Diabetes Flashcards
For diabetic patients who gets diabetic ketoacidosis and who gets diabetic coma
Type I: DKA
Type II: coma
What are the signs of hypoglycemia (9)
- nervousness
- tachycardia
- diaphoresis
- nausea
- headache
- confusion
- tremor
- seizures
- coma
What are the signs of hyperglycemia (3)
polyuria
polydipsia
-weight loss
What is the function of a biguanide
antihyperglycemic
What are the only FDA-approved drugs for treating diabetic neuropathy
- duloxetine (Cymbalta)
- Pregabalin (lyrica)
Most common causes of onychomycosis (2 categories)
dermatophytes and nondermatophytes
Types of dermatophytes that cause onychomycosis (3)
- ***Trichophytan rubrum
- Trichophyton Mentagrophytes
- Epidermophytan Floccosum
Types of Nondermatophytes that cause onychomycosis (1)
Candida albicans
Conversion between Blood sugar, a1C levels, and PVD level
1 a1C level= 30 blood sugar level= 28% PVD
At what a1C level is a patient considered diabetic?
At what a1C level
a1C level of 6.4-7
Wagner Classification system
0- Pre ulcerative
1-superficial ulcer
2- ulcer deep to tendon, capsule, ligaments and bone.
3- abscess/ infection found
4- gangrene of the forefoot
5- gangrene of the rearfoot
University of Texas SA classification system
0-Pre ulcer
1-superficial ulcer
2-Ulcer that probes to tendon, ligament, capsule
3- Ulcer that probes down to bone
A-clean
B-infection
C-Ischemia
D-infection and ischemia
What is the infection rate of a diabetic during surgery
3 times the surgical risk
SIRS criteria for systemic infection (4)
- Temperature: >100.4F or < 96.8
- HR: >90
- Respirations: >20
- WBC: >12
Definition of Sepsis:
SIRS+ Source
Definition of severe sepsis:
Sepsis+ Organ dysfunction/hypotension/hypoperfusion
Definition of septic shock:
severe sepsis+hypotension
Different types of autolytic debridement and general description
- Unna Boot
- Medihoney
- Hydrogel
General info- creates moist occlusive environment for dry/necrotic wounds. Autolytic debridement by body’s own phagocytes
Alginates: product and description
Aquacel
-Highly absorbent for exudative wounds, bacteriostatic, hemostatic
Films: product and description
Tegaderm and Telfa
Low adherence
Foams/hydrocolloid: products and description
Mepilex and duoderm
Adhesive dressing to create moist environment for fibrinolysis, angiogenesis, and wound healing
Low adherence : products and description
Xeroform, adaptic, Owens Silk
Keep wound moist
Enzymatic/Chemical debridement: product and description
Accuzyme and Santyl
collagenase that removes fibrotic tissue
Mechanical debridement: products and
Hydrotherapy, Versajet and wet to dry dressings
Silver nitrate: description
chemically caustic agent used to break down hyper granular wounds so that epithelial borders can touch and close
Apligraft: Material and description
Neonatal foreskin
Consists of epidermal and dermal layer. First FDA approved
Type 1 collagen and ECM
Dermagraft: Material and Description
Neonatal foreskin
Consists of Dermal layer (fibroblast derived)
Collagen and ECM
Theraskin: Material and description
An allograft
Consists of dermis, epidermis and ECM
Prisma: material and description
made of collagen and cellulose
- Becomes a gel when in contact with exudate, forms antibacterial barrier
Acell: material and description
made of porcine urinary bladder matrix
Contains growth factors, collagen and ECM
Integra: material and description
Collagen bilayer matrix.
- –Silicone outer layer
- –shark chondroitin inner layer
Graftjacket: material and description
human dermis
acellular scaffold
Oasis: material and description
made of porcine small intestine
an acellular scaffold
Primatrix: material and description
made of fetal bovine dermis
an acellular scaffold
Regranex: material and description
PDGF
granular and has very good blood flow
Grafix: material and description
amniotic membrane
-mesoderm/epithelial cells…
Amniox: material and description
amniotic membrane with umbilical cord (cryopreserved)
contains mesoderm and epithelial cells
Epifix: material and description
amniotic membrane with umbilical cord (dehydrated)
Iodosorb/iodoform: description
a cicatrizant: promotes healing via formation of scar tissue
Silvadene/ silvasorb: description
Causes maceration.
Caution of a silver allergy
Betadine: description
dries out wound
CAUTION: can kill cells at a high concentration with long term use
Triple antibiotic ointment: name
Bacitracin
Dakins solution description
can kill cells at high concentration/long term use
Stages of wound healing (4)
0- hemostasis
1- inflammation
2- proliferation
3- remodeling
Hemostasis phase of wound healing what occurs
- vasoconstriction
- platelet aggregation, granulation, fibrin formation
Inflammation phase of wound healing what occurs
- neutrophil/monocyte/lymphocyte migrate to the wound site
- CHRONIC WOUNDS get stuck in this phase
Proliferation phase of wound healing what occurs
regrowth of epithelium
- angiogenesis
- collagen formation by myofibroblasts
Remodeling phase of wound healing what occurs
- deposition of matrix
- collagen remodeling
- vascular maturity/regression
Types of skin graft (in terms of sizes)
Thin: .016 inches
Stages of skin graft healing:4
- Plasmatic
- Inosculation
- Reorganization
- Reinnervation
