Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine Block > Diabetes Mellitus > Flashcards

Diabetes Mellitus Flashcards

1
Q

What is involved in a glucose tolerance test?

A

A fasting blood glucose is taken, then patient is given a 75g glucose load. A second blood glucose reading is taken 2 hours after

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

How does increased red cell turnover affect HbA1C?

A

HbA1C value will appear lower than true value

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

What values for fasting and random blood glucose levels are diagnostic for diabetes?

A

Fasting >7mmol/l

Random >11.1mmol/l

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

What HbA1C value would be suggestive of diabetes mellitus?

A

> 6.5% (48mmol/mol)

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

What are the main side-effects with insulin?

A

Hypoglycaemia, weight gain, lipodystrophy

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

What are the main side effects with Metformin?

A

GI upset, lactic acidosis

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

Which drug used in the management of diabetes mellitus shouldn’t be used in patient with a GFR <30

A

Metformin

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

Through which route should GLP-1 agonists be given?

A

Subcutaneous

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

How do GLP-1 agonists help to manage diabetes?

A

Incretin mimetic which Inhibits glucagon secretion

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

Which diabetic medications increase risk of pancreatitis?

A

GLP-1 agonists, DPP-4 inhibitors

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

What suffix do GLP-1 agonists have?

A

-tides

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

Which diabetic medications can cause weight gain?

A

Sulfonylureas, glitazones, insulin

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

Which diabetic medications are typically associated with weight loss?

A

SGLT-2 inhibitors, GLP-1 agonists

-gliflozins, -tides

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

What are the three diagnostic criteria for DKA?

A

Hyperglycaemia >11mmol
Capillary ketones >3mmol or Ketonuria 2++ or more
pH <7.3

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

What are the first steps in DKA management?

A 
Give fluids (according to local policy)
Commence fixed rate intravenous infusion insulin 50 units at a rate of 0.1 unit/kg/hour
Regularly reassess patient obs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is resolution of DKA defined?

A

Ketones <0.6 mmol, venous pH >7.3

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

During management of DKA what would you do if a patient’s blood glucose drops below 14mmol?

A

Add 10% dextrose at rate of 125mls/hr to avoid hypoglycaemia

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

During DKA management a patient has a potassium of 4.2, how would manage their potassium level?

A

Give 40mmol/l KCl (as potassium range is less than 5.5)

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

What would make you consider insulin infusion in a patient presenting with HHS?

A

If there is significant ketonaemia/ketonuria

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

What HHS stand for?

A

Hyperglycaemic hyperosmolar state

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

How will common presentation DKA and HHS differ?

A

onset: DKA (hours), HHS (days)

HHS- hypovolaemia, high osmolality, often in older patients more common in type 2

22
Q

What would you give to a patient who is unconscious to correct their hypoglycaemia?

A

IM glucagon 1mg

IV 20% glucose 75ml over 10 mins

23
Q

How can we reduce GI side effects of metformin?

A

Slowly titrate up their dose
Change to modified release rather than standard release

24
Q

What is first line therapy for T2DM if metformin contraindicated in patients with and without CVD?

A

With CVD: SGLT-2 inhibitor mono therapy
Without CVD: sulfonylureas / DPP-4 inhibitor / pioglitazone

25
What are other types of diabetes mellitus other than type 1 and 2?
LADA- late autoimmune diabetes of adulthood MODY- maturity onset diabetes of the young Gestational diabetes
26
What are other types of diabetes mellitus other than type 1 and 2?
LADA- late autoimmune diabetes of adulthood MODY- maturity onset diabetes of the young
27
What is the diagnosis in a patient with a high serum glucagon and a crusting red vesicular rash spreading across various parts of the body?
Glucogonoma- treated by surgical resection
28
What are cutaneous manifestations in diabetes mellitus?
Acanthosis nigracans, fungal infections and necrobiosis lipoidica (Necrobiosis lipoidica begins as a dull red papule or plaque on the shin which slowly enlarges into one or more yellowish-brown patches with a red rim)
29
What are the effects of insulin in the body?
Triggers cells to take up glucose Inhibits gluconeogenesis Inhibits glycogenolysis
30
Which cells of the pancreas produce glucagon?
Alpha cells
31
When can HbA1c be inaccurate?
Haemoglobinopathies like sickle cell
32
What kind of drug is metformin?
Biguanide
33
How does metformin work?
It increases insulin sensitivity
34
What is a contraindication to metformin?
Impaired renal function
35
How do sulfonylureas work?
They stimulate islet cells
36
What is an example of a sulfonylurea?
Gliclazide
37
What are the two main side effects with sulfonylureas?
Weight gain and hypoglycaemia
38
What are ‘gliptins’ how does this work?
DPP-4 inhibitors, works by improving insulin secretion and inhibit glucagon
39
What type of drug is exenatide?
GLP-1 agonist
40
What are diabetic complications associated with the eyes?
Diabetic retinopathy, maculopapular, rubeosis iridis-> glaucoma, cataracts
41
What is diabetic amyotrophy?
Painful wasting and weakness of proximal lower limb muscles
42
What symptoms might a patient with HHS present with?
Muscle cramps, confusion. In the time leading up to admission likely to have profound weakness, weight loss, polydipsia, polyuria
43
What is the stepwise management of hypoglycaemia?
If patient alert- oral or liquid source of glucose If patient drowsy- oral glucogel (swallow still intact) If patient unconscious- 125ml of 20% dextrose or 1mg glucagon IM injection
44
What are some complications of T2DM?
Microvascular- retinopathy, nephropathy, neuropathy Microvascular- stroke, MI, peripheral vascular disease Diabetic foot, ulcers, charcot joints, poor wound healing, UTIs,
45
What should be assessed with diabetic feet?
Level of ischaemia, level of neuropathy, bony deformity, degree of infection
46
What are surgical indications for a diabetic foot?
Abscess, deep infection, anaerobic infection, gangrene, rest pain
47
What advice should be given to patient taking insulin when they get ill?
Don’t stop taking your insulin! (Often need more with ilness despite reduced food intake) Try to maintain calorie intake Check blood glucose QDS and check for ketonuria
48
What is the stepwise approach to managing neuropathic pain in diabetes?
Paracetamol -> amitriptyline -> gabapentin/pregabalin/duloxetine -> opiates
49
What are some symptoms of autonomic dysfunction in diabetes?
Postural hypotension, erectile dysfunction, gastroparesis
50
At what HbA1c levels should monotherapy, dual therapy and triple therapy be considered?
Mono therapy considered at >48mmol Dual therapy considered > Triple therapy when >58 on dual therapy
51
When is fast acting insulin given in relation to food?
Just before a meal as takes 10-20 minutes to reach its peak. If having hypos around meal time take it after

Medicine Block (11 decks)

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