, resistance to insulin or both

3

What is chronic hyperglycemia associated with

long term damage, dysfunction, and failure of numerous organs, especially the eyes, kidneys, nerves heart, and blood vessels

4

what becomes more prevalent as the population ages and obesity increases

diabetes

5

What is insulin

a hormone produced by the beta cells in the pancreas

6

what does insulin effect

it directly or indirectly effects every organ in the body

7

what does insulin enable

glucose transport into cells to use as energy

8

what are the main functions of insulin

-facilitates glucose uptake from blood into tissues
-speeds oxidation of glucose within cells for energy
-speeds conversion of glucose to glycogen to store in the muscles to prevent it converting back to glucose
-conversion of glucose to fat in adipose tissue

9

what are normal blood glucose levels in healthy individuals

60-150 mg/dl

10

what happens with the increased glucose in the blood in type 1 diabetes

it spills over into the urine, causes excretion of large amts of urine, causes water and electrolyte loss, which signals thirst in the brain

11

What may cells in Type 1 diabetes starving for glucose cause the patient to do

increase food intake, but weight loss may still occur

12

Without glucose for energy in Type 1 was does the body do for energy

metabolizes fat for energy

13

what does the metabolism of fat end in

harmful ketones that accumulate in the blood

14

what are ketones

when in large quantity body cant handle and it causes metabolic acidosis

15

what can metabolic acidosis lead to

a diabetic coma

16

does the insulin production and secretion by the pancreas remain at normal levels in type 2 diabetes

yes

17

what happens in type 2 diabetes

-insulin receptors develop defects and glucose cant be transmitted to the cell

18

what level increases as the insulin resistance of the cells increase

blood glucose levels

19

What is hypoglycemia/insulin shock

-too much insulin which lowers level of blood glucose

20

what is the more common emergency likely to occur in the dental setting, hyper or hypo

hypoglycemia

21

what is hyperglycemic reaction/ diabetic coma (ketoacidosis)

too little insulin, increased levels of blood glucose

22

What is type 1 diabetes

-absolute insulin deficency resulting from the destruction of the insulin-producing beta cells in the pancreas

23

When does type 1 diabetes usually arise

childhood or puberty

24

what are former names of type 1 diabetes

-insulin dependent diabetes mellitus, juvenile diabetes, juvenile onset, ketosis-prone diabetes, brittle diabetes

25

what is type 2 diabetes

pancreatic insulin secretion may be low, normal, or even higher than normal but the patient exhibits an insulin resistance that impairs the use of insulin

26

what is gestational diabetes mellitus

any degree of glucose intolerance with onset or first recognition during pregnancy

27

what is gestational diabetes related to

genetics, obesity, hormones

28

when is gestational diabetes diagnosis reclassified

6 weeks after pregnancy ends

29

what has lessened the danger of gestational diabetes for the mother

insulin adjustment, carefully supervised prenatal care, improved obstetrics

30

What are characteristics of the pregnancy and baby in a mother with gestational diabetes

-larger infant
-premature births more freq
-congential malformations, perinatal death
-tendency to develop type 2 diabetes later in life

31

What do other types of diabetes result from

-genetic defects, diseases, endocrinopathies, surgery, drugs, malnutrition, infections, injury

32

what are some genetic defects that cause diabetes

- genetic defects of the beta cell, or insulin action

33

what are some diseases of the exocrine pancreas that cause diabetes

-diseases that injure or destroy beta cells
-pancreatitis, trauma, pancreatectomy, carcinoma, cystic fibrosis

34

what are endocinopathies that cause diabetes

-HGH, cortisol, glucagons, epi antagonize insulin action
-acromegaly, cushing syndrome, hyperthyroidism

35

what do drugs or chemicals do to induce diabetes

-chemicals impair insulin secretion, insulin action, destroy betal cells
-glucocorticoids, thyroid hormone, dilantin, thiazides

36

what do infections do to cause diabetes-

-viruses can destroy beta cells
-congenital rubella, cytomegalovirus, mumps

37

what are some syndromes associated with diabetes

-down sydrome
-huntingtons disease
-prader willi syndrome

38

what are symptoms of hyperglycemia

polyuria
polydypsia
weight loss
polyphagia
blurred vision
increased susceptibility to infections
impaired growth

39

to diagnose diabetes what should the a1c number be over

6.5%

40

to diagnose diabetes what is the fasting glucose over

126 mg/dl

41

to diagnose diabetes what is the 2 hour plasma glucose greater than

200 mg/dl

42

What are the complications of diabetes relating to infections

-patients are more susceptible to infections
-failure to treat intensifies symptoms of diabetes
-

43

what may cause insulin requirements to increase

fever, infection, inflammation, trauma, bleeding, pain, or stress

44

What is peripherial neuropathy

-pain, numbness, or tingling of mouth, face and extremities
-leads to increased incidence of amputations because of delayed ID of problems

45

what is autonomic neuropathy

-can cause GI symptoms
-food is delayed in stomach, leading to a delay in adsorbtion, and complications managing blood glucose

46

what is nephropathy

-diabetes is the leading cause of renal disease, and most common of end stage renal disease
-dialysis or kidney transplant may be needed

47

what is retinopathy

-diabetes is leading cause of blindness
-patients are more likely to have glaucoma and cataracts

48

what are the complications of diabetes and cardiovascular disease

-heart disease
-peripherial vascular disease
-cerebrovascular disease
-hypertension
may lead to myocardial infarction and stroke

49

what is a major cause of limb amputation

diabetes

50

pregnant patients who have diabetes are at a higher risk for

spontaneous abortion, miscarriages, babies with birth defects, increased weight

51

What are the psychosocial problems of diabetes

-tx regimens challenging to cope with, lead to emotional and social problems, including depression

52

Diabetes is known as

the silent killer

53

what does diabetes reduce

average life span, diabetes and its complications are leading causes of death

54

what are the general procedures for someone who has diabetes

-early diagnosis
-education for self care
-maintain best overall health
-maintain tight glycemic control
-immediate tx for acute symptoms

55

What is an essential part of the tx program which lowers insulin requirements, cardiovascular risk factors

exercise

56

what can many cases of type 2 diabetes be controlled with

weight reduction and exercise alon

57

what are goals of medical nutritional therapy

prevent and manage diabetes and slow the development of complications

58

what are the fundamentals of the diet for a diabetic

-high fiber, low fat, low cholesterol, low sodium

59

What should we know about tobacco use and diabetes

-pt must avoid all types of tobacco
-increases risk of heart disease, stroke, MI, limb amputations, perio disease, numerous health problems

60

Why should diabetic pts avoid excess alcohol?

-can raise blood pressure and contribute to other health problems

61

Do type 1 and type 2 require exogenous insulin?

yes- type 1 for survival and type 2 for control

62

What are the different types of insulin

-rapid, short, intermediate, or long acting based on the onset, peak and duration of action

63

what does the dosage of insulin depend on

-the individual

64

what factors affect the need for insulin

-food intake, illness, stress, variations in exercise, infections

65

what are the methods for insulin administration

-insulin pen
-sub Q injection with syringe
-continuous sub Q insulin infusion with a battery operated insulin pump
-inhalable insulin

66

what are oral hypoglycemic medications used to treat

type 2 in conjunction with diet, exercise, and possibly injection of insulin

67

what has pancrease transplantation eliminated the need for

exogenous insulin in type 1 patients

68

What findings in the gingva occur with diabetes

increased gingival inflammation

69

what findings with the periodontium occur in diabetes

-periodontitis
-attachment loss
-deep pockets
-alveolar bone loss
-tooth mobility and migration
-healing delayed

70

what findings with teeth occur in diabetes

-increased risk of caries related to decreased saliva, diet in poorly controlle diabetes
-in well controlled: caries related to low sugar, regular habits, maintenance

71

what findings with the lips occur in diabetes

-dry, cracking, angular chelitis

72

what findings with the saliva occur in diabetes

-decreased flow
-glucose in sulcular fluid
-xerostomia

73

what findings with the mucosa occur in diabetes

-edematous, red
-candidiasis
-burning mouth or tongue
-delayed healing
-increase lichen planus,

74

what findings with taste occur in diabetes

-hypogeusia, diminished taste perception

75

Perio infections may also affect control of blood glucose by increasing what

insulin resistance in a manner similar to obesity

76

patients with uncontrolled glucose levels have more severe what

perio disease at younger ages

77

diabetes does not cause oral disease but may lower what and increase what

resistance and susceptibility to oral findings

78

what can affect blood sugar levels during a dental appointment

stress

79

When is antibiotic premedication indicated

routine dental tx is deferred until diabetes is stabilized, consult for premed

80

What time should you treat a patient

-treat on a full stomach
-avoid peak insulin level
-ideal time varies with each patient

81

what precautions should be taken in a patient with diabetes

-dont keep waiting
-dont interfere with regular meal
-avoid long stressful procedures
-prevent and treat all infections
-prep. for diabetic emergencies

82

what is diabetes insipidus

a rare disease characterized by polyuria, polysdipsia indued by antidiuretic hormone defect