Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
86 Cards in this Set
- Front
- Back
|
This is the drug of choice for high cholesterol |
statin |
|
|
If allergy to ASA, patients with ASCVD can be put on this medication... |
Clopidigrel |
|
|
The goal for FBG in a diabetic should be this... |
80-130 |
|
|
The GTT will show this number if a person is diabetic... |
>200 |
|
|
A prediabetic will have a FBS of this number.... |
100-126 |
|
|
The goal for a PP glucose in a diabetic is this number... |
180 |
|
|
The HBA1C goal in a diabetic is this... |
7% (6.5% to make the diagnosis) |
|
|
The goal BP in a diabetic is this number... |
140/90 |
|
|
If you have a diabetic that is pregnant, you will want to avoid these medications for BP and use this instead... |
ACEI/BB |
|
|
The goal for triglycerides in a diabetic should be this .... |
<150 |
|
|
The LDL goal in a diabetic without CVD is this... |
<100 (with CVD it is <70) |
|
|
If your BG is below 70, you should have this many grams of carbs... |
15 (then wait 15 minutes...after 3 checks if still not low then call 911) 15 minute rule for tx of hypoglycemia |
|
|
The risk of hypoglycemia will increase as we _______ and _________. |
age; the longer we have diabetes |
|
|
Glucose acts as an osmotic diuretic leading to ______ and ________. |
polyuria and polydipsia |
|
|
What is the PAX-4 gene? |
essential gene used in the development of pancreatic islet cells |
|
|
In a diabetic patient, in urinalysis you will see _______________ and ______________. |
Glycosuria and Ketonuria |
|
|
Ketones over ______mm/L requires hospitalization |
3 |
|
|
Blood samples are obtained at these time intervals after doing a GTT test |
0 and 120 min after ingestion |
|
|
This is the test that is most sensitive for early renal disease... |
Urine microalbumin test |
|
|
This many calories from your daily diet should come from 1. carbs 2. fat 3. protein |
1. 45-65% 2. 25-35% 3. 10-35% |
|
|
If LDL is >100 then cholesterol should be ______________. |
<200 |
|
|
This insulin suppresses glucose between meals and overnight and mimics natural basal insulin secretory patterns... |
basal insulin (continue effect over 24 hours) |
|
|
This type of insulin limits hyperglycemia after meals... |
Bolus insulin |
|
|
Lispro and Gluslisine are rapid acting and have O, P and ED of these times... |
5-10min 1-1.5 hours 3-4 hours |
|
|
human regular are short acting and have O, P and ED of these times... |
30-60min 2 hours 6-8 hours |
|
|
Human NPH is an intermediate insulin and has O, P and ED of these times... |
2-4 hours 6-7 hours 10-20 hours |
|
|
Glargine is long acting and has O, P and Ed of these times... |
1.5 hours flat 24 hours |
|
|
Detemir is a long acting and has O, P and ED of these times... |
1 hour flat 17 hours |
|
|
The ____________the gauge the narrower the number for insulin syringes. |
higher |
|
|
_____% estimated insulin doses on basal. |
50 |
|
|
1 unit of insulin per ____grams of carbohydrates should be given. - Plus 1 unit per _______ of blood glucose above target value of 120. |
15; 50 |
|
|
Rebounding hyperglycemia in early morning that is a response to nocturnal hypoglycemia is called... |
Somogyi effect
|
|
|
The somogyi efffect is usually due to this _____ OR too small of a bedtime snack. |
too much insulin |
|
|
Rise in blood sugar in response to waning insulin and a growth hormone surge is called this... |
Dawn phemonena |
|
|
The goal for HbA1C in a peds patient is this... |
7.5% |
|
|
These 4 classes of drugs increase insulin resistance... |
Glucocorticoids, estrogen, Nicotinic acid (niacin), and statins |
|
|
These two treatments are for hypoglycemia... |
Glucagon (tablets, liquid or gel) or D50 |
|
|
Most symptoms of hypglycemia are blunted or masked in patients receiving this type of medications.. |
BB (except sweating) Beta 1 selective should be used in diabetics |
|
|
Type 1 diabetes screening should begin ____ years after diagnosis |
5 |
|
|
What does DKA result from a shortage of? |
insulin |
|
|
A person in DKA switches to burning ___________________ and producing __________________. |
fatty acids, ketone bodies |
|
|
A person in DKA will have hyper-_______________ and hyper-__________________. |
glycemia; osmolarity |
|
|
These 8 signs are symptoms of DKA in a patient.... |
polyuria polydipsia marked fatigue n/v/abd pain mental status changes marked dehydration kussmals respiration fruity breath |
|
|
The diagnostic studies you will see with a patient in DKA is this... |
plasma glucose >250 (+) serum & urine ketones Increased Bun and Cr. metabolic acidosis serum bicarbonate high anion gap |
|
|
Initially use this % of NaCl to re-expand contracted volume in patients with DKA... |
.9% Nacl (500-1000 in 1st hour then 300-500 over next 12 hours) |
|
|
If serum Na in a patient with DKA is >150, use ______%NaCl |
.45 (you do not want to overload their Na intake) |
|
|
When serum glucose is <300, change to D5W to maintain glucose in the __________________ range. |
250-300 (reduces risk of cerebral edema) |
|
|
In DKA patients, wait to start insulin after K reaches ________________________. |
3.3 Meg/L |
|
|
After initial drop from rehydration , the goal in DKA patients is to reduce glucose ______________mg/dL/hr. |
80 |
|
|
As soon as acidosis starts to resolve in DKA patients, replace K with KCL ______________mEg/h. |
10-20 |
|
|
hypokalemia will present like this on an EKG |
flattened t waves and u waves |
|
|
If a patient who is in DKA presents with deterioration in mental status during treatment, you should think.... |
cerebral edema (mannitol to tx) |
|
|
Metabolic syndrome - you need 3 or more of the following: |
abdominal obesity trigs >150 HDL <40 M, <50 F SBP >130 waist circ >40 M; >35 F FBS >100 insulin resistance or glucose intolerance |
|
|
The most important incretin hormone is ____________. |
GLP-1 (synthesized in ileum and colon) this is reduced in type 2 diabetics |
|
|
These numbers are diagnostic for type 2 diabetes... |
T. chol >200 Trigs 300-400 HDL <30 LDL >100 |
|
|
Sulfonyurea's (Ide's and nide's) stimulate insulin secretion and are contraindicated in _________________patients and ________________patients. |
severe liver or kidney disease elderly (risk of falls) |
|
|
The two risks associated with the sulfonyureas are ______________ and _______________. |
weight gain hypoglycemia (increase risk with long acting such as glyburide) |
|
|
Meglitinide's stimulate insulin release and is useful in patients with ______________. |
renal disease ex. repaglinide, prandin |
|
|
Biguinides are completely metabolied by the kidneys and shoud not be used in patients with renal disorders, however it does NOT caues ___________________ and is first line in these types of patients. |
hypoglycemia obese |
|
|
These are the 5 contraindications with biguinides (metformin)... |
CHF renal insufficiency hepatic disease metabolic acidosis alcoholics |
|
|
TZD's are dependent upon the presence of _______________ and sensitive peripheral tissues to insulin. This will decrease trig level and decrease PP serum glucose. What is the biggest black box warning with this med? |
insulin; MI |
|
|
These are the 3 side effects wtih TZD's... |
fluid retention CHF weight gain does NOT cause hypoglycemia
(ex. Rosiglitazone and Pioglitazone) |
|
|
Alpha glycosylate inhibitors delays ______________ absorbtion and causes bloating and flatulence. |
CHO Acarbose (precose) and Miglitol (glyset) |
|
|
GLP-1 agonists activates GLP-1 receptors and has these 3 main side effects that have been reported... |
DO NOT USE WITH PATIENTS WHO HAVE: pancreatitis, renal impairment, or CKD |
|
|
What is the black box warning risk for the GLP-1 medications (victoza, byetta)... |
increase risk of thyroid cancer with those who have positive family history |
|
|
DPP-4 (gliptin's) is the alternative to GLP-1 and slows incretin metabolism, so it prolongs the action of GLP-1 and has these common side effects... |
URI anaphyaxis angioedema SJS |
|
|
Amylin is released from beta cells with insulin and it reduces PP glucose, slows gastric emptying and promotes satiety and is injected immediately before meals. An example of amylin is _______. |
Pramilintide/symlin |
|
|
Canagloflozin/invokana decreases glucose absorption in the kidney and increases ___________________. |
urine glucose secretion (inhibits Na-glucose transporter) |
|
|
Bromocriptine/Cycloset decreases fasting and PP hyperglycemia without raising insulin. The unique thing about this med is that it also does what? |
resets circadian rhythm and inhibits prolactin secretion by the pituitary |
|
|
The best test for diabetic nephropathy is ... |
urine for microalbumin |
|
|
With diabetic neuropathy there can be orthostatic hypotension, exercise intolerance, resting tachycardia and the most important one... |
silent MI |
|
|
This is the leading cause of mortality in type 2 diabetes... |
CAD/MI |
|
|
A (HHS) hyperglycemic coma in type 2 - is characterized by severe hyperglycemia in absence of significant ______________, because you still have insulin. |
ketosis |
|
|
HHS has a serum glucose of > _______________ and a serum osmolality of > ________________________. |
800; 350 |
|
|
In HHS - fluid replacement is recommended with ____% Nacl because of hyperosmolarity. |
.45 (these patients have too much Na in their system and marked dehydration) |
|
|
In HHS, once blood glucose reaches 250 use _________. |
D5W, D51/2NS, D5NS so as to maintain 250-300. |
|
|
HHS has 10X the death rate that DKA does because of _____________________. |
elderly with other comorbidities |
|
|
NaHCO3 should only be added if pH falls below 6.9 and should be discontinue when it reaches ________. |
7.1 (too much will cause a shift to met alk. by shifting K from serum into the cells - this can lead to arrhythmia or cerebral edema) |
|
|
A normal 2 hour GTT test should read... |
<140 |
|
|
60% of patients develop retinopathy after _______ years. |
15-20 of having DM |
|
|
In diabetic neuropathy, the vagus nerve (along with others) stops sending the signals it should which causes these symptoms in a DM patient... |
delayed gastric emptying, early satiety, dysphagia, constipation, as well as - urinary incontinence, vaginal dryness, and ED |
|
|
Most common peripheral arterial disease complication associated with DM is ___________________. |
claudication |
|
|
The most common infection among DM patients is ________________. |
bacterial foot infections |
|
|
Hyperosmolarity, mental status change and dehydration are the most common signs of _______. |
HHS (hyperglycemic coma without ketones) |
|
|
HHS is characterized by the following lab #'s... |
serum glucose >800 serum Na >140 (severe) serum osmolality >350 increased Bun/Cr |
|
|
One of the most common precipitating even before HHS and DKA is ______________. |
Infection (pneumonia, UTI) |
