Brainscape's Knowledge GenomeTM

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


See full index

NURS 350 > Exam 3 - diabetes mellitus > Flashcards

Exam 3 - diabetes mellitus Flashcards

1
Q

DM is a dysfunction of:

A

the endocrine pancreas

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

What does type 1 DM affect the metabolism of?

A

fat, protein, and carbohydrates

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

DM is not one disease, but a what? with what in common?

A

group of diseases WITH glucose intolerance in common

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

DM is characterized by:

A

hyperglycemia

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

DM can be the result of defects in what?

A
  1. insulin secretion
  2. insulin action
  3. or both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of DM is most common in children?

A

Type 1 diabetes

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

Define type 1 diabetes mellitus:

A

insulin-dependent diabetes mellitus

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

What type of DM is most common in adult? or has an onset during adulthood?

A

type 2 diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

define type 2 diabetes mellitus:

A

non-insulin-dependent diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is type 2 diabetes associated with?

A

obesity and insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are four ways to diagnose diabetes mellitus?

A
  1. glycosylated hemoglobin HgA1C levels
  2. more than 1 fasting plasma glucose greater than 140 mg/dl
  3. 2 hour plasma glucose during oral glucose tolerance testing (OGTT)
  4. random glucose levels about 200 mg/dl with symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What kind of method is HgA1C?

A

method to follow plasma glucose over time

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

What do glucose molecules do with hemoglobin?

A

glucose molecules join to hemoglobin in 120 day life span of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is typical of those with poorly controlled diabetes and HgA1C?

A

those with poorly controlled diabetes have increased levels of glycosylated hemoglobin

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

What values will be elevated with DM?

A

HgA1C, FPG, or OCTT

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

what are two other risk factors for DM?

A
  1. impaired glucose tolerance (IGT)

2. impaired fasting glucose (IFG)

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

what does impaired glucose tolerance come from?

A

diminished insulin secretion

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

what does impaired fasting glucose come from?

A

from enhanced hepatic glucose output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens with the pancreas and beta cells in type 1 DM?

A
  1. pancreatic atrophy

2. loss of beta cells

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

Type 1 diabetes mellitus characterizes what percent of diabetes in western world?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Type 1 diabetes the result of?

A

genetic susceptibility and environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is there a strong genetic associated of with type 1 DM?

A

with HLA class II antigens DR and DQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are two genetic susceptibility factors that increase risk of type 1?

A
  1. first-degree relative with type 1

2. strongest association with MHC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are two environmental factors that increase risk of type 1?

A
  1. viral infection: H. pylori infection

2. exposure to cow’s milk proteins, relative lack of vitamin D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define type 1A:

A

cell-mediated destruction of the B cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What kind of antigen is associated with type 1A:

A

leukocyte antigen HLA-Dr4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Define type 1B:

A

uncommon primary autoimmune condition associated with other autoimmune problems (Hashimoto disease, graves disease, myasthenia gravis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What kind of antigen is associated with type 1B:

A

associated with HLA-DR3 in those between 30 to 50 years of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In type 1 DM, what accumulates in blood? and spills into what?

A

glucose accumulates in blood and spills into urine as renal threshold exceeded

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What occurs in type 1 DM from insulin lack?

A

protein and fat breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Are type 1 DM manifestations acute or chronic:

A

acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the 3 P’s associated with type 1 DM?

A
  1. polydipsia
  2. polyuria
  3. polyphagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

True or false: there is weight gain associated with type 1 DM:

A

false; weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Wide fluctuations of what occur with type 1 DM:

A

wide blood sugar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What kind of condition is associated with type 1 DM:

A

ketoacidosis

36
Q

define ketoacidosis

A

increased levels of ketones occur without insulin

37
Q

Ketones cause a drop in what?

A

pH (metabolic acidosis)

38
Q

What occurs from blowing off acetone with ketoacidosis?

A

fruity breath

39
Q

There is little to no what in type 1 DM:

A

little or no insulin secretion

40
Q

What is the initial symptom of type 1 DM?

A

diabetic coma

41
Q

What combination can be used to treat type 1 DM:

A

insulin, meal planning, exercise, self monitoring of blood glucose

42
Q

What is a transplant associated with type 1 DM:

A
  1. islet cells

2. whole pancreas

43
Q

Type 2 diabetes mellitus characterizes what percent of diabetes in western world?

A

90%

44
Q

What are 5 risk factors of type 2 diabetes mellitus?

A
  1. obesity
  2. hypertension
  3. physical inactivity
  4. family history
  5. metabolic syndrome
45
Q

type 2 diabetes mellitus affect both:

A
  1. adults

2. children

46
Q

What 3 interactions cause type 2 diabetes mellitus?

A
  1. genetic
  2. epigenetic
  3. environmental
47
Q

What 2 factors account for 60-80% of type 2 cases?

A
  1. obesity

2. insulin resistance

48
Q

What occurs with abnormal glucagon secretion in type II cases?

A

decreased B-cell responsiveness to plasma glucose

49
Q

What may be due to decreased B-cell mass or abnormal function in type II diabetes?

A

islet dysfunction

50
Q

What are 2 major mechanisms of type II diabetes?

A
  1. insulin resistance

2. decreased insulin secretion by beta cells

51
Q

Type 2 diabetes has a strong what?

A

inheritance pattern

52
Q

Relatives of type 2 diabetes have a much higher risk of what?

A

developing it as well

53
Q

True or false: there is only 1 gene that is found responsible for type 11 diabetes:

A

false; many different genes associated, but no single gene found responsible

54
Q

What are 4 clinical manifestations of type 2 diabetes?

A
  1. fatigue
  2. pruritus
  3. recurrent infections
  4. visual changes or symptoms of neuropathy
55
Q

What are 5 treatment options?

A
  1. exercise
  2. diet
  3. treatment of obesity
  4. oral hypoglycemia
  5. bariatric surgery
56
Q

What are 5 complications of DM?

A
  1. hypoglycemia
  2. diabetic ketoacidosis
  3. hyperosmolar nonacidotic diabetic coma
  4. somogyi effect
  5. dawn phenomenon
57
Q

What is also called insulin shock or insulin reaction:

A

hypoglycemia

58
Q

What is a typical glucose level in newborns with hypoglycemia?

A

less than 47 mg/dL

59
Q

what is a typical glucose level in children and adults with hypoglycemia?

A

less than 70 mg/dL

60
Q

Which type of diabetes is hypoglycemia more commonly associated with?

A

type 1 diabetes

61
Q

What are 5 clinical manifestations of hypoglycemia?

A
  1. tachycardia
  2. palpitations
  3. diaphoresis
  4. tremors
  5. pallor and arousal anxiety
62
Q

What are 2 treatment options for hypoglycemia?

A
  1. oral or IV glucose

2. glucagon: prescribed for emergency use

63
Q

A neurogenic reaction occurs from what?

A

from low glucose sensed by hypothalamus (increased hr, palpitations, diaphoresis, tremors, pallor and anxiety)

64
Q

What is another type of symptom associated with hypoglycemia and cells?

A

cell malnutrition (headache, dizziness, irritability and fatigue, poor judgment, confusion, visual changes, hunger, seizures and coma, symptoms masked b-blocking drugs)

65
Q

What is a serious complication of DM?

A

diabetic ketoacidosis - responsible for many hospital admissions and death

66
Q

Diabetic ketoacidosis occurs when there is… (2 things)

A
  1. relative/absolute insulin deficiency

2. increase i insulin counter regulatory hormones (catecholamines, cortisol, glucagon, and GH)

67
Q

What 2 things increase with ketoacidosis?

A
  1. hepatic glucose production

2. fat mobilization

68
Q

What 1 thing decreases with ketoacidosis?

A

peripheral glucose usage

69
Q

What 4 things precipitate DKA?

A
  1. infection, trauma
  2. surgery, MI
  3. interruption of insulin
  4. emotional stress
70
Q

symptoms of DKA:

A
  1. polyuria
  2. dehydration
  3. kussmaul respirations
  4. acetone breath odor
71
Q

treatment of DKA:

A

administer insulin to decrease glucose levels, fluids, replacements of electrolytes

72
Q

What is normal in hyperosmolar non-acidotic diabetic coma? What is abnormal?

A

ketones; glucose over 600 mg/dl

73
Q

Due to high BS, glycouria and polyuria cause what in hyperosmolar non-acidotic diabetic coma?

A
  1. severe volume depletion

2. intracellular dehydration

74
Q

blood glucose is high during what time of the day with the somogyi effect?

A

high in the morning

75
Q

somogyi effect is common in what 2 things?

A
  1. type 1 DM

2. kids

76
Q

Hypoglycemia at night with the somogyi effect stimulates what?

A

glucose counteregulation (epinephrine, GH, cortisol, and glucagon release)

77
Q

Glucose is increased by what 2 things with the somogyi effect?

A
  1. gluconeogenesis

2. glycogenolysis

78
Q

What 2 things are mobilized with the somogyi effect? what is inhibited

A

fatty acids and proteins; peripheral glucose use is inhibited

79
Q

define the dawn phenomenon:

A

early morning rise in glucose, no hypoglycemia at night

80
Q

What decreases during the night with the dawn phenomenon?

A
  1. glucose metabolism by muscle and fat
81
Q

What are 4 chronic complications of DM?

A
  1. diabetic neuropathies
  2. microvascular disease
  3. large blood vessel disease
  4. infections
82
Q

Can some neuropathies be reversed?

A

yes; food and wrist drop

83
Q

What are microvascular problems due to?

A

basement membrane thickening

84
Q

What is diabetes the most common cause of?

A

end stage renal disease

85
Q

What is the most common cause of death in those with type 11 DM?

A

CAD

86
Q

What are infections due to in DM?

A
  1. sensory impairment (resulting in injury)
  2. hypoxia
  3. increased pathogen growth in presence of high glucose
  4. reduced blood supply

NURS 350 (6 decks)

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