16. Clinical Approach to DM and Hypoglycemia Flashcards

1
Q

What presentations are similar with diabetes and syphilis

A

Thirst and frequency of urination

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2
Q

What is the most common cause of hyperthyroidism in the elderly **

A

Toxic nodular goiter

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3
Q

What is the more aggressive form of thyroid papillary ca?

A

Tall cell papillary ca

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4
Q

What does MODY stand for? and LADA?

A
MODY = maturity onset Diabetes of Youth
LADA = Latent Autoimmune Adult Diabetes - patients who have antibodies and low C peptides (usually in adults)
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5
Q

Diagnosis of diabetes (lab values - 4)

A

Random plasma glucose >200mg/dL on 2 separate occasions + symptoms
FPG > 126mg/dL on 2 separate occasions
2hr plasma glucose > 200mg/dL
Hb A1C >6.5% ***

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6
Q

How long does the HbA1C give an avg gluocse for?

A

3 months

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7
Q

Natural hx of T2DM (course of disease)

A

Insulin resistance present in obese or people with impaired fasting glucose levels
Insulin levels increase to overcome resistance
B-cell function declines, can’t produce enough insulin to overcome the resistance –> blood glucose levels rise

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8
Q

What is the antibody seen in T1DM?

A

IA-2 antibody (islet antigen 2)

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9
Q

What reduces Hb A1C the most?

A

insulin

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10
Q

What is the first line of therapy in individuals with T2DM?

A

Lifestyle modifications

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11
Q

Long lasting insulin that is given is called what?

A

Glargine (Think: Garg’s mom takes this)

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12
Q

What is the no. 1 cause of blindness in US?

A

Diabetic retinopathy

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13
Q

Diabetic nephropathy has what clinical effects?

A

hypertension, proteinuria, nephrotic syndromes, and renal failure
No. 1 cause of end stage renal failure

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14
Q

What are the clinical effects of diabetic neuropathy?

A

Pain, paresthesia (pins and needles), hyperesthesia (excessive sensation), and weakness

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15
Q

Classifications for diabetic neuropathies

A
  1. acute
  2. predominately motor
  3. assymetrical neuropathy - symptoms in one hip due to encroachment of lateral femoral cutaneous n.
  4. cranial neuropathy - can cause double vision
  5. Chest pain from intercostal neuropathy
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16
Q

Autonomic diabetic neuropathy is acute or insidiuous

A

insidious

17
Q

Effects of exercise (3)

A
  1. reduce hyperglycemia
  2. enhance insulin sensitivity
  3. increase caloric expenditure, promote weight loss, reduce hyperglycemia
18
Q

What percent of body weight does a ptient need to lose to see a change in metabolism?

A

5% of body weight

19
Q

DKA requres 3 thing:

A

hyperglycemia
ketosis
acidosis

20
Q

How to tx DKA

A

fluids and insulin

21
Q

Hyperosmolar nonketotic coma (HHNKC) and tx

A

Small amount of ketones
Hyperosmolar due to very high glucose (>800)
VERY DEHYRDATED

Tx with fluids

22
Q

Difference in tx for DKA and Hyperosmolar nonketotic coma

A

DKA: insulin and fluids

Hyperosmolar nonketotic coma: fluids

23
Q

Why are ACE inhibitors used in patients with DM?

A

prevent or delay microalbuminuria