Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med II FINAL (Annie & Lauren) (the answer is always lifestyle modifications) > Diabetes I (Lauren) > Flashcards

Diabetes I (Lauren) Flashcards

1
Q

Is all diabetes Type 1, Type 2, or gestational?

A

No there is also “Secondary Diabetes” that can be caused by pancreas problems (cystic fibrosis) or drug-induced (steroids)

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

Type 1 diabetes is almost always __________

A

Autoimmune

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

What kinds of antibodies will someone with type 1 diabetes have?

A

GAD 65

Islet cell antibodies

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

Does everyone with type 1 diabetes have a constant rate of B-cell destruction?

A

No it is quite variable, and it is possible for some peopel to make it til they’re like 40 before they become type 1 diabetic

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

What is Latent Autoimmune DIabetes of Adults ?

A

Slow onset type 1 diabetes. (40 yr olds getting newly diagnosed with type 1)

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

What causes the body of someone with type 1 diabetes to just start attacking its B cells?

A

An immunologic trigger

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

What are the CLASSIC symptoms of Type 1 diabetes

A

Polyuria

Polydipsia

Polyphagia

Nocturia

Weight loss

Blurry vision (hyperosmotic state affects lens)

DKA

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

Type 2 diabetes is a (gradual/acute) onset

A

Gradual

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

_______obesity correlates with insulin resistance

A

Visceral

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

Why do peopel with type 2 diabetes end up with impaired insulin secretion?

A

the B cells burn out and die off

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

What happens to the liver in type 2 diabetes?

A

Increased hepatic glucose output

Fatty liver

Dyslipidemia

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

What is the progression of type 2 diabetes?

A
  1. Peripheral insulin resistance causing hyperinsulinemia
  2. Impaired glucose tolerance (Prediabetes)- elevated postprandial glucose, decreased insulin secretion, increased hepatic glucose production
  3. Overt diabetes- fasting hyperglycemia
  4. Beta cell failure- “Burn out”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How will most patients with type 2 DM present?

A

Asymptomatic

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

What are some of the symptoms on Type 2 DM if they’re going to have symptoms?

A

3 P’s

Nocturia

Blurry vision

Paresthesias

Fatigue

Chronic skin infections

Poor wound healing

Vaginal yeast infections ALL the time

Balanitis- yeast infection of penis

Hyperglycemic hyperosmolar state (no ketones)

DKA- very rare, but can happen

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

Acanthosis nigricans is indicative of_____________

A

Insulin resistance

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

Family history of diabetes is more common in type (1/2)

A

2 ***

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

Most common age at diagnosis

Type 1:

Type 2:

A

Type 1: <25, but can occur at any age

Type 2: >25, but increasing in younger people

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

Body type

Type 1:

Type 2:

A

Type 1: thin

Type 2: overweight

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

Autoantibodies present?
Type 1:

Type 2:

A

Type 1: yes

Type 2: no

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

Insulin dependent?

Type 1:

Type 2:

A

Type 1: yes

Type 2: no

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

Insulin sensitivity

Type 1:

Type 2:

A

Type 1: normal when controlled

Type 2: decreased

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

Risk of DKA

Type 1:

Type 2:

A

Type 1: high

Type 2: low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Who needs to be tested for type 2 diabetes?

A

Everyone over 45

People who are overweight/obese who have one or more additional risk factors****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the risk factors for type 2 diabetes?

A

1st degree relative with DM

High risk race- black, hispanic, Native American, Asian, Pacific Islander

CVD

HTN

HDL <35

Triglyceride >250

Women with PCOS/GDM

Sedentary lifestyle

Severe obesity

Acanthosis nigricans

(If they are overweught and have ONE of these, they need to be screened for type 2 DM!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the 3 test that can be done to screen for diabetes?
Fasting plasma glucose 2-hr oral glucose tolerance test HbA1C
26
Which diabetes measurement has a strong predictive value for diabetes complications?
HbA1C
27
Fasting plasma glucose levels Normal: Prediabetes: Diabetes:
Normal: <100 Prediabetes: 100-125 (IFG) Diabetes: 126+ ************
28
2 hr oral glucose tolerance test levels: Normal: Prediabetes: Diabetes:
Normal: <140 Prediabetes: 140-199 Diabetes: 200+ ***********
29
HbA1C levels Normal: Prediabetes: Diabetes:
Normal: <5.7 Prediabetes: 5.7-6.4 Diabetes: 6.5+ ***********
30
When can a single random plasma glucose be diagnostic for diabetes?
If it is over 200 and they have classic symptoms of hyperglycemia
31
If you do a fasting plasma glucose, an OGTT, and an HbA1C, and one of them comes back at diabetes levels, can you diagnose diabetes in someone who is asymptomatic?
No, you would need a second test for confirmation
32
If you have an asymptomatic patient and you do Fasting glucose, OGTT, and HbA1C, and 2 of them come back at diabetes levels, can you diagnose them?
Yes, because you had 2 positive tests
33
If you have an asymptomatic patient and you do Fasting glucose, OGTT, and HbA1C, and only the HbA1C comes back at diabetes levels, when do you need to repeat the HbA1C to confirm the diagnosis?
Repeat it right away | You don’t need to wait 3 months. You’re just trying to rule out lab error
34
If you have do Fasting glucose, OGTT, and HbA1C and only one of them comes back at diabetes levels, which one do you need to repeat to confirm the diagnosis?
Whichever one came back above the threshold Ex: if only HbA1C came back high, you only need to repeat HbA1C (immediately)
35
What HbA1C levels are considered “prediabetic”?
5.7-6.4%
36
Prediabetes puts you at increased risk for:
Type 2 diabetes lol Heart disease Stroke
37
You diagnosed your patient with Prediabetes. Now what?
WEIGHT LOSS NOW. Restores insulin sensitivity **** EDUCATION AND PREVENTION **** Metformin*** Counseling/maintenance programs Screen for and treat risk factors for ASCVD Test them YEARLY for diabetes ***
38
How often do prediabetics need to be screened for diabetes?
yearly ************
39
As HbA1C goes up, risk goes up (linearly/curvilinear)
Curvilinear continuum of risk for HbA1C As A1C rises, the risk for diabetes rises disproportionately ******
40
If you decide to screen a patient for diabetes and they’re not prediabetic or diabetic, how often do you need to repeat testing?
Every 3 years at a minimum
41
Is someone with gestational diabetes always at a higher risk of regular diabetes
Yes
42
What do you need to ask when you’re taking a history from a patient with DM? (Long list sorry)
Age Characteristics of onset of DM (ex age at dx) Nutrition/weight Physical activity/sleep behaviors Dental disease Last dilated eye exam? Psychosocial health SHx- smoking EtOH Review meds and response to tx Review patients glucose log DKA- frequency, severity Hypoglycemic episodes- aware of it? Microvascular complications Macrovascular complications
43
What vaccinations do diabetics need
Hep B Flu Pneumococcal
44
What are some comorbidities commonly seen in diabetics?
Autoimmune disease (Type 1) Fatty liver Obstructive sleep apnea** Cancer** Fractures* Low testosterone in men Dental disease Hearing impairment Depression/anxiety
45
What do you need to do during your physical exam on someone who is diabetic?
Height, weight, BMI BP Fundoscopic exam Thyroid palpation Skin exam FOOT EXAM
46
What labs do you need to order when your diabetic patient comes in for a checkup
HbA1C*** Fasting lipid panel LFTs Urinary albumin to creatinine ratio BMP B12 (if on metformin) TSH (Type 1 DM prone to other autoimmune)
47
What vitamin deficiency may someone on metformin devleop ?
B12– which would cause ~paresthesias~ just like dieabteic neuropathy would whaoaaaaoaaa
48
What is the leading cause of morbidity and mortality for diabetics
ASCVD
49
What 3 conditions fall under the classification of ASCVD?
Coronary heart disease (which may progress to HF and kill them that way) Stroke/TIA PAD (of atherosclerotic origin)
50
Diabetes itself confers independent _______ for ASCVD
Risk
51
What causes diabetic nephropathy
Chronic hyperglycemia | Uncontrolled for a looong time- at least 10 years for type 1 DM, but may be present at diagnosis of Type 2
52
What is the difference between diabetic Kidney disease and Diabetic nephropathy
Diabetic Kidney Disease: CKD related to diabetes. Albuminuria and reduced GFR Diabetic Nephropathy: ~progressive~ albuminuria, HTN, declining GFR in a patient with diabetes for over 10 years (I have no idea what this means)
53
When do you need to start annual screening of diabetic patients for diabetic nephropathy?
Type 1- after they’ve had DM for 5 years Type 2- at time of diagnosis
54
How do you screen for diabetic nephropathy?
Urinary albumin GFR (2-3 specimens of urine collected within a 3-6 month period should be abnormal before considering a pt to have albuminuria)
55
How do you prevent diabetic nephropathy
ACE/ARB Control blood sugar Control BP
56
What is the leading cause of blindness for people 20-74 yrs old?
Diabetic retinopathy wow bet you didn’t see that coming Lololololol
57
Prevalence of diabetic retinopathy is strongly related to _________ and _________
Duration of diabetes Level of glycemic control
58
What are the 2 types of diabetic retinopathy?
Nonproliferative- hemorrhages, lipid exudates, cotton wool spots Proliferative- all of the above plus NEOVASCULARIZATION due to ischemia **************************
59
What kind of vision loss will diabetic retinopathy cause?
Central vision loss
60
Vast majority of patients who develop diabetic retinopathy have (many symptoms/no symptoms)
No symptoms*** Very important to do dilated eye exams yearly
61
When do diabetics need to start doing annual dilated eye exams?
Type 1- within 5 years of DM diagnosis Type 2- at the time of diagnosis
62
If you discover diabetic retinopathy, should you try to handle it all on your own
Refer to ophthalmologist!
63
What are the two types of diabetic neuropathy?
Peripheral neuropathy Autonomic neuropathy
64
Prevalence of diabetic neuropathy varies with both severity and duration of _____________
Hyperglycemia (need high sugar for a looong time)
65
What pattern of sensory loss will someone with diabetic peripheral neuropathy have?
SYMMETRIC STOCKING GLOVE***********
66
What are the the signs/sx of diabetic peripheral neuropathy?
Burning/tingling Numbness and **loss of protective sensation*** Loss of vibratory sensation and altered proprioception** Decreased ankle reflexes
67
Why are diabetics at increased risk of foot ulcers?
Loss of protective sensation= hurt themselves and don’t know it Poor wound healing
68
What are risk factors for developing foot ulcers/amputation of your foot?
Poor glycemic control Peripheral neuropathy with loss of protective sensation Smoking- poor circulation Foot deformity- i.e., Charcot foot** Preulcerative callus or corn Hx of ulcer/amputation Visual impairment- can’t even see the ulcers on their feet Diabetic nephropathy PAD
69
What is Charcot Arthropathy?
A “rocker bottom” foot due to their weird weight distribution
70
How often do you need to do a comprehensive foot evaluation in diabetics?
At least once a year Type 1- starting at 5 years after diagnosis Type 2- starting at time of diagnosis
71
Should you look at DM patients feet at every visit?
Yes
72
How do you do a comprehensive foot evaluation?
Inspection Check pulses Perform an ABI- sx of claudication or decreased/absent pedal pulses **** ON TEST Vibration sensation Pressure sensation- 10-g monofilament testing***** Pinprick or temperature sensation
73
How do you do a monofilament test?
Poke bottom of foot in different places with enough pressure til the monofilament bends (Their eyes should be closed)
74
What is the most useful test to diagnose loss of protective sensation?
Monofilament test
75
What is autonomic neuropathy?
They have dysfunction with their autonomic nervous system
76
What are clinical manifestations of autonomic neuropathy?
Metabolic- hypoglycemia unawareness********** CV- orthostatic hypotension, resting tachycardia GI- gastroparesis, GERD, poop problems GU- Erectile dysfunction ** Sudomotor/vasomotor- can’t regulate sweating Pupillary- pupil doesn’t dilate in the dark
77
In the spirit of 1 health, who do you need to refer diabetic patients to?
Endocrinologist Ophthalmologist Family planning if they wanna b a mom Dietician Diabetes self-management education Dentist Podiatrist 👣 Mental health professional

Clin Med II FINAL (Annie & Lauren) (the answer is always lifestyle modifications) (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions