Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MD4001 WEEK 10 > Clinical aspects of Diabetes Mellitus and Complications > Flashcards

Clinical aspects of Diabetes Mellitus and Complications Flashcards

1
Q

Define diabetes mellitus.

A

“Diabetes mellitus is a group of metabolic disorders characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both.
The chronic hyperglycaemia is associated with long- term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are glycated haemoglobin levels in diabetes?

A

≥48mmol/mol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are fasting blood glucose levels in diabetes?

A

≥7.0mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are 2hr blood glucose levels in diabetes?

A

≥11.1mmol/L following OGTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are random blood glucose levels in diabetes?

A

≥11.1mmol/L in presence of symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the classification of diabetes.

A

Type 1 diabetes ( ß cell destruction) : 10%

Type 2 diabetes : 85%

  • Insulin resistance with relative insulin deficiency
  • Secretory defect with insulin resistance

Other types: 5%

  • Genetic (MODY etc)
  • Pancreatic disease
  • Endocrine disease
  • Drugs

Gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the pathophysiology of type 1 diabetes.

A
  • Autoimmune disease
  • B cell destruction
  • Symptoms when 80% B-cell mass lost
  • Environmental factors e.g viral infection
  • Autoantibodies:
    islet cell; Insulin; GAD (GAD65); tyrosine; phosphatases
  • 85–90% of individuals
  • Strong HLA associations: linkage to the DQA and DQB genes; influenced by the DRB genes.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the genetic and environment factors of type 2 diabetes.

A

Genetic factors:

  • defect of B cell
  • insulin resistance

Environmental factors:

  • Obesity
  • Stress
  • Reduced physical activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the classic presentation of type 2 diabetes.

A
  • Thirst, polyuria
  • Malaise, fatigue
  • Infections e.g. Candidiasis
  • Blurred vision
  • Complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give examples of Sulphonylureas used for treating diabetes.

A

Chlorpropamide
Glipizide
Gliclazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give examples of Biguanides used for treating diabetes.

A

Metformi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give examples of Thiazolidinediones used for treating diabetes.

A

Pioglitazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Give examples of GLP1 Agonists used for treating diabetes.

A

Exanitide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What drugs are used in diabetes.

A
  • Sulphonylureas
  • Biguanides
  • a-glucosidase inhibitors
  • Thiazolidinediones
  • GLP1 Agonists
  • DPP IV Inhibitors
  • SGLT2 Inhibitors
  • Insulin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the acute and chronic complications of diabetes mellitus.

A

Acute:

  • Diabetic Ketoacidosis
  • Hypoglycaemia
  • Other emergencies

Chronic:
- Microvascular
Eyes, Kidneys, Nerves (Feet) - Macrovascular
Heart, Brain, (Feet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the clinical features of DKA?

A

Hyperglycaemia:

  • Dehydration
  • Tachycardia
  • Hypotension
  • Clouding of conciousness

Acidosis:

  • Air hunger (Kussmaul’s respiration)
  • Acetone on breath
  • Abdominal pain
  • Vomiting
17
Q

How is hyperglycaemia treated in DKA?

A

Insulin intravenously 6U/hr then by Sliding scale

18
Q

How is dehydration treated in DKA?

A
  • N/Saline initially
  • May require 4-6litres
  • Dextrose 5% subsequently to replace water losses
19
Q

How are potassium losses treated in DKA?

A
  • Careful monitoring of K+

- Replace as required

20
Q

What are the symptoms of hypoglycaemia?

A 
Adrenergic:
- tachycardia 
- palpitations 
- sweating
- tremor
- hunger
(Flight or fright symptoms)
Neuroglycopaenic:
- dizziness 
- confusion 
- sleepiness 
- coma
- seizure
(Lack of glucose to brain)
21
Q

What blood level glucose classifies hypoglycaemia?

A

Blood glucose= < 2.2mmol/L

22
Q

What are the stages of neuropathy?

A
  • Hyperfiltration
  • Normal
  • Microalbuminuria
  • Overt Nephropathy
  • Chronic Renal Failure
23
Q

What is screened for in nephropathy?

A
  • Albustix
  • Microalbuminuria
  • Creatinine
24
Q

How is nephropathy managed?

A 
- Blood pressure
Aggressive treatment ACEI/AIIRA 
130/80 or lower
- Hyperlipidaemia 
Statin
- Good glycaemic control
- Diet

MD4001 WEEK 10 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions