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8 Cards in this Set
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HPI for a patient with new onset DKA from DM Type I?
How to tell central and nephrogenic DI apart? |
polydipsia, polyuria, polyphagia, emesis, ketotic breath, Kussmaul respirations; acidemia on ABG, ketonuria, glucosuria
do a fluid deprivation and ADH challenge - central = [urine] ability gets better after ADH, not water, and nephrogenic = no improvement in [urine] after ADH. |
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What happens in DI?
Classic presentation of DM Type I? Pathology of DM? |
Pts unable to concentrate urine, decreased permeability of collecting ducts to H2O
polyuria, polydipsia, polyphagia with weight loss, hyperglycemia body is unable to make or use insulin --> hyperglycemia |
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Difference between DM Type I and Type II?
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Type I - Beta cell destruction causes absolute insulin deficiency
Type II - insulin resistance w/ deficiency |
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What are some autoimmune markers in DM I?
Clinical presentation? |
Auto-Ab's to insulin, islet cells, GAD, tyrosine phosphatases
Typically young people w/ S/S, usually present in DKA, can be abrupt onset |
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Criteria for Dx of DM?
DM I patients are at higher risk for what? What is the "honeymoon" phase of treatment? |
BS >200, fasting BS >126, 2 hr BS >200 during an oral GTT
other autoimmune diseases - Hashimoto's, Grave's, Addison's remission of symptoms for several months after insulin treatment |
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What is the the peak age of onset for DM I?
Genetic risks? Associated with what viruses? Which HLA subtypes are at higher risk? |
11-14 y/o
50% concordance in twins mumps, rubella, Coxsackie B4 DR3/DQ2, DR4/DQ8 |
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Who usually gets DM II?
Genetic risks? What are some environmental factors? Some other S/S of DM II? |
older, obese patients
100% concordance in twins obesity, HTN, HLD blurred vision, myopia, pruritus, recurrent infections, skin problems, UTI, vaginitis, balanitis |
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What type of coma can DM II patients come in with?
What is a useful marker for glycemic control? Why? What is GDM? |
hyperosmolar non-ketotic coma
Hgb A1C - correlates with fasting glucose over 2-3 months gestational DM - occurs in pregnancies - usually reverts, but can develop into DM (60%) |
