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Endocrine > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Diabetic foot exam: inspection

A 
Gait
Shoes
Amputation
Deformity 
Ulcers
Scars
Toes
Webbing
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2
Q

Diabetic foot exam: vascular

A

CRT
Temperature
Pulses - all

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3
Q

Diabetic foot exam: neuro

A

Sensation:
Monofilament (fine touch)
Vibration 128hz
Proprioception

Motor:
Power
Wasting
Deformity

Ankle reflex

Autonomic - dry/sweaty

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4
Q

Diabetic foot exam: completion

A 
Full neurovascular exam
ABPI
Doppler
Blood glucose
HbA1c
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5
Q

Management of DM1

A 
3-6 monthly HbA1c (<6.5%)
QDS BM - before meals and bed (4-7mmol/l)
Insulin
Education - hypos, insulin devices
DAFNE
Avoid binge drinking
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6
Q

Complications of DM2

A 
2x stroke
4x MI
HTN
Erectile dysfunction
Retinopathy
Neuropathy
Nephropathy
Diabetic foot
PVD
Glaucoma, cataracts
Hyperosmolar hyperglycaemic state
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7
Q

Hyperosmolar hyperglycaemic state

A

High glucose WITHOUT ACIDOSIS (differs from DKA)

High Na, high Glu, normal pH

Manage with slow rehydration

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8
Q

The stages of diabetic retinopathy

A
  1. Background - hard educates, microaneurysms
  2. Pre-proliferation - cotton wool spots, haemorrhages
  3. Proliferation - new vessel formation
  4. Maculopathy
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9
Q

Causes of diabetes

A 
Insulin resistance 
Disease of the pancreas 
Maturity onset diabetes of the young (MODY)
Gestational
Acromegaly
Cushing's
Steroids
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10
Q

Management of DM2

A
  1. Lifestyle - 16 weeks
  2. Metformin - 6m
  3. Add sulphonyluria/gliptin/piaglitazone/SGL2i
  4. Add another of above
  5. Insulin
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11
Q

Mechanism of metformin

A

Increase insulin sensitivity

Decrease GNG

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12
Q

ADRs of metformin

A

Lactic acidosis

GI sx

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13
Q

CI of metformin

A

Heart, renal, hepatic failure

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14
Q

Name some sulphonyurias

A

‘Zide’

Gliclazide, glipazide

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15
Q

Action of sulphonyurias

A

Increase insulin secretion

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16
Q

ADRs of sulphonylureas

A

Hypos

Weight gain

17
Q

Action of glitazones

A

Increase sensitivity to insulin

Decrease GNG

18
Q

ADRs of pioglitazone

A

Weight gain
Oedema
Bladder cancer

19
Q

CI to pioglitazone

A

HF

20
Q

Action of gliptins

A

DPP4i -> strops breakdown of GLP-1 -> suppresses appreciate, increases insulin release, inhibits glucagon secretion

21
Q

What is the benefit with gliptins?

A

Weight loss

22
Q

Action of SGL2i

A

SGL2 reabsorbs Glu in the PCT. Block this to reduce plasma glucose

23
Q

ADRs of SGL2i

A

UTIs

thrush

Endocrine (4 decks)

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