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Medical Emergencies Dental > Diabetes-Related Emergencies Exam 3 > Flashcards

Diabetes-Related Emergencies Exam 3 Flashcards

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USMLE® Step 1 flashcards
1
Q

What is Diabetes Mellitus?

A

Metabolic disorder characterized by
hyperglycemia

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1
Q

What is the etiology of Diabetes Mellitus?

A
  • Reduction or absence of production of insulin
    by beta cells of pancreas or defect of insulin
    receptors
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2
Q

What does Insulin do?

A

Helps to aids in conversion of sugat and starches to a form transported to cells and used for energy

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3
Q

What are the three types of Diabetes mellitus?

A
  • Type 1
  • Type 2
  • Gestations
  • Prediabetes or impairedd glucose tolerance
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4
Q

Describe type 1 diabetes

A
  • Absolute lack of insulin
  • Pancreatic beta cells within Islets of Langerhan destroyed due to immune dysfunction
  • Dependent on supplemental insulin for survival
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5
Q

Describe Type 2 diabetes

A
  • On the rise due to increase life span, sedentary lifestyle and Poor diet and excerise
  • Body is unable to produce enough insulin
  • Body cannot use the insulin produced
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6
Q

What is Gestational diabetes?

A

Glucose intolerance- occurs during pregnancy

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7
Q

What is the cause of gestational diabetes and what can happen if left untreated?

A

Cause: Enzyme in placenta and destruction of insulin by placenta
Left untreated: Infant can have fetal macrosomia, hypoglycemia, hypocalcemia, or hyperbilirubinemia.

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8
Q

What are the different types of Diabetes tests?

A

A1C test - measure 2-3 months
- 5.7 normal 6.4 pre, 6.4 higher diabetes

Fasting plasma glucose test - 12-14 hour fasting
100-125 pre, 126 diabetes

Oral glucose tolerance test- Fast and drinking glucose drink
140-199 pre , >200 diabetes

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9
Q

What are the FIVE major systemic complications?

A
  • Diabetic retinopathy
  • Diabetic neuropathy
  • Diabetic nephropathy
  • Macrovascular and microvascular
  • Oral manifestations
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10
Q

What is diabetic retinopathy

A
  • Condition that is continuous from another disease/injury
  • Leading cause if blindness ages 20-74
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11
Q

What is dibetic neuropathy?

A
  • Pain in the feet and hands, slowed digestion, and
    other neurological problems are common.
    50% diabetics
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12
Q

What is diabetic Nephropathy?

A
  • Damages of small blood vessels in kidneys
  • Kidney failure- needs dialysis or transplant
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13
Q

What are the oral manifestations of diabetes?

A

Increased incidence of:
* Delayed wound healing leading to secondary
oral and systemic infections
* Periodontal disease
* Abscesses
* Xerostomia
* Caries
* Lichen planus
* Candidiasis

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14
Q

What are the medications and treatments for Type 1 diabeics?

A
  • Insulin
  • Can differ based on onset, peak effectiveness, effective duration and maximal duration
  • Pumps
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15
Q

What are the medications and treatments for Type 2 diabeics?

A
  • Medication based on cause and severity
  • Medications: Metformin (Glucophage)
    Rosiglitazone (Avandia), Tolbutamide (Orinase), Glyburide (Micronase, DiaBeta, Glynase)
16
Q

What questions to ask all diabetic patients?

A
  • Do you monitor glucose levels? If so, how often?
  • What were your most recent glucose levels?
  • How are you feeling?
  • Do you take medication and if so, did you take it today?
  • Have you eaten today? If so, when?
  • Are you having problems with your eyes, feet, and/or legs?
  • Do you see your physician regularly?
  • Do you see an eye doctor yearly?
  • Do you know your average hemoglobin value? HbA1C
17
Q

What are some strategies to implement?

A
  • Schedule appointments in early to mid-morning.
  • Keep appointments short.
  • Instruct patients to continue normal dietary intake prior to appointment.
  • Check patientʼs blood glucose level prior to any invasive procedure or if patient complains of not feeling well.
  • Frequent recall examinations and prophylaxis
  • Use of topical fluoride
  • Recommending saliva substitutes
18
Q

What are some Diabetic medical emergencies?

A
  • Diabetic ketoacidosis (DKA)
  • Hyperosmolar Hyperglycemic Nonketotic
    Syndrome (HHNKS)
  • Hypoglycemia
19
Q

What is an uncommon occurence in a dental office?

A

Diabetic ketoacidosis (DKA)

20
Q

What are the different types of patient affected by diabetic ketoacidosis?

A
  • Newly diagnosed Type 1 diabetics
  • Patients that are not medicating or eating properly
  • Brittle diabetics
  • Patients with infections
  • Patients who use Alcohol and cocaine
21
Q

What causes diabetic ketoacidosis?

A
  • By prodcuts of fatty acides= blood to become more acidic- leads to tachypnea and Kussmaul respirations
22
Q

What are some signs of DKA?

A

Altered mental state
Dehydrated
Skin and mucous warm and dry
Increase thirst
Muscle weakness and severe fatigue
Tachycardia
Hypotension
Vision blurred
Tachypnea and kussmaul

23
Q

What is the treatment of DKA?

A
  • Determine blood glucose level.
  • Need to lower blood glucose level with insulin
  • Should only be administered by medical professional to prevent hypoglycemia
  • Contact EMS.
  • IV fluids needed
  • Monitor vital signs
  • Give oxygen
24
Q

T/F If unsure provide glucose as it will not significantly harm a DKA patient and it will significantly help a hypoglycemic patient.

A

True

25
Q

What is HHNKS?

A

Hyperosmolar Hyperglycemic Nonketotic Syndrome- Patient will be hyperglycemic and dehydrated, but not acidotic.

26
Q

What is Severe Hypoglycemia?

A
  • AKA insulin shock
  • Blood glucose level below 40-50
27
Q

What are the signs and symptoms of severe hypoglycemia ?

A

Dizziness
fainting
weakness
headache
intense hunger
cold, clammy skin
profused perspiration
seizure
confusion
coma
irritability

28
Q

Treatment of severe hypoglycemia conscious patient ?

A
  • Eat/Drink 15g carbs
  • wait 15 min
  • check blood
  • less than 70mg/dl, repeat steps
29
Q

Treatment of severe hypoglycemia unconscious patient?

A
  • Contact EMS
  • Maintain airway
  • Administer 20ml of 50% IV glucagon
  • Monitor VS
  • Give o2

Medical Emergencies Dental (16 decks)

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