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101a Vocab > DM and MS > Flashcards

DM and MS Flashcards

1
Q

Impaired Fasting Glucose

A

FPG 100-125

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2
Q

Impaired Glucose Tolerance

A

Based on result of 2h OGTT

140-199

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3
Q

Hba1c Prediabetes Range

A

5.7-6.4%

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4
Q

Hba1c level diagnostic for DM

A

6.5% or greater

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5
Q

Goal Hba1c for a diabetic pt (ADA)

A

less than 7%

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6
Q

In US, DM is leading cause of (3)

A

non-traumatic amputations
blindness
end stage renal disease

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7
Q

Preferred diagnostic test for DM

A

Fasting Plasma Glucose (after 8 hour fast) venous or cap stick

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8
Q

Diagnostic Criteria for DM

A

Classic s/s hyperglycemia plus random BG 200+
Hba1c 6.5% or higher
FPG 126 or higher
2 hour OGTT of 200 or higher

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9
Q

who is recommended to do SMBG

A

all insulin-treated DM pts
pts on sulfonylureas
pts not achieving glycemic control goals.

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10
Q

Type 1 pts should SMBG

A

3-4x/day

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11
Q

type 1 pts should test urine ketones when

A

during acute illness
when BG consistently elevated
s/s DKA are present

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12
Q

DM pt should not exercise when

A

BG 250

ketones positive

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13
Q

Type 1 pt should eat before exercise

A

15g CHO before moderate activity

more food for more activity

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14
Q

who should carry a readily-absorbable CHO on person

A

Type 1

pts on sulfonylureas or meglinitides

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15
Q

ADA recommended BG for DM pts before and after meals

A

before: 90-130
after: less than 180

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16
Q

drugs that can antagonize (oppose) hypoglycemic effects of insulin

A

corticosteroids
thiazide/loop diuretics
sympathomimetics
thyroid hormone

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17
Q

drugs than can increase hypoglycemic effects of insulin

A

alcohol
anabolic steroids
MAOIs
salicylates

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18
Q

can mask tachycardia from hypoglycemia

A

nonselective beta blockers

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19
Q

Peak action of rapid-acting insulin

A

1 hour

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20
Q

Duration of action of rapid-acting insulin

A

3-4 hours

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21
Q

Three types of rapid-acting insulin

A

Apidra (glulisine)
Humalog (lispro)
Novolog (aspart)

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22
Q

Onset of short-acting (regular) insulin

A

30 min-1 hour

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23
Q

Peak of action of short-acting (regular) insulin

A

2-4 hours

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24
Q

Duration of action of short-acting (regular) insulin

A

6-8 hours

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25
Q

Types of short-acting (regular) insulin

A

Novolin R

Humulin R

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26
Q

Onset of Intermediate-Acting (NPH) insulin

A

1-3 hours

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27
Q

Peak of Action of Intermediate-Acting (NPH) insulin

A

6-8 hours

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28
Q

Duration of action of Intermediate-Acting (NPH) insulin

A

12-16 hours

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29
Q

Types of Intermediate-Acting (NPH) insulin

A

Novolin N

Humulin N

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30
Q

Onset of Action of Long-Acting insulin

A

2-6 hours

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31
Q

Peak of Action of Long-Acting insulin

A

none

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32
Q

Duration of Action of Long-Acting insulin

A

12- 24 hours

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33
Q

DCCT

A

Diabetes Control and Complications Trial
Demonstrated intensive glucose control dramatically reduced the development and progression of complications; also increased risk of hypoglycemia

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34
Q

UKPDS-UK Prospective Study

A

demonstrated a decrease in complications in patients who had Type 2 DM

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35
Q

alcohol consumption is dangerous in DM pts (especially those on insulin) because

A

alcohol inhibits gluconeogenesis and can cause hypoglycemia

May also impair ability to recognize and treat HoG

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36
Q

swan neck deformity

A

affects most distal joint of finger, occurs in RA

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37
Q

ulnar deviation, drift

A

all fingers angle toward ulnar side, occurs in arthritis

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38
Q

Valgus deformities

A

distal arm of joint points away from midline (brings joints closer)

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39
Q

Bunion

A

Hallux valgus deformity of big toe

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40
Q

Genu valgum

A

Valgus deformity of knees (together)

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41
Q

Talipes valgus

A

Eversion of feet (walk on instep)

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42
Q

Varus deformities

A

distal arm of joint points toward midline (moves joints apart)

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43
Q

Talipes varus

A

inversion of feet

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44
Q

Genu varum

A

bow legs

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45
Q

Lordosis

A

exaggerated curvature of lumbar spine; “sway back”; often in pregnant women

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46
Q

Scoliosis

A

lateral curvature of spine, increased when bending forward

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47
Q

Kyphosis

A

increased curvature of thoracic spine; often in elderly with OA

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48
Q

Pes planus

A

flat foot

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49
Q

Pes cavus

A

high instep

50
Q

isometric exercise

A

contraction of muscle but no joint or extremity movement–Kegels, Quad sets

51
Q

isotonic exercise

A

muscle contraction resulting in movement

52
Q

clonus

A

rhythmic contraction of muscle

53
Q

fasciculations

A

involuntary muscle twitches

54
Q

most significant RF of OA

A

age-still not part of normal aging process

55
Q

finger nodules caused by OA

A

Herberden’s and Bouchard’s nodules

56
Q

Total Hip Dislocation Precautions

A

Keep legs abducted
No internal rotation
No flexion 60-90 degrees
No adduction (wedge pillow, pillow bt legs)

57
Q

Hereditary metabolic disturbance of purine metabolism leading to excess uric acid crystals that are deposited in body tissues and joints.

A

Gout

58
Q

Ankylosing Spondylitis

A

Type of RA

systemic inflammatory condition of vertebral column and sacroiliac joints

59
Q

Strain vs. Sprain

A

Strain: stretching of the muscle and its fascial sheath
Sprain: injury to ligaments surrounding a joint caused by twisting motion

60
Q

Compression of median nerve at wrist; entrapment neuropathy

A

Carpel Tunnel Syndrome

61
Q

3 ways to reduce a fracture

A

Closed reduction
Open reduction
Traction

62
Q

fat embolism presentation

A

confusion, respiratory distress, petechiae along chest, axilla, and neck

63
Q

s/s of compartment syndrome (6Ps)

A 
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Pressure
64
Q

goal of skin traction

A

control muscle spasms and immobilize before surgery for short periods Ex. Buck’s extension traction

65
Q

Skeletal traction is used when

A

a joint needs rest; usually large trauma or infected TJR needs to be removed.

66
Q

Bone growth outside the skeleton–bony fragments in soft tissue

A

Heterotopic ossification

67
Q

s/s Hip fracture

A

leg shortened and externally rotated
severe pain
muscle spasms
sometimes ecchymotic

68
Q

when to amputate stump post op

A

Elevate 1st 24h to reduce edema

Don’t elevate past 24h or leave flexed, can cause contracture

69
Q

First sign of osteoporosis

A

Back pain

fracture

70
Q

skeletal disorderof abnormally rapid bone turnover that results in excess localized overgrowth of bone

A

Paget’s disease

71
Q

malignant tumor of plasma cells in bone marrow

A

multiple myeloma

72
Q

pyogenic infection of bone and surrounding tissue

A

osteomyelitis

most commonly Staph

73
Q

once insulin is started in treating DKA, monitor for these two complications

A

hypokalemia and hypoglycemia

74
Q

immediately given to treat DKA

A

isotonic or hypotonic fluids to rehydrate

75
Q

ng tube given to DKA pt because

A

to relieve n/v and prevent aspiration

76
Q

HHNC treatment

A

hypotonic saline
insulin ( bolus or drip)
KCl

77
Q

elevated BUN seen in

A

DKA and HHNC

78
Q

on a sick day a diabetic should test for ketones if BG is below? how often?

A

240; q4h

79
Q

on a sick day a diabetic should call MD if BG is

A

over 300 two times

80
Q

on a sick day a diabetic should test BG

A

every 4 hours, use more insulin if needed.

81
Q

stenosing tenosynovitis

A

trigger finger

82
Q

tennis elbow

A

epicondylitis-pain radiates down dorsal forearm

83
Q

Osteoporosis treatments

A

No cure–goal is to manage pain and prevent fracture
WB exercise
Ca in diet
Biphosphates

84
Q

osteomalacia treatment

A

increase Ca Vitamin D, and light exposure

85
Q

tumor may be chondrogenic or osteogenic

A

osteosarcoma

86
Q

s/s of multiple myeloma

A

back pain
anemia
thrombocytopenia
bleeding tendencies

87
Q

osteomyelitis can complicate into

A

sepsis

88
Q

Most Type 2 diabetics can control BG through weight loss because

A

weight loss increases the number and sensitivity of insulin receptor sites

89
Q

First step tx for newly diagnosed prediabetic

A

attain ideal weight; 10-15 lbs. may increase glycemic control

90
Q

insulin action

A

Anabolic, storage hormone
moves glucose from blood into muscle, liver, and fat cells
stimulates glycogen storage in liver and muscle; inhibits glycogenolysis

91
Q

glucagon action

A

released when BG decreases

stimulates glycogenolysis–glycogen breakdown and glucose release from liver

92
Q

glucose cannot be stored in the liver without

A

insulin

93
Q

osmotic diuresis leading to electrolyte and fluid loss in diabetics results from

A

excess glucose in urine pulling water with it

94
Q

DM especially prevalent inthese groups

A

elderly

Blacks, hispanics, native americans

95
Q

timing of adult DM screening

A

begin at age 45, repeat every three years is normal, more often if pt has risk factors
(BMI >25, other rfs)

96
Q

cause and treatment of somogyi phenomenon

A

gradual excessive admin of insulin; decrease insulin or give bedtime snack

97
Q

cause and treatment of dawn phenomenon

A

surge in cortisol or GH; change time of evening insulin

98
Q

once proteinuria starts in dm nephropathy (middle stage) treat with

A

diuretics

low salt diet, protein modifications

99
Q

final stage of nephropathy treatment

A

dialysis or transplant

100
Q

the early/asymptomatic stage of nephropathy goal is

A

prevention

prompt treatment of anything that impairs kidney function: UTIs, HTN

101
Q

can decrease proteinuria even in non-HTN DM nephropathy patients

A

ACE inhibitors

102
Q

to prevent nephropathy

A

HTN management

low protein diet

103
Q

Kyphosis is associated with

A

OA

103
Q

gangrene-amputation triad

A

Neuropathy +
Vascular disease (large vessel insufficiency+autonomic neuropathy leading to dry cracked skin, decreased sweating) +
infection

104
Q

Risk of spinal HA

A

Myelogram

105
Q

Exam of action potentials made by skeletal muscle contractions to differentiate muscle and nerve disease

A

Electromyogram (EMG)

106
Q

Radioisotope scan Nsg

A

Dose of ri 2hours prior
Empty bladder
Increase fluids after

107
Q

Degree of uptake on RI bone scan indicates

A

Degree of blood flow
Increased-osteoporosis, osteomyelitis, ca, fx
Decreased-AVN

108
Q

After arthrocentesis

A

Compression dsg, observe for leakage or bleeding

109
Q

The longer a dislocated joint remains in reduced. The greater the risk of

A

AVN

110
Q

Impingement syndrome can progress to

A

RCT

111
Q

A pt with a rotator cuff injury can’t

A

Flex and abduct shoulder

112
Q

Stages of fracture healing

A

Hematoma

Granulation Tissue

113
Q

Because irreversible tissue damage from compartment syndrome can happen in only 4-6 hours

A

Neurovascular checks must be done on time

114
Q

Pain from compartment syndrome

A

Unrelenting, greater than expected, and worse on passive ROM

115
Q

S/S Hip Fx

A

Leg shortened and externally rotated

Severe pain and muscle spasms

116
Q

If delayed going to OR with a hip fx

A

Apply Buck’s traction to immobilize hip

117
Q

Increase fluids in a pt with a cast due to increased risk of

A

Constipation and renal calculi

118
Q

Surgeries to repair hip fracture

A

Hemiarthroplasty (treat with total hop dislocation precautions)

Or

ORIF (nothing to dislocate)

119
Q

onset of rapid acting insulin

A

15 min

101a Vocab (9 decks)

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