Exam 3 - Diabetes day 1 jeopardy

Question 1

These are 2 drug classes recommend for DM patients with HTN

Answer 1

ACE-I or ARB’s

Question 2

This is the class of medication recommended for patients with dyslipidemia

Answer 2

Statins

Question 3

These are 2 medications that are FDA approved for neuropathy

Answer 3

Lyrica and cymbalta

Question 4

These are some general rules regarding how we treat the elderly with DM

Answer 4

Less stringent; A1C less than 8; are they able to have help at home, cognitive function, life expectancy

Question 5

These are common signs and symptoms of hyperglycemia

Answer 5

Polys (polyuria, polydipsia, polyphagia) and fatigue

Question 6

This is how frequent we need to test a symptomatic patient if all tests are negative

Answer 6

at least every 3 years

Question 7

to help prevent progression of DM and complications, all patients should do the following

Answer 7

exercise at least 30 min most days of the week, increase fiber, decrease carbs, decrease sugar intake

Question 8

these are the normal values for A1C fasting glucose, and oral glucose load

Answer 8

A1C < 5.7%

Fasting glucose: <140mg/dL

Question 9

these are some important points in regards to the differences in how kids/adolescents respond to insulin compared to adults

Answer 9

• changes in insulin sensitivity due to hormone changes
• growth patterns
• supervision at school and daycare

Question 10

insulin is secreted from this organ and these cells

Answer 10

beta cells from pancreas

Question 11

asymptomatic patients with a BMI greater than or equal to ___ in adults of any age and who have one or more additional risk factors for DM should be tested

Answer 11

25

Question 12

we want to prevent infection…this is how we do this

Answer 12

proper vaccinations

Question 13

these are the diagnostic criteria for A1C, fasting glucose, random glucose and oral glucose tolerance test for DM

Answer 13

A1C: ≥ 6.5%
Fasting glucose: ≥ 126mg/dL
OGT: ≥ 200mg/dL
random glucose + symptoms: ≥ 200mg/dL

Question 14

these are the diagnostic criteria for A1C, fasting glucose, oral glucose tolerance test for pre-diabetes

Answer 14

A1C: 5.7-6.4%
Fasting glucose: 100-125mg/dL
OGT: ≥ 140-199mg/dL

Question 15

this type of DM is much more common in US

Answer 15

type 2

Question 16

this is the goal HTN for a patient with DM (according to the ADA)

Answer 16

< 140/80 and in some cases <130/80 (according to the ADA)

Question 17

these are 2 oral agents that are not recommended to use in gestational DM

Answer 17

biguainides and TZD’s

Question 18

in patients that are asymtomatic an do not have any risk factors, this is when you start to test

Answer 18

> age 45

Question 19

this is the number of people who have DM in the US

Answer 19

~ 25.8 million

Question 20

this is the common macrovascular complication

Answer 20

CAD

Question 21

the best treatment for gestational DM is?

Answer 21

diet and exercise

Question 22

these are risk factors for type 2

Answer 22

• Overweight/Obese
• Sedentary lifestyle
• Family Hx of diabetes
• Cardiovascular disease
• Latino/Hispanic, Non-Hispanic black, Asian American, Native American/Pacific Islander
• Previously identified impaired glucose tolerance/impair glucose fasting
• HTN or on HTN meds
• Increased levels of triglycerides (>250)
• Low concentration of high-density lipoprotein cholesterol (<35)
• Risk Factors for Gestational DM
• Hx of gestational diabetes
• Hx of delivery of an infant w/ birth weight over 9lbs
• Polycystic ovary syndrome

Question 23

these are the general way that we can reduce our macro vascular and microvascular complications

Answer 23

keep glucose consistent and maintain HTN

Question 24

these are the 4 causes of type 2 DM

Answer 24

• Insulin resistance in muscle and adipose tissue
• Progressive decline in pancreatic insulin secretion
• Unrestrained hepatic glucose production
• Other hormonal deficiencies

Question 25

this is how many years a pts. life expectancy is decreased when they have DM and are diagnosed <40 y/o

Answer 25

12-19 yrs

Question 26

these are some risk factors for gestational DM

Answer 26

- >25 y/o - overweight - family hx of DM2 - hx of abnormal glucose metabolism - hx of poor obstetric outcomes - hx of gestational diabetes - hx of delivery of an infant w/ birth weight over 9lbs - Polycystic ovary syndrome - Ethnicity

Question 27

this is the LDL goal for a patient who is DM

Answer 27

<100 (less than 70 is optimal)

Question 28

these are some common microvascular complications

Answer 28

retinopathy, neuropathy, nephropathy

Question 29

these are some risk factors for type 1 DM

Answer 29

genetics

Question 30

We want to prevent infection...this is how we do it

Answer 30

Vaccinations - -> flu - -> pneumococcal

Question 31

These are the diagnostic criteria for A1C, fasting glucose, random glucose and oral glucose tolerance test for DM

Answer 31

AIC: > 6.5% Fasting glucose: > 126n mg/dL OGT: > 200 mg/dL Random Glucose plus symptoms: > 200 mg/dL

Question 32

These are the diagnostic criteria for A1C, fasting glucose, oral glucose tolerance test for pre-diabetes

Answer 32

A1C: 5.7-6.4% Fasting Glucose: 100-125 mg/dL OGT: >140-199 mg/dL

Question 33

This type of DM is much more common in the US

Answer 33

Type 2

Question 34

This is the goal HTN for a patient w/ DM

Answer 34

140/80 and in some cases < 130/80 (according to the ADA)

Question 35

These are 2 oral agents that are not recommend to use in gestational DM

Answer 35

Metformin (Biguainides) | TZD's

Question 36

In pats that are asymptomatic and do not have any risk factors, this is when you start to test

Answer 36

45

Question 37

This is the number of people w/ diabetes in the US

Answer 37

25.8 million

Question 38

This is the common macrovascular complication

Answer 38

Coronary artery disease

Question 39

The best tx for gestational DM is the following

Answer 39

Diet and exercise

Question 40

These are risk factors for type 2

Answer 40

``` Obesity Sedentary life style Family hx Cardiovascular diseases HTN ```

Question 41

These are the general way that we can reduce our macrovascular and microvascular complications

Answer 41

Manage HTN and glucose

Question 42

These are the 4 causes of type 2 DM

Answer 42

1. Insulin resistance 2. Liver producing glucose 3. Pancreas decreases insulin production 4. Hormone deficiencies

Question 43

This is how many yrs a pts life expectancy is decreased when they have DM and are diagnosed < 40 yo

Answer 43

12-19 years

Question 44

These are some risk factors for gestational DM

Answer 44

``` Baby > 9 lbs Previous hx Overweight Polycystic ovarian dz Over 25 years old ```

Question 45

This is the LDL goal for a pt who is DM

Answer 45

<100 (less than 70 is optimal)

Question 46

These are some common microvascular complications

Answer 46

Retinopathy, neuropathy, nephropathy

Question 47

These are some risk factors for type 1 DM

Answer 47

Genetics!! | Sometimes a virus can trigger it

Question 48

This is the cause of type 1 DM

Answer 48

Autoimmune destruction of beta cells