Flashcards in Review Part 1 Deck (118)
What is needed for a diagnosis of DKA?
ketonemia and metabolic acidosis
What is the management for DKA?
-fluid replacement (normal saline) add 5% glucose once BG reaches 250 mg/dL
-replace potassium prophylactically with IV fluids
What is HHNS (hyperosmolar hyperglycemic nonketotic syndrome)?
a state of severe hyperglycemia, hyperosmolarity, and dehydration
Who is HHNS typically seen in?
elderly with type II diabetics
What are common findings with HHNS?
CNS and focal neurologic signs
What is the management for HHNS?
-fluid replacement is most important
-low-dose insulin infusion
What are the autonomic complications of diabetes?
-impotence in men
-gastroparesis - chronic nausea and vomiting, early satiety
What is the most common cause of end-stage renal disease?
What is pathognomonic for DM?
nodular glomerular sclerosis - hyaline deposition in one area of glomerulus
What increases the risk of progression of diabetic nephropathy to ESRD?
What is the treatment used to decrease the rate of progression of nephropathy
ACE inhibitor or ARB
What is the leading cause of blindness in the US?
What does fundoscopic examination show of diabetic retinopathy?
hemorrhages, exudates, micro aneurysms, and venous dilation
What is the leading cause of visual loss in diabetic patients?
edema of the macula
-AKA: distal symmetric neuropathy
-begins in feet, later involves the hands
What symptoms are common in peripheral neuropathy?
numbness and paresthesia
Painful diabetic neuropathy
-hypersensitivity to light touch
-severe "burning" pain (especially at night)
Treatment for diabetic neuropathy
pregablin, gabapentin, duloxetine, TCAs
What Cranial Nerve is most often effected by diabetes?
CN III (oculomotor)
-diabetic third nerve palsy
What macrovascular complications is the most common cause of death in diabetic patients?
coronary artery disease
What is the treatment of diabetic polyneuropathy?
-pharmacologic agents: NSAIDs, pregablin, gabapentin, duloxetine, TCAs
-gastroparesis: promotility agent, such as metoclopramide, exercise, and low-fat diet
What are the renal complications of diabetes?
What is the prophylactic management of renal compilations of diabetes?
Control BP aggressively
-prescribe an ACE inhibitor or ARB if urine test is positive for microalbuminuria
What are the manifestations of diabetes?
-polyuria (peeing a lot)
-polydipsia (constantly thirsty)
-polyphagia (constantly feeling the need to eat)
-numbness, tingling of hands and feet
What is normal Hemoglobin A1c value?
What is impaired fasting glucose Hemoglobin A1c value?
5.7% - 6.4%
What is diabetes Hemoglobin A1c value?
What is the somogyi effect?
glucose is low at 3 am glucose check
What is the treatment for somogyi effect?
evening insulin should be decreased