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Endocrine > DM I > Flashcards

DM I Flashcards

1
Q

What, broadly speaking, is DM?

A

Relative or absolute impairment if insulin secretion, along with varying degrees of peripheral resistance

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2
Q

What are the two most common drugs types that can cause DM?

A

Glucocorticoids

Atypical antipsychotics

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3
Q

What are the disease of the exocrine pancreas that can lead to DM II?

A

Hemochromatosis
Chronic pancreatitis
Pheochromocytoma

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4
Q

What is DM Ia and DM Ib?

A 
Ia = autoimmune etiology
Ib = Non=autoimmune
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5
Q

What are the three major factors that play a role in the pathogenesis of DM I?

A
  • Genetic susceptibility
  • Immune mediation
  • Environmental triggers
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6
Q

What chromosome is the HLA haplotype that is suspected to play a role in the development of DM I on? What does this code for?

A 
Chr 6
MHC class II on macrophages
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7
Q

What are the three HLA haplotypes that are associated with the pathogenesis of DM I?

A

DR3
DQB
DR4

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8
Q

What are the chances of developing DM I if you have an identical twin who has it? Non-identical twin?

A

50%

8%

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9
Q

What are the HLA associations for DM Ib?

A

There are none for Ib, only Ia

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10
Q

What type of hypersensitivity reaction is type Ia DM?

A

IV (T cell mediated)

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11
Q

What is insulitis?

A

Inflammation of the beta cells of the pancreas

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12
Q

What is the most sensitive antibody that can be seen with DM Ia? What is the sensitivity of this?

A

Glutamic acid decarboxylase antibody (GAD65)

80% ish sensitive

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13
Q

True or false: the risk of developing DM Ia is proportional to the number of antibodies present

A

True

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14
Q

What antibodies, besides GAD65, can be found in DM Ia? (3)

A

Insulin antibodies
Islet cell antibodies
Tyrosine phosphatase

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15
Q

True or false: antibodies that are found in DM Ia are found only after ssx present

A

False– before

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16
Q

True or false: defects in insulin secretion is detectable years before the onset of DM Ia

A

True

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17
Q

What are the perinatal factors that are suspected to play a role in the pathogenesis of DM Ia? (5)

A
  • Maternal age over 25
  • Smoking
  • Neonatal resp distress
  • Jaundice
  • Preeclampsia
18
Q

What type of diet is thought to predispose pts to DM Ia?

A

Cows milk, cereal

19
Q

What is the role of Vit D in the pathogenesis of DM Ia?

A

May be protective

20
Q

What are the two viruses that are thought to precipitate DM Ia?

A

Coxsackie

Enterovirus

21
Q

Most cases of DM I occur in what age group?

A

Less than 19 yo

22
Q

True or false: DM I is more common in developed countries

A

True

23
Q

What are the tests that can be used to diagnose DM I?

A
  • Oral glucose tolerance test

- Check C-peptide levels (will be low)

24
Q

True or false: DM II is more common in children than DM I

A

True

25
Q

What happens to bicarb and pH values with DKA?

A

Both decreased

26
Q

What causes the hypotension and tachycardia with DKA?

A

Dehydration 2/2 hyperglycemic enuresis

27
Q

What are the basic ideas when treating DKA?

A
  • Volume resuscitation
  • Correct hyperglycemia
  • Lytes
28
Q

What are the treatment goals of DM I?

A
  • Normoglycemia (HbA1C)

- Normal growth

29
Q

What are the two major long acting insulins?

A

Glargine

Detemir

30
Q

What are the rapid acting insulins?

A

Lispro
Aspart
Glulisine

(“there is no LAG with rapid insulin”)

31
Q

What is the intermediate acting insulin?

A

NPH

32
Q

What is the onset time for rapid, short, intermediate, and long acting insulin?

A
  • Within 30 mins
  • within 1 hour
  • within 2
33
Q

What are the total requirements for insulin for DM I? Basal requirements?

A
  1. 6 units /kg

0. 25 units/Kg

34
Q

What is the use, MOA, and side effects of Pramlintide?

A

Amylin analogue for DM I, that slows gastric emptying, promoting satiety, and slowing glucagon release

35
Q

What is Amylin?

A

Peptide that is usually released with insulin which increases satiety by slowing gastric emptying, decreasing glucagon

36
Q

Are Amylin derivatives such as Pramlintide a replacement or an adjuvant therapy for insulin?

A

Adjuvant

37
Q

What are continuous glucose monitors?

A

SQ device that reposts BG levels every few minutes

38
Q

What are the two types of transplants that can be performed to cure DM I?

A

Pancreatic or islet cell transplants

39
Q

True or false: NEVER stop insulin with DM I

A

True (DKA is bad, M’kay)

40
Q

Acanthosis nigricans is more specific to type I or II DM?

A

DM II

Endocrine (32 decks)

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