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Gaznabi DM
| Question | Answer |
|---|---|
| Between meals insulin production is ________ | minimal |
| Lack of insulin causes ______ of stored fat in the liver cells to form ________ and _________ inc. the tendency of developing ____________ | lipolysis, phospholipids, cholesterol, atherosclerosis |
| In the mitochondria of the liver cells, fat molecules are further broken down to form ________ which turns into ________ bodies | acetoacetic acid, ketone |
| Insulin promotes protein _____ and inhibits ________ of proteins | formation, degredation |
| What are the gastrointestinal hormones that lead to insulin secretion? | Gastrin, CCK, secretin |
| Which gastric hormone causes insulin release from the beta cells? | GIP |
| What factors increase insulin secretion? | Glucagon, Growth hormone, cortisol, parasympathetic stimulation, insulin resistance, obesity, sulfonylurea drugs |
| What are some factors that decrease insulin secretion | Dec. blood glucose, fasting, somatostatin (GH inhibiting hormone) |
| Patients with _______/_______ have immune mediated type Type 1 Diabetes | HLA-DR3/HLA-DR4 |
| What is another gene for genetic risk of Type 1? | 5' polymorphic region of insulin gene |
| Viruses as coxsackie, mumps, rubella, ECV and retrovirus have a strong link to DM-1 due to... | Directly destroying beta cells |
| In type 2 DM why are there no ketones | Endogenous insulin is enough to prevent ketoaciddosis |
| MODY is a ____ insulin dependant diabetes. It is autosomal _________. And the tx is __________ . | non, dominant, insulin |
| In gestational diabetes, inc ______ leads to insulin ________ | requirement, resistance |
| What are the endocrine tumors that can cause hyperglycemia due to tissue insensiticiy? | Acromegaly, Cushing syndrome, Pheochromocytoma |
| What are some Agents that cause hyperglycemia due to tissue insensiticiy? | Corticosteroids, sympathomimetic drugs, niacin |
| What dzs cause hyperglycemia due to tissue insensiticiy? | Cirrohsis, hemachromatosis |
| What is an adipose tissue d/o that causes hyperglycemia due to tissue insensiticiy? | lypodystrophy, truncal obesity |
| What hormonal tumors cause hyperglycemia due to reduced insulin secretion? | Somastinomas, pheochromacytomas |
| What pancreatic disorder cause hyperglycemia due to reduced insulin secretion? | Pancreatitis, hemachromatosis |
| WHich agents cause reduced insulin secretion? | THiazide, phenytoin, pentamidine |
| What are the major signs and symptoms of Type 1 diabetes? | Osmotic diuresis (2nd to hyperglycemia), thirst (due to hyperosmolar state), blurred vision, wt loss w/ loss of apetite, symptoms of postural hypotension, paresthesia and neuropathies (reversible), ketoacidosis |
| At what level does the serum osmolality rise to when mental status is noted | above 330 |
| In Type 2 diabetics, since the pt may be asymptomatic, what is detected in teh urine | glucose |
| What are other signs of DM 2 | polydipsia, polyuria, chronic skin infections, candida/vulvovaginits, big baies, milkd HTN, |
| What are the numbers for fasting BG | >126 two times, diabetc |
| What are the nubers for oral GTT? | >200 diabetes |
| Afasting level of 100-125 or 2 hr GTT of 140-199 means | impaired glucose tolerance |
| What is normal HGB A1C | <5.7% |
| If repeat A1C is > 6.5% | we treat for biabetes bc retinopathy begins shortly after 6.5% |
| HGB A1c btw 5.7-6.4% are considered | high risk |
| What is the secondary test after A1C | Fructosamine (1-2 weeks preceding |
| In DM pts, cholesterol should be limited to ? | 300 |
| T/F Infection leads to insulin resistance? | T |
| What are late clinical manis of DM? | Involvement of small and large BC's, lens of eye, peripheral nerves and skin |
| What are some late clinical manis specifically | HTN, nephropathy, diabetic retinopathy, glaucoma, Autonomic and peripheral neuropathy (gastroparesis), MI, CVS, amputation of lower extremities, DKA, HHS, Lactic Acidosis |
| When should pts with type 2 be referred to opthamologist? Type 1? | 2: at time of diagnosis 1: 5 years after dx |
| DKA is noted to have _______ pain, HHS does not | abdoimnal |
| Metabolic syndrome is 3 or more of the following: | Central obesity, INsulin resistant diabetes, INc. TG's, Inc. BP, Low HDL, Fasting plasma glucose >100 |
| Metformin helps reduce _______ | hyperglycemia |
| TZD increases insulin ________, improves insulin mediated glucose uptake in muscle and adipose tissue | sensitivity |
Created by:
naroby
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