Diabetes

Question 1

Type 1 diabetes is caused by

Answer 1

lack of insulin secretion

Question 2

Type 2 Diabetes is caused by

Answer 2

decreased sensitivity of target tissues to the metabolic effects of insulin (resistance)

Question 3

T/F Insulin insufficiency leads to hyperglycemia from decreased cell entry, increased gluconeogenesis, and glucose release from the liver

Answer 3

TRUE

Question 4

Glucose is reabsorbed by kidney until about ____

Answer 4

180gm/dl

Question 5

DM s/s

Answer 5

hypovolemic hypotension, dehydration, polyuria(osmotic diuresis), polydipsia (intraveascular volume depletion), polyphagia and weight loss (increased appetite from hypothalamus ventromedial nucleus)

Question 6

low insulin leads to muscle and fat ___

Answer 6

catabolism - increases the release of keo acids, causes an anion gap metabolic acidosis

Question 7

DM neurologic

Answer 7

CNS irritability/confusion - hypertonic ECF leads to cell shrinkage

Question 8

what causes visual disturbances

Answer 8

sorbitol formation in lens causes osmotic swelling, glycation leads to opacification. microvascular dz affects perfusion of retina

Question 9

microvascular effects of DM include

Answer 9

nephrophathy, retinopathy, neuropath

Question 10

DM1 - destruction of ___ cells results in loss of insulin release

Answer 10

beta

Question 11

DM1 is caused by

Answer 11

viral infections or autoimmune disorders

Question 12

T/F in DM1, receptor and cellular mechanisms are usually abolished

Answer 12

FALSE - usually preserved

Question 13

DM2 is caused by

Answer 13

greatly diminished sensitivity of target tissues to metabolic effects of insulin

Question 14

T/F High levels of keto acids are usually present in type 2 DM

Answer 14

FALSE

Question 15

which type of DM is more common

Answer 15

2

Question 16

Plasma insulin is ___ in type 2

Answer 16

elevated

Question 17

normal Hgb A1C range

Answer 17

4-5.6%

Question 18

T/F insulin inhibits inflammatory growth factors important in acute MI, and general inflammatory responses

Answer 18

TRUE

Question 19

blood sugar > ___ should be treated

Answer 19

200

Question 20

DKA occurs because of ___ insulin levels or __ counterregulatory hormones (glucagon, cortisol, GH, catechols) that render insulin ineffective

Answer 20

low, elevated

Question 21

dehydration, acidosis, electrolyte depletion are characteristics of

Answer 21

DKA

Question 22

patients with DKA have ___ protein breakdwon

Answer 22

accelerated - leads to increased liver gluconeogenesis, , worsening hyperglycemia

Question 23

DKA leads to ___ of b-oxidation of fatty acids

Answer 23

activation

Question 24

DKA symptoms:

Answer 24

n/v, polyuria/dipsia/phagia, anorexia, orthostatic changes, kussmaul breathing, acetone halitosis

Question 25

LOC changes associated with DKA are related to ____

Answer 25

osmolality (not acidosis)

Question 26

treatment for DKA includes ___ resuscitation, ___ replacement , and ___ therapy

Answer 26

fluid, electrolyte, insulin

Question 27

DKA patients have severe __kalemia

Answer 27

HYPER

Question 28

which dz is has symptoms of thrombosis from hyperviscosity, focal neuro/reflex signs, global neuro signs, confusion, sz. coma?

Answer 28

nonketotic hyperosmolar state

Question 29

T/F treatment of nonketotic hyperosmolar state includes fluid resuscitation, K+, phos, and insulin if needed

Answer 29

TRUE

Question 30

T/f the mortality is higher in DKA than nonketotic hyperosmolar state

Answer 30

FALSE

Question 31

what is the formula for osmolarity

Answer 31

2[NA] + glucose/18 + BUN/2.8

Question 32

early response from the liver to hypoglycemia is ___ breakdown

Answer 32

glycogen

Question 33

late sign of hypoglycemia is ___ stim and ___ release

Answer 33

sympathetic stim, epi release

Question 34

very late sign of hypoglycemia is ___ and ___ secreted

Answer 34

GH and cortisol

Question 35

T/F Insulinoma is beta cell adenoma - shock=coma under 20mg/dl, and treat with glucose (glucagon, epi)

Answer 35

TRUE

Question 36

hypoglycemia shock develops in range of ___

Answer 36

20-50

Question 37

tx for hypoglycemic shock?

Answer 37

D50 + infusion of D5