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Nutrition and Disease 2 > Exam 3 Material > Flashcards

Exam 3 Material Flashcards

1
Q

CCK

A

cholecystokinin, stimulates contraction of gall bladder to release bile, relaxation of sphincter of Oddi, release of pancreatic enzymes

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2
Q

Sphincter of Oddi

A

circular muscle that allows bile and pancreatic juices to enter the duodenum

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3
Q

Bile contains

A

bilirubin, bile salts, cholesterol, phospholipids, immunoglobulins

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4
Q

Choledocholithiasis

A

complication of cholelithiasis, obstruction of bile ducts

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5
Q

Cholecystitis

A

complication of cholelithiasis, inflammation of gallbladder

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6
Q

Cholangitis

A

complication of cholelithiasis, inflammation of bile ducts

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7
Q

Cholecystectomy

A

remove gall bladder

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8
Q

Lithotripsy

A

mechanically fragment stones with sound waves, pass out stones in stool

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9
Q

Litholysis

A

medications to dissolve gall stones, not always effective

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10
Q

ERCP

A

endoscopic retrograde cholangiopancreatography, stone must be small size to be picked up by endoscope, can be diagnostic or treatment

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11
Q

HIDA scan

A

cholescintigraphy, ingest dye/tracer, goes through bile ducts, use scanner to visualize where bile should be going

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12
Q

Malaise

A

general discomfort

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13
Q

Islet of Langerhaans Beta cells

A

produce insulin in pro-hormone form (inactive), in pancreas

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14
Q

Islet of Langerhaans Alpha cells

A

produce glucagon, in pancreas

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15
Q

Diabetes Mellitis Type 1

A

Autoimmune disease where islet of langerhaans beta cells are destroyed (absolute insulin deficiency), Can be immune-mediated or idiopathic, common haplotypes: DR3-DQ2, DR4-DQ8 and variable number tandem repeats (VNTR) shorter (high risk) longer (protective)

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16
Q

Autoimmune response of Diabetes 1 at:

A

Islet cells, insulin, glutamic acid (insulin production)

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17
Q

Diabetes Mellitis Type 2

A

cells grow resistant to insulin, or there is defect in insulin receptor/secretion/action

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18
Q

ADbA guidelines for Fasting/preprandial Glucose

A

Goal: 70-130 mg/dl

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19
Q

ADbA guidelines for Peak Postprandial Glucose

A

<180 mg/dl, 2 hours after first bite of food

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20
Q

AACE guidelines for Fasting/preprandial Glucose

A

<110 mg/dl

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21
Q

AACE guidelines for peak post prandial glucose

A

<140 mg/dl, 2 hours after first bite of food

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22
Q

OGTT

A

2 hour oral glucose tolerance test, fasting glucose measured, given glucose, then glucose measured at 30 minute intervals

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23
Q

Diabetes diagnoses

A

Hb A1C > 6.5%. Fasting plasma glucose >126. 2 hour OGTT > 200. Casual plasma glucose >200 + symptoms. all done on 2+ occasions

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24
Q

IGT

A

Impaired glucose tolerance, pre-diabetes, 2 hour OGTT, >140 but <200

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25
Q

IFG

A

Impaired fasting glucose, pre-diabetes, fasting glucose measured, >100 but <126

26
Q

Normoglycemia

A

Fasting plasma glucose <100

27
Q

Prediabetes risk

A

Hb A1C 5.7-6.4%

28
Q

Insulin shock

A

hypoglycemia, complication of type 1 and 2 diabetes, caused by med error, inadequate food intake, increased activity, alcohol without food

29
Q

DPP (diabetes prevention program)

A

importance of early intervention in reducing risk for progression to type 2 DM

30
Q

DCCT (diabetes control and complications trial)

A

link between degree of glycemic control and the development of complications in patients with type 1 DM

31
Q

UKPDS (united kingdom diabetes study group)

A

diet, exercise, and medications have significant decrease in complications compared to monitoring response to diet/exercise first, type 2 DM

32
Q

Blood glucose

A

venipuncture, capillary glucose, A1C (reflection of 2-3 months)

33
Q

ADbA HbA1C goal

A

<7%

34
Q

AACE HbA1C goal

A

<6.5%

35
Q

Fructosamine test

A

measures glycemic control in past 1-3 weeks, not affected by Hb or RBC life span, not reliable in pts with renal/liver failure/disease, measuring sugar attached to proteins

36
Q

Hb A1C test

A

assess glycemic control of past 2-3 months, can convert A1C to estimated average glucose, measures sugar attached to Hb

37
Q

C-peptide test

A

pro-hormone form of insulin, beta cell function reflection, distinguish between type 1 (none) & type 2 (normal) DM, C is cut off from A/B chain to create insulin

38
Q

Urine testing

A

presence of glucose and ketones (espec), not current status (4 hours ago), not dx, urinary albumin (kidney disease)

39
Q

Rapid Acting Insulin

A

Lispro/Humalog, Aspart/Novolog, Glulisine/Apidra, 5-15 minutes to work and short time working

40
Q

Short Acting (Regular)

A

Humulin R, Novolin R, 30-40 minutes before meal

41
Q

Intermediate Insulin

A

6 hours before meal, NPH, Lente

42
Q

Long acting insulin analogues

A

24 hour peakless insulin, Lantus, levemir

43
Q

Rebound hyperglycemia

A

fasting hyperglycemia, somogyi effect, excessive secretion of insulin antagonists following hypoglycemia, increased blood glucose production, extra insulin bad

44
Q

Dawn phenomenon

A

fasting hyperglycemia, increased release of GH, GH antagonizes insulin

45
Q

Secretagogues

A

oral, pancreas: increase insulin secretion, diabinese, glynase, dia beta, micronase, glucotrol (xl), amaryl, twice a day

46
Q

Secretagogues new class

A

oral, pancreas: increase insulin secretion, prandin, starlix, up to 30 minutes before eating

47
Q

Biguanides

A

oral, liver: decrease hepatic glucose, glucophage (xr)

48
Q

Glucosidase inhibitors

A

oral, GI tract: slow glucose absorption, precose, glyset

49
Q

TZD

A

oral, thiazolidinediones, avandia, actos, muscle: increase insulin action

50
Q

DPP-4 Inhibitors

A

oral, januvia, onglyza, tradjenta, dipeptidyl peptidase-4, affects beta and alpha cells of pancreas via allowing GLP-1 to stimulate insulin release and suppress glucagon release

51
Q

SGLT2

A

oral, sodium glucose co-transporter 2, kidneys: inhibits renal reabsorption of glucose (glucoseria), forxiga, invokana

52
Q

Bile Acid sequestrant

A

oral, welchol, GI track: likely to affect absorption (not primarily DM), lowers LDL

53
Q

Risk factors for DM

A

first degree relatives, race/ethnicity (type 1 - white, type 2 - latino/black), pregnancy (gest. DM), have baby >9 lbs, obesity/inactivity, older adults, hx CVD, PCOS, IGT/IFG, TG >250 mg/dl, HDL 5.7%

54
Q

DKA

A

diabetic ketoacidosis, BG >250 mg/dl, pH <18 mEg/L, serum bicarb, ketonuria, ketonemia, patient needs insulin

55
Q

Hyperosmolar, hyperglycemic, nonketotic coma

A

BG 600-2000 mg/dl, sever dehydration, hypervolemia, serum osmolality >320 mOsm/L, cerebral dysfunction, coma, no acidosis, some insulin & hydration

56
Q

Byetta

A

injectable med, type 2, twice a day (hour before breakfast/dinner), works like GLP-1, restores first phase insulin response, slows rate of gastric emptying, reduce food intake

57
Q

Victoza

A

injectable med, type 2, once a day anytime, like GLP-1

58
Q

Bydureon

A

injectable med, type 2, same mechanims as Byetta, one dosea a week, lowers A1C more, not approved for first line or type 1 DM

59
Q

Symlin

A

mimics amylin, type 1 or 2 (needs to be on insulin), injected at meal times, helps control post-prandial BG

60
Q

Amylin

A

hormone made by pancreas, co-secreted with insulin, affects rate of glucose entry into circulation, reduces hepatic rate of glucose enter into circulation

61
Q

Exercise not advised

A

moderate duration/intensity, >300 mg/dl BG (bad glycemic control)

62
Q

Metabolic syndrome

A

3/5 criteria: hyperglycemia (>100 mg/dl), abdominal obesity, hypertriglyceridemia (>150 mg/dl), reduced HDL cholesterol (<50 mg/dl women), HTN (130/45)

Nutrition and Disease 2 (4 decks)

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