Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Burton > Diabetes > Flashcards

Diabetes Flashcards

1
Q

What microvascular complications does diabetes cause?

A

Retinopathy
Neuropathy
Nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What macrovascular complications does diabetes cause?

A

Stroke
MI
Renovascular disease
Limb ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is MODY?

A

Maturity onset diabetes of the young

Autosomal dominant form of type 2 DM affecting young people.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the WHO criteria for the diagnosis of DM?

A
  1. Raised fasting plasma glucose >7 mmol/L
  2. Random plasma glucose >11.1 mmol/L.

If symptomatic, one value only but if asymptomatic then two values.
For borderline cases: OGTT 2h value >11.1 mmol/L.

  1. HbA1c > 48 mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is impaired glucose tolerance?

A

Fasting plasma glucose < 7mmol/L

OGTT 2 hour between >7.8 - 11.1 mmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you treat a patient with impaired glucose tolerance?

A

Lifestyle intervention to stop progression to diabetes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are other causes of DM?

A

Medications: steroids, anti-HIV drugs

Pancreatic: pancreatitis, surgery, trauma, cancer

Cushing’s disease, acromegaly, pheochromocytoma, hyperthyroidism, pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define metabolic syndrome?

A

Central obesity (BMI>30) plus two of:

  • BP >130/85
  • raised triglycerides
  • low HDL
  • fasting glucose >5.6 mmol/L
  • T2DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the cause of T2DM?

A

Combination of insulin resistance and pancreatic beta-cell dysfunction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should you consider in an older patient presenting with diabetes, which you assume is T2, but not responding to oral hypoglycaemics?

A

LADA - latent autoimmune diabetes in adults.

A form of T1DM that progresses to insulin dependence later in life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How would you test for LADA?

A

Measure islet cell antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What auto-antibodies are present in T1DM?

A

Islet cell antibodies (ICA)

Anti-glutatmic acid decarboxylase (GAD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What diet would you recommend a patient with type 2 diabetes?

A 
Low carbohydrate 
Low‑glycaemic‑index sources of carbohydrate e.g. fruit, veg, grains, pulses 
High fibre
Oily fish
Limit saturated fats
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do fingerpick glucose levels influence insulin doses?

A

Before meal - informs about long acting dose

After meal - informs about short acting dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the blood pressure target for people with diabetes?

A

140/80

130/80 if kidney, eye or cerebrovascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the target HbA1c for patients not at risk of hypoglycaemia?

A

48 mmol/mol (6.5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the target HbA1c for patients at risk of hypoglycaemia (taking drug associated with)?

A

53 mmol/mol (7.0%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What level of HbA1c might you consider intensifying drug treatment?

A

58 mmol/mol (7.5%)

19
Q

What should you look out for in patients taking insulin? How can these complications be prevented?

A

Injection site for infection and lipohypertrophy (fatty change)
Adv to rotate injection sites

20
Q

How is the raised risk of CVD managed in patients with DM?

A

Statin therapy for all patients regardless of lipid levels

21
Q

How is the risk of nephropathy reduced?

A

ACE-I renoprotective if microalbuminuria present - negative urine dip but Urine A:CR >3

22
Q

What are the 4 stages of diabetic retinopathy?

A

Background retinopathy
Pre-proliferative
Proliferative
Maculopathy

23
Q

What might you see on fundoscopy in a patient with background retinopathy?

A 
Microaneurysms - dots
Haemorrhages - blots 
Hard exudates (lipid deposits)
24
Q

What might you see in pre-proliferative retinopathy?

A

Cotton wool spots (infarcts)

Venous beading

25
Q

What happens in proliferative retinopathy?

A

New blood vessels form in response to VEGF growth factor released by the retina.

26
Q

What is a risk of maculopathy?

A

Retinal detachment

27
Q

How can you educate patients in diabetic foot care?

A

Daily foot inspection - mirror for sole
Comfortable shoes
Regular chiropody to remove callus’

28
Q

What might you find on neurological examination of a diabetic patient?

A

Decreased sensation in the stocking distribution
Charcot joint
Absent ankle jerk reflex

29
Q

What areas must you assess when presented with a diabetic foot ulcer?

A

Neuropathy - clinically
Ischaemia - doppler
Bony deformity e.g. Charcot joint - X-Ray
Infection - swabs, blood culture, X-Ray

30
Q

What are the 4 types of diabetic neuropathies?

A

Symmetric sensory polyneuropathy
Mononeuritis multiplex
Amyotrophy
Autonomic neuropathy

31
Q

How would you expect symmetric sensory polyneuropathy to present?

A

Tingling, numbness or pain in glove and stocking distribution

32
Q

How would you expect amyotrophy to present?

A

Painful wasting of quadriceps and other pelvifemoral muscles

33
Q

What are signs of autonomic neuropathy?

A 
Postural BP drop
Gastroparesis - early satiety, bloating, N+V
Urine retention
Erectile dysfunction
Diarrhoea
34
Q

What is a Charcot joint?

A

Neuropathic arthropathy

Bony destruction and deformity of a weight bearing joint secondary to neuropathy

35
Q

What investigations are needed when a patient presents with hypoglycaemia in the acute setting?

A 
Capillary blood glucose
Urine dip
Plasma insulin 
C-peptide
Sulphonylurea levels
ABG - check acid-base status
36
Q

What blood result would indicate endogenous insulinaemia, possibly due to insulinoma?

A

C-peptide raised

37
Q

What are the causes of hypoglycaemia in a patient without diabetes?

A

Drugs - beta blockers
Endocrine - pituitary insufficiency, Addisons disease, insulinomas
Liver failure
Malaria
Post-gastrectomy hypoglycaemia - low ghrelin (suppresses insulin release)

38
Q

How could you test for Addison’s disease as a cause of hypoglycaemia?

A

Synacthen test

39
Q

How are people with IGT or IFG managed?

A

Lifestyle modifications

Annual review

40
Q

How is true hypoglycaemia confirmed?

A

Whipples triad:

  1. symptoms/signs of hypoglycaemia
  2. low plasma glucose
  3. resolution of symptoms once glucose back to normal
41
Q

What is the gold standard for diagnosis of insulinoma?

A

72 hour fast

42
Q

How might diabetes present as complications of the disease?

A

Recurrent infections - skin, thrush
Poor wound healing
T1 - DKA

43
Q

How does T1DM typically present?

A 
Younger age
Weight loss
Polydipsia
Polyuria
Lethargy
DKA
44
Q

How does T2DM typically present?

A 
Tiredness
Polyuria
Polydipsia
Recurrent infections - skin,UTI
HHS

Burton (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions