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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
IFG
Impaired fasting glucose, pre-diabetes, fasting glucose measured, >100 but <126
26
Normoglycemia
Fasting plasma glucose <100
27
Prediabetes risk
Hb A1C 5.7-6.4%
28
Insulin shock
hypoglycemia, complication of type 1 and 2 diabetes, caused by med error, inadequate food intake, increased activity, alcohol without food
29
DPP (diabetes prevention program)
importance of early intervention in reducing risk for progression to type 2 DM
30
DCCT (diabetes control and complications trial)
link between degree of glycemic control and the development of complications in patients with type 1 DM
31
UKPDS (united kingdom diabetes study group)
diet, exercise, and medications have significant decrease in complications compared to monitoring response to diet/exercise first, type 2 DM
32
Blood glucose
venipuncture, capillary glucose, A1C (reflection of 2-3 months)
33
ADbA HbA1C goal
<7%
34
AACE HbA1C goal
<6.5%
35
Fructosamine test
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
Hb A1C test
assess glycemic control of past 2-3 months, can convert A1C to estimated average glucose, measures sugar attached to Hb
37
C-peptide test
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
Urine testing
presence of glucose and ketones (espec), not current status (4 hours ago), not dx, urinary albumin (kidney disease)
39
Rapid Acting Insulin
Lispro/Humalog, Aspart/Novolog, Glulisine/Apidra, 5-15 minutes to work and short time working
40
Short Acting (Regular)
Humulin R, Novolin R, 30-40 minutes before meal
41
Intermediate Insulin
6 hours before meal, NPH, Lente
42
Long acting insulin analogues
24 hour peakless insulin, Lantus, levemir
43
Rebound hyperglycemia
fasting hyperglycemia, somogyi effect, excessive secretion of insulin antagonists following hypoglycemia, increased blood glucose production, extra insulin bad
44
Dawn phenomenon
fasting hyperglycemia, increased release of GH, GH antagonizes insulin
45
Secretagogues
oral, pancreas: increase insulin secretion, diabinese, glynase, dia beta, micronase, glucotrol (xl), amaryl, twice a day
46
Secretagogues new class
oral, pancreas: increase insulin secretion, prandin, starlix, up to 30 minutes before eating
47
Biguanides
oral, liver: decrease hepatic glucose, glucophage (xr)
48
Glucosidase inhibitors
oral, GI tract: slow glucose absorption, precose, glyset
49
TZD
oral, thiazolidinediones, avandia, actos, muscle: increase insulin action
50
DPP-4 Inhibitors
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
SGLT2
oral, sodium glucose co-transporter 2, kidneys: inhibits renal reabsorption of glucose (glucoseria), forxiga, invokana
52
Bile Acid sequestrant
oral, welchol, GI track: likely to affect absorption (not primarily DM), lowers LDL
53
Risk factors for DM
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
DKA
diabetic ketoacidosis, BG >250 mg/dl, pH <18 mEg/L, serum bicarb, ketonuria, ketonemia, patient needs insulin
55
Hyperosmolar, hyperglycemic, nonketotic coma
BG 600-2000 mg/dl, sever dehydration, hypervolemia, serum osmolality >320 mOsm/L, cerebral dysfunction, coma, no acidosis, some insulin & hydration
56
Byetta
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
Victoza
injectable med, type 2, once a day anytime, like GLP-1
58
Bydureon
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
Symlin
mimics amylin, type 1 or 2 (needs to be on insulin), injected at meal times, helps control post-prandial BG
60
Amylin
hormone made by pancreas, co-secreted with insulin, affects rate of glucose entry into circulation, reduces hepatic rate of glucose enter into circulation
61
Exercise not advised
moderate duration/intensity, >300 mg/dl BG (bad glycemic control)
62
Metabolic syndrome
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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