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Dental Hygiene II > Module 12 Exam 2 > Flashcards

Module 12 Exam 2 Flashcards

1
Q

What is diabetes mellius

A

a group of metabolic diseases characterized by hyperglycemia

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2
Q

what does hyperglycemia result from

A

and insulin deficiency, resistance to insulin or both

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3
Q

What is chronic hyperglycemia associated with

A

long term damage, dysfunction, and failure of numerous organs, especially the eyes, kidneys, nerves heart, and blood vessels

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4
Q

what becomes more prevalent as the population ages and obesity increases

A

diabetes

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5
Q

What is insulin

A

a hormone produced by the beta cells in the pancreas

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6
Q

what does insulin effect

A

it directly or indirectly effects every organ in the body

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7
Q

what does insulin enable

A

glucose transport into cells to use as energy

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8
Q

what are the main functions of insulin

A
  • facilitates glucose uptake from blood into tissues
  • speeds oxidation of glucose within cells for energy
  • speeds conversion of glucose to glycogen to store in the muscles to prevent it converting back to glucose
  • conversion of glucose to fat in adipose tissue
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9
Q

what are normal blood glucose levels in healthy individuals

A

60-150 mg/dl

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10
Q

what happens with the increased glucose in the blood in type 1 diabetes

A

it spills over into the urine, causes excretion of large amts of urine, causes water and electrolyte loss, which signals thirst in the brain

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11
Q

What may cells in Type 1 diabetes starving for glucose cause the patient to do

A

increase food intake, but weight loss may still occur

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12
Q

Without glucose for energy in Type 1 was does the body do for energy

A

metabolizes fat for energy

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13
Q

what does the metabolism of fat end in

A

harmful ketones that accumulate in the blood

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14
Q

what are ketones

A

when in large quantity body cant handle and it causes metabolic acidosis

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15
Q

what can metabolic acidosis lead to

A

a diabetic coma

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16
Q

does the insulin production and secretion by the pancreas remain at normal levels in type 2 diabetes

A

yes

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17
Q

what happens in type 2 diabetes

A

-insulin receptors develop defects and glucose cant be transmitted to the cell

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18
Q

what level increases as the insulin resistance of the cells increase

A

blood glucose levels

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19
Q

What is hypoglycemia/insulin shock

A

-too much insulin which lowers level of blood glucose

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20
Q

what is the more common emergency likely to occur in the dental setting, hyper or hypo

A

hypoglycemia

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21
Q

what is hyperglycemic reaction/ diabetic coma (ketoacidosis)

A

too little insulin, increased levels of blood glucose

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22
Q

What is type 1 diabetes

A

-absolute insulin deficency resulting from the destruction of the insulin-producing beta cells in the pancreas

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23
Q

When does type 1 diabetes usually arise

A

childhood or puberty

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24
Q

what are former names of type 1 diabetes

A

-insulin dependent diabetes mellitus, juvenile diabetes, juvenile onset, ketosis-prone diabetes, brittle diabetes

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25
Q

what is type 2 diabetes

A

pancreatic insulin secretion may be low, normal, or even higher than normal but the patient exhibits an insulin resistance that impairs the use of insulin

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26
Q

what is gestational diabetes mellitus

A

any degree of glucose intolerance with onset or first recognition during pregnancy

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27
Q

what is gestational diabetes related to

A

genetics, obesity, hormones

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28
Q

when is gestational diabetes diagnosis reclassified

A

6 weeks after pregnancy ends

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29
Q

what has lessened the danger of gestational diabetes for the mother

A

insulin adjustment, carefully supervised prenatal care, improved obstetrics

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30
Q

What are characteristics of the pregnancy and baby in a mother with gestational diabetes

A
  • larger infant
  • premature births more freq
  • congential malformations, perinatal death
  • tendency to develop type 2 diabetes later in life
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31
Q

What do other types of diabetes result from

A

-genetic defects, diseases, endocrinopathies, surgery, drugs, malnutrition, infections, injury

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32
Q

what are some genetic defects that cause diabetes

A
  • genetic defects of the beta cell, or insulin action
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33
Q

what are some diseases of the exocrine pancreas that cause diabetes

A
  • diseases that injure or destroy beta cells

- pancreatitis, trauma, pancreatectomy, carcinoma, cystic fibrosis

34
Q

what are endocinopathies that cause diabetes

A
  • HGH, cortisol, glucagons, epi antagonize insulin action

- acromegaly, cushing syndrome, hyperthyroidism

35
Q

what do drugs or chemicals do to induce diabetes

A
  • chemicals impair insulin secretion, insulin action, destroy betal cells
  • glucocorticoids, thyroid hormone, dilantin, thiazides
36
Q

what do infections do to cause diabetes-

A
  • viruses can destroy beta cells

- congenital rubella, cytomegalovirus, mumps

37
Q

what are some syndromes associated with diabetes

A
  • down sydrome
  • huntingtons disease
  • prader willi syndrome
38
Q

what are symptoms of hyperglycemia

A 
polyuria
polydypsia
weight loss
polyphagia
blurred vision
increased susceptibility to infections
impaired growth
39
Q

to diagnose diabetes what should the a1c number be over

A

6.5%

40
Q

to diagnose diabetes what is the fasting glucose over

A

126 mg/dl

41
Q

to diagnose diabetes what is the 2 hour plasma glucose greater than

A

200 mg/dl

42
Q

What are the complications of diabetes relating to infections

A

-patients are more susceptible to infections
-failure to treat intensifies symptoms of diabetes
-

43
Q

what may cause insulin requirements to increase

A

fever, infection, inflammation, trauma, bleeding, pain, or stress

44
Q

What is peripherial neuropathy

A
  • pain, numbness, or tingling of mouth, face and extremities

- leads to increased incidence of amputations because of delayed ID of problems

45
Q

what is autonomic neuropathy

A
  • can cause GI symptoms

- food is delayed in stomach, leading to a delay in adsorbtion, and complications managing blood glucose

46
Q

what is nephropathy

A
  • diabetes is the leading cause of renal disease, and most common of end stage renal disease
  • dialysis or kidney transplant may be needed
47
Q

what is retinopathy

A
  • diabetes is leading cause of blindness

- patients are more likely to have glaucoma and cataracts

48
Q

what are the complications of diabetes and cardiovascular disease

A

-heart disease
-peripherial vascular disease
-cerebrovascular disease
-hypertension
may lead to myocardial infarction and stroke

49
Q

what is a major cause of limb amputation

A

diabetes

50
Q

pregnant patients who have diabetes are at a higher risk for

A

spontaneous abortion, miscarriages, babies with birth defects, increased weight

51
Q

What are the psychosocial problems of diabetes

A

-tx regimens challenging to cope with, lead to emotional and social problems, including depression

52
Q

Diabetes is known as

A

the silent killer

53
Q

what does diabetes reduce

A

average life span, diabetes and its complications are leading causes of death

54
Q

what are the general procedures for someone who has diabetes

A
  • early diagnosis
  • education for self care
  • maintain best overall health
  • maintain tight glycemic control
  • immediate tx for acute symptoms
55
Q

What is an essential part of the tx program which lowers insulin requirements, cardiovascular risk factors

A

exercise

56
Q

what can many cases of type 2 diabetes be controlled with

A

weight reduction and exercise alon

57
Q

what are goals of medical nutritional therapy

A

prevent and manage diabetes and slow the development of complications

58
Q

what are the fundamentals of the diet for a diabetic

A

-high fiber, low fat, low cholesterol, low sodium

59
Q

What should we know about tobacco use and diabetes

A
  • pt must avoid all types of tobacco

- increases risk of heart disease, stroke, MI, limb amputations, perio disease, numerous health problems

60
Q

Why should diabetic pts avoid excess alcohol?

A

-can raise blood pressure and contribute to other health problems

61
Q

Do type 1 and type 2 require exogenous insulin?

A

yes- type 1 for survival and type 2 for control

62
Q

What are the different types of insulin

A

-rapid, short, intermediate, or long acting based on the onset, peak and duration of action

63
Q

what does the dosage of insulin depend on

A

-the individual

64
Q

what factors affect the need for insulin

A

-food intake, illness, stress, variations in exercise, infections

65
Q

what are the methods for insulin administration

A
  • insulin pen
  • sub Q injection with syringe
  • continuous sub Q insulin infusion with a battery operated insulin pump
  • inhalable insulin
66
Q

what are oral hypoglycemic medications used to treat

A

type 2 in conjunction with diet, exercise, and possibly injection of insulin

67
Q

what has pancrease transplantation eliminated the need for

A

exogenous insulin in type 1 patients

68
Q

What findings in the gingva occur with diabetes

A

increased gingival inflammation

69
Q

what findings with the periodontium occur in diabetes

A
  • periodontitis
  • attachment loss
  • deep pockets
  • alveolar bone loss
  • tooth mobility and migration
  • healing delayed
70
Q

what findings with teeth occur in diabetes

A
  • increased risk of caries related to decreased saliva, diet in poorly controlle diabetes
  • in well controlled: caries related to low sugar, regular habits, maintenance
71
Q

what findings with the lips occur in diabetes

A

-dry, cracking, angular chelitis

72
Q

what findings with the saliva occur in diabetes

A
  • decreased flow
  • glucose in sulcular fluid
  • xerostomia
73
Q

what findings with the mucosa occur in diabetes

A
  • edematous, red
  • candidiasis
  • burning mouth or tongue
  • delayed healing
  • increase lichen planus,
74
Q

what findings with taste occur in diabetes

A

-hypogeusia, diminished taste perception

75
Q

Perio infections may also affect control of blood glucose by increasing what

A

insulin resistance in a manner similar to obesity

76
Q

patients with uncontrolled glucose levels have more severe what

A

perio disease at younger ages

77
Q

diabetes does not cause oral disease but may lower what and increase what

A

resistance and susceptibility to oral findings

78
Q

what can affect blood sugar levels during a dental appointment

A

stress

79
Q

When is antibiotic premedication indicated

A

routine dental tx is deferred until diabetes is stabilized, consult for premed

80
Q

What time should you treat a patient

A
  • treat on a full stomach
  • avoid peak insulin level
  • ideal time varies with each patient
81
Q

what precautions should be taken in a patient with diabetes

A
  • dont keep waiting
  • dont interfere with regular meal
  • avoid long stressful procedures
  • prevent and treat all infections
  • prep. for diabetic emergencies
82
Q

what is diabetes insipidus

A

a rare disease characterized by polyuria, polysdipsia indued by antidiuretic hormone defect

Dental Hygiene II (19 decks)

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