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Emergency Medicine > Long Term Illnesses > Flashcards

Long Term Illnesses Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What are the reductions in life expectancy for diabetes

A

Type 1 -15
Type 2 - 10

90% of people have type 2

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2
Q

What is the physiology for low blood sugar

A

Pancreas creates glucagon from alpha cells

Glucagon tells liver to break down glycogen
Stops livers up take of glucose
And promotes break down of amino acids

Until glucose levels balance out.

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3
Q

What is the physiology of high blood sugar

A

Pancreas creates insulin from beta cells

Stops break down of fat for energy by inhibiting glucagon release.
Stimulates liver to collect glucose to turn into glycogen
Unlocks cell membrane

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4
Q

Who gets type 1 diabetes

What is it’s onset

A

Juvenile usually Develops in childhood and risk diminishes until 40

Sudden onset

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5
Q

Who gets type 2 diabetes

What is it’s onset

A

Maturity onset usually People over 40 with poor lifestyle choices

Slow onset

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6
Q

What is the pathophysiology of type 1 diabetes

A

Caused by an immunodeficiency. Immune system attacks a destroys the beta cells until there’s none left so can’t can’t make insulin

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7
Q

What is the pathophysiolgy of type 2 diabetes

A

Age and poor lifestyle lead to the clogging of the beta cells gradually preventing insulin making. Diet controlled.

Also block cell receptors so glucose can’t enter. Tablet controlled

May lead to insulin controlled if not managed properly

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8
Q

Symptoms of diabetes at onset

A

Excessive thirst
Increased urination
Tiredness

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9
Q

Short term complications of diabetes

A

Hypoglycaemia
Hyperglycaemia
Diabetic ketoacidosis DKA

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10
Q

Long term complications of diabetes

A

Cardiovascular disease
Neuropathy
Kidney disease

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11
Q

Hypoglycaemia is most likely to affect what type of diabetes

What happens

A

Type 1

Either they OD on insulin or use up there energy stores quicker than they can be replaced due to inability of getting glucose into cells.

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12
Q

What are the signs and symptoms of hypoglycaemia

A 
Reduced GCS
Headache
Sweating
Dizziness
Tiredness
Impaired vision
Trembling/shakiness
Feeling of hunger
Pallor
Fast heart rate
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13
Q

Who does it affect hyperglycaemia

A

Affects type 2 the most

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14
Q

What are the signs and symptoms of hyperglycaemia

A

High blood glucose
High levels of sugar in the urine
Frequent urination
Increased thirst

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15
Q

Diabetic ketoacidosis DKA

What happens?

A

Happens to patients that stop taking mess (think mental)

Body makes last ditch effort to get rid of sugar by blowing it off before coma or death

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16
Q

What are DKA symptoms

A 
Deep, rapid breathing
Fruity smelling breath
Shortness of breath
Flushed face
Nausea and vomiting
Stomach pain
Decreased conciousness 
Dulled senses that worsen to a coma
Fatigue
Frequent urination or thirst that lasts more than a day
Headache
17
Q

What is the management for diabetes

A 
ABCD
History
Observations
Encourage patient to consume oral carbs (hypo)
Oral glucose gell (hypo)
Paramedic help
Rapid transportation (DKA)
18
Q

What is metformin

A

Type 2 medication
Helps lower glucose
Reduces glucose released by liver
Increases insulin sensitivity

19
Q

How does the body control breathing

A

Chemoreceptors in the brain cell gauge O2 and CO2 amounts

Phrenic nerve

Flatten diaphragm

Lung pressure goes down

Oxygen enters

Diaphragm relaxes

20
Q

What is chronic bronchitis

A

Cough with sputum over two successive years

Long term inflammation 
Excessive mucus production
Productive cough
Compromises small airways
Can lead to right side heart failure
21
Q

What are the signs and symptoms of chronic bronchitis

A 
Cough
Oedema
Cyanosis
Dyspnoea and tachypnoea
Reduced 02
Rhonchi/wheezes
Use of accessory muscles
Tachycardia
Bp normal or slightly raised
Slow cap refil
22
Q

What is emphysema

What causes it

What happens

A

A chronic condition caused by distension of the alveoli and destructive changes in their wall

Airborne irritants cause elasticity and muscularity to be compromised

Air fails to reach point of diffusion

23
Q

Signs and symptoms of emphysema

A 
Thin
Pursed lips on expiration
Barrel chest
Often normal colour
Dyspnoea and tachypnonea
Tachycardia
Use of accessory muscles
Confusion and anxiety
Wheezes and crackles on inspiration
Cardiac dysrhymias may develop
May develop oedema

Emergency Medicine (5 decks)

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