Patho/Pharm - Diabetes Mellitus (Flash cards) Test 3

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RachelPeaches
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Patho/Pharm - Diabetes Mellitus (Flash cards) Test 3
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2012-04-14 15:58:46
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Patho Pharm Diabetes Mellitus
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Patho/Pharm Diabetes Mellitus Test 3
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  1. Define diabetes mellitus
    • A syndrome (group of symptoms)
    • Chronic hyperglycemia
    • Absolute or relative insulin deficiency
    • Disturbances of carbohydrate, protein and fat metabolism
    • A whole body disease that can effect the brain, eyes, heart, pancreas, kidneys, and blood vessels
  2. Normal reulation of serum glucose
    • We eat >>serum glucose rises
    • Pancreas responds with >> insulin
    • Beta cells release insulin into >> plasma
    • Cells have insulin receptors on membranes
    • Insulin binds with >> receptor sites
    • Intracellular activation mechanism responds. Glucose enters the cells >> serum glucose levels drop.
    • Pancreas senses drop in serum glucose >> stops secreting insulin
    • When serum glucose drops, alpha cells secrete >> glucagon into plasma
    • Glucagon travels to the liver and >> stimulates release of stored glucose into serum
    • Liver releases >> glucose
    • Serum glucose >> increases

    • **(Summary)**
    • Dietary glucose>>Increase serum glucose>>insulin>>decreased serum glucose>>glucagon>>increase serum glucose
    • **Normal (fasting) glucose range is 70-100 mg/dl**
  3. What unlocks the cells so glucose can get back in?
    insulin
  4. Body makes little or no insulin. Usually occurs in children or young adultspancreas -> no insulin
    Type 1 diabetes
  5. Body makes too little insulin. Or body prevents insulin from workin gproperly. More common in overweight older adults.
    Type 2 diabetes
  6. What are some common clinical manifestations of hyperglycemia in types 1 and 2?
    • Polydipsia: increase in thirst, secondary to cellular dehydration
    • Polyuria: increase in urination, secondary to hyperglycemia acting as a osmotic diuretic.
    • Polyphagia: increase in hunger, secondary to cellular starvation
    • Weight loss: secondary to diuresis and loss of body tissue as fats and proteins are used for energy.
    • Fatigue: secondary to metabolic changes
    • Vision changes
    • Skin problems - dry/itchy, frequent infections
  7. Symptoms generally have a rapid onset with ______
    type 1
  8. Polydipsia
    increase in thirst, secondary to cellular dehydration
  9. Polyuria
    increase in urination, secondary to hyperglycemia acting as a osmotic diuretic.
  10. Polyphagia
    increase in hunger, secondary to cellular starvation
  11. What is weight loss secondary to?
    Diuresis and loss of body tissue as fats and proteins are used for energy
  12. What is fatigue secondary to?
    Metabolic changes
  13. Type 1 diabetics must have ______
    insulin
  14. Type 2 diabetics can be controlled with ____ and ____
    Diet and exercise (and sometimes insulin)
  15. Who does type 2 primarily affect?
    • People over 40
    • age and oesity are the 2 greatest risk factors
    • symptoms are generally vague and devop gradually
  16. Hypoglycemia
    a drop in serum glucose levels to less than 70mg/dl
  17. What are 4 chronic complications of DM?
    • Diabetic neuropathies
    • Microvascular diesase
    • Macrovascular diesase
    • Infection
  18. Somogyi effect
    Hypoglycemia followed by rebound hyperglycemia

    Hormones cause liver to release large amounts of glucose into bloodstream
  19. Dawn phenomenon
    Rise in blood sugar early in AM although patient has not eaten for several hours
  20. What is Diabetes Mellitus?
    • Syndrome of chronic hyperglycemia with absolute or relative insuline deficiency.
    • Caused by altered beta cell function in pancreas
    • Primarily affects people over 40
    • Risk factors include - obesity, ethnic minority, and family history
  21. This complication occurs when there is too much insulin, too little food intake and too much exercise.

    Symptoms may include tachycardia, palpitations, diaphoresis, and tremors.
    Hypoglycemia
  22. Symptoms of hypoglycemia are:
    Symptoms may include tachycardia, palpitations, diaphoresis, and tremors.
  23. A chronic complication of DM which may put the client at high risk for lesion, ulcers, and gangrene secondary to cocclusions of the small arteries.
    Peripheral vascular disease (Macrovascular disease)
  24. What are the MOST common clinical manifestations of hyperglycemia?
    • Polydipsia
    • Polyuria
    • Polyphagia
  25. Often affects young people around the age of puberty
    Can also be induced by chemicals or drugs
    Immune system mistakenly destroys Beta cells
    Symptoms generally have rapid onset
    Type I Diabetes
  26. A serious complication r/t a deficiency of insulin and an increase in counter-regulatory hormones (catecholamines, cortisol, glucagon, growth hormone)
    Diabetic Ketoacidosis
  27. A type of Microvascular disease
    Glomerular changes that lead to decreased perfusion to the kidney
    May lead to uncontrolled hypertension and renal failure
    Diabetic Nephropathy
  28. A condition that is generally treated with a oral rapid acting carbohydrate, such as: glucose tablets, glucose gel, juice, milk, or graham crackers.
    If the patient is unconscious or NPO, condition is treated with 50% Dextrose IV, glucagon IM or buccal glucose gel
    hypoglycemia
  29. True or false:
    You can get diabetes from eating too much sugar
    False
  30. True or False:
    Some people are borderline diabetics
    false - you either are diabetic or you're not. It is a lifelong disease that may be manages by diet and exercise, but you still have the condition
  31. Absolute insulin deficiency means:
    NO action of insulin
  32. What is the pathophysiology of diabetes?
    The immune system mistakenly destorys insulin producing Beta cells
  33. What is the goal of treatment for Type 2 Diabetes?
    Restoration of euglycemia (normal BG levels) and correction of relatd metabolic disorders
  34. What are 4 types of severe hyperglycemia?
    • DKA
    • HHNKS
    • Somogyi effect
    • Sawn phenomenon
  35. DKA is what type of a complication?
    acute
  36. What are some characteristics of DKA?
    • serum glucose level >400mg/dl
    • symptoms: fatigue, sleepiness, warmth/flushing, feeling full/anorexic, fruity breath
    • can lead to coma and death
    • mainly seen in type 1
  37. What is a classic symptom of DKA?
    fruity breath
  38. DKA is mainly seen in which type of diabetes?
    Type 1
  39. HHNKS is mainly seen in which type of diabetes?
    Type 2
  40. This syndrome is an uncommon complication of Type 2 diabetes with a high mortality rate. Glucose leves are >500mg/dl
    HHNKS
  41. What is the most common complication of diabetes?
    Diabetic neuropathies
  42. Diabetic retinopathy and nephropathy are examples of what type of disease?
    Microvascular disease
  43. Coronary artery disease
    Cerebral vascular accident/stroke
    Peripheral vascular disease

    These are examples of what type of disease?
    Macrovascular disease

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