Long Term Illnesses Flashcards
What are the reductions in life expectancy for diabetes
Type 1 -15
Type 2 - 10
90% of people have type 2
What is the physiology for low blood sugar
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.
What is the physiology of high blood sugar
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
Who gets type 1 diabetes
What is it’s onset
Juvenile usually Develops in childhood and risk diminishes until 40
Sudden onset
Who gets type 2 diabetes
What is it’s onset
Maturity onset usually People over 40 with poor lifestyle choices
Slow onset
What is the pathophysiology of type 1 diabetes
Caused by an immunodeficiency. Immune system attacks a destroys the beta cells until there’s none left so can’t can’t make insulin
What is the pathophysiolgy of type 2 diabetes
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
Symptoms of diabetes at onset
Excessive thirst
Increased urination
Tiredness
Short term complications of diabetes
Hypoglycaemia
Hyperglycaemia
Diabetic ketoacidosis DKA
Long term complications of diabetes
Cardiovascular disease
Neuropathy
Kidney disease
Hypoglycaemia is most likely to affect what type of diabetes
What happens
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.
What are the signs and symptoms of hypoglycaemia
Reduced GCS Headache Sweating Dizziness Tiredness Impaired vision Trembling/shakiness Feeling of hunger Pallor Fast heart rate
Who does it affect hyperglycaemia
Affects type 2 the most
What are the signs and symptoms of hyperglycaemia
High blood glucose
High levels of sugar in the urine
Frequent urination
Increased thirst
Diabetic ketoacidosis DKA
What happens?
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
What are DKA symptoms
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
What is the management for diabetes
ABCD History Observations Encourage patient to consume oral carbs (hypo) Oral glucose gell (hypo) Paramedic help Rapid transportation (DKA)
What is metformin
Type 2 medication
Helps lower glucose
Reduces glucose released by liver
Increases insulin sensitivity
How does the body control breathing
Chemoreceptors in the brain cell gauge O2 and CO2 amounts
Phrenic nerve
Flatten diaphragm
Lung pressure goes down
Oxygen enters
Diaphragm relaxes
What is chronic bronchitis
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
What are the signs and symptoms of chronic bronchitis
Cough Oedema Cyanosis Dyspnoea and tachypnoea Reduced 02 Rhonchi/wheezes Use of accessory muscles Tachycardia Bp normal or slightly raised Slow cap refil
What is emphysema
What causes it
What happens
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
Signs and symptoms of emphysema
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
