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Week 10 Flashcards

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1
Q

Define Diabetes mellitus

A
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2
Q

How do we diagnose diabetes?

A
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3
Q

What are the classifications of DM?

A
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4
Q

Describe the pathophysiology of Type 1 DM

A

Autoimmune

Beta cell destruction
- Symptoms when 80% beta cell mass loss

85-90% will get Autoantibodies
- Islet cell
- Insulin
- GAD65
- tyrosine phosphatases

Strong HLA associations
- link to DQA and DQB genes
- influenced by DRB genes

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5
Q

What is Osmotic lens change in DM type 1?

A

Hyperglycemia causes glucose to move into the eye’s lense, causing it to puff up and not accomodate as well

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6
Q

What is important for individuals newly diagnosed DM to know about?

A
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7
Q

What is the main way that individuals with DM will give themselves insulin?

A

Basal Bolus regime

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8
Q

What are some genetic factors of Type 2 DM?

A

Defect of Beta cell
Insulin resistance

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9
Q

What are some environmental factors of Type 2 DM?

A

Obesity
Stress
Reduced physical activity

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10
Q

What is the clinical presentation of Type 2 DM?

A
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11
Q

Roughly describe the progression of Type 2 DM

A
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12
Q

What are some of the Acute and Chronic complications of DM?

A
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13
Q

What are some clinical symptoms of Hyperglycaemia & Acidosis?

A
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14
Q

What electrolyte imbalance causes most deaths in DKA?

A

Potassium
(Arrythmias))

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15
Q

In DKA, what are the treatments for:
- Hyperglycaemia
- Dehydration
- Potassium losses

A
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16
Q

What are the two sets of symptoms of Hypoglycaemia
AND
What are some examples of each?

A
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17
Q

What are the 3 most common causes of Hypoglycaemia?

A
  • Too much insulin
  • Too little food
  • Unusual exercise
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18
Q

What is the bodies natural response to Hypoglycaemia?

A
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19
Q

What is used to treat Hypoglycaemia?

A

IV 50% Dextrose

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20
Q

Name and roughly describe 2 other DM related conditions

A
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21
Q

What are the stages of Nephropathy?

A
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22
Q

Describe the management of Neuropathy

A
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23
Q

What is a vascular complication of DM?

A

Microangiopathy

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24
Q

What are the stages of Diabetic Retinopathy?

A
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25
What are some examples of **Diabetes drugs**?
26
Roughly define a **Stressor** and **Stress**
27
What are the 2 key components of the **stress system**?
28
What structures produce **Cortisol** and **Epinephrine** respectively?
Adrenal **Cortex** Adrenal **Medulla**
29
In the context of Cortisol, roughly **describe the HPA** (hypothalamic-pituitary axis)
30
What are some conditions related to **Increased activity of HPA**?
- Chronic stress - Panic disorder - DM - Hyperthyroidism - OCD
31
What are some conditions related to **decreased activity of HPA**?
- Atypical/seasonal depression - Postpartum period - PTSD - Hypothyroidism - Rheumatoid arthritis
32
What are the **immediate effects of the Stress Response**?
33
What **health problems** are related with Chronic Stress?
34
What is the relationship between **Cortisol and Depression**?
35
What are the **"goals" of cortisol**?
Provide adequate nutrients for ATP synthesis during stress
36
What effects does cortisol have on the bodys organs?
**Adipose tissue** - Increased lipolysis **Liver** - Increased Gluconeogenesis - Increased Glycogenolysis - Therefore increased Blood Glucose **Brain** - Increased glucose availability - Increased glucose metabolism **Extrahepatic tissue** - Increased fat oxidation - Decreased glucose metabolism - Decreased protein synthesis - Increased blood aa's
37
What should be done when suspecting **hypo/hyperfunction of an endocrine gland**?
**Hormone suppression test**
38
Describe the effects of a **Dexamethasone suppression test** on Cortisol
39
Describe the relationship between **Cortisol and Mood**
40
How does the **stress response effect the immune system**?
41
How does **Cortisol** impact the immune system?
42
Describe **Transrepression** as a model for glucocorticoids
Glucocorticoids have the ability to supress transcription factors that would otherwise produce Inflammatory proteins Leads to weakend inflammatory response, more prone to infection
43
What are some examples of **Synthetic Glucocorticoids**?
**Prednisolone** **Dexamethosone**
44
Describe the **immunosuppressive action of Glucocorticoids**
45
What are some **side-effects** of Glucocorticoids?
46
What is done in order to avoid the **withdrawal symptoms** of coming off of Glucocorticoids?
47
State the %'s of people with the different types of **diabetes mellitus**
48
How high can our insulin get before being **detected in urine**?
**>10 mM**
49
Name some **rapid-acting soluble insulins**
**LAG** - Insulin **Lispro** - Insulin **Aspart** - Insulin **Glulisine**
50
Name some **longer-acting insulins**
51
Describe the difference between **Fixed** and **Flexible** dose insulin regimens
52
53
What are the 3 types of **Insulin Therapy**?
- **1, 2, 3 injections/day** - **Basal-bolus** - **Insulin pump**
54
What are some **lifestyle modifications** to prevent prediabetes?
55
**Name and describe** the oral tablet used as first line anti-diabetic medication
56
Describe **Metformin's MOA**
57
Name and describe **Sulphonylureas** Insulin Secretagogues
58
Name and describe **Meglitinides** Insulin Secretagogues
59
Describe **Sulphonylureas MOA**
60
Describe **Incretins**
61
What are some **Incretin Mimetics**?
62
Name some **DPP-4 Inhibitors** (Gliptins)
63
Name some **Selective Sodium Glucose Cotransporter 2 inhibitors** (SGLT2)
64
Name and describe some **alpha-Glucosidase inhibitors**
65
Describe the body's **control of Blood Glucose**
66
Rougly describe the **onset / origins of T1DM**
67
Describe how we get **Diabetic Ketoacidosis**
68
Describe **T2DM**
69
Describe how a person progresses from **Prediabetes to T2DM**
70
What test is used to **measure diabetes and prediabetes**?
**Oral Glucose Tolerance Test**
71
72
Describe **glucose regulation during pregnancy**
73
Describe the **prevelance and risks of GDM** (gestational)
74
Describe **glucose monitoring** in the context of **T1DM**
75
What is an **HbA1c measurement** **AND** What may it indicate?
76
What **3 criteria** may be met to **diagnose Diabetes**
77
What are 3 of the **long term pathologies of Diabetes Mellitus**?
- Angina - Cardiac Arrhthymias - Renal Disease
78
Describe the **two tissues in the adrenal glands**
79
Name and describe the **4 layers of the Adrenal Gland**
80
What **arteries** supply the adrenal glands?
sup. mid. inf. **Adrenal art.**
81
What **steroid hormones** are produced within the adrenal gland?
82
What types of hormones bind to **intracelluclar receptors**?
83
Describe some chacracteristics of **Cortisol**
84
What is the **main effect of Cortisol**?
Promote **Gluconeogenesis**
85
What is the action of **Aldosterone on Mineralcorticoids**?
86
Describe the **MOA of suppression of Glucocoricoid activity in renal tubular cells**
87
What are some **long-term stress responses** due to Mineralcorticoids and Glucocorticoids?
88
What are some **short-term stress responses** due to Catecholamines?
89
Roughly describe the **characteristics of Catecholamines**
90
Outline **Catecholamine synthesis** within a chromaffin cell
91
What are the **fluid compartments percentages** in the body
92
Describe the **exchange of fluid across the capillary membrane**
**Arterial end** - Hydrostatic pressure > Osmotic pressure **Venous end** - Osmotic pressure > Hydrostatic pressure
93
What are the **rough compositions** of the fluid compartments in relation to Ions
94
Describe the difference between **sweat** and **Insensible water loss**
95
How do we **control water balance**?
96
How do we **control plasma Na+**?
97
Roughly describe the **physiological response to a drop in BP**
98
Roughly describe the **physiological response to a rise in BP**
99
Describe some of the ways we **gain & lose Na+**
100
Describe the **3 causes of HYPOnatraemia**
101
Describe **3 reasons for HYPERnatraemia**
102
How do we **control K+ levels**?
103
What are **3 causes of HYPERkalaemia**?
104
What are **3 causes of HYPOkalaemia**?
105
What are some **vital signs indicative of Hypovolaemia**?
106
What are some clinical signs of a **Fluid Overload**?
- Raised JVP - Peripheral Oedema - HT - Inspiratory crackles (base of lung)
107
What are some **tests that may be done to assess fluids**?
108
What are the 4 IV **Crystalloid fluids**?
109
What are the 3 IV **Colloid fluids**?
110
When should we be cautious when using IV fluids?

Neuro (14 decks)

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