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Pathology 1 > Week 10 > Flashcards

Week 10 Flashcards

Diabetes Mellitus

1
Q

What are the (4) “G”s?

A
  • Gluconeogenesis
  • Glycogenesis
  • Glycolysis
  • Glycogenolysis
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2
Q

Creation of glucose from sources other than carbohydrates describes which G?

A

Gluconeogenesis

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3
Q

(3) Examples of glucose made from other sources for gluconeogensis?

A
  • Proteins
  • glycerol
  • lactate
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4
Q

Creation of Glycogen describes which G?

A

Glycogenesis

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5
Q

What is a carbohydrate that is easily transformed into simple glucose

A

Glycogen

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6
Q

The breakdown of glucose with an individual cell to release energy in the form of ATP describes which G?

A

Glycolysis

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7
Q

Breakdown of glycogen to simple glucose describes which G?

A

Glycogenolysis

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8
Q

What hormone drives glucose into the cells?

A

Insulin

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9
Q

Where is insulin produced?

A

In the Beta cells of Pancreas

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10
Q

Why do we need insulin to drive glucose into the cells?

A

cell membranes are impermeable to glucose without insulin

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11
Q

What is glucose stored in the liver as?

A

Glycogen

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12
Q

Does insulin stimulate or inhibit glucose breakdown for energy within a cell?

A

Stimulates

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13
Q

What is the main goal of insulin?

A

Reduce blood glucose and so it promotes storage and breakdown

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14
Q

What prevents fat breakdown (lipolysis) and glycogen breakdown (glycogenolysis) when needed?

A

Insulin

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15
Q

Where is glucagon made?

A

Made in the Alpha cells

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16
Q

What stimulates the release of glucose into your blood when needed?

A

Glucagon

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17
Q

Where is the is prime storage depot for glucagon?

A

Liver

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18
Q

What increases Glycogenolysis (breakdown of glycogen to glucose)?

A

Glucagon

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19
Q

The goal of glucagon is to mobilize glucose stores from the liver so that this glucose can be sent to what (2) vital organs?

A
  • brain
  • heart
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20
Q

What increases transport of amino acids to liver to stimulate gluconeogenesis?

A

Glucagon

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21
Q

What (2) things work together to maintain normal blood sugar concentration?

A

Insulin and glucagon

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22
Q

What are (3) hormones that affect blood
glucose?

A
  • Catecholamine
  • Growth hormone
  • Glucocorticoids
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23
Q

What (3) things counteract storage functions of insulin to reduce the
depletion of serum glucose?

A
  • Fasting
  • Exercise
  • Illness (fever)
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24
Q

What disease is an abnormality in blood glucose regulation and nutrient storage?

A

Diabetes mellitus

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25
Q

Diabetes mellitus problems can be either (2)?

A
  • absolute deficiency in insulin or
  • resistance to the actions of insulin
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26
Q

Is diabetes mellitus characterized by hypoglycemia or hyperglycemia?

A

Hyperglycemia

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27
Q

What are (3) classifications of diabetes?

A
  • Type 1
  • Type 2
  • Gestational
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28
Q

What type of diabetes relates to complete loss of production of insulin?

A

Type 1 (5-10%)

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29
Q

Type 1 diabetes can be further divided into what (2) sections?

A
  1. Type 1A immune mediated diabetes
  2. Type 1B idiopathic (non-immune) related diabetes
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30
Q

Type 1 diabetes can happen at any age, but primary people under?

A

25 and below, but not before 6 months

31
Q

What subtype of type 1 diabetes comes from a genetic predisposition and an
environmental triggering event?

A

Type 1A immune mediated diabetes (95%)

32
Q

Is type 1A immune mediated diabetes considered an autoimmune disorder?

33
Q

What subtype of type 1 diabetes has cases of beta cell destruction but with no evidence of autoimmunity?

A

Type 1B idiopathic related diabetes

34
Q

What type of diabetes causes insulin resistance (metabolic) by body cells?

35
Q

What are (4) risk factors of type 2 diabetes?

A
  • age
  • obesity
  • sedentary lifestyle
  • genetic (family history)
36
Q

What are (3) metabolic abnormalities included with type 2 diabetes?

A
  1. Insulin resistance
  2. Increased glucose production
    by the liver
  3. Deranged (or decreased) secretion of insulin
37
Q

What are (4) features of the metabolic syndrome and insulin resistance?

A
  • Abdominal obesity
  • Hyperglycemia
  • Hypertension
  • Hyperlipidemia
38
Q

What is the first role of adipose tissue in Type 2 diabetes?

A

Increase in Free fatty acids (FFAs)

39
Q

Excess, chronic elevation of FFAs causes what problem for the pancreatic beta cells?

A

pancreatic beta cell dysfunction
(lipotoxicity)

40
Q

Excess FFAs will inhibit what (2) things?

A

glucose uptake & glycogen
storage

41
Q

Accumulation of FFAs & triglycerides will lead to?

A

Reduction in hepatic insulin sensitivity

42
Q

When the hepatic insulin sensitivity is reduced, what happens? (2)

A

Increased hepatic glucose production &
hyperglycemia

43
Q

What type of diabetes occurs when any degree of glucose intolerance that begins
during pregnancy?

A

Gestational diabetes

(Occurs in 5-10% of pregnancies)

44
Q

What are (6) risk factors for gestational diabetes?

A

▪Glycosuria - glucose in urine
▪Strong family history of Type 2 DM
▪Obesity
▪Polycystic ovary disease
▪Prior history of gestational diabetes
▪Previous delivery of a large-for-gestational age infant

45
Q

In gestational diabetes, the placenta will produce hormones that will (2)?

A

-Help shift nutrients from mother to fetus
-Prevent development of low blood glucose for the mother

46
Q

What hormones resist insulin action &
lead to higher glucose levels in gestational diabetes?

A

placenta hormones

47
Q

In attempt to decrease glucose levels in the body of a mother, how will the the body try and increase the insulin?

A

Her body will increase insulin production by 3X more

48
Q

gestational diabetes results if the pancreas cannot do?

A

Produce enough insulin

49
Q

If a mother is high risk for gestational diabetes, then what test is done ASAP?

A

Glucose testing

50
Q

If a mother is average/low risk for gestational diabetes, what test is done?

A

Oral glucose tolerance test (OGTT)

(this is done at 24-28 weeks gestation)

51
Q

Fetal abnormalities included for gestational diabetes are (5)?

A
  • Macrosomia (large baby)
  • Hypoglycemia (low blood sugar)
  • Hypocalcemia (low blood calcium)
  • Polycythemia (overproduction of RBCs)
  • Hyperbilirubinemia (Jaundice)
52
Q

What (3) things are treatment of Gestational Diabetes?

A
  • Close observation of mother and fetus
  • Dietary alterations
  • Insulin therapy (when dietary alterations are not effective enough)
53
Q

What percentage of mothers that have gestational diabetes will develop Type 2 diabetes within 5-10 years?

54
Q

What are the (3) P’s to detect manifestations diabetes?

A
  • Polyuria (excessive urination)
  • Polydipsia (excessive thirst)
  • Polyphagia (excessive hunger)
55
Q

Elevated blood glucose (hyperglycemia) makes the blood turn?

A

Hypertonic

56
Q

What are (5) clinical manifestations of
type 1 diabetes?

A
  • Weight loss
  • Blurred vision (or double vision)
  • Paresthesia (tingling, numbness)
  • Fatigue/Weakness
  • Chronic infections
57
Q

What is a recurrent infection that can happen with type 2 diabetes in women?

A

vaginal yeast infection

58
Q

What are (5) diagnostic tests for diabetes?

A
  1. Fasting plasma glucose
  2. Casual blood glucose test
  3. Oral glucose tolerance test (OGTT)
  4. Capillary blood glucose monitoring
  5. Glycosylated hemoglobin (HbA1C)
59
Q

The treatment plans in diabetes involve (3)?

A
  1. Dietary management
  2. Exercise
  3. Antidiabetic agents
  • Oral antidiabetics (Type 2 DM)
  • Injections (Type 1 & Advanced Type 2 DM)
60
Q

What type of diabetes will always require insulin replacement?

61
Q

What type of diabetes eventually will require insulin?

62
Q

What are (3) major acute complications of unmanaged diabetes?

A
  1. Diabetic ketoacidosis (DKA)
  2. Hyperosmolar hyperglycemic state (HHS)
  3. Hypoglycemia

All of these are LIFE THREATNING

63
Q

When there is a lack of insulin that results in rapid breakdown of energy stores from muscle and fat, this is referred to as?

A

Diabetic ketoacidosis (DKA)

64
Q

In diabetic keto acidosis (DKA), what do the fatty acids convert to?

65
Q

In the presence of ketosis, what hormones are released leading to hyperglycemia?

A

there are an increase in counter-regulatory hormones

66
Q

Clinical diagnosis of DKA includes (4)?

A
  • hyperglycemia (>13.8 mmol/L)
  • low serum bicarbonate
  • low arterial pH
  • positive ketones (urine & blood)
67
Q

Fluid shifts from DKA can lead to?

A

hyperkalemia

68
Q

What are (4) manifestations of DKA?

A
  • Breath has a fruity
    smell
  • HR increases (tachycardia)
  • Hypotension
  • Rate and depth of respiration increases
    (Kussmauls’ respirations)
69
Q

What are (4) DKA treatment goals?

A
  • Improve circulatory volume and tissue
    perfusion (IV fluids)
    *Decrease blood glucose (Insulin infusion)
    *Correct acidosis
    *Correct electrolyte imbalance (Potassium in fluids)
70
Q

What occurs from an excess of insulin in the blood resulting in below-normal blood glucose levels?

A

Hypoglycemia

71
Q

What causes hypoglycemia? (6)

A

*error in insulin dose
*failure to eat
*increased exercise
*decreased insulin need after removal of stressful situation
*medication changes
*change in insulin injection site

72
Q

The most effective treatment for hypoglycemia is?

A

Stat administration of 15-20 g of glucose in a concentrated SIMPLE carbohydrate source.

73
Q

If person who is hypoglycemic is unconscious or unable to swallow, what can the nurse give them to treat them?

A

glucagon can be given intramuscularly or
subcutaneously

74
Q

What are (3) chronic complications of
Diabetes Mellitus?

A
  • Microvasculature complications (Neuropathies, Nephropathies, Retinopathies)

Pathology 1 (14 decks)

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