diabetes cpc

Question 1

what are the measurement parameters for diabetes?

Answer 1

Symptoms plus one of the following

• A fasting plasma glucose > 7 mmol/L
  
  • A 2 hour plasma glucose in a GTT > 11.1 mmol/L
  • HbA1c > 6.5% (48 mmol/mol)

Or 2 bloods but no symptoms

Question 2

what is the BbA1c for a non-diabetic person?

Answer 2

○ Non-diabetic HbA1c < 42 mmol/mol

Question 3

3 causes of metabolic alkalosis?

Answer 3

H+ loss (e.g. vomiting)
Hypokalaemia - hyopkalaemic alkalosis
Ingestion of Bicarbonate

Question 4

formula for osmolality?

mmemonic?

Answer 4

im usually 2 nakud but I’m a g:

2 (Na+K) + U + G

Question 5

formula for anion gap?

Answer 5

Na + K - Cl - Bicarbonate

remember that apart from Na and K, the last 2 are different from the other equation we have to learn.

Question 6

3 causes of cushings?

Answer 6

Pituitary adenoma
Ectopic ACTH
Adrenal tumour

Question 7

when ACTH levels are very very high, what is the cause of severe hypokalaemia?

Answer 7

cortisol binding to MR receptor

Question 8

what is acute tubular necrosis and what is the treatment ?

Answer 8

Acute tubular necrosis is classified as a “renal” (i.e. not pre-renal or post-renal) cause of acute kidney injury.

Diagnosis is made by a FENa (fractional excretion of sodium) > 3% and presence of muddy casts (a type of granular cast) in urinalysis.

Rx: treat underlying cause eg stop drug and rehydrate.
last call - dialysis for 3 weeks

Question 9

treatment of Diabetic glomerular kidney disease ?

Answer 9

dialysis for life

Question 10

Cushings showing bilateral adrenal hyperplasia. treatment?

Answer 10

bilateral adrenalectomy

Question 11

treatment of MI?

Answer 11

STEMI

1. PCI aka Primary angioplasty
   
   • within 120 mins
2. If PCI not available :
   
   • fibrinolysis (if not contraindicated) : MONA

          ○ Morphine
     ○ Aspirin + P2Y12 inhibitor (clopidogrel/ticagrelor)   ○ IV GTN - consider this   ○ Beta-blocker

NSTEMI:
If stable -> MONA
If unstable -> Revascularisation (PCI/CABG) + MONA

Question 12

Hypertonia
Hyperreflexia
Spasticity
Reduced power

poiositve babinsky - remember my baby one

are examples of?

Answer 12

Upper Motor Neurone Signs

Question 13

Hypotonia/ atonia
Hyporeflexia
Fasciculations
Flacid muscle weakness

are examples of?

Answer 13

Lower Motor Neurone Signs