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Step 2: Endo2
Endo 2
Question | Answer |
---|---|
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) |