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MAP III > Diabetes > Flashcards

Diabetes Flashcards

1
Q

3 components to exam for patients with diabetes

A

glucose abnormalities, autonomic neuropathy, vascular complications

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2
Q

Where are the insulin receptors primarily reside?

A

muscle cell.

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3
Q

How do you diagnose diabetes

A

2 consecutive high fasting glucose levels.

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4
Q

oral glucose tolerance test

A

fast for 8 hours. then orally drink sugary drink. Then they monitory your blood glucose incrementally for 8 hours.

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5
Q

HbA1c

A

a way to monitor how well pts are monitoring diabetes. Measure of long term glucose control. over the last 3 mo

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6
Q

normal fasting blood glucose

A

80-100 mg/DL

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7
Q

diabetic fasting blood glucose

A

+126 mg/DL

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8
Q

hypoglycemia

A

lethargic, drowsy, downregulation of the nervous system, confusion, irritability. Wendy is more concerned with hypo than hyper. easier to quick fix hyperglycemia.

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9
Q

Diabetes target goals

A

HbA1c <7%, BP-135/80, Blood glucose 70-130 before meals.

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10
Q

T/F huge effect on HbA1c with exercise

A

T. especially long term.

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11
Q

Ketoacidosis

A

Occurs when there is not enough insulin (usually type 1). Body still needs glucose for energy but insulin is not available for glucose metabolism.

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12
Q

Early sign of ketoacidosis

A

thirst, dry mouth, frequent urination, high blood glucose levels, high urine ketone levels, sweet breath

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13
Q

Later signs of ketoacidosis

A

constant fatigue, dry or flushed skin, nausea, vomiting, abdominal pain, difficulty breathing, difficulty concentrating, confusion.

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14
Q

elevated resting heart rate or orthostasis could indicate

A

autonomic neuropathy

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15
Q

autonomic neuropathy

A

damage to sympathetic/parasympathetic nerves

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16
Q

with diabetes there is a low grade inflammatory component that make nerves

A

hyper excitable

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17
Q

High levels of glucose ends up damaging

A

nerves (smallest to largest)

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18
Q

damage to autonomic system causes increase in

A

blood pressure

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19
Q

If the autonomic system is compromised, we know that

A

peripheral nerves are starting to go or will soon

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20
Q

gait analysis autonomic neuropathy

A

weaving

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21
Q

macrovascular complications of diabetes

A

coronary artery disease, peripheral arterial disease, stroke

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22
Q

microvascular complications of diabetes

A

nephropathy, neuropathy, retinopathy

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23
Q

how is PAD most often missed

A

not removing shoes/socks during an exam

24
Q

____% of patients that have diabetes have diabetic neuropathy

A

50

25
Q

Hyperalgesia

A

Pain that is much more pain that you would feel normal.

26
Q

Allodynia

A

something that shouldn’t hurt but does hurt

27
Q

If they cannot feel a 10 g monofiliment

A

They cannot tell if there is a stone in their shoe (protective sensation). A-delta fibers

28
Q

Where do you apply the tuning fork when testing vibratory sense in diabetes?

A

Base of great tonail

29
Q

tinel testing

A

tapping over a nerve looking to see if the sensation runs down the length of the nerve, it should not

30
Q

what will happen regarding intrinsic mm with pts with diabetes

A

they will become weak and lose your normal nice arch.

31
Q

Why are certain msk conditions more prevalent in pts with diabetes

A

chronic inflammation leading to fibrosis (collogen disorders) Limited mobility

32
Q

adhesive capsulitis is a fancy word for

A

frozen shoulder

33
Q

when referring to msk conditions, compared to pts without diabetes, pts with diabetes will have the following:

A

younger age, less painful, responds less well to treatment, takes longer to resolve

34
Q

Cardinal sign for hand syndrome in diabetes patients

A

prayer sign. they will have a space between their hands.

35
Q

Hand syndromes are more prevalent in patients with

A

Type 1 diabetes

36
Q

Most syndromes associated with diabetes have to do with

A

collagen issues

37
Q

The anterior longitudinal ligament ossifies and causes decreased ROM. Eventually they will ossify

A

diffuse idiopathic skeletal hyperostosis DISH

38
Q

painful peripheral neuropathy and muscle wasting. usually proximal as opposed to distal. Can recover with resistance training and proper treatment

A

diabetic amyotrophy

39
Q

Destruction of mid foot structure

A

charcot jt.

40
Q

extrinsic factors in foot ulceration with diabetes

A

poorly fitting shoes, trauma

41
Q

main reason ppl with DM go to hospital and leading cause of non-traumatic amputations

A

foot ulcers

42
Q

risk factors for LE amputation in diabetic foot

A

limited jt ROM, obesity, impaired vision, poor glucose control, poor footwear, ulcer

43
Q

T/F exercise can influence the pathology of DM

A

T

44
Q

Width of shoe.
Height of shoe.
Heels.
Back of shoe

A

at met heads, should be a 1/4 inch in on each side.
Raise their great toe 1/2 inch before it hits the top.
Less than an inch tall.
Less than 1/4 inch in between heel and shoe

45
Q

If patients have protective sensation, it is indicate to have them walk barefoot.

A

T

46
Q

If patients do not have protective sensation, they should always have some sort of footwear protection.

A

T

47
Q

best way to offload

A

total contact casting

48
Q

Why do you get excess albumin in the urine when you exercise.

A

breaking down muscle from working out too hard. Avoid by working at less than 70% 1RM, and watch for increased blood pressure.

49
Q

Fitness needed for successful ambulation in elderly amputees

A

sustain more than 50 percent of VO2max

50
Q

capsaicin

A

pain cream that blocks substance P

51
Q

T/F antidepressants and anticonvulsants work for peripheral neuropathy

A

T

52
Q

rapid acting inulin

A

begins in 15 min (to see BGlucose drop)

53
Q

Regular/Short Acting

A

acts in 30 min

54
Q

intermediate acting

A

acts in 2-4 hours (most commonly used)

55
Q

long acting

A

acts in 3-4 hours and continues over 2-4 hours

MAP III (5 decks)

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