Endocrine 6

Question 1

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

Answer 1

a. peripheral sensitivity to insulin is reduced
b. it is more likely to cause hyperglycemic hyperosmolar syndrome

Question 2

_________ and _________ don’t need insulin for glucose uptake

Answer 2

The brain and liver

Question 3

With DM, although glucose is present in the bloodstream, it is

Answer 3

unable to enter many of the cells that require it which shifts metabolism towards protein catabolism and lipid oxidation

Question 4

Type 1 DM is characterized by

Answer 4

a lack of insulin production (beta cell destruction)

Question 5

Type 2 DM is characterized by

Answer 5

a relative lack of insulin+ insulin resistance

Question 6

__________ describes a group of characteristics that are common to patients with DM or to those who are at higher risk of developing DM

Answer 6

Metabolic syndrome

Question 7

Diagnostic criteria of metabolic syndrome includes

Answer 7

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

Question 8

_____________ is more common with type 1 DM

Answer 8

diabetic ketoacidosis

Question 9

Diabetic ketoacidosis is usually caused by

Answer 9

infection

Question 10

Treatment of DKA includes

Answer 10

volume resuscitation, insulin, and potassium after acidosis subsides

Question 11

_____________ is more common with type 2 DM

Answer 11

Hyperglycemic hyperosmolar state

Question 12

Hyperglycemic hyperosmolar state is usually caused by

Answer 12

insulin resistance or inadequate insulin production

Question 13

With HHS, glucose is typically

Answer 13

higher than DKA and metabolic acidosis is mild if present

Question 14

Treatment of HHS includes

Answer 14

volume resuscitation, insulin, and electrolyte correction

Question 15

Criteria for diagnosis of DM includes

Answer 15

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%

Question 16

Classic symptom triad of DM is

Answer 16

polyuria
polydipsia
dehydration

Question 17

Treatment of type 1 DM includes

Answer 17

insulin (always required)

Question 18

Treatment of type 2 DM includes

Answer 18

weight reduction
dietary changes
oral hypoglycemic agents
insulin

Question 19

Symptoms of DKA may include

Answer 19

Kussmaul’s respirations d/t metabolic acidosis & acetone causes fruity-smelling breath

Question 20

The following factors can mask the signs of intraoperative hypoglycemia EXCEPT:
a. general anesthesia
b. propranolol
c. diabetic autonomic neuropathy
d. hydrochlorothiazide

Answer 20

d. hydrochlorothiazide

Question 21

_________ suggests an increased risk of difficult intubation in the DM patient

Answer 21

The prayer sign

Question 22

The DM patient may have reduced range of motion of the

Answer 22

AO joint

Question 23

DM patients are at risk of

Answer 23

aspiration
hypothermia
orthostatic hypotension

Question 24

___________ impairs the patient’s ability to mount a sympathetic response to hypovolemia & the cardio-depressant effects of anesthetic drugs

Answer 24

Diabetic autonomic neuropathy

Question 25

Hypoglycemia can be masked by

Answer 25

General anesthesia or beta-blockers

Question 26

When should surgery be scheduled for the Dm patient?

Answer 26

early in the day to prevent interruption of nutrition and hypoglycemic therapy

Question 27

Peripheral neuropathy usually begins in a

Answer 27

“stocking and glove” distribution

Question 28

Peripheral neuropathy is treated with

Answer 28

NSAIDs, antidepressants, and anticonvulsants

Question 29

Osmotic diuresis leads to

Answer 29

fluid and electrolyte abnormalities

Question 30

This fluid could cause hyperglycemia

Answer 30

Lactate in LR can be converted to glucose

Question 31

The DM patient should be assessed for

Answer 31

renal dysfunction

Question 32

Hyperglycemia worsens neurologic outcome after

Answer 32

ischemic brain injury

Question 33

Diabetic dysfunctions include

Answer 33

risk of dysrhythmias
reduced vagal tone– tachycardia
painless myocardial ischemia
diarrhea & constipation
regional anesthesia can worsen neurologic defects in the patient with diabetic polyneuropathy