Adult Endocrinology Flashcards
what are clinical presenting sx of DM
Polyuria Polydypsia Nocturia Blurred Vision Weight Loss Infections/Slow healing
What is the diagnostic fasting glucose for a diabetic
> 126
What is the two hour plasma glucose levels following a 75g OGTT
> 200mg
What could be a cause of mental status changes in someone with DM
High or low blood sugar
Which hyperglycemic events are more likely in type 1 DM? Type 2?
Type 1 DKA
Type 2 is HHS
What main things lead to DKA
Inadequate Insulin administration Infection Infarction Surgery certain drugs (cocaine)
what are initial symptoms of DKA
Anorexia Nausea Vomiting Polyuria Thirst
what symptoms indicated progression of DKA
Abdominal pain
Altered mental status
Coma
What type of acidosis would DKA illicit
High Anion gap
also metabolic but I didnt know how to ask High anion without giving it away. if you knew that rate 5 and be on your way
what would you monitor in the ICU for DKA
Acid-base status
Renal Function
Potassium and other electrolytes
what is the general 1-2-3 rule of fluid replacement
2-3 L NS over 1-3 hrs
1/2 saline at 150mL/hr
When glucose gets to 250 mg switch to D5 1/2 NS
What is the initial insulin regiment for DKA correction
10-20 units IV
then 5-10 units/hr continuous IV
increase if no response
What is important to evaluate about your patient with DKA
underlying cause! or else they will relapse
What electrolyte needs to be replaced in DKA
Potassium
keep an eye on cardiac function throughout
What are absent in NKHS (HHS) to differentiate it from DKA
absent N/V. abdominal pain, and kussmaul respirations
What is the major cause of mortality in T2DM
Cardiovascular disease
What does an HbA1C tell you clinically (not what it is)
the 3-4 month average level of blood sugar.
Good for checking compliance
What is a good way to evaluate nephropathy
Spot/random urine sample
-look for protein
is 24 hr urine collection used often
no it can be cumbersome
but i think this is outpatient
What should DM pts do daily
Foot inspection
What should be the levels of TSH and Free T4 in primary hypothyroidism
TSH up
T4 down
What should be the levels of TSH and Free T4 in primary hyperthyroidism
TSH down
T4 Up
What is the temperature trend of thyroid nodules and how likely they are to malignant
Colder more malignant
What should suspect if Calcium and phosphate are opposite
PTH issue
What should you suspect if the calcium and phosphate do the same thing
Vit D issue
what are the classifications of hypercalcemia
- parathyroid-related
- Malignancy-related
- Vit-D
- Associated high bone turnover
- Renal Failure
what is the EKG finding of hypercalcemia
shortened QT interval
