Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Case 11 > Overview of Diabetes > Flashcards

Overview of Diabetes Flashcards

1
Q

Define diabetes

A

Chronic hyperglycaemia @ levels to cause specific microvascular complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is diabetes diagnosed?

A

Test on 1 occasion if symptomatic, 2 if asymptomatic

Need 1 of:

  • Fasting plasma glucose > 7
  • Random plasma glucose > 11.1
  • HbA1c > 6.5%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the symptoms of diabetes?

A
  • Polydipsia/polyuria - increased osmotic load
  • Blurred vision - increased fluid build up in lens
  • Thrush
  • (Weight loss in T1 only) - catabolic state > fat break down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is pre-diabetes?

A
  1. Impaired glucose tolerance (fasting < 7 AND 2hr 7.8-11)

2. Impaired fasting gcylaemia (>6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of diabetes?

A
  • T1
  • T2
  • Gestational
  • Other - MODY, exocrine pancreas disease, endocrinopathies, genetic…
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the key features of T1D?

A
  • B cell destruction > absolute insulin deficiency
  • Immune mediated
  • Anti-GAD, IA2, ZnT8, Anti-insulin
  • Idiopathic
  • Chronic
  • Rapid onset
  • Ketosis prone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is T2D?

A

Ranges from predominantly insulin resistance with relative insulin deficiency > predominantly secretory defect with insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the micro-vascular complications of diabetes?

A

Retinopathy
Nephropathy
Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the genetics of T1D?

A

HLA DR3/4 predisposition
Caucasian
3/4 male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the acute complications of diabetes?

A
  • DKA
  • Hyperglycaemia, hyperosmolar syndrome
  • Hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What blood glucose is considered hypoglycaemia?

A

< 4

< 2.5 = loss of consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What blood glucose is considered hyperglycaemia?

A

> 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the definition of DKA?

A
  1. Hyperglycaemia (BS > 11)
  2. Ketonaemia (> 3)
  3. Acidosis (either pH < 7.3, HCO3 < 15)

Low glucose = increased BG so start producing ketone bodies as source of fuel = acidic so pH drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is DKA treated?

A
  1. IV fluids +
  2. Insulin
  3. K+ replacement (as insulin moves K into cells so it can drop)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of death in DKA?

A
  • Cerebral oedema esp in children
  • Underlying condition - sepsis, ARDS, MI
  • Hypokalaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the presentation of hypoglycaemia?

A
  • Autonomic = sweating, palpitations, shaking, hunger
  • Neuroglycopenic = confusion, drowsiness, odd behaviour speech difficulty, incoordination
  • General malaise = headache, nausea
17
Q

How do you treat hypoglycaemia patients which are conscious, orientated + able to swallow?

A
  • Quick acting CHO
  • If BS remains low need parental therapy
  • After BS > 4 give long acting CHO
18
Q

How do you treat hypoglycaemia patients who are unconscious/aggressive/seizures?

A
  • IV therapy

- After BS > 4 give long acting CHO

19
Q

What are the macro-vascular complications of diabetes?

A
  • IHD
  • Peripheral vasc disease
  • Stroke
20
Q

What is HbA1c?

A
  • Glycosylated haemoglobin
  • Reflects average plasma glucose over 8-12 weeks
  • Accurate measure of chronic glycaemia levels (but shouldn’t be used in diagnosis if T1D, symptom onset within 2m, haemolytic anaemia + haemoglobinopathies)
21
Q

What is a basal bolus regime?

A
  • Slow acting insulin which lasts throughout day

- Short acting insulin with each meal

22
Q

What are the key points of the endocrine system?

A
  • Broadcasts hormonal messages by secretion into blood + CSF
  • Negative feedback
23
Q

Which are the hypothalamic releasing hormones and what effect do they have on the pituitary?

A
  • Corticotrophin releasing hormone (CRH) > ACTH secretion
  • Thyrotropin releasing hormone (TRH) > TSH & Prolactin secretion
  • Growth hormone releasing hormone (GHRH) > GH secretion
  • Somatostatin > Inhibits GH secretion
  • Gonadotropin releasing hormone (GnRH) > LH + FSH secretion
  • Prolactin releasing hormone (PRH) > PRL secretion
  • Prolactin inhibiting hormone (dopamine) > Inhibits PRL secretion
24
Q

What are the characteristics of hypothalamic releasing hormones?

A
  • Pulsatile secretion
  • Transduce signals via 2nd messengers
  • Stimulates release and synthesis of pituitary hormones
  • Induces hyperplasia and hypertrophy
25
Q

What hormones does the anterior pituitary release?

A
  • TSH
  • ACTH (glucocorticoids, mineralocorticoids, androgens)
  • FSH
  • LH
  • GH (linear growth, regulation of fat, muscle, bone mass)
  • PRL
  • MSH
26
Q

What hormones does the posterior pituitary release?

A
  • ADH/vasopressin

- Oxytocin

27
Q

What is thyroid hormone production dependent on?

A

Adequate iodine uptake

28
Q

What is the normal thyroid state?

A
  • T4 = predominant circulating hormone
  • T4 = deiodinated to T3
  • T3 = more active than T4 but has shorter 1/2 life
29
Q

What are the most common causes of hypothyroidism?

A
  • Primary thyroid failure due to autoimmune diseases
  • Idiopathic
  • Ablative therapy
  • Iodine deficiency
30
Q

What are the signs and symptoms of hypothyroidism?

A

Signs:

  • Hoarseness
  • Hypothermia
  • Preorbital puffiness
  • Delayed relaxation of ankle jerks
  • Loss of outer 3rd of eyebrow
  • Cough, rough, dry skin
  • Non-pitting edema
  • Bradycardia
  • Peripheral neuropathy

Symptoms:

  • Fatigue
  • Weight gain
  • Cold intolerance
  • Depression
  • Menstrual irregularities
  • Constipation
  • Joint pain
  • Muscle cramps
  • Infertility
31
Q

What lab tests are seen in euthyroid sick syndrome?

A

Low T3
Normal/Low TSH
Normal free T4

32
Q

What lab tests are seen in secondary hypothyroidism?

A

Low T4

Low TSH

33
Q

Which are the adrenal gland hormones?

A
  • Mineralocorticoids
  • Glucocorticoids
  • Androgens
  • Catecholamines
  • Peptides
34
Q

What is cortisol?

A
  • Stress hormone
  • Regulates metabolism
  • Reduces inflammation
  • Assists with memory function
  • Controls blood glucose levels, salt, water balance + BP
35
Q

What is Cushing’s syndrome?

A
  • Endocrine disorders causes by high levels of cortisol in blood
  • Can be causes by taking glucocorticoid drugs or by tumours that produce cortisol or ACTH
36
Q

What do Corticotroph’s target?

A

Adrenal gland
Adipocytes
Melanocytes

37
Q

What do Somatotroph’s target?

A

All tissues

Liver

Case 11 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions