Endocrine 6 Flashcards
Compared to type 1 DM, choose the statements that MOST accurately describe type 2 DM (select 2).
a. peripheral sensitivity to insulin is reduced
b. it is more likely to cause hyperglycemia hyperosmolar syndrome
c. is usually associated with a thin body habitus
d. it is usually caused by an autoimmune response
a. peripheral sensitivity to insulin is reduced
b. it is more likely to cause hyperglycemic hyperosmolar syndrome
_________ and _________ don’t need insulin for glucose uptake
The brain and liver
With DM, although glucose is present in the bloodstream, it is
unable to enter many of the cells that require it which shifts metabolism towards protein catabolism and lipid oxidation
Type 1 DM is characterized by
a lack of insulin production (beta cell destruction)
Type 2 DM is characterized by
a relative lack of insulin+ insulin resistance
__________ describes a group of characteristics that are common to patients with DM or to those who are at higher risk of developing DM
Metabolic syndrome
Diagnostic criteria of metabolic syndrome includes
at least three of the following:
fasting plasma glucose >100-110 mg/dL
abdominal obesity (>40 in in men and >35 in women )
serum triglyceride level >150 mg/dL
serum HDL <40 mg/dL in men and <50 mg/dL in women
BP >130/85 mmHg
_____________ is more common with type 1 DM
diabetic ketoacidosis
Diabetic ketoacidosis is usually caused by
infection
Treatment of DKA includes
volume resuscitation, insulin, and potassium after acidosis subsides
_____________ is more common with type 2 DM
Hyperglycemic hyperosmolar state
Hyperglycemic hyperosmolar state is usually caused by
insulin resistance or inadequate insulin production
With HHS, glucose is typically
higher than DKA and metabolic acidosis is mild if present
Treatment of HHS includes
volume resuscitation, insulin, and electrolyte correction
Criteria for diagnosis of DM includes
fasting plasma glucose >126 mg/dL
random glucose level >200 mg/dL + classic symptoms
two hour plasma glucose >200 mg/dL during an oral glucose tolerance test
hemoglobin A1C> 6.5%
Classic symptom triad of DM is
polyuria
polydipsia
dehydration
Treatment of type 1 DM includes
insulin (always required)
Treatment of type 2 DM includes
weight reduction
dietary changes
oral hypoglycemic agents
insulin
Symptoms of DKA may include
Kussmaul’s respirations d/t metabolic acidosis & acetone causes fruity-smelling breath
The following factors can mask the signs of intraoperative hypoglycemia EXCEPT:
a. general anesthesia
b. propranolol
c. diabetic autonomic neuropathy
d. hydrochlorothiazide
d. hydrochlorothiazide
_________ suggests an increased risk of difficult intubation in the DM patient
The prayer sign
The DM patient may have reduced range of motion of the
AO joint
DM patients are at risk of
aspiration
hypothermia
orthostatic hypotension
___________ impairs the patient’s ability to mount a sympathetic response to hypovolemia & the cardio-depressant effects of anesthetic drugs
Diabetic autonomic neuropathy
Hypoglycemia can be masked by
General anesthesia or beta-blockers
When should surgery be scheduled for the Dm patient?
early in the day to prevent interruption of nutrition and hypoglycemic therapy
Peripheral neuropathy usually begins in a
“stocking and glove” distribution
Peripheral neuropathy is treated with
NSAIDs, antidepressants, and anticonvulsants
Osmotic diuresis leads to
fluid and electrolyte abnormalities
This fluid could cause hyperglycemia
Lactate in LR can be converted to glucose
The DM patient should be assessed for
renal dysfunction
Hyperglycemia worsens neurologic outcome after
ischemic brain injury
Diabetic dysfunctions include
risk of dysrhythmias
reduced vagal tone– tachycardia
painless myocardial ischemia
diarrhea & constipation
regional anesthesia can worsen neurologic defects in the patient with diabetic polyneuropathy
