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Step 2: Endo2

Endo 2

Which diabetes oral agent: has lactic acidosis as a rare but worrisome affect? Metformin
Which diabetes oral agent: most common side affect is hypoglycemia? Sulfonylureas, meglitinides (-glinides)
Which diabetes oral agent: are the oldest and cheapest? sulfoylureas
Name the 3 sulfonylureas. Glipizide, Glyburide, Tolbutamide
Which diabetes oral agent:are often used in combo with other drugs? Metformin
Which diabetes oral agent: help lower TAG/LDL levels? Metformin
Which diabetes oral agent: are unsafe in CHF patients? Thiazlidenidiones (-glitazones)
Which diabetes oral agent: should NOT be used in pt's with raised creatinine (renal insufficiency)? Metformin, Sulfonylureas
Which diabetes oral agent: should NOT be used in patients of inflammatory bowel disease? Acarbose
Which diabetes oral agent: require monitoring of hepatic enzyme levels? Metformin, Thiazolidenidianoes (-glitazones)
Which diabetes oral agent: used for overweight patients (don't cause weight gain)? Metformin
Which diabetes oral agent: metabolized in liver, so are good choice for renal disease patients Thiazolidenidiones (-glitazones)
Which diabetes oral agent: taken with meals; effects postprandial Glc levels? Acarbose
Which diabetes oral agents: stimulate insulin release? Sulfonylureas, Meglitinides
Why are ketone levels not checked to determine if patient has come out of DKA? What is checked instead? Ketones correct very late. Check serial Anion gap.
Describe Kussmaul breathing of DKA. Slow, deep breaths
HHNK in DM2 patients occurs at Glc levels >______. 800!
What is the FIRST STEP in treating DKA? Give IV fluids! (Normal Saline)
What IV medications/solutions should be given to a DKA patient? IV insulin, IV KCl (to replace K+), IV Glc
How long do you give IV Glc to a DKA patient? Until anion gap is corrected
What are the two types of diabetic retinopathy? What is the difference pathologically? Background retinopathy vs Proliferative retinopathy. Proliferative has neovascularization (risk of hemorrhage)
Giving 5% in NON-DKA hyperglycemic coma has what benefit? helps prevent cerebral edema
Target BP for Diabetics? <130/80
Target LDL for Diabetics? <100 (<70 if vessel disease present)
How often should diabetics get eye exams? every year
What vaccines are important for Diabetics? Influenza and Pneumonia
Diabetic nephropathy usually develops after _____ years of DM. Common nodules found in microscopy are called _______________. 20+ years, Kimmelsteil-Wilson nodules
What is the FIRST STEP to treat DM nephropathy? Control the Diabetes!! then give ACEi/ARB
What is the difference between neural and vascular causes of diabetic neuropathy? neural cause is polyneuronal; vascular causes are mononeuronal
What drug can be used to treat pain of diabetic neuropathy? What are some alternatives in case of s/e? TCAs such as amitryptiline. alternatives: phenytoin, carbamazepine, gabapentin (used in case of urinary problem)
When do you amputate a foot with a diabetic foot ulcer? Any form of gangrene present
Why must you be careful using erythromycin or cimetadine with Viagra (for ED of DM pts)? can lead to priapism
Why are B-blockers dangerous in hypoglycemic patients? They mask the signs of hypoglycemia that are typically caused by epinephrine (tachycardia, etc)
Greatest cause of death in diabetics? Cardiac complications!
Next step in suspected DM nephropathy? U/A, then 24h urine protein
What 2 medications can be used if surgery isn't possible in insulinoma? octeotride, diazoxide
How does alcohol cause hypoglycemia? gluconeogensis inhibition (low NADPH levels)
Created by: jsad



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