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Exam > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Why might someone be at risk for developing DKA (3)

A
  1. Medications (insulin)
  2. Illness
  3. New diagnosis
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2
Q

General treatment for DKA

A 
Insulin
Fluids
Potassium 
Bicarb 
D5w
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3
Q

When you diagnose someone with diabetes what questions should you ask (about symptoms)?

A 
Diet
Weight loss
Polyuria
Polydipsia 
Symptoms of retinopathy 
Symptoms of Neuropathy
Fatigue
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4
Q

What should you assess for on physical exam when you diagnose someone with diabetes

A

Retinopathy
Neuropathy
CVD

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5
Q

Best test to diagnose Diabetes

A

A1C

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6
Q

Non prescription treatments for diabetes (3)

A
  1. Wt. loss
  2. Low glycemic index diet
  3. Smoking cessation
  4. Psyllium fiber (Lowers A1C by 0.6)
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7
Q

List 2 first line medications for Type 2 Diabetes and when you would use one over the other

A
  1. Biguanide (metformin)

2. SGLT-2 inhibitor (Jardiance)-Can use first line in renal or cardiac disease

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8
Q

List three second line medications in Type 2

A

DPP-4 (Januvia)
GLP-1 (ozempic)
Sulfonylureas (gliclazide)

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9
Q

List a third line medication in type 2 diabetes

A

Insulin

Start with basal Qhs then Add bolus once per day

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10
Q

List two side effexts/risks of SGLT2 inhibitors

A

Jardiance
Euglycemic DKA
Yeast vaginitis/blanitis
AKI

Contraindicated in Type 1

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11
Q

How to initiate insulin

A

10 units NPH hs to start

Just as good as lantis

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12
Q

Rules for driving

A

Check sugars q 2h if you have unawareness
Check sugars Q 4h if you don’t have unawareness
Take 6 lifesavers if you have a low and wait 40 minutes

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13
Q

When can you diagnose Diabetes

A

2 tests in level or one test and symptoms
A1C >6.5
FPG >7
2hr PG 75 OGTT >11.1

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14
Q

When to diagnose prediabetes and waht that means

A

A1C 6-6.5
FPG 6.1-6.9
75g OGTT 7.8-11

25-50% change of developing diabetes in the next 5 years

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15
Q

List 3 things that can impact your A1C

A

Pregnancy
Hemoglobinopathy
Anemia
Renal Disease

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16
Q

List one benefit, one risk and two side effects of Biguanide

A

Metformin

  1. Good for CVD
  2. Lactic Acidosis
  3. GI SE
  4. Lowers B12
17
Q

List one benefit and 1 effects of DPP4

A

Januvia

  1. Less side effects/good for elderly
  2. No injections
  3. Pancreatitis

No CVD impact

18
Q

List two benefits, one risk, and one contraindication of GLP1 agonists

A

Ozempic

  1. CVD benefit
  2. Wt. loss
  3. Retinopathy
  4. GI effects
  5. Thyroid Cancer
19
Q

List three benefits, three risks and one contraindication for SGLT2 inhibitors

A

Jardiance

  1. CVD benefit
  2. Improved CHF
  3. CKD
  4. Vaginitis/balanitis
  5. AKI
  6. DKA
  7. If they are taking Labetalol
20
Q

Whats your target A1C

A

Usually <7
Can be <8.5 in elderly or recurrent hypoglycemia
6.5 in healthy young people

21
Q

Why might someones A1C not be falling when they are on Insuling

A 
Adherence 
Infection /inflammation 
Injection Technique
Lipodystrophy 
Insulin ruined (temperature, expired)
22
Q

List 10 risk factors for type two diabetes

A 
Age >40
Gestational Diabetes
Delivery of macrosomic infant 
Family history 
Prediabetes 
Certain medications (atypical antipsychotics, steroids, HAART, statins, antirejection) 
Obesity/Metabolic syndrome 
PCOS 
Aboriginal, African, Asian, Hispanic, or Sough Asian Descent
Cushings 
HAART
NASH
CF
23
Q

What tools can you use to check someone’s risk of diabetes

A

CANRISK

FINDRISC

24
Q

Who should you screen for diabetes

A

A1C q 3 years after the age of 40

Can be more often and earlier if high risk

25
Q

What should you do at a yearly check up for you diabetes patients (list 5)

A 
1. Check BP: HTN 130/80
ACE or ARB (If CVD, microvascular complications)
2. Lipid profile yearly 
Start a statin at age 40 or if microvascular or CVD complications 
3. ACR yearly 
4. Optometry yearly 
5. Monofilament testing yearly
6. Weight
26
Q

Risks for hypoglycemia

A 
Old 
Insulin 
Food insecurity 
Neuropathy 
Cognitive impairment
27
Q

What madications should you stop if you are sick

A 
SGLT2 and sulonyuria 
ACE
Diuretics
Metformin 
ARB
NSAIDS
28
Q

Symptoms of hypoglycemia

A

Palpitations
Swating
Anxiety
Hunger Nausea

Confusion 
Weakness
Headache
Dizziness
LOC
29
Q

Sequele of diabetes that you have to report to transport canada

A 
Retinopathy
Neuropathy
Stroke
MI
Hypoglycemia

Exam (100 decks)

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