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TEST FIVE STUFF
diabetes/some review stuff
| Question | Answer |
|---|---|
| Insulin is secreted by the beta cells in the pancreas as blood levels rise and goes where? | to blood stream then to body tissues then binds to receptors that allow some glucose to get into the cells so we can use it for energy. |
| Once the glucose is in the cells what can happen? | -Burn it to produce ATP - Store it as glycogen or fatty acids which are triglycerides. |
| Where is glycogen stored? | liver and skeletal muscles |
| Where are triglycerides stored? | adipose tissue |
| Description of Type 1 DM | -# of people are staying the same - Beta cells are destroyed - no insulin is being made - formally called juviniele diabetes |
| Risk factors for type 1 DM | Idiopathic, much less common than type 2, increased risk with a family history |
| Tx for type 1 diabetes | -Insulin injections 3-4 times per day at meals and night time snacks(insulin pump)-calorie control(especially carbs)-monitor blood sugar, could be 2-4 times per day(adjust insulin and calories based on results) |
| Description of type 2 dabetes | Problem with how the body responds to insulin -Problem not in the pancreas-Insulin resistant- Receptors are less sensitive-Most common form-# of people are rising |
| Risk factors for type 2 DM | Ideopathic-increased risk is obesity |
| Tx tor type 2 DM | Lifestyle changes(diet and exercise and loose weight)-Oral hypoglymics(decrease blood sugar)-Insulin injections(only if oral meds and diet and exercise do not control) -Monitor (usually 2-4 times daily) and adjust meds and calories based on results |
| What are the three different responses of the body to oral medications? | -Make body respond to insulin that they have already - cause body to make more insulin - affect how digestive system processes or absorbes glucose |
| Upon injury, the local acute immune response is... | Chemicals are released as mediators of inflammation (P.H.O.L.K- Prostaglandins, Histamine, Opson, Leukotrienes, Kinias) |
| Immediate changes from chemical mediators | -Arterioles dilate -Pain -Leukocytosis |
| Type 3 DM | Gestational Diabetes - more simular to type 2 DM |
| Classic S/S of DM | Hyperglycemia - increased appitite-increased thirst-increased urination-Glucoseuria(glucose appears in urine when BS level is over 180mg/dl) |
| Diagnosis for DM | Fasting BS (12 hour fast) = single draw testing for glucose(over 125mg/dl is positive for DM)-OGTT oral glucose tolerance test |
| OGTT procedure | 12 hour fasting glucose is drawn -Drink glucose solution(75 mg of glucose or 100 mg of glucose if testing for gestational diabetes -test for glucose 2 hours after drinking solution |
| Results of OGTT | -less than 140mg/dl = normal - 140-200mg/dl = glucose intolerant(at risk for diabetes) - greater than 200 = positive for DM -Must have more than one positive result to confirm DM |
| Functions/purposes of the inflammatory response | Pain- To keep you from using it and causing more damage Swelling- Helps with delivery and removal of WBCs |
| What are the monitoring therapies for DM | Home glucose monitor - Hemoglobin A1c - Microalbumin |
| Home glucose monitoring | To help adjust to keep tight control on a day to day basis |
| Stage 1/Prodromal stage of HIV | Occurs within two months of infection -Lasts up to 2 weeks, although usually less than a week |
| Stage 2/Asymptomatic stage of HIV | Lasts 6-10 years -No symptoms or visible signs -Clinical signs include viremia and a presence of HIV antibodies |
| Stage 3/AIDS of HIV | -CD4 count has dropped to 200 or less OR opportunistic diseases have developed (TB, salmonella, pneumocystis carinil, kaposi's sarcoma) |
| Opportunistic diseases of AIDS- Pneumocystis carinil | Fungal pneumonia caused by normal lung flora |
| Opportunistic diseases of AIDS- Kaposi's Sarcoma | Cancer of blood vessels, affects lung, skin, and GI lining |
| Etiology of systemic lupus erythematosus | Idiopathic- young women mostly, age 20s to 30s |
| Signs/Symptoms/Diagnosis of systemic lupus erythematosus | -Inflamed skin (Photosensitivity) -Joints (Arthritis) -Inflamed mucus membranes |
| Photosensitivity | Aggrevates skin and brings on red rashes on the face |
| Inflamed mucus membranes | Nose/mouth/throat ulcers, lung inflammation, pericarditis, glomerulonephritis, ecephalitis, bone marrow -False positive for syphilis -Positive LE prep (abnormal WBCs) |
| Treatment of systemic lupus erythematosus | Steroid anti-inflammatory drugs, only on it during exacurbation -Other issues are treated separately |
| Prognosis of systemic lupus erythematosus | Life long, variable -Occasional to fatal -Most cases fall somewhere in between |
| Prevention of colorectal cancer | A diet low in saturated fat and management of Inflammatory Bowel Disease |
| Diagnosis of colorectal cancer | Screening test- Fecal occult blood test beginning at age 40, and a colonoscopy beginning at age 50 Confirmation- Biopsy |
| Prevention of prostate cancer | No way to prevent it: depends on age |
| Diagnosis of prostate cancer | Screening test- Digital rectal exam or a PSA test (Prostate-specific antigen) Confirmation- Biopsy |
| Prevention of lung cancer | Quit smoking and avoid respiratory irritants |
| Diagnosis of lung cancer | Screening test- Chest x-ray (Not very sensitive) Confirmation- Biopsy |
| Prevention of breast cancer | Reduce or stop alcohol consumption, quit smoking, exercise, and get checked regularly |
| Diagnosis of breast cancer | Screening test- Breast self exam starting at age 30, mammogram starting at age 40 Confirmation- Biopsy |
| Prevention of cervical cancer | Use safe sex practices, do not have multiple partners |
| Diagnosis of Cervical cancer | Screening test- PAP smear Confirmation- Biopsy |
| Hemoglobin A1c | Allows doctor to see how well you have been maintaining control for the last 3-4 months - Doctor can adjust meds accordingly |
| Microalbumin | Checking for protein in the urine. Checking for kidney damage |
| What is tight glucose control? | Keeping close to normal results - better control means decreased risk for complications. |
| What are the two types of insulin injections? | Rapid and Intermediate |
| Rapid insulin | starts working within minutes but is short acting-most common form= Regular Insulin, "R" on label |
| Intermediate Insulin | takes longer to work but lasts at least 6 hours (30 minutes to 6 hours approximaltely) - Most common form = NPH or Lente, "N" or "L" on lable |
| Most diabetics use what kind of insulin and where is it injected? | A blend of 70-30/ 70= rapid and 30=intermediate - it is injected in adipose tissue |
| Whate are the acute complications of DM and its treatment? | Hypoglycemia and Hyperglycemia |
| Etiology of Hypoglycemia | Blood sugar drops below 70 - skipped meal (too few calories) - Too much insulin or meds - More active than normal |
| S/S of hypoglycemia | Start when BS drops below 50 - Skin= moist cool clammy pale - Respirations= Slow, shallow - Behavior = Drunk, slurred speach, uncoordinated, combative |
| Tx for hypoglycemia | Give calories |
| Prognosis for hypoglycemia | -Normally BS and thinking get back to normal - If no treatment it can lead to Insulin shock which can be fatal |
| Etiology of hyperglycemia | Blood sugar higher than 180-200 - Forgot to take insulin or other meds - Too many calories - less active - infection or inflammation |
| S/S of hyperglycemia | skin = red warm and dry - Respirations = deep, fast, fruity smell on breath - Behavior = Stoned, lethargic, drowsey, non responsive |
| Tx for hyperglycemia | Take to ER. They need rapid acting insulin, will probably be admitted to get BS under control |
| Prognosis for hyperglycemia | If BS is not under control could lead to Diabetic Ketoacidosis which can lead to Diabetic coma which can be fatal |
| Diabetic Ketoacidosis | increase level of ketones leads to decreased pH. Ketones are a waste product from burning fat. |
| Chronic complications from DM | take years - Diabetics who are poorly contoled - can cause vascular damage, neuropathy, hyperlipidemia |
| Vascular damage complications of DM | Damage to capillaries can cause retinopathy, kidney damage, or poor peripheral circulation |
| Neuropathy complications of DM | Decreased sensivity of extremeties or Gastroparesis(paralysis of stomach) |
| Hyperlipidemia complications of DM | Atherosclerosis causing CAD(heart attacks), CVD(stroke) and PVD(amputation) |
| Prognosis for DM | Depends on how well blood sugar is controlled. Most common cause of death is heart attack or stroke. |
Created by:
owossopatho
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