Brainscape's Knowledge GenomeTM

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


See full index

Pharmacology Test #3 > Diabetes Day 1 > Flashcards

Diabetes Day 1 Flashcards

1
Q

What is the cause of type 1 diabetes?

A

Autoimmune destructive of pancreatic beta-cells

Viruses cause beta-cell destruction; congenital rubella, coxsackievirus B, cytomegalovirus, adenovirus, mumps

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

What is the prevalence of type 1 diabetes?

A

< 10%

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

What is the cause of type 2 diabetes?

A

Combo of complex metabolic disorders:

  1. Insulin resistance in muscle/adipose tissue
  2. Progressive declinein pancreatic insulin secretion
  3. Unrestrained hepatic glucose production
  4. Other hormonal deficiencies (amylin/incretin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the prevalence of type 2 diabetes?

A

> 90%

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

What are the signs and symptoms of hyperglycemia?

A

Polyuria

Polydispsia

Polyphagia

Fatigue

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

What are the 2 most important risk factors for type 2 diabetes?

A

Overweight or obese

Sedentary lifestyle

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

What are other risk factors for type 2 diabetes?

A

Family Hx of diabetes

Cardiovascular dz

Non-white

Previously ID’d impaired glucose tolerance or impaired fasting glucose

Hypertension (> 140/90 or on HTN meds)

Increased levels of triglycerides (> 250), los concentrations of high-density lipoprotein cholesterol (< 35) or both

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

What are the risk factors for gestational diabetes?

A

Hx of gestational diabetes

History of delivery of an infant w/ birth weight > 9 lbs

Polycystic ovary syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When would you screen a patient for diabetes?

A

Asymptomatic pts w/ BMI >/= 25 kg/M2 in adults of any age and who have 1+ additional risk factors

Pts w/o risk who have a high BMI starting @ age 45

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

When would you retest in pts w/ high BMI w/ or w/o risk factors if their initial test is negative?

A

3 year intervals

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

What is A1C testing for?

A

HbA1C

of glucose attached to RBC

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

When testing A1C in a pt w/ diabetes, what A1C value considered well controlled, not controlled, and what are the other values?

A

Well controlled = 6

Not controlled = 12

Everything else is in between

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

What blood tests are used to diagnose diabetes?

A

A1C

Fasting Plasma Glucose (can’t eat for 8 hours)

Random Glucose + Symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What A1C levels are considered normal?

A

< 5.7%

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

What A1C levels are considered pre-diabetes?

A

5.7 - 6.4%

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

What A1C levels are considered diabetes?

A

≥ 6.5%

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

What fasting plasma glucose is considered normal?

A

< 100 mg/dL

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

What fasting plasma glucose is considered pre-diabetes?

A

100 - 125 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What fasting plasma glucose is considered diabetes?

A

≥ 126 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What random glucose + symptoms are considered diabetes?

A

≥ 200 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is oral glucose tolerance testing done?

A

Dx gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are treatment goals for diabetes?

A

A1C: < 7% for most pts (can be more or less strict for certain pts)

Fasting: < 100 mg/dL

Before meals: 70 - 120 mg/dL

After meals: < 180 mg/dL (not used often)

23
Q

If a pt is determined to be pre-diabetic what treatment can be considered?

A

Metformin

Annual monitoring for development of DM

24
Q

What factors should be considered when treating a pre-diabetic w/ metformin?

A

BMI > 35kg/m2

< 60 years of age

Women w/ prior GDM

25
Q

What are the macrovascular complications of diabetes?

A

Coronary Artery Disease

HTN

Dyslipidemia

26
Q

What are the microvascular complications of diabetes?

A

Retinopathy

Neuropathy

Nephropathy

27
Q

How would you manage coronary artery disease?

A

ASA (baby aspirin) –> 81 mg daily

28
Q

Which patients should be on baby aspirin?

A

Men > 50 yo/Women > 60 yo w/ at least 1 additional risk factor

Risk Factors: Family Hx of CVD, HTN, Smoking, Dyslipidemia, Albunemia

29
Q

What is the goal BP for pts w/ HTN?

A

140/80

130/80 (Certain pts)

30
Q

How would you treat pts w/ HTN?

A

ACE-1

ARB

31
Q

What is the goal lipid levels for pts w/ dyslipidemia?

A

LDL < 100

32
Q

How would you treat pts w/ dyslipidemia?

A

Statins

33
Q

Which pts do you put on statins?

A

Hx of MI

> 40 yo w/ other risk factors

34
Q

How do you prevent retinopathy?

A

Manage HTN/Glucose

35
Q

How would you treat retinopathy?

A

Laser Tx

36
Q

How do you prevent Neuropathy?

A

Manage HTN/Glucose

37
Q

What are the sings of peripheral neuropathy?

A

Numbness/tingling in hands/feet

38
Q

How do you treat peripheral neuropathy?

A

Yearly foot exams

Gabapentin = first-line; 2400 - 3600mg daily

Lyrica/Cymbalta (FDA approved)

TCAs

39
Q

What are the signs/symptoms of autonomic neuropathy and how would you treat said signs?

A

Erectile dysfunction –> PDE-5 inhibitors

Gastropyresis (nausea, pain bloating, full easily) –> Reglan (first-line)/Erythromycin

Constipation –> Stool softeners

40
Q

How do you decrease risk of infections for diabetic pts?

A

Annual influenza vaccine

Pneumococcal polysaccharide vacine

41
Q

What are the non-pharmacological therapies for diabetics?

A

Exericse (30 min most days)

Diet (avoid foods high in saturated fats, carbs, sugar; increase fiber)

42
Q

What are the complications for gestational diabetes?

A

Macrosomia (baby > 9 lbs –> C-section)

Neonatal metabolic problems

Preinatal mortality

HTN/preeclamsia during pregnancy

43
Q

What are the risk factors for gestational diabetes?

A

> 25 yo

Overweight/obese

Family Hx of DM2 (first degree relative)

Hx of abnormal glucose metabolism

Hx of poor obstetric outcomes (miscarriage)

Hx of delivery of infant > 9 lbs

Hx of polycystic ovarian dz

Ethnicity –> non-whites

44
Q

When would you screen pregnant women for gestational diabetes?

A

Pts w/ risk factors = first prenatal visit

Pts w/o risk factors = OGTT @ 24 - 28 weeks

45
Q

What are the first line treatments for gestational diabetes?

A

Dietary Modifications

Exercise

Insulin

46
Q

What are the oral agents that are used to treat gestational diabetes?

A

Glipizide

Glyburide

47
Q

Which oral agents are NOT recommended to treat gestational diabetes?

A

Biguanides

TZDs

48
Q

What are the follow up recommendations for a woman who has had gestational diabetes?

A

Tested 6 - 12 wks postpartum

Screened every 3 yr for development of DM or pre-diabetes

49
Q

What are the complications in treating children and adolescents for diabetes?

A

Changes in insulin sensitivity d/t hormone changes

Growth patterns

Supervision @ school/daycare (to be giving themselves insulin)

Unique vulnerability to hypoglycemia and DKA

50
Q

Because kids are more sensitive to hypoglycemia and DKA, where do you want their A1C levels?

A

> 8

**less strict

51
Q

How are the treatment goals for children compared to adults with diabetes?

A

Laxed b/c of hypoglycemia risk

**kids < 5 have risk of developing sever neurological damage from hypoglycemia

52
Q

What do diabetic pts > 65 have increased rates of?

A

Premature death

Functional/cognitive impairment

Co-morbid conditions (heart dz, stroke, etc)

53
Q

When treating pts > 65 when do you want to be more strict with their treatment goals?

A

Have significant life expectancy

Functional

Cognitively intact

** fasting > 100; A1C > 6.5

54
Q

What are the therapy goals for diabetic pts > 65?

A

Avoid hypoglycemia (can lead to falls) so be more laxed if you have to

Treat all heart conditions

Pharmacology Test #3 (6 decks)

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