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Flashcards in Review Part 1 Deck (118)
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1

What is needed for a diagnosis of DKA?

ketonemia and metabolic acidosis

2

What is the management for DKA?

-insulin
-fluid replacement (normal saline) add 5% glucose once BG reaches 250 mg/dL
-replace potassium prophylactically with IV fluids

3

What is HHNS (hyperosmolar hyperglycemic nonketotic syndrome)?

a state of severe hyperglycemia, hyperosmolarity, and dehydration

4

Who is HHNS typically seen in?

elderly with type II diabetics

5

What are common findings with HHNS?

CNS and focal neurologic signs

6

What is the management for HHNS?

-fluid replacement is most important
-low-dose insulin infusion

7

What are the autonomic complications of diabetes?

-impotence in men
-gastroparesis - chronic nausea and vomiting, early satiety

8

What is the most common cause of end-stage renal disease?

diabetic nephropathy

9

What is pathognomonic for DM?

nodular glomerular sclerosis - hyaline deposition in one area of glomerulus

10

What increases the risk of progression of diabetic nephropathy to ESRD?

hypertension

11

What is the treatment used to decrease the rate of progression of nephropathy

ACE inhibitor or ARB

12

What is the leading cause of blindness in the US?

diabetic retinopathy

13

What does fundoscopic examination show of diabetic retinopathy?

hemorrhages, exudates, micro aneurysms, and venous dilation

14

What is the leading cause of visual loss in diabetic patients?

edema of the macula

15

Peripheral Neuropathy

-AKA: distal symmetric neuropathy
-"stocking/glove pattern"
-begins in feet, later involves the hands

16

What symptoms are common in peripheral neuropathy?

numbness and paresthesia

17

Painful diabetic neuropathy

-hypersensitivity to light touch
-severe "burning" pain (especially at night)

18

Treatment for diabetic neuropathy

pregablin, gabapentin, duloxetine, TCAs

19

What Cranial Nerve is most often effected by diabetes?

CN III (oculomotor)
-diabetic third nerve palsy

20

What macrovascular complications is the most common cause of death in diabetic patients?

coronary artery disease

21

What is the treatment of diabetic polyneuropathy?

-complex management
-pharmacologic agents: NSAIDs, pregablin, gabapentin, duloxetine, TCAs
-gastroparesis: promotility agent, such as metoclopramide, exercise, and low-fat diet

22

What are the renal complications of diabetes?

diabetic nephropathy

23

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

24

What are the manifestations of diabetes?

-polyuria (peeing a lot)
-polydipsia (constantly thirsty)
-polyphagia (constantly feeling the need to eat)
-fatigue
-weight loss
-blurred vision
-fungal infections
-numbness, tingling of hands and feet

25

What is normal Hemoglobin A1c value?

<5.6%

26

What is impaired fasting glucose Hemoglobin A1c value?

5.7% - 6.4%

27

What is diabetes Hemoglobin A1c value?

>6.5%

28

What is the somogyi effect?

glucose is low at 3 am glucose check

29

What is the treatment for somogyi effect?

evening insulin should be decreased

30

What is dawn phenomenon?

glucose is elevated at 3 am glucose check