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Pathophysiology - year 3 > Diabetes > Flashcards

Diabetes Flashcards

1
Q

what is the normal plasma glucose level?

A

Homeostatic mechanisms of the body generally maintain glucose at a level <6.0 nmol/L

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2
Q

autonomic symptoms, able to self-treat

A

mild hypoglycemia

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3
Q

autonomic and neuroglycopenic symptoms, able to self–treat

A

moderate hypoglycemia

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4
Q

unable to self-treat, requires assistance, unconsciousness may occur

A

severe hypoglycemia

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5
Q

what is the blood glucose for severe hypoglycemia?

A

<2.8 mmol/L

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6
Q

Generally hypoglycemia occurs when BG levels are between _____

A

2.5-3.3 mmol/L

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7
Q

etiology in diabetes

A
  • relative excess of insulin in the blood

- deficits in glucose counterregulation

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8
Q

____ occur due to an abrupt cessation of glucose delivery to the brain

A

neuroglycopenic symptoms

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9
Q

treatment for mild to moderate hypoglycemia

A

15 g carb - 2.1 mmol/L increase within 20 mins

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10
Q

treatment for severe-conscious hypoglycemia

A

20g carb - 3.6 mmol/L increase at 45 mins

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11
Q

treatment in unconscious person with severe hypoglycemia >5 years of age

A
  • 1 mh glucagon SC or IM

- IV glucose 10-25 over 1-3 mins

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12
Q

Acid-base imbalance specifically metabolic acidosis due to ketoacidosis is always present in ___

A

DKA

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13
Q

Electrolyte imbalances occurs due to

A

metabolic acidosis and osmotic diuresis

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14
Q

The result of glycogenolysis and gluconeogenesis is

A

hyperglycemia

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15
Q

total body deficit of water in adults in DKA

A

5-7 L

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16
Q

total body deficit of water in adults in HHNKS

A

7-12 L

17
Q

acteone breath and Kussmaul-Kein respiration present

A

DKA

18
Q

glucose > 14 mmol/L

A

DKA

19
Q

glucose > 34 mmol/L

A

HHNKS

20
Q

pH is usually normal in ….

A

HHNKS

21
Q

has severe ECFV depletion (osmolality >320)

A

HHNKS

22
Q
  • Is an alternative metabolic pathway for tissues not requiring insulin for glucose transport.
  • These include the kidney, RBCs, blood vessels, eye lens, and nerves
A

Polyol Pathway

23
Q

sorbitol + fructose -> increased intracellular osmotic pressure -> cell injury

A

polyol pathway

24
Q

basement membrane components in the microcirculation

A

Glycoproteins or AGEs

25
Q

chronic complications arise from a decrease in O2 delivery in small vessels

A

Tissue oxygenation/oxidative stress

26
Q

defect in RBC ->

A

release of O2 Hgb impaired

27
Q

chronic hyperglycemia ->

A

increases production of ROS

28
Q

intracellular hyperglycemia increases the synthesis of DAG which activates ___

A

protein kinase C

29
Q

vascular damage and associated disease of the retina, kidney and nerves can be caused by activation of ___ in these blood vessels.

A

PKC

30
Q

characterized by thickening of the basement membrane, endothelial cell hyperplasia, thrombosis and pericyte degeneration

A

microvascular disease

31
Q

involves retina, nerves, kidneys and GI tract

A

microvascular disease

32
Q

may involve the spinal cord, posterior root ganglia or the peripheral nerves

A

somatic neuropathy

33
Q

Neuropathic pain may be managed with

A

tricyclic antidepressants, anticonvulsants and opioid analgesia.

34
Q

What glomerular changes are seen in nephropathy?

A
  • capillary basement membrane thickening
  • diffuse glomerular sclerosis
  • nodular glomerulosclerosis
35
Q

what is one of the 1st clinical manifestations of nephropathy?

A

microalbuminuria

36
Q

The underlying pathophysiology of macrovascular complications is

A

atherogenesis or atherosclerosis

37
Q

most common cause of death in people with T2DM, common in T1DM as well

A

CAD - coronary artery disease

38
Q

what type of stroke in more common?

A

Ischemic

39
Q

goal for A1C

A

<7%

Pathophysiology - year 3 (8 decks)

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