Fundamentals Exam

Question 1

Define polyphagia

Answer 1

excessive hunger

Question 2

Define polydipsia

Answer 2

excessive thirst

Question 3

Low blood sugar signs and symptoms (less than 60 mg/dL)

Answer 3

Shakiness
Dizziness
Sweating
Hunger
Headache
Pale Skin Color
Mental/behavior changes
Lethargy
Clumsy/jerky movements
Seizures
Difficulty concentrating
Tingling around mouth

Question 4

High blood sugar sign and symptoms (greater than 200 mg/dL)

Answer 4

polydipsia
polyuria
polyphagia
blurred vision
fatigue
weight loss
slow healing cuts and sores
headaches
difficulty concentrating
vaginal and skin infections
irritability

Question 5

How does glucose arrive in bloodstream?

Answer 5

-carbs eaten orally
-glucose released from stored glycogen in muscles and liver cells
-gluconeogenesis (newly made glucose made in pancreas or kidney cells)

Question 6

If glucose levels fall low…

Answer 6

Insulin release is suppressed
Glucose remains in the bloodstream instead of being driven into the cells
Glucagon is released from the pancreatic alpha cells
Glucagon stimulates production and release of glucose from glycogen stores in the liver

Question 7

Epidemiology of T1DM

Answer 7

Commonly diagnosed below age 30
Previously referred to as juvenile-onset diabetes
Affects more than 400,000 children under age 14

Question 8

Pathophysiology of T1DM

Answer 8

Triggered by an autoimmune process, insulin-producing beta cells of the pancreas are destroyed
Results in a lack of insulin
Causes high blood sugar

Question 9

Normal blood sugar levels?

Answer 9

60-100 mg/dL

Question 10

How is insulin administered

Answer 10

ONLY by injection (subq) or IV
must be given with food to work off of

Question 11

treatment for T1DM?

Answer 11

Insulin level is never zero
Modern insulin analogs and insulin pumps more closely mimic the actions of a healthy pancreas

Question 12

3 methods of assessing glycemic control

Answer 12

Self-monitoring of blood glucose
Continuous blood glucose monitoring
Monitoring of HgbA1c

Question 13

What are some complications related to T1DM and T2DM?

Answer 13

Diabetic ketoacidosis- inadequate insulin for normal glucose metabolism
Hypoglycemia- low blood sugar
Dawn phenomenon- blood sugar spikes in between the hours of 2-8AM
Somogyi effect-insulin lowers blood sugar but the body sends more glucose

Question 14

Who is at a higher risk for diabetes?

Answer 14

People who are obese, African Americans, Native Americans, women with PCOS, Latinos, people with cardiovascular disease, people 45 or older, genetics with a history of diabetes, pregnant women or a woman who has given birth to a 9+ pound baby, people who are less active.

Question 15

Epidemiology of T2DM

Answer 15

Growing epidemic in U.S.
In adults, type 2 accounts for 90%-95% of cases
More common in adults than in juveniles
Once called “adult-onset diabetes”
Risk factors involve genetics and lifestyle
Prediabetes is a warning sign for type 2 DM
The CDC estimated that 84.1 million had prediabetes and only 11% knew they had it.

Question 16

DM Management

Answer 16

Pharmacological interventions and self-management
Many are overweight with insulin resistance
Advised to perform at least 150 min/week of moderate-intensity activity and strength training 3x/week
Increase water intake
Modify life style

Question 16

Medications:

Answer 16

Type I DM requires lifelong outside source of insulin to maintain life
Type II DM- unable to control glucose levels with oral antidiabetic drugs and/or diet.
Insulin is not a cure- it treats the symptoms of hyperglycemia

Question 17

What are Herbal Supplements?

Answer 17

Herbal supplements are products derived from:
Plants
Oils
Roots
Seeds
Berries
Flowers

Question 18

What forms do herbal supplements come in?

Answer 18

Liquid
Extract
Teas
Tablets/Capsules
Bath salts
Oils
Ointments

Question 19

What’s important to ask all patients?

Answer 19

ALL medications they are on, including vitamins/supplements

Question 20

Aloe

Answer 20

Topically for pain, inflammation, itching, healing agent for sunburn

Question 21

Black cohosh

Answer 21

Reduces symptoms of PMS, dysmenorrhea, menopause

Question 22

Chamomile

Answer 22

Anti-inflammatory and antispasmodic effects, digestive aid for bloating

Question 23

Echinacea

Answer 23

Nonspecific immunostimulant, prevent or treat common cold
Not recommended in patients with autoimmune disorders or diseases affecting immunity (AIDS)

Question 24

Ephedra

Answer 24

Bronchodilator, nasal decongestant, CNS stimulant
Touted as weight-loss product, energy booster, aphrodisiac, and mental stimulant
Common ingredient in OTC weight-loss products
Deaths have occurred from overuse
Precursor to illegal methamphetamine synthesis
Contraindicated in patients with heart conditions, hypertension, diabetes, and thyroid disease

Question 25

Feverfew

Answer 25

Reduces frequency and severity of migraines

Question 26

Garlic

Answer 26

Most widely used herbal medicine
Lowers serum cholesterol and triglycerides
Reduces platelet aggregation; use with extreme caution in patients receiving platelet inhibitors; monitor for bleeding

Question 27

Ginger

Answer 27

Alleviates nausea and vomiting

Question 28

Ginkgo

Answer 28

Treat short-term memory loss, headache, dizziness, tinnitus, emotional instability
Vasodilator improves cerebral blood flow
May help with intermittent claudication, ED, improve peripheral blood flow in diabetics
Reduces platelet aggregation, monitor for bleeding

Question 29

Ginseng

Answer 29

Unsubstantiated claims to increase resistance to stress and disease
May affect platelet aggregation, monitor for bleeding
Raises insulin levels in animals, monitor for hypoglycemia

Question 30

Goldenseal

Answer 30

Antiseptic and astringent
Some patients may believe (inaccurately) that goldenseal will prevent detection of drugs in urine

Question 31

Green tea

Answer 31

Improves cognitive performance
Stimulant effects may increase with other stimulants

Question 32

St. John’s wort

Answer 32

treat mild depression; wound healing
May cause photosensitivity
May decrease effectiveness of birth control pills
Contributes to serotonin syndrome if two or more drugs that affect serotonin levels are taken together (signs and symptoms: confusion, agitation, shivering, fever, diaphoresis, N/D, muscle spasms, tremor, may progress to coma); need washout period

Question 33

Valerian

Answer 33

Used for restlessness, promotes sleep
Do not confuse with Valium
Avoid other CNS depressants
Mild tranquilizer

Question 34

Coenzyme Q10

Answer 34

for heart failure, CV disease, adjunct therapy for CHF

Question 35

Creatine

Answer 35

Performance-enhancing substance, may cause water retention; patients with renal failure should avoid

Question 36

Gamma-hydroxybutyrate (GHB)

Answer 36

“Rave” drug can cause death, banned by FDA, but still marketed as dietary supplement, can purchase kits and recipes on Internet; euphoriant, sedative at higher doses; coma, vomiting, aspiration, and death have occurred
Date rape drug

Question 37

Lycopene

Answer 37

May reduce risk of cancers, lower LDL, cholesterol

Question 38

Melatonin

Answer 38

Sleep aid and treatment for jet lag, withdrawal from benzodiazepines
Causes drowsiness, use safety precautions; may cause paradoxical response

Question 39

Policosanol

Answer 39

Lower cholesterol levels, platelet inhibitor, enhances anticoagulants, monitor for bleeding

Question 40

Omega-3 fatty acids

Answer 40

Reduce incidence of MI, lower triglycerides, stabilize plaque formation, reduce risk of blood clots, lower blood pressure
Fishy aftertaste, consider purity, calories added to improve taste, dose range varies

Question 41

S-adenosylmethionine (SAM-e)

Answer 41

Treats depression, fibromyalgia, osteoarthritis (expensive)
Stomach distress, may interact with other antidepressants