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2514 Patho/phys/assess > Week 1 - Diabetes Patho > Flashcards

Week 1 - Diabetes Patho Flashcards

1
Q

What are the 4 counter regulatory hormones?

A

Cortisol
Epi
glucagon
growth hormone

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2
Q

Do the counter regulatory hormones increase or decrease blood sugar?

A

increase

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3
Q

What are the 4 things that the incretin hormone GLP-1 (glucagon like peptide) does to control blood sugar levels?

A
  1. talks to the pancreas to release insulin - drops BS
  2. talks to the pancreas to stop glucagon - stops BS rise
  3. slows gastric emptying - prevent hyperglycemia
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4
Q

What 3 things does insulin do for the cell?

A

helps it take in
1. glucose
2. K+
3. amino acids

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5
Q

glycogenesis in the liver and muscle cells

A

glucose to glycogen storage
(genesis - making glycogen)

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6
Q

glycogenolysis in the liver

A

glycogen stores broken down to release glucose

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7
Q

gluconeogenesis

A

breakdown of proteins to make glucose

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8
Q

what are the 5 aspects of metabolic syndrome?

A
  1. HTN
  2. Diabetes
  3. Central obesity
  4. high LDL
  5. low HDL
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9
Q

Insulin is decreased when activity is (decreased/increased) and food intake is (decreased/increased)

A

increased
decreased

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10
Q

Insulin is increased when stress is (decreased/increased) and infection is (increased/decreased)

A

increased
increased

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11
Q

What are the macrovascular consequences of DM?

A
  1. Brain
  2. Heart
  3. extremities
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12
Q

Is atherosclerosis microvascular or macrovascular?

A

macrovascular

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13
Q

What does the macrovascular effect of DM do to the brain?

A
  1. stroke (TIA)
  2. decrease mental status
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14
Q

What does the macrovascular effect of DM do to the Heart?

A

CAD (arteries) due to HTN and insulin resistance

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15
Q

What does the macrovascular effect of DM do to the extremities?

A

PVD - feet and hands - gangrene- necrosis

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16
Q

what are the 3 chronic complications of DM (macrovascular)?

A
  1. Stroke
  2. Heart attack (MI)
  3. PAD
17
Q

what are the 3 things that occur with DMII?

A
  1. tired beta cells
  2. insulin resistance on muscle, fat, liver
  3. liver is unreliable (basal & bolus insulin)
18
Q

What are the 3 microvascular complications of DM?

A
  1. Eye problems
  2. Kidney issues
  3. Neuropathy
19
Q

What eye problems occur with DM?

A

retinopathy
glaucoma
cataracts

20
Q

what are the 2 kidney problems that occur with DM?

A
  1. HTN (glomerulus filtration issue)
  2. over worked kidney trying to constantly deal with too much sugar
21
Q

what are the 2 neuropathy problems that occur with DM?

A
  1. nerve damage = no feeling and worse damage = gangrene and numbness
  2. PNS/SNS impaired
22
Q

What are the 4 reasons why infection is bad with DM?

A
  1. inflammatory cells have problems (neutrophils, phagocytes, monocytes)
  2. increase in yeast infections (sugar)
  3. increase in UTI - (sugar in urine)
  4. can’t feel infected areas- gangrene
23
Q

What are the 7 signs of hyperglycemia?

A
  1. glucoseuria
  2. polyuria
  3. polydipsia
  4. polyphagia
  5. weight loss
  6. blurry vision/ blind
  7. dehydration
24
Q

what are the 7 signs of early hypoglycemia and what is the bs number?

A
  1. diaphoresis
  2. tremors
  3. hunger
  4. nervous
  5. anxious
  6. pallor
  7. pallpations
    <4 mmol/L
25
Q

what is the late stage of hypogycemia and what is the progression and what is the bs number?

A

neuroglycopenic
confused/can’t speak, seizure, coma, death
<2.8 mmol/L

26
Q

What type of DM does DKA affect ONLY

A

Type 1
19-28 mmol/L

27
Q

What is DKA and why does it happen?

A

hyperglycemia because the body can’t use the glucose due to not enough insulin

28
Q

What physiological process does DKA lead to?

A

break down of fat for glucose - ketogenesis

29
Q

What does prolonged ketogenesis lead to?

A

Metabolic acidosis
Kussmal respirations

30
Q

Why does dehydration occur in DKA?

A

because in metabolic acidosis there are too many H+ ions and they kick K+ into the blood stream.
Na+ goes into the blood stream to try to get keytones out.
loss of K+ and Na+ in urine. Where Na+ goes - so does water

31
Q

What makes acidosis worse?

A

vomitting because eventually all the bicarb is thrown up and you are left with H+ - which leads to dehydration as in DKA

32
Q

What is hyperosmolar hyperglycemic state (HHS) and which type of diabetes does it occur in?

A

type II
> or equal to 34 mmol/L
too much glucose and not enough insulin (but can still deal with it somewhat)
causes osmotic diuresis

33
Q

What electrolytes are lost in HHS?

A

Na+, K+, Phos =dehydration (water follows Na+)

34
Q

will hematocrit be high or low with HHS?

A

high - b/c of lots of Na+ in blood stream compared to fluid

35
Q

what are late stages of hyperglycemia in a type 1 diabetic?

A

severe dehydration
fruity breath
kussmals respirations
abdominal pain
lethargy - coma

36
Q

why might someone with diabetes develop hypoglycemia?

A
  1. meds effects
  2. lack glucose
  3. too much insulin
37
Q

What are the 4 classic symptoms of hyperglycemia?

A

1.Polyuria
2. Polydipsia
3. glucoseuria
4. elevated bs

38
Q

what is diabetic foot?

A

motor neuropathy= foot deformities
can’t feel toes, lose them, pressure ulcers etc. (microvascular)
- lack of circulation to the extremities (macrovascular)

2514 Patho/phys/assess (27 decks)

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