Brainscape's Knowledge GenomeTM

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


See full index

Endocrinology > Diabetic Complications & Hypoglycemia > Flashcards

Diabetic Complications & Hypoglycemia Flashcards

1
Q

what diabetic complication leads to end stage renal disease?

A

nephropathy

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

kidney functioning at 10-15% of normal capacity

A

end stage renal disease (ESRD)

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

which type of DM is nephropathy more common in?

A

type 1 DM

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

how does nephropathy initially present?

A

proteinuria (increased albuminuria)

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

what should the ratio of albumin to creatinine be in the first morning void urine to be considered normal?

A

< 30 albumin mcg : 1 mg creatinine

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

what is a good predictor of future chronic renal disease?

A

ratio of albumin to creatinine in first morning void urine

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

how many abnormal readings of ratio of albumin to creatinine, and how often, to diagnose a patient with neuropathy d/t DM?

A

two abnormal readings
over 3-6 months

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

what 5 other conditions can cause albuminuria?

A

short term hypoglycemia
exercise
UTI
heart failure
fever

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

why is it important to identify diabetic nephropathy early?

A

to prevent progression to end stage renal disease

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

how can we prevent progression of nephropathy to end stage renal disease? (3)

A

glycemic control
low protein diet
ACE inhibitor or ARB

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

why is an ACE inhibitor or ARB used for nephropathy?

A

lowers intraglomerular pressure

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

what do the combination of atherosclerosis and dyslipidemia caused by DM, lead to?

A

3-5x increased risk of MI

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

what can peripheral vascular disease lead to, due to DM? (2)

A

ischemia of lower extremities
gangrene of feet

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

diseased blood vessels cannot supply blood to nerves - nerves shrivel up and lead to decreased sensation in extremities

A

peripheral neuropathy

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

what is the prevalence of peripheral neuropathy?

A

50% of older patients with type 2 DM

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

what kind of pattern is seen in peripheral neuropathy?

A

stocking and glove pattern

(distal symmetric polyneuropathy)

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

what is gone first in peripheral neuropathy? how does the patient present? (3)

A

sensory

decreased pain
decreased vibratory
decreased temp

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

what exam can we use to determine if a patient has peripheral neuropathy?

A

Semmes Weinstein filament

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

dot hemorrhages, exudates, and retinal edema present in 60% of diabetes after 16 years

A

non-proliferative retinopathy

20
Q

what occurs in non-proliferative retinopathy? what does it lead to?

A

retinal capillary leaks proteins and lipids into retina/macula

visual impairment

21
Q

what is the most common cause of visual impairment?

A

non-proliferative retinopathy

22
Q

neovascularization in the retina and vitreous chamber due to capillary being totally closed off and not providing any nutrients to retina

A

proliferative retinopathy

23
Q

what does proliferative retinopathy lead to? (leading cause in the US)

A

blindness

24
Q

what can severe hypertriglyceridemia lead to?

A

cutaneous xanthomas

25
Q

brown, painless spots that don’t require treatment

A

shin spots

26
Q

what kind of infection can DM cause below the breasts, axillas, between the fingers, and vulvovaginitis?

A

candidal infection

27
Q

if a patient presents with shin spots, when do they say the onset was?

A

1-2 weeks ago

28
Q

hyperpigmented, velvety plaques located in the axillae, groin, and posterior neck

A

acanthosis nigricans

29
Q

how is acanthosis nigricans described?

A

hyperkeratosis (increased production of skin)

30
Q

in which DM type is hyperpigmentation/ acanthosis nigricans common in?

A

type 2 DM

31
Q

in patients with DM, what should be done at every annual appointment? (6)

A

foot exam
optometry with dilation
U/A
serum creatinine
lipid panel
LFT

32
Q

what are we looking for in a U/A for DM patients? (2)

A

albumin
glucose

33
Q

what vaccines should we encourage at appointments for DM patients?

A

flu vaccine annually
pneumococcal q 5 yrs

34
Q

how often should Hgb be checked?

A

at least q 6 months

35
Q

what is our goal for BP and LDL in patients with DM? (2)

A

BP 120-130/90

lower LDL by 30-50%

36
Q

at what glucose level is endogenous insulin inhibited?

A

glucose < 80

37
Q

at what glucose level does glucagon get released into the blood?

A

glucose < 70

38
Q

what is released into the blood when glucose is below 65? (3)

A

epinephrine
GH
cortisol

39
Q

what occurs when glucose is below 50?

A

decreased alertness

40
Q

a patient presents with diaphoresis, palpitations, hunger and anxiety. what is their approximate glucose level?

A

less than 65

41
Q

what causes the sweating, palpitations, nausea, hunger, anxiety and tremor in hypoglycemia?

A

adrenergic surge (cortisol and epi)

42
Q

what causes the blurred vision, decreased fine motor skills, poor concentration, and dizziness in hypoglycemia?

A

decreased cognitive function

43
Q

what 3 components are required to diagnose hypoglycemia? what is the name for it?

A

hx of hypoglycemic symptoms

fasting BG < 45

immediate recovery after getting glucose

Whipple’s Triad

44
Q

what are 4 causes of hypoglycemia?

A

fasting
excess insulin
postprandial (reactive)
alcohol

45
Q

in which patients is postprandial (reactive) hypoglycemia seen?

A

after gastric bypass

46
Q

what is the treatment for a patient that is asymptomatic/mildly symptomatic with glucose equal to or less than 70?

A

give 15-20 grams of oral glucose

Endocrinology (17 decks)

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