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41 Cards in this Set

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