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NAPLEX Prep > Diabetes > Flashcards

Diabetes Flashcards

screening, lifestyle, comprehensive care, natural products, tx algorithms, non-insulins, insulin dosing and calc, BG monitoring, hypoglycemia management, acute care DM, key counseling points

1
Q

risk factors for DM

A

physical inactivity
BMI >/= 25
race/ethnicity
PMH gestational
a1c >/=5.7
first degree relative
HDL <35, TG >250
BP >140/90
CVD or smoking hx

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2
Q

s/sx diabetes

A

3 P’s
polyuria
polydipsia
polyphagia

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3
Q

what a1c, FBG and PPG are considered pre-DM

A

a1c 5.7-6.5
FBG 100-125
PPG 140-199

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4
Q

what a1c, FBG and PPG are considered DM

A

a1c >/= 6.5
FBG >/= 126
PPG >/= 200

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5
Q

an a1c of 6% = average BG of ______
and an increase of 1% = an increase in average BG of_______________-

A

126mg/dL

1% : 28mg/dL

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6
Q

lifestyle modifications for DM

A

weight loss 5% +
carb counting
exercise 150+ min a week
smoking cessation
comprehensive care

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7
Q

microvascular complications

A

nephropathy
retinopathy
neuropathy

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8
Q

macrovascular complications

A

ASCVD, MI, CVD
CVA
PAD

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9
Q

ASA recommendation for DM

A

secondary prevention only, 81mg po qd

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10
Q

how often should patients get an eye exam in DM

A

q1-2 years

1 year is if they have retinopathy

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11
Q

what vaccines are recommended in DM

A

HBV
influenza
pneumococcal

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12
Q

how often should DM patients get foot exams

A

annually

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13
Q

HLD management in DM

which statin? what is the LDL goal?

A

> 40 yo w ASCVD – > high intensity

no ASCVD or <40 w ASCVD –> mod intensity

goal <55 w ASCVD
goal <70 without ASCVD

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14
Q

how often should eGFR and UAlb be monitored in DM

A

yearly

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15
Q

what medications are recommended for hyperalbuminuria in DM

A

ACEi, ARB, SGLT2i, finerenone

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16
Q

BP goal in DM

A

<130/80

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17
Q

BP management in DM

A

no albuminuria or CAD: thiazide, ACE, ARB, CCB

albuminuria or CAD: ACEi or ARB

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18
Q

first line for ASCVD or high risk patient (>55 w 2 RFs)

A

GLP1RA
SGLT2i

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19
Q

first line for HF concern

A

SGLT2i

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20
Q

first line for CKD concern
= eGFR ____
= Ualb____

A

eGFR </= 60
UAlb >30

SGLT2i if eGFR >20 then GLP1RA

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21
Q

rybelsus dosing

A

3mg po qd 30 min before breakfast x30d then increase to 7mg po qd, MDD 14mg

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22
Q

GLP1RAs with cardiorenal benefits

A

semaglutide SC, liraglutide, dulaglutide

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23
Q

SGLT2i with cardiorenal benefits

A

dapa empa canag

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24
Q

TZD example

A

pioglitazone

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25
Q

DPP4-i
drugs in class

A

-gliptins

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26
Q

GLP1RA are not to be used with ______ due to overlapping MOA

A

DPP4-i

27
Q

metformin is titrated every ________

A

week

28
Q

metformin should not be started when __________, but is safe to continue until ______

A

should not be started with eGFR 40-45 but is ok to continue until eGFR of 30

29
Q

BBW for metformin

A

lactic acidosis

30
Q

lactic acidosis due to metformin is at an increased risk with

A

alcohol consumption

31
Q

glyburide
brand
dosing
MDD

A

Glynase
2.5-5mg QD, MDD 30mg

32
Q

glipizide
brand
dosing
MDD

A

Glucotrol
5mg QD (MDD 40 for IR, 20 for ER)

33
Q

doses >_____ must be divided BID with glipizide

A

15mg

34
Q

glimepiride
brand
dosing
MDD

A

Amaryl
1-2mg QD
MDD 8mg

35
Q

glipizide should be administered

A. with breakfast
B. 30 min before a meal
C. after lunch
D. anytime of day with a glass of water

A

B. 30 min before a meal

preferably breakfast

36
Q

sitagliptin
brand
MOA
dosing

A

Januvia
DPP4-i
100mg PO QD
eGFR <30 –> 25mg PO QD
eGFR 30-45 –> 50mg PO QD

37
Q

linagliptin
brand
MOA
dosing

A

Tradjenta
DPP4-i
5mg PO QD

38
Q

which DPP4-is have a warning for HF

A

saxogliptin and alogliptin

39
Q

pioglitazone
dosing

A

15-30mg PO QD, MDD 45mg

40
Q

rapid acting insulins

A

Novolog (aspart)
Admelog (lispro)

41
Q

short-acting insulins

A

regular!!
Humulin-R
Novolin-R

42
Q

intermediate acting insulins

A

NPH
(Humulin-N)
(Novolin-N)

43
Q

glargine brand names

A

Semglee
Lantus
Toujeo
Basaglar

44
Q

detemir

A

Levemir

45
Q

degludec brand

A

Tresiba

46
Q

basal insulin dose for patients with T2DM

A

0.1-0.2 units/kg/day

47
Q

how do we add on a bolus insulin dose in a T2DM

A

10% of TDD

48
Q

how do we initiate insulin in a T1DM

A

0.5U/kg/day
take 50% as bolus and 50% as basal

49
Q

how do we calculate ICR for type 1 diabetics

A

for regular insulin 450/TDD
for rapid insulin 500/TDD

50
Q

what does an ICR represent

A

1 unit of insulin will cover X carbs

51
Q

correction factor calculations

A

regular insulin 1500/TDD
rapid acting insulin 1800/TDD

52
Q

humalog expiration date

A

10 days

53
Q

novolog exp date

A

14 days

54
Q

glargine exp date

A

28d

55
Q

regular insulin exp date

A

28d

56
Q

levemir exp date

A

42d

57
Q

tresiba exp date

A

56d

58
Q

toujeo exp date

A

56d

59
Q

what drugs dec BG

A

FQ
BB
tramadol
linezolid

60
Q

what meds inc BG

A

steroids
FQ
APs
BB
thiazides
loops
tacro
CYA
protease-i

61
Q

inpatient BG goals

A

140-180mg/dL

62
Q

DKA vs HHS

A

DKA: BG >250, ketones, HAGMA, pH <7.35
HHS: BG >600, pH>7.3, osmolality >320

63
Q

DKA/HHS treatment

A

fluids (NS then D5W1/2NS once BG <200)

regular insulin 0.1U/kg bolus then 0.1U/kg/hr OR 0.14 U/kg/hr

bicarb if acidotic

K if needed

NAPLEX Prep (57 decks)

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