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PANCE prep JQ > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Type 1A v. Type 1B diabetes

A

Both beta cell destruction

1A- autoimmune

1B -not autoimmune

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2
Q

Risk factors for type 2 diabetes

A 
Obesity
Family hx
Hispanic, African American, Pacific Islanders 
Htn
Hypld 
Delivery of >9lb infant
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3
Q

Classic diabetes symptoms

A

Polyuria
Polydipsia
Polyphagia
Weight loss

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4
Q

Describe the types of diabetic retinopathy

A

Nonproliferative: dot or flame shaped hemorrhages and cotton wool spots

Proliferative: neovascularization

Maculopathy: macular edema, blurred vision and central vision loss

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5
Q

MC cause of end stage kidney disease

A

Diabetes

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6
Q

First sign of diabetic nephropathy

A

Microalbuminuria

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7
Q

What is expected on biopsy of the diabetic kidney?

A

Kimmelstiel-Wilson: modular glomerulosclerosis w/ pink hyaline material

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8
Q

Macrovascular complications of DM

A

CAD
PAD
CVA

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9
Q

Presentation of hypoglycemia

A

Sweating, tremors, palpitations, nervousness, tachycardia, HA, lightness, confusion, slurred speech, and dizziness

Sx when BS<60 and brain dysfunction when BS <50

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10
Q

Lab values that indicate diabetes

A

Fasting glucose >126

2GGT >200

A1c >6.5%

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11
Q

When should you screen for diabetes?

A

ADA: adults over 45 every 3yr and adults with BMI >25 with addition risk factor

USPSTF: 40-70yo if overweight or obese

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12
Q

A1c monitoring

A

Every 3mo if uncontrolled

Twice a year if controlled

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13
Q

A1c goals

A

<7.0% for most pts

7-8% if multiple comorbidities or older than 70

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14
Q

Metformin MOA

A

Decreases hepatic glucose production and increases peripheral glucose utilization

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15
Q

Metformin SE/cautions

A

Lactic acidosis
GI issues
Metallic taste
Macrocytic anemia due to decreased B12 absorption

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16
Q

2nd generation sulfonylureas

A

Glipizide
Glyburide
Glimepride

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17
Q

Sulfonylureas MOA

A

Stimulates pancreatic insulin release

18
Q

Sulfonylureas SE/caution

A

Hypoglycemia
GI upset
Disulfiram reaction
Weight gain

19
Q

A glucosidase inhibitors

A

Acarbose

Miglitol

20
Q

A glucosidase inhibitors MOA

A

Delays intestinal glucose absorption

21
Q

A glucosidase inhibitors SE/caution

A

Hepatitis

GI issues

22
Q

Thiazolidinediones

A

Pioglitazone (Actos)

Rosiglitazone (Avandia)

23
Q

TZD MOA

A

Increased peripheral insulin sensitivity

24
Q

TZD SE/cautions

A

Fluid retention/edema

Avandia-cardiotoxic

25
Q

GP1 agonists

A

Exenatide (Byetta)

Liraglutide (Victoza)

26
Q

GLP1 agonist MOA

A

Mimics incretin increasing insulin secretion and delaying gastric emptying

27
Q

GLP1 agonist C/I

A

Hx of gastroparesis

28
Q

DPP4 inhibitors

A

Sitagliptin (Januvia)

Linagliptin (Tradjenta)

29
Q

DPP4 inhibitor MOA

A

Prevents breakdown of GLP1 and intecrin

30
Q

DPP4 SE/caution

A

Pancreatitis
Renal failure
GI symptoms

31
Q

SGLT2 inhibitor

A

Empagliflozin
Canagliflozin
Dapagliflozin

32
Q

SGLT2 inhibitor MOA

A

Increased urinary excretion of glucose and Na

33
Q

SGLT2 inhibitor SE/cautions

A

Thirst
Nausea
Abd pain
UTI/fungal infection

34
Q

Dawn phenomenon

A

Rise in glucose between 2-8am

35
Q

Somogyi effect

A

Nocturnal hypoglycemia followed by rebound hyperglycemia due to surge in growth hormone

36
Q

Plasma glucose in DKA

A

Usually >250

37
Q

Plasma glucose in hyperosmolar hyperglycemic syndrome

A

> 600

38
Q

Impaired fasting glucose (IFG)

A

Fasting level of 100-125 mg/dL

39
Q

Impaired glucose tolerance (IGT)

A

Levels of 140-199mg/dL 2 hr after 75g glucose load

40
Q

Rank antidiabetic meds by A1c lowering

A

1-2: metformin and sulfonylureas

  1. 5-1.4: TZDs
  2. 5-1:nonsulfonylureas,SGLT2 inhibitors, GLP1 agonists
  3. 5-0.8: a-glucosidase inhibitors, DPP4 inhibitors

PANCE prep JQ (15 decks)

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