Approach to Endocrine Topics 1

Question 1

Diabetes Type 2 Pathophysiology

Answer 1

insulin resistance leading to ineffective transport of glucose out of blood vessels

Question 2

What is a major outcome of hyperglycemia?

Answer 2

organ damage

Question 3

What value for HbA1c determines diabetes type 2?

Answer 3

HbA1 > 5.7

Question 4

What are some risk factors for diabetes type 2?

Answer 4

age > 45
BMI > 25
sedentary lifestyle
HbA1c and high fasting glucose

Question 5

What are some clinical presentations of diabetes type 2?

Answer 5

polyuria
polydipsia
polyphagia (excessive eating)

recurrent UTIs, tingling & pain

Question 6

What are some physical exam findings for diabetes type 2?

Answer 6

acanthosis nigricans
retinopathy
foot ulcer

Question 7

What are the criteria for type 2 diabetes diagnosis from the ADA?

Answer 7

HbA1c > 6.5%
fasting glucose > 126
2 hour glucose > 200 on oral glucose tolerance test
random glucose > 200 with symptoms of hyperglycemia

Question 8

What do you look for on a diabetic foot exam?

Answer 8

callus/corn formation, dryness, breaks in skin,
check pulses
check sensation

Question 9

Management for diabetes type 2

Answer 9

lifestyle changes
oral metformin
insulin

check HbA1c every 3 months

BP & lipid control

Question 10

Ominous Octect for Diabetes type 2

Answer 10

NT dysfxn
increased lipolysis & reduced glucose uptake
impaired insulin secretion
increased glucagon secretion
increased glucose reabsorption
increased hepatic glucose production
decreased incretin effect
decreased glucose uptake

Question 11

What are some complications assoc w/ diabetes type 2?

Answer 11

microvascular diseases
macrovascular disease (stroke, PVD)
increase in infections (unusual infections)

Question 12

What is diabetic ketoacidosis?

Answer 12

mental changes
nausea, vomiting, abdominal pain
signs of dehydration
Kassmual respirations
fruity smelling breath

Question 13

What are some precipitating factors for diabetic ketoacidosis?

Answer 13

Inadequate insulin treatment (out of meds)
new onset diabetes
acute illness

Question 14

Signs of DKA

Answer 14

hyperglycemia (blood glucose > 200)
metabolic acidosis
ketosis

Question 15

Signs of HHS

Answer 15

marked hyperglycemia (>600)
minimal acidosis
absent or mild ketosis
marked serum osmolality

Question 16

Management for DKA/HHS

Answer 16

Admit to hospital (electrolyte correction)
Need IV fluids, IV insulin, potassium replacement

Do NOT manage as outpatient

Question 17

Diabetes Type 1 Pathophysiology

Answer 17

immune-mediated beta cell destruction

Question 18

What are risk factors for diabetes type 1?

Answer 18

genetic susceptibility

environmental trigger

Question 19

Clinical presentation of diabetes type 1

Answer 19

polydipsia (excessive thirst)
polyuria
weight loss w/ hyperglycemia or ketonemia
DKA (first presenting sign)

Question 20

What are some associated conditions w/ type 1 diabetes?

Answer 20

autoimmune thyroiditis
celiac disease
addison’s disease

Question 21

Management of type 1 diabetes

Answer 21

education

insulin

Question 22

Metabolic syndrome pathophysiology

Answer 22

metabolic abnormalities that confer increased risk of CVD & diabetes (increased risk w/ increased age)

Question 23

What are some risk factors assoc w/ metabolic syndrome?

Answer 23

overweight
sedentary lifestyle
genetics/aging
DM type 2
CVD
lipodystrophy

Question 24

Diagnosis guidelines for metabolic syndrome

Answer 24

Need 3 of:

Abdominal obesity
Triglycerides >150
HDL <40 in men &amp; <50 in women
BP > 130/85
fasting glucose >100

Question 25

Assoc Conditions for Metabolic Syndrome

Answer 25

Polycystic ovary syndrome
Obstructive sleep apnea
Nonalcoholic fatty liver disease
Hyperuricemia

Question 26

Management for metabolic syndrome

Answer 26

LIFESTYLE (diet & exercise)
weight loss medication
weight loss surgery
BP meds
Metformin

Question 27

Presenting signs of metabolic syndrome

Answer 27

weight gain/loss
urinary frequency
excessive thirst
numbness/tingling in feet or hands
vision changes
diet & exercise
family history