Diabetes

Question 1

DKA is associated with ______ anion - gap METABOLIC ACIDOSIS that is usually accompanied by compensatory RESPIRATORY ALKALOSIS.

This combination yields a
low pH
___ serum bicarbonate,
___ PaCO2.

Answer 1

elevated anion gap
low
low

Question 2

Screening for early-stage diabetic nephropathy in this patient would best be accomplished by measuring the urinary concentration of

Answer 2

Albumin

slowly rises as disease progresses

Question 3

is a nonabsorbable anion-exchange resin that binds intestinal phosphate to reduce absorption.

Answer 3

Sevelamer

oral phosphate binder

Question 4

most common cause of death

Answer 4

MI

Question 5

Type 2 DM suspected pathophysiology

Answer 5

Increasing resistance to Insulin
Progressive Beta cell failure due to Hyperglycemia/Obesity causing amyloid deposits in islet cells thus reducing insulin secretion.

Question 6

DKA occurs when insulin is absent and ____ are present

Answer 6

ketones

Question 7

DKA most commonly occurs in DM1 and usually occurs in DM2 when there is a triggering event like

Answer 7

Infarction (MI etc.)
Infection
Insulin deficiency

Question 8

What is seen in DM2 histology

Answer 8

Islet Amyloid Polypeptide (IAPP) deposits

Question 9

What is seen in DM1 histology

Answer 9

Islet leukocyte infiltration

Question 10

Fatty acid metabolism produces Acetyl CoA in quantities that overwhelms the Kreb’s cycle.
Consequently, Acetyl CoAs combine to form ____ that flow into the circulation to provide energy to cells.

Answer 10

acidic ketones:
Acetone
Beta Hydroxybutyrate
Acetoacetic acid

Question 11

DKA presents with

Answer 11

Dehydration
Kussmaul breathing (Tachypnea, rapid/deep breaths)
Altered mental status

HyperKalemia/glycemia (depleted intracellular K+/tot. K+)
Fruity breath
Ketonuria/ketonemia

Question 12

Complications of DKA:
Mucormycosis
Heart failure
(2)

Answer 12

Arrythmias
Cerebral edema

(MAHC)

Question 13

Insulin present, Ketones absent

Answer 13

Hyperosmolar hyperglycemic state

more common in DM2

Question 14

Severe dehydration in patient unable to get water (elderly, stranded, hospitalized) precipitates hyperglycemia (>600), but with a normal pH.

Presents with focal neurological deficits or seizures or lethargy

Answer 14

Hyperosmolar hyperglycemic state

more common in DM2

Question 15

DKA is associated with an elevated anion gap ____ that is usually accompanied by compensatory _____.

Answer 15

METABOLIC ACIDOSIS
RESPIRATORY ALKALOSIS (rapid breathing)