5 - Diabetes

Question 1

What is a SE of sulfonylureas?

Answer 1

Hypos

Question 2

What is the contraindication for prioglitazone?

Answer 2

Heart failure

Question 3

Which needs to be tested before starting metformin?

Answer 3

Renal function

Question 4

What is the definition of diabetes mellitus?

Answer 4

Level of hyperglycaemia sufficient to cause diabetic microvascular complication.

Question 5

What level of fasting glucose indicates DM?

Answer 5

>11.1 mmmol/L

Question 6

What random blood glucose indicates DM?

Answer 6

> 13 mmol/L

Question 7

What value of HBA1C indicates DM?

Answer 7

48 mmol/mol

Question 8

Can steroids cause DM?

Answer 8

Yes, or at least contribute to increased blood glucose

Question 9

What risk factors are there for DM?

Answer 9

Male

Obeistiy - viseral

Black and south asian

Age

inactivity

Question 10

Causes of increased urination

Answer 10

diabetes mellitus

diabetes insipidus

Hypercalcaemia

Question 11

What regulates Ca serum levels?

Answer 11

Increased: parathyroid hormone and calcitriol

Decreased: calcitonin

Question 12

Causes for hypercalceamia?

Answer 12

maligangncy

primary hypercalcaemia

Question 13

Which medication for diabetes mellitus reduces peripheral insulin resistance?

Answer 13

Metformin

Pioglitazone

Question 14

Which medication for diabetes mellitus increases ß pancreatic cell activity?

Answer 14

Sulphonureas

Meglitinides

Question 15

Which medication for diabetes mellitus increase GLP-1

Answer 15

DDP4i

incretins

Question 16

Which medication for diabetes mellitus slow glucose absoption?

Answer 16

acarbose

Question 17

Which medication for diabetes mellitus enhances glocuse secretion from the kidneys?

Answer 17

SGL2 antagonists

Question 18

What are the SE of metformin?

Answer 18

GI symptoms and weight loss

Question 19

What are the SE for Pioglitazone?

Answer 19

osteoperosis

Question 20

What are the SE for sulphonureas?

Answer 20

weight gain

hypoglyceamia

Question 21

What are the SE for incretins and DPP4i?

Answer 21

wieght loss

Question 22

What are the SE for SGL2 antagonists?

Answer 22

wieght loss

increased risk of UTI

Question 23

Which medication for insulin have and increased risk of hypoglyceamia?

Answer 23

Pioglitazone

Sulphonureas

Insulin

Question 24

What is the first line therapy for DM?

Answer 24

life style change

Question 25

What is the 2nd line therapy for DM?

Answer 25

metformin

Question 26

What is the 3rd line therapy for DM?

Answer 26

Metformin + DDP4i Pioglitazone sulphonureas SGLT-2

Question 27

What is the 4th line therapy for DM?

Answer 27

Triple therapy including: Metformin DDP4i Pioglitazone sulphonureas SGLT-2

Question 28

At what threshold would you increase the dose of medication for DM?

Answer 28

increase if HBA1C \> 58 mmol/mol

Question 29

What is metabolic syndrome?

Answer 29

diabetes dyslipideamia hypertension This leads to an increased risk of obeisity and CVD

Question 30

Symptoms of diabetic ketoacidosis?

Answer 30

Hyperventilation Vomiting Dehydration Hypotention **with** warm peripheries Decreased consciousness

Question 31

What occurs in diabetic ketoacidosis?

Answer 31

Hyperglyceamia Hyperketonaemia Acidosis

Question 32

Diffentiation between HSS and DKA?

Answer 32

DKA has hypernetonaemia which isn't present in HSS

Question 33

What occurs during presentation of DKA?

Answer 33

hypernaturaemia hyperkalaemia hyperglycaemia metabolic acidosis

Question 34

How to treat HHS or DKA?

Answer 34

**IV fluids** K⁺ replacment insulin LMWH

Question 35

Where are GLUT 2 transporters?

Answer 35

ß pancreatic cells

Question 36

What is the target BP of diabetics?

Answer 36

\<140/80 mmHg

Question 37

What should the Total cholesterol/ HDL in diabetics?

Answer 37

\< 3

Question 38

What can acanthiosis nigracans indicate?

Answer 38

diabetes (not limited too)

Question 39

What are the symptoms of a severe hypoglyceamia?

Answer 39

Adreniergic symptoms - sweating symptoms, trembling, hunger Neuroglycopenia - confusion, blurred vision, paraesthesiae

Question 40

A patient has hypoglyceamia but is fully conscious. What treatment do you give?

Answer 40

30ml of Lucazade or glucose bollus

Question 41

A patient has hypoglyceamia and is fitting or unconsious. What treatment do you use?

Answer 41

IM,SC or IV glucagon Can use 50% glucose IV