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diabetes/some review stuff

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