Medical HX & Systemic Diseases Flashcards

Question

Type II Diabetes

Answer 1

``` NIDDM Milder form of diabetes usually seen in adults usually obese ketoacidosis uncommon clinical onset slow blood sugar levels much more stable ```

Answer 2

any degree of abnormal glucose tolerance during pregnancy obesity during pregnancy is a know risk factor After childbirth the mother's glycemic control usually returns to normal, but these women have an increased risk of developing diabetes within 5-10 years

Answer 3

Body produces high levels of blood acid called ketones Develops when your body can't produce enough insulin Kussmauls respirations-deep and labored breathing pattern can be triggered by infection or other illness rare in ppl with type 2

Answer 4

``` polyuria polydipsia polyphagia dry, warm skin kussmauls respirations fruity breath odor rapid, weak pulse altered level of consciousness ```

Answer 5

``` pale, moist skin weakness, dizziness shallow respirations headache altered level of consciousness onset very sudden blood glucose values , 50 mg/100ml ```

Answer 6

``` position patient comfortable - ABC Administer 100% O2 Oral carbohydrates if conscious Unconscious - cake icing - 50% dextrose - glucagon 1mg IM or IV - epinephrine 1/1000 0.5 mg IM medical assistance ```

Answer 7

Self test - perform with a blood glucose meter - tells you what your blood sugar level is at that point in time A1c - measures the average amount of sugar in your blood over the past 2-3 months

Answer 8

hbA1c (hemoglobin A1c) - monitors long term glucose control over 30-90 days if you have diabetes an ideal HbA1c level is 6.5% or below if you are at risk of developing type 2 diabetes, your target HbA1c should be 6% If patient doesn't know their A1c, test the patient with a glucometer

Answer 9

<70mg/dl-consider deferring elective treatment or give carbohydrates >200mg.dL-defer elective treatment and refer to physician Fastinging (8-12 hours) glucose level - 80-130mg/dL 1-2 hours after a meal < 180 mg/dL A major goal is to prevent insulin shock (very low blood glucose). pt skips a meal but takes their insulin

Answer 10

Patients who are treated with insulin must closely adhere to their diet. If they fail to eat in accordance with their diabetic management plan but continue to take their regular insulin injections, they may experience a hypo-glycemic reactions caused by an excess of insulin Rxn or shock caused by excess insulin occurs in three well-defined stages, each more severe and dangerous than the one preceding

Answer 11

Characterized by hunger, weakness, trembling, tachycardia, pallor, and sweating; paraesthesia may be noted on occasion It may occur before meals, during excercise or when food has been omitted or delayed

Answer 12

Blood glucose drops substantially, the pt becomes incoherent, uncooperative, and sometimes belligerent or resistant to reason or efforts at restraint; judgement and orientation are defective. - almost like drunk The chief danger during this stage is that patients may injure themselves or someone else

Answer 13

Complete unconsciousness with or without tonic or clonic muscular movements. Moves of these rxns take place during sleep, after the first two stages have gone unrecognized. May also occur after exercise or alcohol ingestion if the earlier signs have been ignored. Sweating, pallor, rapid and thready pulse, hypotension, and hypothermia may be present

Answer 14

The rxn to excessive insulin can be corrected by giving the patient sweetened fruit juice or anything with sugar in it. Patients in the severe stage (unconsciousness) are best treated with an Iv-glucose solution; glucagon or epinephrine may be used for transient relief

Answer 15

Treat uncontrolled patient only with consultation with physician. Decrease insulin on day of treatment if pt will be eating less. Consider chronic complications. Early morning appts - cortisol is at its highest. Good medical history

Answer 16

Periodontal disease is commonly seen. Bidirectional-hyperglycemia affects oral health while periodontalitis affects glycemic control (increased HbA1c) Xerostomia Increased infections and poor wound healing burning mouth syndrome increased incidence and severity of gingival inflammation periodontal abscess

Answer 17

an Abnormal or hypersensitive response of the immune system to a substance introduced into the body

Answer 18

``` rapid onset-less than one hour type 1 - true IgE mediated anaphylaxis antibiotics analgesics narcotics preservatives in anesthetics - articaine venom of stinging insects ```

Answer 19

Related to humoral immune system and usually occur soon after second contact with an antigen; many ppl have repeated contacts with a specific drug or material before they become allergic to it

Answer 20

an acute rxn involving smooth muscle of the bronchi in which antigen-IgE antibody complexes form in the surface of mast cells which causes sudden histamine release from these cells. The potential end result is acute respiratory compromise and cardiovascular collapse

Answer 21

pallor, rash, itching, hives, angio-edema, hypotension, dyspnea, GI upset, bronchospasm, laryngeal edema, rhinorrhea, circulatory collapse, dysrhythmias, cardiac arrest - there are diseases linked to these common symptoms

Answer 22

``` position patient supine BCLS oxygen monitor vital call 911 Epinephrine 1/10,000 3.0 cc IV or Epi 1,000 0.3 cc IM/SC Benadryl 50mg IV or IM Obtain medical assistance and transport to hospital ```

Answer 23

Expensive - go find info

Answer 24

Onset greater than 1 hour, usually non-life threatening, antibiotics, narcotics, preservatives anesthetics Signs/symptoms - rash, pruritus (itching), urticaria (hives), edema, rarely - hypotension, dyspnea, coma

Answer 25

Terminate procedure position patient based upon comfort BCLS if indicated (usually not) Benadryl 50 mg PO or IM q 4 h depending upon severity of symptoms continue Benadryl for 24 hours after symptoms disappear