Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AB 4th Year Gen Med > Endocrine - Diabetes and Complications > Flashcards

Endocrine - Diabetes and Complications Flashcards

1
Q

what causes T1DM?

A

autoimmune destruction of the pancreatic islet cells
causes beta cell failure
absolute insulin deficiency results

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what autoantibodies can those with T1DM have?

A

GAD

islet auto antigen 2 (IA-2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

symptoms of T1DM?

A 
wt loss
tired
thirsty
thrush
blurred vision
polyuria
sweet smelling urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ix for T1DM? what level is needed for diagnosis?

A

HbA1c ≥48
fasting glucose ≥7
OGTT ≥11.1
random glucose ≥11.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what treatment regime is used for T1DM? names of drugs?

A

basal bolus regime
long acting e.g lantus
rapid acting e.g humalog

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the mealtime targets for T1DM? how many times should BM be checked?

A

pre meal 4-7
1-2hrs after <10

atleast 4 times a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what should T1DM aim for with their HbA1c?

A

48

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

at a DM annual review, what is covered?

A 
weight
BP
HbA1c
U+Es, eGFR, A:C, lipids
urinalysis
insulin injections
retinal + foot screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

features of a DKA?

A 
thirst
tired
blurred vision
polyuria
vomiting 
kussmaul's respiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ix in DKA and results?

A 
ketones >3
BM >11
bicarbonate <15/pH <7.3 (acid)
high K, low Na
high creatinine
high lactate
high amylase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx for a DKA?

A 
500ml NaCl + KCl
Insulin with 0.9% NaCl
continue long acting subcut regime 
Glucose 10% once BM <14
LMWH

FIND CAUSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what bloods should be monitored in DKA?

A

K
BM
blood ketones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

features of a hypo?

A 
sweating 
pale
tremor
palpitations
nausea
hungry
confused
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx for a hypo?

A

20-30g glucose IV/buccal/oral (depending on consciousness level)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is charcot’s athropathy?

A

destructive inflammatory process of a foot with neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is MODY inherited?

A

aut dom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what causes MODY?

A

gene defect causing impaired insulin secretion from pancreatic beta cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

risk factors for T2DM?

A 
FHx
CVD
HT
PCOS
obesity
inactivity
GD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

pathology behind T2DM?

A

progressive loss of beta cells

background of insulin resistance due to adiposity and lipotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

blood test and results for diagnosis of T2DM?

A

HbA1c ≥48
fasting ≥7
OGTT ≥11.1
random ≥11.1

21
Q

what is the HbA1c aim for T2DM?

A

<53

22
Q

drug pathway for T2DM?

A

metformin
+ DPP-4 or TZD or SU

metformin + DPP-4 +SU
OR
metformin + TZD + SU

insulin

23
Q

example of a DPP-4, SU, TZD?

A 
DPP-4 = sitagliptin
SU = gliclazine
TZD = pioglitazone
24
Q

what cholesterol lowering drugs are given in T2DM? when?

A

20mg atorvastatin

25
Q

BP target for T2DM?

A

135/85mmHg (at home)
140/90 in GP
(10 above if over 80)

26
Q

what complications can diabetes lead to?

A

macrovascular

  • stroke
  • CVD
  • PVD
  • ED

microvascular

  • retinopathy
  • nephropathy
  • neuropathy (peripheral and autonomic)
27
Q

who usually presents with hyperglycaemic hyperosmolar syndrome?

A

old patients
frail
high carb intake

28
Q

how does hyperglycaemic hyperosmolar syndrome present?

A

hypovolaemia
hyperglycaemia
no ketonaemia
high osmolality

29
Q

what is the pathology behind diabetic nephropathy?

A

afferent arteriole dilates
hyperfiltration and increased GFR
high glucose causes renal hypertrophy
nephrotic syndrome can result

30
Q

what are the features of nephrotic syndrome?

A

proteinuria
hypoalbuminaemia
oedema

31
Q

Ix for diabetic nephropathy?

A

urinalysis
albumin:creatinine ratio
eGFR
U+Es

32
Q

BP aim for those with diabetic nephropathy?

A

130/80mmHg

33
Q

Tx for diabetic nephropathy?

A

ACE/ARB
statins
BP and BM control
transplant

34
Q

who gets hyperosmolar hyperglycaemic state?

A

old people

T2DM with some insulin deficiency

35
Q

what can increase risk of hyperosmolar non ketotic coma?

A

diuretics

steroids

36
Q

features of hyperosmolar non ketotic coma?

A

dehydrated
coma
polyuria
polydipsia

37
Q

Ix for hyperosmolar non ketotic coma?

A 
BM (>50)
ABG
FBC 
U+Es
ketones
plasma osmolarity
38
Q

Tx for hyperosmolar non ketotic coma?

A 
NaCl + KCl (if neede)
Insulin 
Glucose (once BM lowers)
heparin
warfarin
39
Q

what blood results are needed to a T1DM diagnosis?

A

hyperglycaemia symptoms + fasting/random once

OR

fasting/random twice

OR

OGTT

40
Q

what levels are defined as an impaired fasting glucose?

A

fasting <7

OGTT >7.8 but <11.1

41
Q

what levels are defined as an impaired glucose tolerance?

A

fasting >6.2 but <7

42
Q

what is the management for those with an impaired fasting glucose/glucose tolerance?

A

lifestyle

annual review

43
Q

what drug is favoured in treating MODY?

A

SU (e.g gliclazide)

44
Q

at what HbA1c should a second drug be added in T2DM?

A

58

45
Q

what drugs causes hypos?

A

SU

incretins (exanatide)

46
Q

what drug increases risk of thrush?

A

SGLT-2 (dapagloflozin)

47
Q

what drugs to avoid in CKD?

A

SU

48
Q

what drugs cause wt gain?

A

SU

TZDs

AB 4th Year Gen Med (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions