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41 Cards in this Set
- Front
- Back
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Diabetes mellitus: acute symptoms common to both types
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polydipsia, polyuria, polyphagia, weight loss
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Diabetes mellitus: match: (DKA/hyperosmolar coma) with (type I/type II)
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DKA=type I, hyperosmolar coma=type II
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Diabetes mellitus: effects (increased/decreased) of insulin deficiency and glucagon excess on 1) glucose uptake, 2) protein catabolism, 3) lipolysis
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1) decreased, 2) increased, 3) increased
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Diabetes mellitus: increased plasma free fatty acids leads to
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ketogenesis
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Diabetes mellitus: hyperglycemia has what effect on blood volume and electrolytes
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decreased volume (osmotic diuresis), electrolyte depletion
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Diabetes mellitus: three chronic manifestations
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retinopathy (hemorrhage, exudate, microaneurysm), nephropathy (nodular sclerosis), neuropathy (sensory, motor, autonomic)
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Diabetes mellitus: sorbitol accumulation leads to what sequelae in the eye
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cataracts, glaucoma
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Diabetes mellitus: three tests - what are they? which one measures long-term glucose control?
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fasting glucose, glucose tolerance test, HbA1c
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Type 1 - juvenile onset: % of diabetes
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0.15
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Type 1 - juvenile onset: Insulin necessary in treatment
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Always
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Type 1 - juvenile onset: Age
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<30
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Type 1 - juvenile onset: Association with obesity
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No
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Type 1 - juvenile onset: Genetic predisposition
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weak, polygenic
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Type 1 - juvenile onset: Association with HLA system
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Yes (HLA-DR3 & 4)
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Type 1 - juvenile onset: Glucose intolerance
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Severe
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Type 1 - juvenile onset: Ketoacidosis
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Common
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Type 1 - juvenile onset: B-cell numbers in the islets
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decreased
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Type 1 - juvenile onset: Serum insulin levels
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decreased
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Type 1 - juvenile onset: Classic symptoms of polyuria, polydipsia, thirst, weight loss
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Common
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Type 1 - juvenile onset: Theorized cause
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viral or immune destruction of B cells
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Type 2 - adult onset: % of diabetes
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0.85
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Insulin necessary in treatment
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Sometimes
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Type 2 - adult onset: Age
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>40
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Type 2 - adult onset: Association with obesity
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Yes
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Type 2 - adult onset: Genetic predisposition
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Strong, polygenic
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Type 2 - adult onset: Association with HLA system
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No
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Type 2 - adult onset: Glucose intolerance
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mild to moderate
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Type 2 - adult onset: Ketoacidosis
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Rare
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Type 2 - adult onset: B-cell numbers in the islets
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Variable
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Type 2 - adult onset:
Serum insulin levels |
Variable
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Type 2 - adult onset: Classic symptoms of polyuria, polydipsia, thirst, weight loss
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Sometimes
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Type 2 - adult onset: Theorized cause
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increased resistance to insulin
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Diabetic Ketoacidosis (type 1): What precipitates this
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Increase in insulin requirements from increase in stress (e.g. infection)
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Diabetic Ketoacidosis (type 1): Ketone bodies from where
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Excess fat breakdown, increase ketogenesis from increased free fatty acids which are made into ketone bodies
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Diabetic Ketoacidosis (type 1): Signs/Symptoms
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Kussmaul respirations (rapid/deep breathing), hyperthermia, nausea/vomiting, abdominal pain, psychosis/dementia, dehydration, fruity breath odor
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Diabetic Ketoacidosis (type 1): Labs
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Hyperglycemia, high H+, low HCO3- (anion gap metabolic acidosis), high blood ketone levels, leukocytosis
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Diabetic Ketoacidosis (type 1): Complications
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Life threatening mucormycosis, Rhizopus infection, cerebral edema, cardiac arrhythimias, heart failure
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Diabetic Ketoacidosis (type 1): Treatment
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Fluids, insulin, and potassium; glucose if necessary to prevent hypoglycemia.
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Diabetes insipidus: summary
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intensive thirst, polyuria, inability to concentrate urine with fluid constriction owing to lack of ADH (central DI) or to lack of renal response to ADH (nephrogenic DI). Caused by lithium or demeclocycline
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Diabetes insipidus: Findings
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Urine specific gravity < 1.006; serum osmolality > 290 mOsm/L
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Diabetes insipidus: Treatment
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adequate fluid intake; Central DI - intranasal desmopressin (ADH analog); nephrogenic DI - hydrochlorothiazide, indomethacin, or amiloride
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