dhubbard

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Author:
dhubbard
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189208
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dhubbard
Updated:
2012-12-12 22:47:20
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Podiatry Boards Part
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Diabetes
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  1. what drugs can induce DM?
    Thiazides, diuretics, steriods, phenytoin
  2. What are the classical findings/symptoms of DM?
    polydispsia, polyphagia, polyuria
  3. What is the oral glucose test?
    75g of glucose in 300ml of water after overnight fast. Positive for DM if above 200mg/dl at both 2 hours and at least one other time before the 2 hour mark.
  4. What is the life of a RBC?
    120 days, basically correlates with Hemoglobin A1c levels
  5. What are the characteristic findings of ketoacidosis in the blood?
    pH,7.2, hyperglycemia, hyperventilation, increase in anion gap, hyponatremia, hyperkalemia, increase in bun/cr ketones in blood and urine
  6. How do you tx ketoacidosis?
    • Fluids to restore intravascular volume
    • Bicarb w/ shock or coma
    • Monitor EKG
    • Phosphate, because serum levels may be low
  7. What is the glucose level of a nonketotic hyperglycemic coma?
    • >600mg/dl
    • Lethargy, confusion, seizures, coma, dehydration, HTN, polyuria, polydipsia
  8. What is infection greater with DM?
    • Neuropathy, vascular problems, immunopathy
    • Overall decrease in granulocytes and defective phagocyte ingestion
  9. What is the whipples triad?
    • Risk of hypoglycemia
    • BS 40 mg/dl
    • Immediate recurrence following admin of glucose
  10. What is the somogyi phenomenon?
    Hypoglycemia results in rebound hyperglycemia and may be due to secretioin of counter hormones such as glucagon and epinephrine
  11. What is the major likely cause of Dm neuropathy?
    Sorbitol pathway and schwann cell hyperosmolaity due to sorbitol excess. 
  12. What are the stages of DM charcot?
    • Developmental
    • Colescence
    • Reconstruction
  13. What if you are going to do a major surgery on a DM 1 or IDDM?
    • Preop tests- EKG, UA, Chem 2, CBC, A1c
    • If on oral hypoglycemics discontinue morning before surgery
    • Well controlled with insulin take 1/2 the dose morning of. 
  14. How should you manage a DM during surgery?
    • Pre-op start IV of 1000ml of 5% dextrose with 40 mEq/L of KCl run at about 100ml/hr
    • Then decrease down to 80 ml/hr but monitor them with regular insulin coverage
  15. When can they start their oral hypoglycemics again?
    next day after surgery
  16. What is a intermediate insulin?
    NPH (Neutral protamine hagedorn)
  17. What is Metformin?
    Biguanide: Classified as a antihyperglycemic not a hypoglycemic
  18. What is the MOA of Metformin?
    • Decreases intestinal glucose uptake
    • Increases peripheral glucose uptake
    • Decreases hepatic glucose production
  19. What is the does of Metformin?
    500mg bid
  20. What is the MOA of thiazolidinediones?
    Increase target cell response in insulin
  21. What is a combo therapy for DM tx?
    Sulfonylureas, Metformin, Insulin

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