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Medical Diagnostics > Diabetic Lab Values > Flashcards

Diabetic Lab Values Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the cause of type 1 diabetes?

A
  • Destruction of pancreatic beta cells

- NO INSULIN MADE

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2
Q

What is the cause of type 2 diabetes?

A

-Insulin is made, but cells don’t react to it

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3
Q

What are 3 ways to check glucose?

A
  • Plasma
  • Whole blood
  • Interstitial fluid
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4
Q

What is the preferred method of checking glucose and how is it done?

A
  • Plasma glucose
  • Done in the lab
  • Can be 10-15% higher than whole blood measurement
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5
Q

What is a normal FASTING glucose?

A

70-100 mg/dL

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6
Q

What is a normal glucose after eating?

A

<125 mg/dL

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7
Q

How do you check a whole blood glucose?

A
  • Finger stick using a glucometer

- Less accurate than plasma glucose

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8
Q

What is the least accurate way to measure glucose and how is it done?

A
  • Interstitial fluid
  • Measured using a continuous glucose monitor
  • Measuring the tissue glucose NOT the blood glucose level
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9
Q

What is interstitial fluid good for when checking glucose?

A

Sometimes can be helpful to find patterns of overall glucose control

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10
Q

What can cause increased glucose levels?

A
  • Carbohydrates
  • IV fluids with dextrose
  • Glucocorticoids
  • Inflammation
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11
Q

What is hemoglobin A1c?

A
  • Measure of average blood glucose for 3-4 months

- Identified as the subtype which correlates with glycemic control

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12
Q

What is the normal range of HgbA1c?

A

Up to 6%

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13
Q

What can cause A1c to be falsely low? (conditions that reduce the life span of RBCs)

A
  • Acute anemia
  • Blood transfusions
  • Presence of chronic renal or liver disease
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14
Q

What can cause A1c to be falsely high?

A

RARE

-In theory, conditions that increase the # of RBCs

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15
Q

What is a lower A1c associated with?

A

-Decreased risk for microvascular complications associated with diabetes (kidney’s, eyes, extremeties)

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16
Q

How do you interpret A1c?

A 
A1c = 6, mean BG = 120
7, 150
8, 180
9, 210
10, 240
11, 270
12, 300
*A1c of 9 means their average sugar over 3-4 months was 210
17
Q

What are two categories of increased risk for diabetes? (pre-diabetes)

A
  • IFG = impaired fasting glucose (100-125)
  • IGT = impaired glucose tolerance (140-199 after a 75g oral glucose load)
  • A1c = 5.7-6.4
18
Q

What four things could diagnosis someone with diabetes???

A
  1. A1c > 6.5%
  2. Fasting Plasma Glucose > 126
  3. Two-hour plasma glucose >200
  4. A patient with classic symptoms of hyperglycemia or hyerglycemic crisis with a random plasma glucose of >200
    - If two different tests and one positive and one negative for diabetes, repeat the POSITIVE TEST
19
Q

What is a microalbumin test?

A
  • If high, it means there is protein in your urine WHICH IT SHOULD NOT BE –> this is a sign of kidney disease
  • Initial test at the time of diagnosis for DM2
  • Initial test after 5 years for DM1
20
Q

What are normal values for pH, PCO2, and bicarb?

A 
pH = 7.4
PCO2 = 40
Bicarb = 24
21
Q

What is someones pH if they are in metabolic acidosis?

A

pH <7.35

22
Q

What are the two types of metabolic acidosis?

A
  1. Non-anion gap acidosis

2. Anion gap acidosis (look at the BMP, decreased bicarb)

23
Q

What does MUDPILES stand for?

A 
Methanol
Uremia
Diabetic Ketoacidosis
Paraldehyde
Lactic Acid (elev. sepsis)
Isoniazid
Ethylene glycol 
Salicylates (aspirin)
24
Q

What are the clinical presentations of diabetic ketoacidosis?

A
  • Abdominal pain
  • Nausea/vomiting
  • Altered mental status
25
Q

Is DKA more common in DM1 or DM2?

A

DM1

26
Q

How do you diagnosis DKA?

A
  • Elevated glucose
  • Ketones + in blood
  • Decreased pH (<7.35)
  • Decreased bicarb
27
Q

What on a BMP indicates DKA?

A
  • Elevated anion gap >12
  • Hyperglycemia >200
  • Decreased bicarb <22
28
Q

How do you treat DKA?

A
  • FLUIDS

- Insulin drip (patients often go to the ICU)

29
Q

What are the levels of severity of DKA? (pH’s)

A
  • Mild = 7.25-7.35 (pt alert)
  • Moderate = 7.00-7.25 (mild drowsiness)
  • Severe = <7.00 (coma may occur)
30
Q

What is Hyperosmolar Hyperglycemic State? (HHS)

A

Similar to DKA, but without an anion gap or the presence of ketones

31
Q

When do you see HHS more, DM1 or DM2?

A

DM2

32
Q

What lab values are typical of HHS?

A
  • Extremely elevated BG, often >600
  • No ketones
  • No anion gap
33
Q

How do patients typically present in HHS?

A
  • Volume depleted state

- Altered mental status

34
Q

What is the treatment for HHS?

A
  • IV hydration
  • Insulin drip
  • Supplementing electrolytes?

Medical Diagnostics (10 decks)

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