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ENRP - Exam 2 > Diabetic Complications > Flashcards

Diabetic Complications Flashcards

1
Q

What is the most common complication for Type 1 DM?

A

Diabetic Ketoacidosis

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2
Q

What 3 things can trigger Diabetic Ketoacidosis?

A

Non-compliance
Initial presentation
Precursor infections

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3
Q

What are the 3 signs of Diabetic Ketoacidosis?

A

Hyperglycemia
Ketonemia
Metabolic Acidosis

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4
Q

What are the 3 signs of DKA?

A

Hyperglycemia
Ketonemia
Metabolic Acidosis

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5
Q

Describe the pathogenesis of DKA

A
  • No insulin = Hyperglycemia in the blood only
  • No glucose in the tissues = body breaks down fat (ketones)
  • Ketones and Glucose in the blood draws in water
  • Kidney dumps water, ketones, glucose into the urine
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6
Q

What molecule can continue to worsen the Diabetic Ketoacidosis?

A

Epinephrine

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7
Q

What should you test the urine for if you suspect Diabetic Ketoacidosis?

A

Ketones

acetoacetic acid and beta-hydroxybutyrate

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8
Q

Due to the Hyperglycemia, what 2 things will be present with DKA?

A

Polydipsia

Polyuria

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9
Q

What are the symptoms present with DKA?

A

Kussmaul respirations
Increased HR
Dehydration

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10
Q

What are the symptoms present with DKA?

A

Kussmaul respirations
Increased HR
Dehydration

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11
Q

Kussmaul respirations try to offset the metabolic acidosis with DKA, how?

A

Decreasing the pCO2 in order to decrease the acid

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12
Q

What type of DM can present with Hyperglycemic Hyperosmotic Syndrome?

A

Type 2

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13
Q

What causes Hyperglycemic Hyperosmotic Syndrome?

A

Culmination of prolonged insulin deficiency

  • Increased gluconeogenesis
  • Decreased glucose uptake into tissues
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14
Q

What symptoms present with Hyperglycemia Hyperosmotic Syndrome?

A

Dehydration
Impaired renal function
Obtundation/coma

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15
Q

What symptoms present with Hyperglycemic Hyperosmotic Syndrome?

A

Severe Dehydration
Impaired renal function
Obtundation/coma

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16
Q

DKA and HHS - pH

A

DKA - < 7.3

HHS - > 7.3

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17
Q

DKA and HHS - bicarbonate

A

DKA - < 18

HHS - > 18

18
Q

Anion Gap for DKA?

19
Q

DKA and HHS - Osmolality

A

DKA - < 320

HHS - > 320

20
Q

DKA and HHS - glucose levels

A

DKA - > 250

HHS - > 600

21
Q

If the glucose levels are greater than 600, what should you be thinking?

A

Hyperglycemic Hyperosmolar Syndrome

22
Q

Will Ketones be present in the urine with DKA and HHS?

A

ONLY WITH DKA

23
Q

What can measure the long term control of Diabetes?

A

Hemoglobin A1C

24
Q

What is Hemoglobin A1C?

A

Irreversible glycosylated hemoglobin

25
What is the most common cause of death with Diabetes?
MI
26
How is LE Gangrene a possible complication of Diabetes?
Vascular damage leads to endothelial dysfunction --> narrowed vessels = less blood to heal/etc. => Gangrene
27
What are 3 pathologic conditions that can occur with Diabetic Nephropathy?
Glomerular Sclerosis Arteriosclerosis Pyelonephritiis
28
What occurs with Glomerular Sclerosis?
Basement membrane THICKENS - - It is disrupted - -> Allows large molecules to leak into urine
29
If you suspect Diabetic Nephropathy, what should you measure?
Albumin:Creatinine Ratio in the urine
30
What is a normal level of the urine Albumin:Creatinine ratio?
< 30
31
Microalbuminemia and Macroalbuminemia are defined as what level of the albumin:creatinine ratio in the urine?
``` Micro = 30-300 Macro = > 300 ```
32
Diabetics are at an increased susceptibility for?
Infections
33
Hyperglycemia can damage peripheral?
Peripheral nerves = neuropathies
34
How does Diabetes lead to Retinopathy?
Hypoxia - -> VEGF overexpression - -> Neovascularization
35
What are 4 symptoms of Diabetic Retinopathy?
Hemorrhage Blindness Cataracts Glaucoma
36
What are 4 symptoms of Diabetic Retinopathy?
Hemorrhage Blindness Cataracts Glaucoma
37
Diabetes can lead to gangrene. In general, how?
Vascular damage leads to endothelial dysfunction
38
Diabetes complications are due to persistent _____
Hyperglycemia
39
How long does it take for glucose to bind to hemoglobin that makes it a good measure of long term diabetes control?
1+ months
40
What causes the obtundation/coma with Hyperglycemic Hyperosmotic Syndrome?
Hyperosmolality

ENRP - Exam 2 (21 decks)

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