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Diabetes > Diabetes > Flashcards

Diabetes Flashcards

1
Q

Which are the clinical manifestations of DM1?

A 
3P -> polyuria              
             Polydipsia.                       
             Polyphagia.               
          - weight loss
          - early onset
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2
Q

Which are the clinical manifestations for DM2 ?

A
  • overweight
    - asymptomatic
    - polyphagia
    - polyuria
    - polydipsia
    - > 40y.o
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3
Q

Diagnostic criteria for DM.

A
  1. Fasting glycose test >126
  2. Symptoms+ Random glucose test >200
  3. OGTT >200 + 75g glucose ingestion
  4. HbA1c > 6,5% (glucosylated hemoglobin)
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4
Q

Diagnostic criteria for diabetic patient with multiple sclerosis

A
  1. Hypertriglyceridemia >150
  2. Hypo HDL <40 m, <50 w
  3. Hypertension
  4. Abdominal obesity
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5
Q

Risk factors for DM1.

A

Genetics
Family history
Geography
Age

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6
Q

Risk factors for DM2

A 
Family history 
Obesity (>25)
Physical inactivity 
Hypertension >140\90
Polycystic ovary syndrome
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7
Q

Which are the chronic complications for DM?

A
  1. Neuropathy
  2. Nephropathy
  3. Retinopathy
  4. Cardiomyopathy
  5. Skin manifestation
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9
Q

Etiology of DKA.

A

Infection
Infarction
Intoxication
Inadequate insulin

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10
Q

Signs & Symptoms of DKA.

A 
3P
Weight loss 
Abdominal pain 
Nausea 
Vomiting 
Kussmalls breathing
Ketones breath
Tachycardia 
Tachypnea
Dehydration 
Confusion 
Muscular weakness 
Dry skin
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11
Q

Diagnostic criteria for DKA.

A

Cbc -> hyperglycemia, hyperketonemia, WBC high
Urinalysis-> ketonuria, glucosuria
ABG -> ph low, HCO3 low
Ecg -> arrhythmia

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12
Q

Management of DKA

A
  1. Fluid + electrolytes
  2. Insulin
  3. Sodium bicarbonate
  4. Infection
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13
Q

Diagnostic criteria for HHS.

A

Osmolarity >360mosm/l
Glucose >360
Ph >7.5
Extreme dehydration

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14
Q

Signs & symptoms of hhs

A 
Lethargy 
Polyuria 
Polydipsia 
Weakness 
Confusion 
Coma
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15
Q

Causes of hypoglycemia.

A
  1. Too much insulin intake
  2. Not eating enough
  3. Skipping meals
  4. Increasing exercise
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16
Q

Treatment of hypoglycemia in conscious person.

A

Oral sugar administration (simple carbohydrates)
Retest in 15’ to ensure Glucose >4.0 mmol + 15g carbohydrates
Eat usual snacks/meals with carbo and protein

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17
Q

Treatment of hypoglycemia in unconscious patient.

A

1mg glycagon SC/IM

Call

18
Q

Symptoms of hypoglycemia

A

Neurogenic: tremor, sweating, hunger, nausea, palpitations
Neuroglycopenic: confusion, weakness, drowsiness, vision changes, dizziness, difficulty of speaking

19
Q

Metabolic syndrome: Definition

A

A cluster of conditions that may cause heart disease, seizures

20
Q

Causes of MS

A

Insulin resistance
Obesity
Inactivity

21
Q

Diagnostic criteria for MS.

A
  • abdominal obesity ( waist >40 m, >35 f inches )
  • fasting glucose >100
  • BP > 130/80
  • triglycerides >150
  • HDL <40 m, <50 f
22
Q

Treatment for obesity

A

Lifestyle management
Orlistat drug (Xenical 120mg)
Bariatric surgery when bmi >40kg/m2

23
Q

Treatment for dyslipidemia

A

Lifestyle adjustment
Statins (simvastatin 20-40mg, rosuvastatin -> crestor 20-40mg)
Nicotinic acid
Fibrates (fenofibrat lph 200mg)

24
Q

Diagnosis for obesity

A

Height measurement
Weight measurement
Waist circumference
BMI

25
Q

Diabetic retinopathy: pathology

A

High blood flow
High capillary permeability (leakage)
Basement membrane thickening

26
Q

Signs of diabetic retinopathy

A

Neovascularization
Micro aneurysm
Edema
Cotton wool spots

27
Q

Screening for Diabetic retinopathy

A

Visual acuity
Digital fundus photography
Exam fundus through dilated pupil

28
Q

Treatment of diabetic retinopathy

A 
Glucose control 
Htn control
Ace inhibitors (captopril 12,5-25,50 mg) (lisinopril 10-20-40)
Early detection 
Laser photo coagulation
29
Q

Which are the acute complications for DM?

A
  1. Diabetic ketoacidosis
  2. Lactic acidosis
  3. Hyperglycemic hyperosmolar nonketonic state
  4. Hypoglycemia
30
Q

Which is the first line treatment of DM2 + its side effects.

A

Metformin (biguanides) -> improves peripheral glucose uptake, high insulin sensitivity, low hepatic glucose production

Side effects: nausea, vomiting, flatulence, diarrhea, abdominal pain, lactic acidosis, weight loss

31
Q

Side effects + mechanism of sulfanylureas + examples.

A

Increase the pancreatic secretion of insulin

Side effects: hypoglycemia, weight gain, renal impairment

1st: chlopropamide
2nd: glibenclamide, gliquidone, gliclazide
3rd: glimepiride

32
Q

Meglitinides: side effects +mechanism

A

Repaglinide + nateglinide

Increased secretion if insulin
Side effects: hypoglycemia, weight gain

33
Q

Thiazoladinediones: side effects, mechanism.

A

Decrease insulin resistance

Pyoglitazone + rosigitazone

Side effects: weight gain, hypoglycemia, heart failure, edema

34
Q

Alpha glucosidase inhibitors: side effects, mechanism.

A

Acarbose

Blocks glucose absorption in the bowel
Take it before every meal

Side effects: flatulence, diarrhea, abdominal pain

35
Q

Glucagon like peptide-1 : everything

A

Exenatide 2 injection/day

Mechanism: decrease glucagon release, decrease gastric emptying, improves insulin sensitivity

Side effects: weight loss, pancreatitis, nausea, vomiting, dyspepsia

36
Q

SGLT-2: everything

A

Canagliflozin, dapagliflozin

Reduces renal tubular glucose re absorption

Side effects: polyuria, urinary infection, yeast infection, polydipsia

If kidney impairment, NOT recommended

37
Q

Which of the drugs have as side effects weight loss?

A

Biguanides

GLP-1

Diabetes (1 decks)

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