endo Flashcards
markers in type 1 DM
islet cell antibodies, antibodies to glutamic acid decarboxylase, islet cells and insulin
features type 1 DM
2 peaks- pre school and teenagers. children present - few weeks history of polyuria, polydipsia, weight loss
other features type 1 DM
enuresis, skin sepsis, candida, infection
late features type 1 DM
DKA
features DKA
vomiting, dehydration, abdominal pain, Kussmauls breathing (hyperventilation),hypovolaemic shock, coma, death, drowsy, acetone breath
diagnosis type 1
random >11, glycosuria, ketonuria. fasting >7 or incr HbA1c
rapid acting insulin analogues
insulin lispro, glulisine, aspart
long acting insulin analogues
detemir, glargine
when should you give short acting regular insulin before meals
15-30 mins before meal
why should you rotate injection sites with insulin
prevent lipohypertrophy or lipoatrophy
onset rapid acting insulin
30-60m
onset long acting insulin
1-2h
what are the insulin regimens
basal bolus or continuous pump
how does basal bolus work
3x daily short acting boluses, 1x long acting bolus
what happens first in puberty for girls
breast development- 8.5-12.5 years
when does pubic hair growth and rapid height spurt occur (female)
after breast development
when does the menarche occur
2.5 years after puberty
what happens first in puberty for males
testicular enlargement >4ml
what follows testicular enlargement
pubic haisr- 10-14 years
when does height spurt occur in males
testicular vol 12-15ml
what causes closure of the growth plates
sex hormones- females have their height spurt earlier when have menarche so stop growing after that, whereas males continue growing for a while and then have their growth spurt