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Endocrine > Type 1 DM > Flashcards

Type 1 DM Flashcards

1
Q

what drugs can induce diabetes?

A

glucocorticoids

atypical antipsychotics

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2
Q

T1DM with autoimmune etiology

A

Type 1a

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3
Q

T1DM with no evidence of autoimmunity

A

Type 1b

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4
Q

which chromosone has major susceptibility genes for T1DM

A

on HLA region of chrom 6

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5
Q

which haplotypes make one more susceptible for DM1

A

HLA-DR3
DQB
DR4

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6
Q

is genetic risk higher for kids who has affected mother or father?

A

affected father

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7
Q

what mediates the immune response in Type 1 DM?

A

inappropriate adaptive immune response that targets beta cells

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8
Q

does type 1A or 1B have an HLA association?

A

type 1A

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9
Q

what specifically mediates destruction of the beta cells

A

T cells

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10
Q

80% of ppl are positive for what Ab at time of dx?

A

glutamic acid decarboxylase Ab (GAD65)

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11
Q

is risk of Type1 DM proportional to number of Ab present?

A

yes

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12
Q

perinatal factors related to incr risk of Type 1 DM (5)

A
  1. maternal age >25
  2. smoking
  3. preeclampsia
  4. neonatal respiratory distress
  5. jaundice
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13
Q

what may be protective against type 1 DM?

A

breastfeeding, vitamin D, exposure to immune-mediated diseases in childhood

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14
Q

what is the bimodal distribution of T1DM?

A

age 4-6, 10-14

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15
Q

what is needed for Dx of T1DM (3)

A
  1. formal OGTT
  2. Ab may be present
  3. low C-peptide
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16
Q

how does DKA present?

A

dehydration, acidosis, low BP, orthostasis, tachycardia, acetone smell, decr body temp

17
Q

tx of DKA (3)

A
  1. aggressive volume resuscitation
  2. correct hyperglycemia with insulin
  3. replete elecrolytes
18
Q

tx goals of diabetes (4)

A
  1. normoglycemia
  2. normal A1c
  3. normal growth
  4. tx cardiac risk factors
19
Q

which meds are used to meet basal needs (2)

A
  1. glargine

2. detemir

20
Q

what sort of insulin to use for meal or stress needs

A

bolus/rapid insulin

21
Q

what is the total insulin requiremnt in T1DM

A

0.6 units/ kg bodyweight

22
Q

what is basal insulin requirement?

A

0.2-0.3 U/Kg body weight

23
Q

what percentage of daily insulin needs to be given as basal insulin?

A

50%

24
Q

what is a continous subcut insulin infusion

A

pump

25
Q

what is the best way to minic basal and bolus insulin

A

pump

26
Q

what sort of insulin can be used in a pump?

A

shorter/rapid acting insulin

27
Q

what mimics amylin, slows GI transit, decr glucagon, decr appetite

A

pramlitide

28
Q

use of pramlitide?

A

use in addition to insulin to help with post meal control in T1DM

29
Q

what allows you to monitor glu every few min?

A

CGMS

Endocrine (31 decks)

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